The risk of lung cancer

LUNG CANCER

  

The Lungs

The lungs are a pair of cone-shaped organs that are situated inside the chest. The lungs bring oxygen into the body and take out carbon dioxide, which is a waste product of the cells of the body.

Tubes called bronchi make up the inside of the lungs.

Your lungs have an extensive network of blood and lymph vessels. Cancer cells may grow into these vessels and be carried by the blood or lymph and be deposited elsewhere in the body.

Cancer can spread from the lungs to almost any site in the body. Most commonly it spreads to the brain, bone, bone marrow and liver. Lung cancer takes many years to develop. It is the second most common cancer in women.

There are two basic types of lung cancer - small cell and non-small cell cancer. These different types grow and spread in different ways. Small cell lung cancer is a disease in which cancer cells are found in the tissues of the lungs. It is usually found in people who smoke or who used to smoke cigarettes.

The non-small cell type of lung cancer is a common disease and is usually associated with people who used to smoke, passive smoking and radon (a radioactive gas) exposure.

SIGNS AND SYMPTOMS

These can include:

- hoarseness - persistent cough - blood in your phlegm - shortness of breath

- chest pain - loss of appetite - difficulty in swallowing - weakness - paleness

- high temperature - joint swelling - bone pain or tenderness - weight loss

Smoking causes about 85% of lung cancer cases. Cigarette smoke contains over 4,000 different chemicals, many of which are proven carcinogens (materials that are known to cause cancer). Lung cancer occurs most in people over 50 who have a long history of cigarette smoking.

RISK FACTORS

The risk of lung cancer increases, the more cigarettes smoked per day.

Also, the earlier the age at which smoking began, the greater the risk of lung cancer.

Passive smoking is also known to increase the risk.

In rare cases, exposure to certain industrial substances, such as arsenic, certain organic chemicals and asbestos.

Radiation exposure from occupational, medical and environmental sources.

EXAMINATIONS

If the patient has a persistent cough that produces phlegm, the phlegm will be examined for cancer cells.

The doctor may order a chest X-ray or a specialised X-ray such as the CAT scan, which helps to locate any abnormal spots in the lungs. A bronchoscopy may be performed. A bronchoscope is a small tube inserted through the nose or mouth, down the throat, into the bronchial tubes. During this examination, the doctor may also obtain a biopsy or other sample of lung tissue to test for cancer cells. Pressure is felt during the examination but very seldom pain.

TREATMENT

Surgery may cure lung cancer. It is used in early stages of the disease.

Radiation therapy can also be used.

This is used:

in a combination with chemotherapy and sometimes with surgery to offer relief from pain.

Chemotherapy may be used: in a combination with chemotherapy and sometimes with surgery to offer relief from pain.

along with surgery.

in more advanced stages of the cancer.

in all the stages of small cell cancer.

PREVENTION :

STOP SMOKING

Try to avoid second-hand smoke/passive smoking.

Ask questions about your work environment if you are exposed to industrial dusts and fumes, as it can be very dangerous.

New Ways to Diagnose Colon Cancer

New advances in colonoscopy promise faster and easier screenings.

(continued)

Looking to the Future continued...

Macari says that in order to avoid dual prep times some medical centers are coordinating the virtual colonoscopy with a gastroenterologist who is standing by.

"In the event the virtual colonoscopy reveals a problem, the gastroenterlogist is right there ready to perform a standard colonoscopy without the need for a second prep," says Macari.

This dual-system screening is currently being performed in a select number of major medical centers nationwide.

New Ways to Diagnose Colon Cancer

New advances in colonoscopy promise faster and easier screenings.

(continued)

The Virtual Test

While looking towards the future is promising, there is also one futuristic method of colon screening that is available right now. It's called a "Virtual Colonoscopy" -- a noninvasive screening that uses X-ray beams to look inside the colon.

Doctors say there is so little fuss and bother, the whole procedure is over in less than 10 minutes.

"For the most part, when a patient leaves here they are pleased and happy. They are on and off the table in no time, and there is no sedation. You can literally go back to work in 10 minutes," says Michael Macari, director of abdominal imaging at NYU Medical Center in New York City.

Besides the fact that the screening is noninvasive, Marcari says that prior to the test his center also uses carbon dioxide -- compared with "room air" -- to extend the colon. The difference, he says, means very little cramping and almost no residual pain after the screening is completed.

"Initially there is a little pressure but the carbon dioxide gets absorbed so fast, by the time they leave they feel fine," says Macari.

Looking to the Future

While the screening itself may be fast and easy, right now it requires the same preparation as the regular colonoscopy, so patients are not spared the pretesting discomfort.

However, Macari reports that may change in the not-too-distant future, with the advent of a process called "fecal tagging."

In this procedure, he says, patients drink an agent which -- once inside the colon -- latches onto the fecal material and helps doctors differentiate between that and polyps on the scan.

"We just completed study of 80 patients using fecal tagging and no bowel cleansing and we had a very high rate of detection of polyps over 10 millimeters, which many believe is the real threshold for removal," says Macari.

In another study published in the journal Radiology doctors from Belgium compared fecal tagging with standard colonoscopy preparation. They found that fecal tagging left behind more fecal residue, but improved differentiation of polyps. The fecal tagging also dramatically reduced patient discomfort, side effects, and sleep disturbances.

Still, Marcari says he would not routinely recommend it for virtual colonoscopy -- at least not until larger studies are done.

"Right now it's used if a patient simply cannot tolerate the standard prep, or if a medical condition precludes them from participating in the standard prep," says Macaria.

As easy as a virtual colonoscopy appears to be, Brooks cautions that should a polyp be found during the exam, the patient must still undergo a standard colonoscopy to have the growth removed.

"This requires a second prep and a second procedure whereby if you have the standard colonoscopy screening and something is found, it can be removed on the spot without the need for a second procedure," he says.

Understanding Colorectal Cancer - Symptoms

What Are the Symptoms of Colorectal Cancer?

In its early stage, colorectal cancer usually produces no symptoms. The most likely warning signs include:

• Changes in bowel movements, including persistent constipation or diarrhea, a feeling of not being able to empty the bowel completely, or rectal bleeding
• Dark patches of blood in or on stool; or long, thin, "pencil stools"
• Abdominal discomfort or bloating
• Unexplained fatigue, or loss of appetite or weight

Call Your Doctor About Colorectal Cancer If:

• You notice a change in your bowel movements, experience bleeding from the rectum, or notice blood in or on your stool. Don't assume you have hemorrhoids; your doctor will most likely perform a rectal examination and possibly a sigmoidoscopy or schedule a colonoscopy -- an examination that involves a long flexible tube inserted in your rectum.
• You experience persistent abdominal pain, unusual weight loss, or fatigue. These symptoms may be due to other causes, but they could also be linked to cancer.
• You are diagnosed with anemia. In determining its cause, your doctor should check for bleeding from the digestive tract because of colorectal cancer.

Myth: Tanning Can Hide Cellulite

Tanning may make the cellulite less obvious, but when the tan fades, the cellulite might look even worse. That’s because frequent exposure to UV rays can damage the skin, making it thinner and less resilient, according to the International Academy of Cosmetic Dermatology.

Risk Factors You Can Control

Although you can’t completely prevent cellulite, your lifestyle choices may affect its appearance. Factors that worsen the condition include:

• Yo-yo dieting
• An excessively high-carbohydrate diet
• An increase in total body fat
• Being inactive
• Fluid retention or being dehydrated

Risk Factors You Can't Control

Genetics is destiny when it comes to cellulite. If your mother has cellulite, you probably will, too. White women are more likely to have cellulite than Asian women. Other risk factors include:

• Hormonal changes in pregnancy
• Aging

Myth: Skinny People Don’t Have Cellulite

Cellulite is related to the structures within the skin, so even slender women are likely to have some cellulite. And if thin skin runs in your family, the cellulite you have will be more visible.

Causes of Cellulite

Cellulite is caused by fat deposits that sit side-by-side with tough collagen fibers that are anchored to the muscle beneath. When the fibers pull tight, or the fatty areas grow larger, the fat deposits may bulge out. Cellulite is much more common in women than in men.

Signs of Cellulite

Cellulite is purely a cosmetic problem, not an illness or medical

condition. It can look like faint dimples or an "orange peel" texture,

and may only be seen when the skin is pressed. But for some people

cellulite can be very conspicuous, forming large areas of lumpy skin,

deep dimples, and creases.  While it's most common on the thighs and

backside, it occurs on the abdomen, upper arms, and breasts, too.

What Is Cellulite?

Cellulite is the rippled appearance of skin, usually on the thighs and buttocks of women, that's caused by the underlying layer of fat. Paparazzi sometimes zoom in on Hollywood stars in bikinis to show the puckering in their skin. It doesn't mean the stars gained weight or failed to work out. The ugly truth: Almost every woman will eventually develop cellulite.

How Lung Cancer Affects the Body

Types of Lung Cancer

      The type of lung cancer will determine how quickly it will spread and take a toll on the body.

      The types of lung cancer are treated differently. The most common types are named for how the lung cancer cells look under a microscope:

      Small cell lung cancer: About 13 percent of lung cancers are small cell lung cancers. This type tends to spread quickly.

      Non-small cell lung cancer: Most lung cancers, about 87 percent, are non-small cell lung cancers. This type spreads more slowly than small cell lung cancer.

      To find out what stage the cancer is in, your doctor will measure the lump, check to see if the cancer has spread and perform tests such as bone and lung scans and tissue or bone biopsies. The results of the tests will help you and your doctor decide on a treatment plan.

How Lung Cancer Affects the Body

    *

      Besides the symptoms of lung cancer, which are generally due to the direct effects of the primary tumor to effects of metastatic tumors in other parts of the body or to disturbances of hormones, blood or other systems caused by the cancer, there are other issues that affect the body due to treatment depending on the type of lung cancer and whether or not it is metastatic lung cancer. The effects on the body include:

      Lung cancer most often spreads to the liver, the adrenal glands, the bones and the brain.

      Metastatic lung cancer in the liver usually does not cause symptoms, at least by the time of diagnosis.

      Metastatic lung cancer in the adrenal glands also typically causes no symptoms by the time of diagnosis.

      Metastasis to the bones is most common with small cell cancers but also occurs with other lung cancer types. Lung cancer that has metastasized to the bone causes bone pain, usually in the backbone (vertebrae), the thighbones and the ribs.

      Lung cancer that spreads to the brain can cause difficulties with vision, weakness on one side of the body and/or seizures.

Radiation and Chemotherapy

    *

      Depending on the stage of the lung cancer and the growth of the tumor, the doctor may suggest chemotherapy or radiation.

      Chemotherapy uses chemicals that travel through the bloodstream. It affects both cancerous and healthy cells. This accounts for the many well-known side effects of chemotherapy, including nausea and vomiting, hair loss, skin problems, mouth sores and fatigue.

      Radiation therapy does not affect cells throughout the body the way chemotherapy does. However, it does affect healthy tissues overlying or directly adjacent to the tumor. To a certain extent, the side effects of radiation depend on which part of the body is targeted with radiation.

      Surgery is another alternative. It is the preferred treatment for patients with early stage NSCLC. Unfortunately, 60 to 80 percent of all patients who have advanced or metastatic disease are not suitable for surgery. Surgery has it benefits but it takes a toll on the patient. Many people experience pain, weakness, fatigue and shortness of breath after surgery. Most have problems moving around, coughing and breathing deeply. The recovery period can be several weeks or even months.

New Type 2 Diabetes Treatment Options

Find out how new diabetes medications are bringing more options and convenience to diabetes care.

Over the past decade, the list of type 2 diabetes medications has grown -- helping people gain better blood sugar control. But the drugs' side effects -- plus taking several pills every day -- can be frustrating.

"There are two problems with diabetes," explains Ronald Goldberg, MD, associate director of the Diabetes Research Institute at the University of Miami Medical Center. "Your body doesn't make enough insulin. And your organs are resistant to using insulin that is produced."

If lowering high blood sugar is the primary goal, today's diabetes drugs do their job "but only to a limited extent," Goldberg tells WebMD. "Even when patients respond to one drug, they will need more and more drugs over time, as the pancreas deteriorates."

Type 2 Diabetes Treatments: New Options

Fortunately for many, advances in treatment are helping to make a difference, giving people with type 2 diabetes a growing list of options, including:

    *

      Complex new drugs, like Byetta, which is taken by injection but is not insulin. It attacks high blood sugar from multiple angles and suppresses appetite. "Byetta is a real advance," says Stephen Davis, MD, chief of Diabetes, Endocrinology, and Metabolism at Vanderbilt Medical Center in Nashville, Tenn.
    *

      Januvia is a novel drug that works with gut hormones, natural enzymes, and the body's own insulin to control blood glucose. Tradjenta (linagliptin) is another drug in the same class.
    *

      Several two-drug combination pills have been approved by the FDA in the past two years -- reducing the number of pills people must take. The well-known drug metformin is now available in an extended-release, once- or twice-a-day dosage -- without bothersome intestinal side effects.

    * Symlin a synthetic form of a hormone made and secreted from the pancreas which help lowers blood sugars after meals.

Metformin: Diabetes Workhorse Drug

Metformin has long been the workhorse of the oral diabetes drugs. Metformin "mostly works by preventing the liver from releasing too much sugar," Goldberg explains.

He says metformin is good at controlling glucose. "And it's a drug that does not cause weight gain. Also, the generic version is less expensive for patients. For all those reasons, metformin is usually the medication we start patients on."

However, because of side effects -- gas, bloating, and diarrhea -- some people have trouble tolerating metformin in its standard form, says Davis.

Extended-release metformin takes care of that problem. The drug has fewer side effects, says Davis, "and is absolutely an advance ... much better tolerated."

New Combination Drugs for Diabetes

The new combination medications join metformin with other well-known diabetes drugs. Sulfonylureas like Amaryl and Glucophage help stimulate the pancreas to make more insulin. Thiazolidinediones (TZDs) like Actos and Avandia help "sensitize" fat and muscle cells, making them more responsive to the body's natural insulin, thus overcoming insulin resistance. However, the FDA has restricted Avandia for use in new patients only if they can't control their blood sugar on other medications and are unable to take Actos. Current users can continue Avandia if they choose to do so. All patients using Avandia must review and fully understand the cardiovascular risks.

New Combination Drugs for Diabetes

Here's the current list of FDA-approved combination drugs:

    * Glucovance (metformin and glyburide, a sulfonylurea)
    * Metaglic (metformin and glipizide, a sulfonylurea)
    * Avandamet (metformin and rosiglitazone, a TZD)
    * Avandaryl (glimepiride, a sulfonylurea and rosiglitazone, a TZD)

"The combination drugs make sense," Davis tells WebMD. "The individual components are effective drugs, and in putting them together you get an additive effect." For people with early to moderate diabetes, the combinations can be effective, he says. "A once-a-day pill is also easier for patients to remember to take. Plus they're cost-effective, since patients get two medications with one co-pay."

However, the two-in-one drugs have a downside, Davis says. "If there are side effects with one drug, you cannot change the dosage to reduce them. The patient may have to quit the drug altogether."

Combination drugs are not appropriate for people with advanced diabetes, he adds. "Their glucose is more difficult to control, and they are less able to tolerate side effects. I would not prescribe them for those patients."

Sophisticated New Treatment Options for Type 2 Diabetes

The two-pronged mission of Byetta -- a drug derived from lizard spit -- has generated lots of interest, says Goldberg. The drug stimulates insulin production after a meal, but only when blood glucose is high. It also represses glucagon, a hormone that increases blood sugars. The drug is given by injection.

The drug mimics a natural blood-sugar-lowering hormone made in the gut (GLP1), Goldberg explains. "The drug does this very, very effectively. Plus, the appetite-suppressant effect and weight lossalso helps control the diabetes."

Symlin is used along with insulin injections in those with type 1 and type 2 diabetes. It is a synthetic form of a hormone made and secreted from the pancreas along with insulin. This medication help lowers blood sugars after meals. It works by slowing gastric emptying, repressing glucagon, and suppressing appetite. Symlin is given by injection.

Prandin and Starlix (meglitinides drugs) are fast-acting drugs that -- after you eat -- release enough insulin to control excess blood sugar. You take the drugs before sitting down to a meal. However, the drugs "are not dependable," says Goldberg. "The drug dosage has to be carefully calculated, and patients must watch their blood sugar carefully."

The drugs Precose and Glyset (alpha-glucosidase inhibitors) take a very different approach. They block the digestion of starch in the intestine, so blood sugar doesn't rise as much after a meal, Goldberg explains. "Trouble is, there are a lot of side effects with Precose, so it's not used much at all. Mainly, the problem is flatulence."

The Future of Diabetes Drugs: Beyond Blood Sugar Control

Side effects may not always present a problem. For example, research has revealed positive "side effects" of Precose and many other already-available diabetes drugs:

    * Metformin and Precose can reduce the risk of developing type 2 diabetes in at-risk individuals, when combined with a healthy diet and exercise.
    * Actos can reduce the risk of heart attack, stroke, and premature death among people with type 2 diabetes.

"We now think of diabetes as than more than just managing glucose. To manage a patient with diabetes effectively, you need to control blood pressure, lipids, glucose, and even inflammation. please call me.

Find out how new diabetes medications are bringing more options and convenience to diabetes care.

Diabetes: Newer Medications

Januvia (sitagliptin) is in a novel class of diabetes drugs called DPP-4 inhibitors. By inhibiting this natural enzyme, Januvia significantly increases the levels of incretin-a hormone, which helps regulate blood sugars. It also increases the synthesis and release of insulin. Januvia has received the FDA's blessing.
Don't Forget: Treatment With Exercise, Healthy Diet

To get the most benefit from any diabetes medications, you must stick to a healthy lifestyle, Davis says. He doesn't advise patients to follow extreme diets, like low-carb or vegan diets -- even though one study by the American Diabetes Association found that a vegan diet can reduce the need for diabetes medications.

"I certainly wouldn't recommend a vegan diet. You can get nutritional deficiencies," Davis tells WebMD. "I advise a well-balanced, nutritious diet that includes protein, fat, and carbohydrates."

Exercise prompts your body to use insulin efficiently -- if you eat a sensibly-sized meal, Davis says. "However, if you eat a very large meal, the medications may not be able to cope with the excess blood sugar. So yes, diet and exercise are important. Exercise controls insulin, blood pressure, weight, and well-being."

Carcinophobia: Fear of Cancer

People with carcinophobia or cancerophobia live with an irrational dread of developing cancer. Every bodily discomfort becomes a sign for them that they have a malignant growth somewhere inside. A headache, for instance, is a sign for them that they have a brain tumor. Cognitive therapy can help someone with carcinophobia regain control of their life.

Emetophobia: A Gut Feeling

Emetophobia is an unnatural fear of vomiting that typically starts early in life from some traumatic episode. For instance, someone may have witnessed a schoolmate vomiting in public or done so himself. The anxiety can be triggered by thoughts of vomiting or thinking of somewhere such as a hospital, where vomiting is common. As with aerophobia, hypnotherapy is commonly used in part of the treatment.

Paranormal Fears

Some phobias sound like they belong on the chiller channel on cable TV. Triskaidekaphobia is an abnormal fear of anything related to the number 13. If the thought of ghosts makes you overly anxious, you may have phasmophobia. And despite the fact that vampires aren't real, some people are terrified of bats. Their phobia is called chiroptophobia.

Blood-Injection-Injury Phobias

There is a spectrum of blood, injection, and injury phobias including hemophobia (fear of blood) and trypanophobia (fear of receiving an injection). Some people have an injury phobia, and others have a phobia about invasive medical procedures. These phobias are associated with fainting.

Aerophobia: Afraid to Fly

Someone who has aerophobia is afraid of flying. The phobia generally develops after a person has a traumatic experience involving an airplane, such as going through extreme turbulence or witnessing another passenger have a panic attack. Even after the incident is forgotten, the fear stays and can even be triggered by watching film of a plane crash on TV. Hypnotherapy is commonly used to identify the initial trauma and to treat this phobia.

Acrophobia: Fear of Heights

Acrophobia is an excessive fear of heights and manifests as severe anxiety. A person could have an attack just walking up stairs or climbing a ladder. Sometimes the fear is so great a person can't move. Acrophobia can create a dangerous situation for someone who has it. An anxiety attack can make it extremely difficult to safely get down from whatever high place triggered the attack.

Brontophobia: Fear of Thunder

The Greek word bronte means thunder and brontophobia means fear of thunder. Even though people with brontophobia may realize thunder won't hurt them, they may refuse to go outside during a thunderstorm. They may even hide indoors by crouching behind a couch or waiting out the storm in a closet. An abnormal fear of both thunder and lightning is called astraphobia, a phobia shared by people and animals.