MEDICAL

Malignant disease of the liver can be primary, that is coming from the cells of the hepatic structures, and secondary – the expansion of the liver secondary metastatic tumor sites of cancer cells listed in the liver from other internal organs. Metastatic liver tumors to register 20 times more frequently than the primary because, through the liver as a filter that passes the blood coming from the internal organs.

Primary liver cancer – a relatively rare disease, constituting, according to various sources, from 0,2 to 3% of all cases of cancer. Among patients with predominant males aged 50 to 65 years. There are several forms of cancer of the liver, different in origin.

Emit:

·  hepatocellular carcinoma (hepatitis, hepatocellular carcinoma, originating, as the name implies, the cells of the liver parenchyma);

·  holangiokartsinomu (tumor of the epithelial cells of the bile ducts, representing 5-30% of all primary malignant tumors of the liver);

·  angiosarkomu liver (malignant gemangioendoteliomu liver – one of the most malignant liver tumors that grow from the endothelium of blood vessels);

·  hepatoblasts (liver tumor of childhood).

Causes

1. Cancer of the liver contributes to chronic viral hepatitis (hepatitis B, hepatitis C). The risk of hepatocellular carcinoma in carriers of the virus increases 200 times.

2. Cirrhosis of the liver.

3. Hemochromatosis (excess iron content in the body).

4. Parasitic diseases (opisthorchiasis, shistosomtoz and others).

5. Syphilis.

6. Chronic alcoholism.

7. Exposure to carcinogens (polychlorinated biphenyls, chlorinated hydrocarbon solvents, such tetrahloristy carbon black, nitrosamines, chlorinated organic pesticides, aflatoxins, contained in food).

Clinical picture

In the initial stages of cancer is a general malaise, various diarrheal disorders (loss of appetite, nausea, sometimes vomiting), feeling of heaviness in the right hypochondrium, dull aching pain, fever. , General weakness, weight loss, anemia (anemia).

With the development of the disease can be detected enlargement of the liver, the liver can act out from under the costal arch, can acquire ligneous density, roughness. When probing the liver tumor formation can be detected. Gradually increases jaundice.

Diagnosis

Initially, the assumption that liver injury occurs on the basis of complaints and the appearance of the patient.

Instrumental

Ultrasound (ultrasonography) is of great importance in the diagnosis of tumor of the liver due to the wide availability and sufficient accuracy. With the help of ultrasound can identify the nodal formation in the liver, the special characteristics to differentiate them benign and malignant nature.

CT (X-ray computed tomography), MRI (magnetic resonance imaging, nuclear magnetic resonance imaging) are used for the diagnosis of liver cancer if the diagnosis is not possible to put more simple methods, or to clarify the prevalence of the process.

Additional information can be obtained by radioisotope scanning of the liver.

Laboratory

Determination of blood parameters, indirect evidence in favor of liver injury.

This:

·  biochemical analysis of blood, which can detect increased levels of bilirubin, reducing the protein content increased liver enzymes;

·  blood test for tumor markers (indicators, which increased in the blood indicates the presence in the body of a tumor).

It should be remembered that the identification of any, even malignant disease at an early stage improves the forecast of the forthcoming treatment.

Treatment

The primary method of treatment of liver cancer – surgical.

In the case of hepatocellular carcinoma removed segment of the liver with the tumor or the proportion of the liver (hemihepatectomy).

When cholangiocarcinoma in some cases, may remove the duct with the tumor, followed by fistulization (anastomosis).

When individual sites can their ablation (radiofrequency ablation, himioablyatsiya, krioablyatsiya) – a method of treatment, when a node of the liver and enter a special needle under the influence of various mechanisms of the node is destroyed.

Performing as intravascular chemotherapy, with a blood vessel to the tumor site is brought thin catheter, which is introduced chemotherapeutic agents thus act directly on the tumor more intensive chemotherapy and a negative effect on the organism less.

The method of treatment depends on tumor type, condition and other parameters to determine which is possible only with careful examination of the patient.

Metastasis

For primary tumors of the liver characterized by local invasive growth, particularly tumor often sprouts in the diaphragm. Distant metastases most often found in the lungs (up to 45% of cases).

Forecast

The flow of liver cancer depends on the type of tumor, but usually rapid without treatment over several months leads to the death of the patient. In resectable tumors, the average life expectancy of patients after surgery is 3 years. 5-year survival rate – about 20%.

Prevention

Since cancer of the liver contributes to chronic viral hepatitis B and of virus, some parasitic diseases, carcinogenic effect on liver industrial poisons, based on primary prevention is the prevention of these diseases and the environment. Secondary prevention is early detection and timely treatment of chronic liver disease.

Of particular importance is the struggle with alcoholism, as cirrhosis (especially large-form) show approximately 60-90% of patients with hepatoma.

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Adrenal – a pair specialized gland, releasing hormones that affect the maintenance of blood pressure, the exchange of electrolytes (potassium, sodium, magnesium and others). Cancer of these glands is relatively rare, more common benign changes, but because the hormones produced by suprarenalopathy exceed the amount of hormones available to healthy gland, they usually cause different changes. Tumors of the external (cortical) layer of the gland are more often benign.

From the inner layer of the adrenal (brain) can develop two types of tumors – neuroblastoma, affecting mostly children, and pheochromocytoma. Cancerous tumors account for only about 10% of these entities.

Another type of tumors, affect both cortical and adrenal medulla – insidentalomy – so-called silent tumors that do not produce hormones, up to 10% of adrenal tumors.

Clinical picture

Manifestations of the disease depend on the hormone, which provides tumor. Any damage to the cortex of adrenal gland may be Cushing’s syndrome, characterized by significant changes in the body: fat deposits on the body, especially on the back of the neck, hips, muscle weakness, thinning of skin with formation of characteristic bands in the lower abdomen, hips – stretch marks. For women, possible hair growth on face and body of male pattern in tumors that produce male steroid. It is also possible the development of diabetes. Often, the main symptom of the cortical layer of the adrenal tumor is arterial hypertension with constant high blood pressure numbers. In a further possible breach of the kidneys. The above symptoms occur, and adrenal gland cancer, and in benign lesions. Tumors of the adrenal medulla, most pheochromocytomas, produce hormones that affect blood pressure and stress responses, so they can cause a variety of symptoms, but the main manifestation of these tumors is a frequent arterial hypertension with hypertensive crisis. During crises pressure rises to 250-300 at 120-150 mm Hg. After the crisis is accompanied by a decrease in pressure sweating, loss of consciousness, involuntary urination. Hypertensive crises may lead to various complications, the most dangerous of which is a stroke (cerebral infarction or cerebral haemorrhage). These tumors are more common in middle-aged persons. At large sizes adrenal tumors, it can probe through the abdominal wall. Heavy changes to the body accompanying the hormone-producing adrenal tumors, as well as possible complications, suggest an appropriate assessment as soon as possible.

Survey

The clinical picture in itself allows the doctor to assume, in what layer of the adrenal gland – the cerebral cortex or – most likely there are violations.

Instrumentlnye methods

Ultrasound (ultrasonography) is not always possible to identify the adrenal tumor because of inconvenient location of the body. However, in a high class specialists and equipment, suspected adrenal tumors according to ultrasound can. With large tumor diagnosis according to ultrasound easier. CT (computed tomography) and MRI (magnetic resonance imaging): in the case of adrenal tumors, two of these methods are the main instrumental diagnostic methods. In the case of a malignant process is performed to exclude metastasis from lung radiography, radionuclide bone scans of the skeleton.

Laboratory

For diagnosis of adrenal tumors gormonprodutsiruyuschih important to determine the content of certain hormones in the blood and urine, as well as the determination of ACTH (adrenkortikotropnogo hormone) in the blood – the hormone of the pituitary (gland located in the brain governing the work of the adrenal glands). It should be remembered that the identification of any, even malignant disease at an early stage improves the forecast of the forthcoming treatment.

Treatment

Treatment of adrenal tumor surgery. The specialists of our department operations for tumors of the adrenal glands are performed as open access, and laparoscopic (without a large incision, and a few punctures on the anterior abdominal wall). The operation is to remove the affected adrenal gland, and in the case of malignant lesions – removal of adrenal glands from nearby lymph nodes. For the treatment of pheochromocytoma is also used treatment with a radioactive isotope. When injected into a vein isotope penetrates the tumor and causes the death of a sufficient number of cells to reduce tumor size, and even to reduce the size of metastases. In some tumors, chemotherapy gives good results.

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And the benign and malignant tumors of the urinary bladder accounted for 4 percent of all tumors in general. Question of the causes of bladder tumors still remains completely unclear. It is known that tumors of the bladder often occur in people engaged in the manufacture of aniline dyes. However, most patients with exposure to disease agents, formed in the manufacturing cycle of aniline dyes, are not there. Disease also contributes to smoking, phenacetin abuse, and treatment with cyclophosphamide.

It is known that people with bladder cancer in urine contained more endogenous carcinogens – carcinogens formed in the human body. These carcinogens are decay products of some amino acids. There is a relationship between the parasitic disease – shistozomatozom and the emergence of cancer. The disease occurs most commonly in Africa and the Middle East. Most tumors of the bladder occur in men.

What are the cancer of the bladder?

There are tumors that arise from the most superficial layer of the wall – from the epithelium, as well as tumors arising from other tissues, particularly of the connective (fibromas, fibromiksomy, hemangioma, leiomyoma, and others). Tumors are divided into benign and malignant. The former includes adenoma, endometrioznye tumor, pheochromocytoma. Conditionally this group include papilloma. These often act as the initial stages of cancer. For malignant tumors are cancer and sarcoma. The most frequently arises transitional cell carcinoma.

What are the symptoms of bladder cancer?

The most common sign of bladder tumors is the identification of blood in the urine (hematuria). Usually there is blood for no apparent reason, against the background of the normal state of health. Lasts hematuria may be a few hours, then can be stopped, and then arise again. Sometimes the number lost by the blood is not great, and hematuria is determined only according to the clinical analysis of urine.Unfortunately, the appearance of blood in the urine may already be a sign of advanced tumors.

Germinate in the wall of the bladder, cancer is a violation of the body that manifests the appearance of pain during urination or permanently. Growing pains at the end of urination. When running cancer pain constant, painful, give the perineum, in the pubic area, anus, in men – in the scrotum. In the decay of tumor associated infection, which causes the phenomenon of cystitis.

Tumor may clog the entrance ureter into the bladder. This results in a violation of the outflow of urine, increased ureters, renal pelvis. Can develop pyelonephritis, and with prolonged duration – hydronephrosis and deactivating the kidneys.

Bladder cancer spread to the lymph and blood vessels in other organs, causing their defeat.

Diagnosis

The main method of diagnosis of bladder tumors, including cancer, is a cystoscopy – endoscopy. Through the urethra entered a thin metal tube, through which the produce inspection of the bladder. Also conducting research on urine sediment, which can detect cancer cells. Investigation of the tumor before surgery is performed using a special cystoscope. During the study takes a piece of tissue.

Of great importance in the diagnosis of playing X-ray study. Contrast material is injected, and then carry pictures of the bladder, which can be determined by the tumor. Contrast agents may be introduced, and through the urethra.

Treatment

The main method of treatment of bladder tumors, including cancer, is surgery. As additional methods used chemotherapy, radiation therapy. Small benign tumors removed using endoscopic techniques. If you can not perform operations such removal through an incision in the suprapubic region. Removing all or part of the bladder is performed with cancer. Complete removal of the bladder, ureters sewed in the anterior abdominal wall. With the help of special bags attached to places of urinary output is carried out care.

Radiotherapy and chemotherapy can improve results of surgical treatment, and in advanced tumors, sometimes allow to stabilize the condition.

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Approximately 90-95% of malignant tumors of the stomach, and from all malignant tumors of more than 95% of cancer. Gastric cancer mortality and morbidity took 2 nd place after lung cancer.

In men, stomach cancer is found in 2 times more frequently than women. Most ill persons over 40-45 years, although not so rare cancer of the stomach occurs in patients aged 30-35-years of age and even younger.

Causes

The cause of the disease as the cause of all other malignancies, thoroughly unknown. However, one can identify the main causes that increase the risk of gastric cancer:

Clinical picture

Clinical symptoms of gastric cancer in initial stages of the disease are scarce and uncertain. Not only the patients, but doctors often see them as a manifestation of gastritis and, without conducting a full Gastroenterological survey, limited the appointment of various medicines. However, carefully analyzed the complaint can catch a number of symptoms that alerted to the presence of malignant disease:

Along with the common features of malignant disease may develop symptoms suggestive of gastric:

The symptoms can be detected either on the background of full health, or on the background of already existing gastric diseases (gastritis, stomach ulcer, duodenal ulcer). In these cases draw attention to the change in the old, familiar feeling sick and adherence to new symptoms.

In the event of complications such as gastrointestinal bleeding, obstruction (tumor overlapping exit from the stomach, resulting in food from the stomach can not come to the bowel), perforation of the tumor, the clinical picture changes.

In gastric bleeding (which may arise from izyazvivsheysya tumor) appears severe weakness, until loss of consciousness, nausea, vomiting, such as "coffee grounds" or dark blood with clots, black ( "degteobrzny") chair. Such a situation is urgent, often it comes to hours or even minutes, so the appearance of the above signs should immediately call an ambulance.

When perforation (breakout) tumor and leaving the stomach contents into the abdominal cavity develops peritonitis (sudden severe abdominal pain, abdominal muscle strain, fatigue, fever).

When obstruction (stenosis of the output of the stomach) are concerned heaviness in the epigastric region, constant nausea, vomiting food eaten a few days ago, gastric contents with a greenish tint. This situation usually does not occur overnight, as the bleeding, but also is serious and requires nazamedlitelnogo treatment to the doctor.

All of the described complications require immediate medical intervention!

With far come process may result in permanent pain, giving back, weight loss, up to cachexia (wasting), skin become earthy hue, there is severe weakness.

Diagnosis

The presence of previously submitted symptoms may come across you or your doctor to conduct the necessary research. Diagnosis of gastric cancer consists of a series of instrumental and laboratory methods.

Instrumental

Major public and instrumental methods of inquiry are EGDS (esophagogastroduodenoscopy, gastroscopy) and X-ray of the stomach (X-ray of the stomach).

Combination EGDS and biopsy likely to make the correct and timely diagnosis, even at an early stage of stomach cancer is 95%.

X-ray of the stomach – is in addition to gastroscopy, but is often the method and independent research. When X-ray may reveal a tumor of the stomach, even if it is impossible to define it with gastroscopy.

In complex cases, as well as to determine the prevalence of the process, applied CT (X-ray computed tomography), MRI (magnetic resonance imaging, nuclear magnetic resonance imaging).

To prevent stomach cancer metastasis to other organs in addition to CT and MRI are used ultrasound and chest x-rays, with which it is possible to identify the presence of metastases, after which, accordingly, to change the strategy of treatment.

Laboratory

Blood examination did not provide clear indicators of cancer, but reduced hemoglobin and increased erythrocyte sedimentation rate can not be ignored.

Determination of tumor markers (specific indicators of blood, rising in the presence of malignant tumor in the body) is important, but is in addition to the basic methods of diagnosis and is used frequently to monitor the treatment process.

It should be remembered that the identification of any, even malignant disease at an early stage improves the forecast of the forthcoming treatment.

Treatment

In the treatment of gastric cancer main role belongs to the surgical method. The volume of surgical treatment of gastric cancer depends on the incidence of tumors in the stomach, the degree of regional lymph nodes and presence of distant metastases. The type and volume of transactions will determine the surgeon, depending on the lesion.

In common forms of stomach cancer may be the implementation of combined operations with the removal of not only the stomach, but also involved in the process of the pancreas, part of the large intestine, spleen, part of the liver that the world data increases the duration and quality of life for these patients. Removal of the tumor is sent for histological examination, after which further defined the tactics of treatment – may need chemotherapy.

Metastasis

Stomach cancer metastasizes (provides screenings) in the lymph nodes, the liver, ovaries, the peritoneum. Sometimes metastases detected at the first treatment the patient to the doctor. The presence of metastases (ie stage 4 cancer of the process) is not a reason for refusal of treatment the patient (as unfortunately happens in many hospitals). Full recovery is virtually impossible to achieve, but can prolong the lives of many patients.

Prevention

Prevention of gastric cancer is the timely treatment of precancerous conditions – gastric polyposis, chronic ulcers and gastritis, as well as in compliance with normal diet, reducing alcohol consumption.

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Suspicion of a tumor of the brain and spinal cord occurs when symptoms that usually develop gradually over time are burdened. However, in some cases, these symptoms may occur suddenly.

Early detection of brain tumor depends on its localization. Tumors arising in the most important structures of the brain can produce symptoms at an earlier date than those that developed in the less important structures.

Tumors of the brain and spinal cord function is often violated in the area where they arose. For example, tumors of the spinal cord often cause numbness and weakness of the lower extremities.

Brain tumors are located in any area it can cause increased intracranial pressure, which leads to headaches, nausea, vomiting, the appearance veil before my eyes. Headache has been noted in 50% of patients.

These symptoms are not specific only to tumors of the brain and spinal cord and can occur in other diseases. Less than 1% of headaches caused by brain tumors. 10% of seizures in adults are the cause of brain tumors.

Diagnosis of tumors of the brain and spinal cord

If you suspect a tumor of the brain or spinal cord is assigned a survey.

During the conversation with your doctor to ask about the signs and symptoms of disease, family history and conduct a general and neurological examination. If necessary, consultations may be called a neurologist and neurosurgeon.

Research Methods

Most people with suspected tumor of the brain and spinal cord used computed tomography (CT) and magnetic resonance imaging (MRI), which enables diagnosis in 95% of cases.

With positron emission tomography (PET) is introduced into the vein of radioactive glucose and then conducted a study that makes it possible to determine the degree of accumulation of glucose in tumor and normal tissues. Tumors of high malignancy absorb more glucose than normal tissue, brain and spinal cord. On the other hand, low-grade tumors accumulate less sugar than normal tissue.

This method allows to evaluate the effectiveness of the treatment, but also provides an opportunity to distinguish between residual scar tissue from the tumor.

Angiography. In the vein or artery is introduced contrast agent, with an estimated blood supply to tumors, helping to plan the operation.

Biopsy. A survey of the above methods suggests the presence of tumor, but the final diagnosis is established only after microscopic examination of the suspect on a remote piece of tumor tissue.

Spinal puncture is made in the lumbar region in order to obtain a small amount of cerebrospinal fluid for microscopic examination to detect tumor cells. This procedure is particularly necessary in patients with lymphoma, so that it often extends into the spinal canal.

Treatment of tumors of the brain and spinal cord

Tumors of the central nervous system (CNS) treated with surgery, radiation and chemotherapy. Often used several methods.

By neinfiltriruyuschim astrocytoma include: juvenile pilocytic astrocytoma occurring most frequently in the cerebellum of young people, and subepindemalnye giant-astrocytomas, almost always associated with tuberous sclerosis. In most cases, these tumors are treated surgically, and only an incomplete removal of tumor is assigned radiotherapy.

Low-grade astrocytomas. Due to the fact that these infiltrative tumor normal brain tissue, they can not be cured with surgery. After the maximum tumor removal is carried out radiotherapy. However, exposure of such patients gives a smaller effect compared with patients suffering from astrocytomas high degree of malignancy. In this regard, radiation therapy may not be assigned at all or be delayed until the onset of symptoms.

Astrocytomas high degree of malignancy. These types of astrocytic not cured by surgery. After the maximum tumor removal performed radiotherapy followed by chemotherapy. The most frequently used antitumor drug CCNU (TSTSNU), other drugs and their combinations are not allow to improve results of treatment.

Lymphoma. These tumors are not treated with surgery, because they tend to spread widely throughout the brain.

The role of surgery is only a biopsy (taking podozitelnogo the tumor piece of tissue for microscopic examination). The standard treatment for lymphoma of the brain and spinal cord is irradiated. Chemotherapy can also have a positive effect. Exceptions are patients with lymphoma in combination with AIDS.

Lymphoma more amenable to chemotherapy compared with other tumors of the brain and spinal cord. It uses a variety of combinations of anticancer drugs. Important role in the treatment of patients with lymphoma, such locations are corticosteroids, whose appointment is likely to reduce the size of the tumor. The use of radiotherapy in combination with chemotherapy can often achieve a lasting improvement (remission).

At detection of tumor cells in the cerebrospinal fluid anticancer drugs introduced into the spinal canal.

Oligodendrogliomas. These tumors can not be cured with one operation, although such intervention may relieve symptoms and prolong life. In these cases, often carried out chemotherapy followed by irradiation.

Ependymomas. These tumors do not germinate in normal brain and can be completely removed surgically. If the remaining tumor is assigned an additional radiation therapy.

Meningeomy. Patients with this disease can be treated with complete removal of the tumor. Some tumors, for example, located on the skull, can not be removed entirely. Some of them are malignant and may recur (return again) after apparent complete removal.

Shvannomy. These tumors are usually benign and effectively treated surgically. For malignant tumors form after an operation is assigned exposure.

Tumors of the spinal cord. These tumors are treated by analogy with brain tumors. Meningeomy subject to surgical treatment, as well as some ependymomas of the spinal cord. Incomplete removal of ependymomas carried radiotherapy.

Astrocytomas of the spinal cord can not be completely removed surgically, so after a biopsy is appointed by irradiation.

Some tumors are more common in children than in adults. These include: astrocytoma of the brain stem, germinal tumor, tumor of the pituitary, kraniofaringeomy, choroid plexus tumors, medulloblastoma and primitive neuroectodermal tumor.

Average survival of patients with low-grade astrocytomas or oligodendrogliomas is approximately 6-8 years. Patients with anaplastic astrocytoma average survival rate – about 3 years. Average survival for glioblastoma patients is 12-18 months.

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Tumors of the lungs and bronchial tubes are usually considered together, combining their title bronchopulmonary cancer.

There are two forms: a central lung cancer originating from the bronchus, and peripheral cancer that develops from the very fabric of the lung.

Causes

1. The development of lung cancer may be preceded by chronic inflammatory processes (chronic pneumonia, bronchiectasis, chronic bronchitis, scarring in the lung after previously transferred tuberculosis, etc.).

2. Important role played by smoking, because, according to most statistics, lung cancer in smokers tend to have significantly more likely than non-smokers. Thus, when smoking out of two or more packs of cigarettes a day rate of lung cancer increases by 15-25 times.

3. The work on the asbestos industry.

4. Irradiation.

Clinical picture

Symptoms vary depending on where the primary tumor arises – in the bronchi or lung tissue.

If the central cancer (cancer of the bronchus) disease usually begins with a dry hacking cough, and then a sputum, often mixed with blood. Very typical for this form of periodic gratuitous appearance of lung inflammation, the so-called pneumonitis, accompanied by increased cough, high fever, general weakness, and sometimes chest pain. The reason for the development of pneumonitis is a temporary blockage due to bronchial tumor joining inflammation.

In the future course of the disease takes a firm character: stubborn cough, increasing weakness, fever and chest pain. Respiratory disorders may be significant in violation ventilation lobe or entire lung.

For peripheral lung cancer developing in the lung tissue itself, the beginning of the disease is almost asymptomatic. In the initial stage of the tumor is often discovered by accident while preventive care to the patient when performing fluorogram or X-ray light. Only with the increasing size, the accession of inflammation or swelling during germination of the bronchus or esophagus (the envelope of light) there is a bright symptoms to severe pain, cough with increasing temperature.

In the advanced stage because of the tumor in the cavity of the pleura (membrane lung) cancer develops pleurisy (inflammation of the pleura) with the accumulation of fluid, often up to several liters, resulting in addition to the above symptoms appear shortness of breath.

Diagnosis

In the early stages of the disease external examination the patient is of little use for the diagnosis of cancer.

With extensive lesions of the lung tissue there is shortness of breath, grayish-pale complexion, weight loss, weakness.

Instrumental

X-ray study – the main method of detection of lung cancer. In the central lung cancer on chest radiographs revealed the shadow of a tumor may identify lower section of the light airiness with occlusion of the bronchus by the tumor. Can also identify lymph node metastases. Any suspicious changes on chest radiographs require further examination.

Methods relating to the X-ray study – bronhografiya – allows you to identify the presence of tumor in the bronchial tree, compression of the bronchus by the tumor.

Bronchoscopy – a method that is performed in suspected presence of tumor in the bronchial tree, as well as a fence material (biopsy) for morphological studies.

CT (X-ray computed tomography), MRI (magnetic resonance imaging, nuclear magnetic resonance imaging) are used for the diagnosis of lung cancer, if the diagnosis is not possible to put more simple methods, or to clarify the prevalence of the process.

Also under the control of CT possible execution puncture (puncture), lung tumor cells to take on the morphological examination (biopsy).

The final method of instrumental diagnosis – diagnostic thoracoscopy.

For a comprehensive survey of the patient, to exclude the presence of metastases, used ultrasound of the liver, CT of the brain, the study of bones of the skeleton (scintigraphy).

Laboratory

Blood examination did not provide clear indicators of cancer, but reduced hemoglobin and increased erythrocyte sedimentation rate can not be ignored.

Determination of tumor markers (specific indicators of blood, rising in the presence of malignant tumor in the body) is important, but is in addition to the basic methods of diagnosis and is used frequently to monitor the treatment process.

It should be remembered that the identification of any, even malignant disease at an early stage improves the forecast of the forthcoming treatment.

Treatment

Choice of treatment depends on the form of cancer, its prevalence, the presence of metastases.

Typically, treatment of lung cancer is complex and combined surgical treatment, chemotherapy, radiation therapy. Priority or exclusion of any method is determined depending on the type of tumor and the incidence of cancer.

Depending on the evidence in the performance of the operation may remove one (two) lobe (lobectomy and bilobektomiya), total lung (pulmonektomiya), a combination of them with lifadenektomiey (removal of lymph nodes).

In disseminated form of the disease the main method of treatment is chemotherapeutic. As an additional method of applying radiation therapy. Operative intervention is used very rarely.

Metastasis

Metastases to the lymph nodes the root of the lung, mediastinum, as well as more distant groups of the neck, the supraclavicular area. Also, lung cancer can spread to the liver, bone, brain, and the second lung. The aggressiveness of the tumor in terms of metastasis is determined by its histological structure.

Forecast

The prognosis for lung cancer depends primarily on the stage of the process, as well as histology of the tumor.

Prevention

To preventive measures that should result in broadly include the timely and correct treatment of various inflammatory processes in the bronchi and lungs in order to prevent their diversion for chronic forms. It is very important preventive measure is smoking cessation. Employees in hazardous occupations with high dust level should use the methods of personal protection in the form of masks, respirators, etc.

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Fibroids - benign tumor that develops in the wall of the uterus from immature muscle cells. Myoma occurs often enough, according to medical statistics, it is diagnosed in 20% of all women who have attained the age of 30. And in most cases in the uterine wall appears not once, but several tumor sites of various sizes. Myoma are different, one can "sit" in the wall of the uterus, other vybuhayut into the abdominal cavity, the third – in the uterine cavity.

Symptoms and course

Is manifested by cyclic uterine bleeding (menorrhagia), against which there are acyclic (metrorrhagia). If the tumor grows in the direction of the bladder and rectum, then a feeling of being crushed by these bodies. Growth of tumor is relatively slow, it is sometimes asymptomatic.

Causes

The main reason for the disease – hormonal changes – namely, increased content in the body of female sex hormones. Therefore fibroids are almost never concerned about young girls and women who had at the time of menopause. But from 25 to 50 years to have her chances are very high. Especially, this probability increases dramatically during pregnancy, inflammatory processes of genital organs and the general decline of immunity. Researchers cite several factors that can trigger uterine myoma:

In addition, not so long ago, scientists discovered that there is a direct relationship between uterine myoma and stress.

Treatment

Dynamic observation: gynecologic examinations every 3 months in child-bearing age – after the end of menstruation. The indications for surgery are: the rapid growth of the tumor, its growth into the lumen of the uterus, uterine, exceeding the $ 12-13-week pregnancy, heavy uterine bleeding, leading to anemia, symptoms of compression of adjacent organs, necrosis (eating disorders), site of the tumor. The operation can be palliative – vyluschivanie myoma nodes or radical – hysterectomy.

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Melanoma - one of the most malignant tumors, metastatic rapidly lymphogenous and hematogenous route. She comes from cells called melanocytes. Melanoma of the skin develops from the epidermal melanocytes as normal skin, and pigmented nevus.

Melanoma occurs in about 10 times less frequent than skin cancer – it is about 1% of the total number of malignant tumors. The frequency of occurrence of melanoma in recent increases in women it occurs more frequently than men. The incidence of melanoma is increasing dramatically in the age group 30-39 years, then there is a gradual, slow increase in the frequency of tumors until old age.

Previous illness

Melanoma usually develops from the acquired and congenital nevus and melanosis Dyubreya.

Pigmented nevi are found in 90% of people. Depending on the layer of skin, from which they develop, distinguish epidermal-dermal, or border, vnutridermalnye and mixed. The most dangerous border nevi. They represent a well-defined nodule black-brown, black and gray or black with a smooth, dry surface, on which there is no hair. Knot flat or slightly raised above the surface of the skin, painless. Has a soft-elastic consistency. Sizes range from a few millimeters to 1 cm border nevi are usually localized on the head, neck, hands and feet, torso. The frequency of malignancy mixed nevus is much lower. And from the dermal nevus melanoma develops in individual cases.

Surgery for nevus previously considered dangerous. This view was erroneous. At the present time believe that excision of any and even border nevus within healthy tissue recovery and ensures a reliable measure for preventing melanoma. Highly recommended removal of nevi located on the soles, foot, nail bed, in the perianal region, which are almost always in their structure are borderline and are often subjected to trauma.

Predisposing factors

The transformation of pigmented nevi in melanoma contributes to trauma, ultraviolet radiation and hormonal changes in the organism. The latter two factors may influence the occurrence of melanoma in the skin unchanged. 

The role of trauma is beyond doubt. Approximately 40% of patients with malignant melanoma symptoms appear shortly after the accidental or intentional injury pigmented nevi. Insolation associated with a greater frequency of melanoma in southern countries and regions, as well as the frequent occurrence of tumors on the exposed parts of the body.

Is assumed the role of endocrine influences on the development of melanoma, which rarely occur before puberty and during puberty, pregnancy and menopause sometimes observed acceleration of tumor growth. In some cases a change in hormonal status leads to inhibition and even regression of the tumor.

Localization, growth and spread

In contrast to the predominant location of skin cancer melanoma on his face is not observed. Almost half of the patients the tumor occurs in the lower extremities, more rarely on the trunk (20-30%) and upper extremities (10-15%) and only 10-20% – in the head and neck.

The growth and spread of melanoma occur by sprouting of surrounding tissues, lymphogenous and hematogenous metastasis.

Melanoma is increasing in three ways: over the skin on its surface and depth, consistently grow layers of the skin and underlying tissues. The deeper subject strands of tumor cells, the worse the prognosis.

Metastasis

Melanoma is characterized by rapid and early metastasis. Most metastases are affected regional lymph nodes. Metastases to distant lymph nodes are less common.

Often there are metastases in the skin. They have the appearance of multiple small, slightly above the level of skin rash brown or black. 

Hematogenous metastases may occur in any organ, but most often affects the lungs, liver, brain and adrenal glands.

"Alarms" - signs of possible malignancy of pigmented nevi:

Should follow the rule: every mole, speaking above the surface, changes in color, weeping, bleeding, or causing unpleasant subjective sensations, suspicious for melanoma. Need advice oncologist.

Treatment

Treatment of melanoma is a difficult task and should only be conducted in a specialized institution.

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Leukemia (blood cancer, leukemia, lymphosarcoma) – is a group of tumors, which is characterized by uncontrolled proliferation and varying degrees of differentiation of hematopoietic cells. Leukemic cells at the same time are the descendants of one mutated cell clones.

Causes of leukemia

The cause of leukemia, as a rule, are chromosomal aberrations, ie changes in the structure of chromosomes as a result of various restructuring processes of their structure: translocations, deletions, inversion, fragmentation.

In accordance with the traditional classification, all divided into acute leukemia (AL) and chronic (CL). This division is associated with different ability data for differentiation of proliferating tumor cells.

In the case of acute leukemia differentiation was virtually absent in the blood builds up a lot of immature, nonfunctional blast cells, resulting in inhibition of normal hematopoiesis of all germs. These features are identified in the blood of more than 80% of cases. Chronic leukemia (leukemia) gives the population of differentiated cells, usually granulocyte gradually replace normal cells in peripheral blood.

Acute leukemia divided into Lymphoblastic and myeloblastic.

Acute lymphoblastic leuco W (ALL) usually develops from a precursor B-lymphocytes (about 75% of cases). There are also B-ALL and T-ALL. Cytogenetic counts the presence of Philadelphia chromosome.

Acute myeloblastic leukemia (acute myeloid leukemia) is often called "nelimfoblastny leukemia", to emphasize its diversity and unlike ALL, because blasts at the same time can have granulocyte, erythrocyte, and even platelet origin. Acute leukemia nelimfoblastny histologically classified by the letter M with the numbers from 0 to 7, for example, M7 – it megakarioblastnaya acute leukemia.

Chronic leukemia in children are rare and are also a diverse group of diseases:

The diagnosis of leukemia is put together research on blood and bone marrow.

When the diagnosis is crucial is not the clinical picture, and cytogenetics, morphology and immunology detected blasts. From identified with the parameters will depend not only staging a definitive diagnosis but also prognosis, treatment and outcome.

Forecast for leykimii generally more favorable in children (1-9 years), and also depends on the type of pathology, cell type and timing of detection of the disease.

Treatment

Mainstay of treatment for leukemia is chemotherapy. Treatment protocol today, but because each type of pathology and some of its features are relevant to the choice of the treatment protocol. In acute leukemia treatment is based on chemotherapy. Its efficiency is higher in acute limfolekoze is 95%. In acute myeloid leukemia effectiveness of chemotherapy is over 80%, but is often accompanied by complications, and 5-year remission was observed only 40% of patients, while recurrence at ALL – a rare phenomenon. In the treatment of CML effectiveness of chemotherapy is not 20-40%.

The best results so far gives allogeneic bone marrow transplantation. Satisfactory results are obtained by alpha-interferon therapy. Recently, high hopes for drugs that block the activity of protein tyrosine kinase Bcr-Abl, for example, the drug STI-571. It is believed that these drugs can be used for maintenance monotherapy, ie for the prevention of blast crisis. In general, the treatment of leukemia should be conducted in a specialized department, with the possibility of applying the most modern and effective treatment that guarantees a greater likelihood of complete remission and full recovery from the full range of therapeutic measures.

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The peak incidence of colorectal cancer occurs after 50 years. Cancer of the colon in men sick 1,5-2 times less frequently than women, but cancer of the rectum, on the contrary – in 1,5 times more often.

Despite improvements in methods of patient examination using X-ray and endoscopic techniques, expanding the network of well-equipped diagnostic centers, has so far failed to significantly improve the early detection of colorectal cancer: patients arrive for treatment in hospitals mainly in stages III-IV disease.

In most cases, late diagnosis of colorectal cancer is related to the fact that long-term illness does not manifest itself, to the same after 50 years, there is usually a "bunch" of chronic diseases, against this background that many people do not notice the disease. Unfortunately, the symptoms that are specific only for colorectal cancer, no.

Now we know the following major risk factors and symptoms that may be the guideline for the early diagnosis:

Many years ago, Duquesne proposed scheme symptom-complex of colon cancer as a "syndrome of the right" and "syndrome of the left" half. This scheme has not lost its importance and relevance to the present day, as it enables the doctor in any specialty, which first addressed the patient complained of abdominal discomfort, suggests not only the tumor pathology of the colon, but also to determine approximately the location of the tumor.

When the location of the tumor in the right ascending colon, in addition to general discomfort, the leading symptom is a decrease in hemoglobin in the blood due to the constant podkravlivaniya of the tumor (at the same time patients note a crimson color stool). Patients themselves are often overlooked symptoms such as fatigue, weakness, frequent dizziness, loss of appetite, explaining their fatigue, nervous and physical overload, etc., and only when paying close attention to the grayish hue of the skin of the patient, he first comes to the doctor.

Formal survey in the clinic (fluorography, ultrasound – Ultrasound – abdominal and pelvic X-ray or endoscopic examination of the stomach) often does not reveal the true cause of the disease. The patient usually exhibit chronic gastritis and "write off" the reduction of hemoglobin in iron deficiency anemia. Begin appropriate treatment, which for some time brings relief, but the disease continues to evolve and progress.And as a result lost precious time to effectively help!

When the location of the tumor in the colon on the right, under the liver, patients often note a dull aching pain, heaviness in the right hypochondrium, a hallmark of chronic calculouse (with stones) or nekamennogo cholecystitis. Examine the colon does not occur to either the patient or doctor. Once identified the "cause" of pain (by ultrasound revealed signs of chronic cholecystitis, pancreatitis), it is possible to restrict this survey. And again history repeats itself – lost time!

When the tumor is located in the lateral part of the colon and the left hypochondrium (ie the projection of the stomach, pancreas, spleen), pain is often mistaken for manifestations of gastritis, pancreatitis. Again colon remains in the "shadow", and the result still the same – the neglect of the disease.

For tumors of the left half of the colon (descending colon and sigmoid colon) is characterized by constipation. Many people suffer from constipation for many years and get used to this illness, why not just pay attention to the increase in their duration (more than 3 days). Knowing that they had chronic colitis, patients resorted to self-healing, different diets, etc., to the doctor is treated as an afterthought, often fall into is the surgical department of a hospital with symptoms of acute intestinal obstruction caused by tumor, about we have already mentioned above.

In tumors of the rectum has its own symptoms. This constipation, difficulty emptying the bowel at defecation, tenesmus (false urge to defecate), flatulence (bloating) and allocation of blood from the rectum. The presence of blood and mucus in the stool are not afraid of the patient: in fact it could be hemorrhoids. And who is there not? How to cure hemorrhoids know everything or almost everything, and treated.

Unfortunately, in some cases, doctors to whom the patient turns on the allocation of blood during a bowel movement, is limited to stating this fact, is diagnosed with a bleeding hemorrhoids and prescribe appropriate treatment.

The incidence of colorectal cancer is increasing worldwide. In some countries over the past 10-15 years, cancer of the colon and rectum cancer has moved into the structure of 5-6-th position in the 2-3rd, behind only lung cancer and prostate cancer in men and breast cancer in women.

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