About Cancer

Pain Management: Little things go a long away

2011-10-22T02:37:00.000-07:00

Some people suffer from chronic pain because of trauma, injuries and diseases like cancer, diabetes, shingles and arthritis. Most people, however, have chronic pain owing to years of strain and damage to the body. The body may be damaged by abuse from sports activities and even in ordinary daily activities.

Simple activities like sitting in an office chair all day without stretching the muscles once in a while can contribute to chronic pain as one ages. Standing for long periods of time and years of sporting improper posture can also cause damage to the body. As a rule, anything that puts excessive or constant strain on the body can become a source of chronic pain later on.

Constant and repetitive activities which are seemingly not strenuous like using a computer for several hours can cause muscle and joint pains especially in the neck, shoulders, arms and wrists. What can we do then to avoid chronic pain when the activities causing it are indispensable to our work and in our lives? The answer is pain management.

Pain management does not only refer to the treatment of aches and pains. It also involves the application of measures and techniques in handling pain and avoiding damage to the body. For instance, using pads to support forearms and shoulders while using a computer have proven to be very effective in reducing muscle pain and tension especially in the neck and shoulders. Various other pain management techniques may also be used such as aligning the computer monitor to the proper eye level. This prevents straining the neck too much. Adjusting the height of the computer table is also important so that the arms and wrists can comfortably rest on the working surface. To avoid straining the back and shoulders, the chair may also be adjusted to a more comfortable height.

Sometimes, using the mouse and the keyboard can add strain and cause pain to the wrists and arms as well. Using a wrist pad or adjusting the distances of the mouse and keyboard to your body will usually minimize the discomfort. It is equally important to stand up, walk around a bit and do stretching exercise once in every few hours. Also, keeping your back straight and maintaining the correct and proper posture when working on a computer will alleviate back pain. In fact, having good posture all day will do wonders for your pain. One should keep in mind that these little things which seem so trivial will go a long way in managing or even preventing chronic pain.

It is a fact that chronic pain greatly affects worker efficiency and productivity. Pain also affects a person's disposition, mood and work ethics. Industries like call centers, companies which are into software development and other offices whose employees are constantly working in front of computers will enjoy more output and greater productivity if they invest on proper facilities and equipment which promote pain-free working conditions.

About the Author:

Seomul Evans is a senior Medical Marketing consultant expert for a leading Pain Management Specialist clinic.

Human Papilloma Virus: Fear or Fact? Cervical Cancer and the HPV Vaccine

2011-10-22T02:19:00.000-07:00

By Caleb Joseph

Unless you've been living in isolation for the past 1 - 2 years, you would have found it almost impossible to avoid hearing about the risk of cervical cancer, and the two new HPV (Human Papillomavirus) vaccines (Gardasil and Cervarix) that have now been introduced as a prevention strategy against this disease. In a revolutionary age where media campaigning has tremendous power and potential to infiltrate thinking and ideas on national and global scales, distinguishing fact from emotion becomes a confronting, yet subtle dilemma.

It is very important therefore to maintain a healthy lifestyle at all times in order to have a good immune system that will fight the virus in case it shows up unexpectedly. In other words your antibodies need to be alert and in good working order because the fight is internal. This could be an uphill task for anyone who could be having a weak immune system and fighting the HPV symptoms becomes an unattainable target.

The HPV vaccine is not recommended for pregnant women. A study has found that pregnant women who received the vaccine were no more likely to have adverse outcomes than those who received a placebo. However, it is still recommended that a woman who is pregnant complete her pregnancy before receiving the vaccine. If a woman learns she is pregnant after starting the course of the vaccination, then she should wait until after she has had her baby to receive the second and third injections.

Warts as a result of HPV vary in appearance and size. They may look similar to small parts of a cauliflower, or may be very tiny and difficult to see or large, raised lesions, Although HPV is not curable, one can opt for their removal or go for the prescribed medication. There are various ways that can be used to achieve your goal. Over-the-counter medications are available too but not recommended for use without a doctors attention. This is because of their strong nature and dangerous to use in sensitive areas such as the genitals.

This is because the HPV virus is spread by contact with the skin. Condoms do not cover all of the areas that could be infected. Before a young girl or woman becomes sexually active, they should consider taking the vaccine.

About the Author:

Learn more about how to get help with Curing HPV Genital Warts.

Industrial Illness & Occupational Disease Campaign Article

2011-10-22T01:11:00.001-07:00

By Daleim Nust

In general, it is a tick-borne illness that became so common, especially in the United States. Such tick-borne diseases are very much similar to the other illness like Ehrlichiosis and Babesiosis. So it is very much important for every individual to understand the symptom of Lyme disease and also theis treatment.

We have built up one of the UK's largest databases of employers and workplaces where staff have suffered industrial illness, as a result they have instant access to insurers information making the process of claiming much quicker. Asbestos - Asbestos was formally regarded as a wonder substance due to its heat resistant properties. Regrettably exposure to asbestos has also caused large numbers of people to suffer from disabling and life threatening medical conditions. Since the 1930s it has been recognised that asbestos was capable of causing disease.

As long as we are chasing down ghost causes for our ailments, they'll continue to get rich and never have to tell us the complete truth about how their products are the underlying cause of so many of our illnesses. The real truth of their drugs' dangers and the fact that they are causing more sickness than any other cause.

As a result the Health & Safety Executive predicts that people will still be suffering from and dieing as a result of asbestos related conditions after the year 2030. Asbestos related conditions are not reserved for people who are still alive and worked with asbestos. Successful claims have also been made by:- o Employees who worked in the vicinity of other people using asbestos o Family members who were exposed to dust brought home on relatives clothing o Occupiers of premises where asbestos existed or was removed o Relatives of family members who have died from Asbestos related disease Hand Arm Vibration Syndrome (HAVS) - is vibration which reaches the hands whilst working with handheld power tools, hand-guided machinery, or by holding materials against a moving surface.

Hand Arm Vibration Syndrome (HAVS) is the collective term for a range of long-term injuries to arms, hands, wrists, fingers or thumbs resulting from prolonged exposure to hand transmitted vibration. Damage occurs to the circulation and nerve supply to the hands, the symptoms of which include blanching (whitening), numbness, tingling and loss of nerve function. (VWF), the most well known form of Hand Arm Vibration Syndrome or HAVS, results from damage to the blood circulatory system. Typically, fingers become white when cold and then red and painful when warmed up again.

The Real Cause You don't get sick because your body lacks prescription drugs, you get sick because your body lacks healthy nutrients. Every day we eat calorie rich diets that are woefully poor in any real nutrition. America is the most well-fed country in the world, yet, by and large, they are still among the sickest people on the planet. How is that a country full of people with medical insurance, access to physicians and medicine chests full of drugs end up being so sick. The answer is twofold - the diets are almost completely devoid of proper nutrition and they are eating drugs like candy and paying the price for it.

Doctors normally ask to its patients whether they saw any ticks that made the rash, how long the tick was attached to the body, or at least an idea about the tick that attach to it before removing out of the skin. This idea actually helps doctors to understand the symptoms and conditions of the disease. Only through this way, doctors can exactly track the point and the disease and then only they could start with the Lyme disease treatment. So it becomes very important that people keep track on the how the rash occurred and should rush to the doctor to get rid out of it.

About the Author:

Sigita Kim How To Find An Arizona DUI Lawyer When You're In Trouble, A Criminal DUI Lawyer Can Help

Get more information: Birmingham std testing

2011-10-19T03:38:00.001-07:00

By Truce Nigel

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2011-10-19T03:31:00.000-07:00

By Truce Nigel

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What You Should Know About Nose Job (Rhinoplasty)

2011-10-18T08:23:00.001-07:00

By Dr Payman Simoni

Most rhinoplasties are performed because the patient desires an improvement in appearance and/or nasal function. (S)he may simply want a nose which is in harmony with the rest of the face rather than one which is out of proportion with respect to the other facial features.

Rhinoplasty surgery is one of the most difficult of all plastic surgery procedures. The surgeon should use his artistic judgment to fit each patient's nose to his or her face. With the advanced computer technology now every patient can explain and observe desired changes prior to surgery. Dr. Payman Simoni utilizes computer generated before and after pictures during his consultations. The modification to each nose should be determined by many factors, including one's height, age, skin thickness, and ethnicity. Facial features such as the forehead, eyes and chin also play an important role. All in all, Dr. Payman Simoni strives for a natural looking nose rather than one which appears to have been surgically altered. An operated looking nose job is not flattering and should be avoided.

Nasal Plastic Surgery is considered an outpatient procedure. Nose job is a very delicate operation and is extremely different from other cosmetic surgery procedures such as breast implant or tummy tuck. In the hand of a good rhinoplastic surgeon, it carries a minimal post operative discomfort.

After creating well hidden internal nasal incisions, the nose is reshaped by carefully modifying underlying bones and cartilages. Dr. Payman Simoni has modified his rhinoplasty techniques so there is no need to pack the nose after surgery. With the elimination of packing, majority of pain, swelling, bleeding, discoloration, etc., are significantly reduced making the recovery period much more pleasant for the patient. Dr. Payman Simoni achieves this by an advanced delicate internal suturing eliminating the need for packing.

One of the most feared questions by patients is "do you have to break my nose?" Dr Payman Simoni avoids breaking the nose by making an incision into the nasal bones. Using this technique, he has eliminated the more antiquated technique of "breaking" the nose. This technique also allows for superior control of the procedure and reduces the patient's worry about having surgery.

About the Author:

Payman Simoni, MD is a dual board certified Los Angeles cosmetic surgeon. Dr. Simoni's background in nose surgery combined with his natural looking results, has made him one of the most sought after Los Angeles nose job expert.

Singapore Chiropractor Relieves Pain Safely Without Surgery

2011-10-18T07:55:00.000-07:00

By Aras Chiropractic

There are many good chiropractors to choose from when looking for a Singapore Chiropractor to help alleviate joint pain and back discomfort. Chiropractors, also called doctors of the chiropractic or chiropractic physicians, deal with musculoskeletal problems. Their idea is that the spine, nervous, muscular and skeletal systems work better together when they are all in balance with each other.

Singapore offers a wide variety of chiropractic offices that specialize in everything from general chiropractors to sports related or pediatric. Some offices may be more convenient than others and doing a little bit of research can help patients make a good choice that will work for them on a long term basis.

There are Chiropractic offices that offer on-line scheduling, allowing people to make or cancel an appointment 24 hours a day, 7 days a week. Other offices open extra early in the morning or stay open late for patients coming from outside the city or who work irregular hours. Finding out about what insurance is accepted is an important first step when scheduling a Chiropractor appointment. Many insurance companies may not cover chiropractic services or only cover certain chiropractic physicians within their group. Finding out what is and is not covered can save a lot of time.

Chiropractors work on injuries or distress stemming from the musculoskeletal system. If the primary source of discomfort appears to be from there, a manual spinal adjustment may be performed. Because chiropractors do not perform surgery they take a more holistic approach. They do not use drugs in their practice but look for alternative forms to relieve pain. Simple exercises, sleep style modifications, general change in lifestyle are all ways a chiropractor may advise a patient to adopt.

Alternative and holistic options are used by chiropractors such as heat, acupuncture, massage. Although medical doctors may feel that these are not traditional methods of practice, many patients find relief from their day to day aches and pains by seeing a chiropractor on a regular basis. They may open a patients eyes to a more healthy lifestyle that can benefit them in the long-term.

Chiropractors are not medical doctors and cannot perform surgery or prescribe medication. A Singapore chiropractor can be called upon to help alleviate pain and discomfort that arises from a sports injury such as shin splints or a car accident that causes whiplash. A good chiropractor may be able to find a solution when a medical doctor is unable to.

About the Author:

For more articles and videos on alternative medicine check out singapore chiropractic. Additional health and wellness information available at singapore true healing.

Acute lymphocytic leukemia: Prevention and Special concerns

2008-08-24T23:41:00.001-07:00

By about cancer

Prevention

There are few preventive measures to take against ALL. Those who work with chemicals should be cautious, particularly around benzene. Pregnant women should avoid exposure to ionizing radiation to reduce the risk to their unborn children.

Special concerns

Parents of children with ALL have specific concerns regarding the long-term consequences of treatment for ALL, such as learning disabilities. Organizations devoted to childhood cancer, hospital social workers, pediatric oncologists and other parents can be important resources when advocating for the educational needs of the child with ALL.

When cranial radiation must be used, children have a risk of developing secondary cancers in the central nervous system years later. Some children are left infertile by the treatment. Chicken pox can be lethal in children with ALL. The introduction of the chicken pox vaccine has reduced this risk, but parents must still be vigilant.

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Acute lymphocytic leukemia: Clinical trials

2008-08-24T23:41:00.000-07:00

By about cancer

Clinical trials

There are numerous clinical trials looking at novel strategies for the treatment of ALL in adults and children. Most oncologists consider bone marrow transplants to be state-of-the-art in specific circumstances, and some insurance companies agree. Many still require extensive reviews before approving coverage for transplant.

A variety of biological agents are currently under study. These include antibodies that react specifically against leukemic cells, causing their death, and chemicals that interfere with the leukemic cells’ normal DNA function or their ability to make proteins.

Researchers are developing second and third generation versions of established chemotherapeutic drugs, isolating the molecular components of those drugs that seem to be most useful in ALL and amplifying them. Some of these drugs include 9-aminocamptothecin, aminopterin, annamycin, Ara-G, codrycepin, decitabine, and trimetrexate. Quinine shows promise in reducing the incidence of drug resistance that is sometimes seen in leukemic cells.

Locating and enrolling in clinical trials has been made easier by listings on the Internet. A general search under “clinical trials and leukemia” will yield several listings. University-affiliated hospitals and oncologists participate in many trials and can refer patients to other sites if necessary.

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Acute lymphocytic leukemia: Coping with cancer treatment

2008-08-23T23:31:00.003-07:00

By about cancer

Coping with cancer treatment

CHILDREN.

The presence of parents during treatment is critical. While some hospitals exclude parents during treatments, others invite them to be present. Blood can be drawn and intravenous catheters placed while children sit in their parents’ laps. If at all possible, a parent should spend the night during any hospitalizations. Like adults, children can take anti-nausea drugs an hour or so before scheduled treatments. Children, and some adults, can apply topical anesthetic creams to sites of bone marrow aspirates or spinal taps. Favorite stuffed animals or blankets can be present for most procedures.

Play and fun are as important to children with cancer as to healthy children. Items such as board games, modeling clay, video games, dolls, and toy cars can be enjoyed even with intravenous lines in place. Play dates with friends should be encouraged, with proper screening to limit exposure to contagious illnesses.

School districts are required to accommodate the special needs of children. Children with ALL might require shorter school days or the provision of a tutor at home. Children who develop learning disabilities due to treatment might require the intervention of a special education team.

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Acute lymphocytic leukemia: Coping with cancer treatment

2008-08-23T23:31:00.002-07:00

By about cancer

Coping with cancer treatment

The treatment of ALL can be particularly draining, not only due to adverse effects but due to its prolonged time course. Although much of the treatment can be given on an outpatient basis, many protocols utilize lengthy intravenous infusions of chemotherapy and require hospitalization.

ADULTS. To prevent nausea and vomiting, adults can take oral anti-nausea medication an hour or so before scheduled treatments, including intrathecal treatments. To avoid headache, they should remain flat for at least 30 to 60 minutes after intrathecal chemotherapy. Nurses can give instructions in mouth care if mouth sores occur and skin care if rashes occur after radiation treatment. Books, music, and television can provide distraction and reduce anxiety during chemotherapy infusions. Patients scheduled for inpatient stays can bring their own pillows, pajamas and even food, with their doctor’s approval. Temporary issuance of handicapped parking stickers are often helpful.

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Acute lymphocytic leukemia: recurrent ALL for children

2008-08-23T23:31:00.001-07:00

By about cancer

Recurrent ALL

CHILDREN.

The treatment and prognosis of children who relapse depends on the timing of that relapse. Relapse that occurs within six months is often treated with bone marrow transplantation. Early relapse carries the least favorable prognosis, with only 10% to 20% chance of long-term survival. Relapse that occurs more than a year after initial treatment is finished can be treated with another full round of chemotherapy, and bone marrow transplant reserved for those children who relapse a second time. Those with such late relapses have a 30% to 40% chance of long-term survival.

Recurrent disease may occur in a sanctuary site, or a part of the body difficult to penetrate with chemotherapeutic drugs. The central nervous system is the most common site of such recurrences. Children who have an isolated central nervous system relapse during the first 18 months of treatment have a 45% likelihood of longterm survival. Children with central nervous system relapse after the first 18 months of treatment have up to an 80% chance of long-term survival. Treatment for relapse in the central nervous system includes intrathecal chemotherapy, and for most children, the use of radiation therapy to the brain and spinal cord.

The testicles are the second most common site of relapse. Early testicular relapse (within the first 18 months of treatment) carries a 40% chance of long-term survival, and late testicular relapse carries an 85% chance of long-term survival. Another sanctuary site is the eye, but isolated relapse here is unusual.

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Acute lymphocytic leukemia: recurrent ALL for children

2008-08-23T23:31:00.000-07:00

By about cancer

Recurrent ALL

CHILDREN. The treatment and prognosis of children who relapse depends on the timing of that relapse. Relapse that occurs within six months is often treated with bone marrow transplantation. Early relapse carries the least favorable prognosis, with only 10% to 20% chance of long-term survival. Relapse that occurs more than a year after initial treatment is finished can be treated with another full round of chemotherapy, and bone marrow transplant reserved for those children who relapse a second time. Those with such late relapses have a 30% to 40% chance of long-term survival.

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2008-08-23T23:30:00.000-07:00

By about cancer

Recurrent ALL

ADULTS. Adults who relapse after initial remission and maintenance therapy often undergo reinduction chemotherapy and are then referred for bone marrow or stem cell transplant. Some receive transplants of umbilical cord blood. Such transplants carry the risk of graft versus host disease, but also carry the possibility of graft versus leukemia, in which the transplanted cells attack the residual leukemic cells. Unlike graft-versus-host disease, graft versus leukemia is useful.

New treatments for relapsed ALL include immunotherapies or biological response modifiers. Some reduce adverse effects of treatment and others are used to fight the leukemia. Some of these include cytokines, substances that stimulate the production of blood cells after treatment has suppressed the bone marrow, and colony- stimulating factors, which have the same effect. Other immunotherapies, such as monoclonal antibodies and interferon, have not yet been shown effective against ALL, but are still under study.

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Acute lymphocytic leukemia: ALL in remission therapies for children

2008-08-22T23:24:00.000-07:00

By about cancer

ALL in remission

CHILDREN.

In children, remission induction therapy is followed by a phase termed consolidation or intensification, and then by a phase termed maintenance. During intensification, children receive intermediate or highdose methotrexate, plus some of the same drugs that are used in induction, new drugs that do not cross-react with those used in induction, high-dose asparaginase, or some combination of these.

The maintenance phase of treatment for children with ALL continues for 18 to 30 months. Daily oral mercaptopurine and weekly oral or injected methotrexate are given on an outpatient basis, with frequent blood tests and examinations. Some protocols add pulses of vincristine and prednisone during the maintenance phase.

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Acute lymphocytic leukemia: therapies for adults

2008-08-22T23:23:00.003-07:00

By about cancer

ALL in remission

ADULTS. Remission is achieved in many people within days of beginning treatment. Treatment does not end at that point, but rather enters into the next phases, called consolidation and maintenance. Several different approaches can be used in these. Some patients receive long-term chemotherapy with drugs that might include cytarabine, cyclophosphamide, methotrexate, 6-mercaptopurine, vincristine, prednisone, or doxorubicin. Other patients undergo high-dose chemotherapy or combination chemotherapy and radiation therapy to ablate or wipe out their own bone marrow, and then have bone marrow or stem cell transplants. Adverse effects of bone marrow transplant include significant risk of serious infection and graft versus host disease (GVHD), in which the transplanted cells fail to “recognize” the host’s cells as self and attack the host cells. Medications to decrease this risk include those that suppress the immune system and steroids.

Central nervous system prophylaxis, as either intrathecal chemotherapy or radiation therapy or both, typically continues through at least a portion of the postremission therapy.

Adults who receive intensive chemotherapy have a 40% likelihood of long-term survival.

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Acute lymphocytic leukemia: Alternative and complementary therapies for children

2008-08-22T23:23:00.002-07:00

By about cancer

Alternative and complementary therapies

CHILDREN.

Complementary and alternative treatments are recommended less frequently for children. Real caution must be used in administering herbal remedies to children, whose metabolisms are very different from those of adults. For example, jin bu hua, a traditional Chinese medicine, can cause heart or breathing problems. Life root and comfrey can both cause fatal liver damage in children.

While many children are too young for formal guided imagery, they can be distracted from the fears and pain associated with some treatments by toys and videotapes. Reading favorite books during scary procedures can relieve some of their fears.

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Acute lymphocytic leukemia: Alternative and complementary therapies for adults

2008-08-22T23:23:00.001-07:00

By about cancer

Alternative and complementary therapies

Supplements that have not been proven to be of value or are potentially dangerous to those with leukemia include camphor, sometimes called 714-X. Green tea has received much press for its reported abilities to enhance the immune system and fight cancer, but studies have had conflicting results. Some show that green tea has preventive benefits and others show no effect. A few animal studies suggest that growth of tumors might be slowed by green tea, but this has not been shown in humans yet.

Hoxsey is another supplement touted as a cancer treatment, but no studies have confirmed any benefit. Some of its ingredients have serious adverse effects. Vitamin megadoses have long been advocated as beneficial in cancer, but no conclusive studies show benefit, and they have significant potential for adverse effects, such as diarrhea, kidney stones, iron overload, nerve damage and liver disease.

Laetrile, or amygdalin, was once touted as a cure for cancer and leukemia. No human or animal studies conducted in the decades since have shown any benefit other than relief of some pain. Laetrile can, however, cause cyanide poisoning.

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Acute lymphocytic leukemia: Alternative and complementary therapies in adults

2008-08-22T23:23:00.000-07:00

By about cancer

Alternative and complementary therapies

ADULTS. Individuals with leukemia often employ alternative or complementary therapies. Some of these provide pain relief and improve psychological well being. No controlled studies have yet shown that alternative treatments offer cures for ALL, although some may hold promise of benefit.

Patients with ALL sometimes use acupuncture, which offers relief from generalized pain, nausea, and vomiting. Other methods that may help with the physical and often emotional side effects of treatment include hypnosis, guided imagery, and yoga.

Nutritional supplements and herbs are sometimes utilized by persons with leukemia. Coenzyme Q10 is an antioxidant, a substance that protects cells from toxic byproducts of metabolism. Early studies suggest, although it is not proven, that coenzyme Q10 can improve immune function and counteract some of the harmful effects of chemotherapy and radiation on healthy cells. Adverse effects of coenzyme Q10 include headache, rash, heartburn and diarrhea. Another supplement with potential benefit is polysaccharide K (PSK). A few studies have shown PSK to have some benefit in improving immunity.

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Acute lymphocytic leukemia: Clinical staging, treatments, and prognosis in children

2008-08-21T23:18:00.003-07:00

By about cancer

Clinical staging, treatments, and prognosis

CHILDREN.

The treatment of ALL in children represents one of the great success stories of modern oncology. In contrast to adults, most children with cancer enter into research protocols, strict treatment regimens with careful follow-up that are built on the most successful aspects of earlier treatments. Childhood ALL now has an 80% long-term survival rate, due in large part to the extensive and widely disseminated research on the disease.

Within the United States, research on ALL was conducted for many years under the auspices of either the Children’s Cancer Group or the Pediatric Oncology Group. In 1998, recognizing the benefits of cooperation and collaboration, these two groups joined forces with the National Wilms’Tumor Study Group and the Intergroup

Rhabdomyosarcoma Study Group to form the Children’s Oncology Group. Remission induction chemotherapy for children includes vincristine, a steroid, and asparaginase. Children at higher risk of relapse are often given daunomycin as well. The adverse effects of these drugs include bone marrow suppression, risk of infection, nausea, vomiting, hair loss, and mouth sores. Although these drugs can reduce sperm counts, most survivors of childhood ALL grow up to have normal fertility. The drugs can be administered intravenously or as oral preparations. Oral prednisone has a particularly unpleasant taste that is hard to disguise and parents must be vigilant to ensure that their children are taking their proper doses.

Like adults, children also receive prophylaxis against central nervous system spread. They receive multiple doses of intrathecal chemotherapy, with the drugs delivered directly to the spinal fluid through a lumbar puncture or spinal tap. Cranial radiation as central nervous system prophylaxis for children is infrequently used. Though once standard, brain radiation produced a high incidence of cognitive and learning disabilities, especially among those younger than five years old. Cranial radiation is reserved for those children felt to be at high risk of central nervous system disease, including those older than ten at the time of diagnosis, those with initial white blood cell counts of more than 50,000 per microliter, and those with T-cell leukemia. Some high-risk children who enter remission rapidly with induction chemotherapy receive intrathecal chemotherapy alone, without radiation therapy.

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Acute lymphocytic leukemia: Clinical staging, treatments, and prognosis

2008-08-21T23:18:00.002-07:00

By about cancer

Clinical staging, treatments, and prognosis

ALL does not have a formal staging system, but treatment is different in different phases of the disease. These phases are often divided into untreated ALL, ALL in remission, and recurrent ALL. Conventional treatment for ALL consists of chemotherapy for disease in the bone marrow and treatment aimed at preventing central nervous system disease.

ADULTS.

The first phase of treatment is remission induction. The chemotherapeutic drugs typically include prednisone, vincristine, cytarabine, cyclophosphamide and asparaginase. Most are given intravenously and a few are given orally. Depending on the disease, these drugs can achieve a complete remission in 60% to 90% of adults. The relapse rate is higher in adults than in children. A 50% 3-year survival has been noted in some research series, and very aggressive treatment with multiple drugs has produced up to a 70% survival rate.

Adverse effects of these drugs include:

• bone marrow suppression

• anemia, pallor, fatigue, shortness of breath, and angina in older patients

• bleeding, bruising

• increased risk of infection

• hair loss (alopecia)

• mouth sores

• nausea and vomiting

• menopausal symptoms

• lower sperm counts

• tumor lysis syndrome, in which the dead cancer cells can harm healthy organs

Treatment that is directed at preventing central nervous system spread is called prophylactic. Because of the blood brain barrier, a physical and chemical barrier that prevents toxins from reaching the brain and spinal cord, chemotherapeutic drugs do not easily reach the central nervous system. Thus, chemotherapeutic drugs are administered directly into spinal fluid, which circulates around the brain and spinal cord. This is called intrathecal chemotherapy. The drugs are given by spinal tap or through an Ommaya reservoir, which is surgically inserted under the scalp. This reservoir empties into the spinal fluid around the brain. Some patients receive prophylactic radiation therapy to the brain, in addition to or instead of intrathecal chemotherapy.

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Acute lymphocytic leukemia: Treatment team

2008-08-21T23:18:00.000-07:00

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Treatment team

The treatment team consists of a hematologist/oncologist who directs care, oncology nurses familiar with administering chemotherapy, and often social workers, who can address both insurance issues and psychological support. The patient’s regular physician should be kept informed of all cancer-related care. Because treatment is so prolonged, most patients have long-term intravenous catheters placed by a surgeon. In many hospitals, a Child Life specialist will participate in the care of children with ALL. They ensure that children with cancer are seen, first and foremost, as children, organizing play times, providing distraction during scary procedures and giving parents some much-needed respite.

Clinical staging, treatments, and prognosis

ALL does not have a formal staging system, but treatment is different in different phases of the disease. These phases are often divided into untreated ALL, ALL in remission, and recurrent ALL. Conventional treatment for ALL consists of chemotherapy for disease in the bone make the diagnosis immediately. The chromosome studies require several days to complete. The bone marrow aspirate will be repeated occasionally during treatment to confirm remission and to look for possible relapse.

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Acute lymphocytic leukemia: Diagnosis (continued)

2008-08-21T23:17:00.000-07:00

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Continuing from previous post about description of acute leukimia;

A lumbar puncture, or spinal tap, will be performed to rule out spread of ALL to the central nervous system. A thin needle is inserted between two vertebrae in the lower back, and spinal fluid removed. This fluid is examined microscopically for the presence of lymphoblasts. Topical anesthetics eliminate most of the discomfort of a spinal tap, although many patients experience headaches afterwards. Remaining flat for 30 minutes after a spinal tap decreases the likelihood of headache.

A chest x ray will show enlargement of internal lymph nodes or the thymus gland. No preparation is necessary for most of the testing done to diagnose ALL. Younger children will often receive mild sedatives before procedures like spinal taps and bone marrow studies. Topical anesthetic cream can be applied an hour in advance of either a bone marrow test or a spinal tap. When treatment is complete, tests for minimal residual disease can be performed. These new tests detect the presence of lingering leukemic cells that would have been missed by standard testing. The presence of a certain amount of residual disease probably has an impact on prognosis and the likelihood of relapse.

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Acute lymphocytic leukemia: Diagnosis

2008-08-21T23:15:00.000-07:00

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Diagnosis

There are no screening tests for leukemia. The patient’s history and physical examination raise the physician’s suspicions, triggering orders for appropriate tests. Pallor, swollen lymph nodes, bleeding, bruising, pinpoint red rashes, and in children, a swollen abdomen, will suggest the diagnosis. Testing is similar for adults and children.

The first test is a complete blood count (CBC), examining red cells, platelets and white cells. In early leukemia, the total white blood cell count might be normal, but there will usually be circulating lymphoblasts, which is always abnormal. The red cell and platelet counts may be low.

The abnormal CBC results trigger a referral to a hematologist/oncologist who will perform a bone marrow aspiration and biopsy, in which a small sample of marrow is removed with a hollow needle inserted in the hipbone. Although topical anesthetic will numb the skin and bone, most patients experience brief pain during this procedure. The sample will be examined microscopically for evidence of lymphoblasts. The marrow will be further studied to determine whether the lymphoblasts are of Tcell or B-cell origin and the cells tested for chromosomal abnormalities. A pathologist can examine the marrow and make the diagnosis immediately. The chromosome studies require several days to complete. The bone marrow aspirate will be repeated occasionally during treatment to confirm remission and to look for possible relapse.

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Acute lymphocytic leukemia: Symptoms

2008-08-20T02:39:00.000-07:00

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Symptoms

ADULTS.

ALL in adults can cause any or all of the following symptoms:

fevers, chills, sweats
weakness, fatigue, shortness of breath
frequent infections
depressed appetite, weight loss
enlarged lymph nodes
easy bleeding or bruising
rash of small, flat red spots (petechiae)
bone and joint pain

Symptoms of central nervous system involvement include:

headache
nausea and vomiting
confusion
seizures

CHILDREN.

Symptoms in children are similar, but young children may be unable to communicate them.

They include:

fevers
frequent infections
fatigue, irritability, decreased activity levels
easy bruising or bleeding
bone or joint pain
a limp
swollen belly
enlarged lymph nodes, T-cell ALL can invade the thymus gland in the upper chest, which can cause compression of the windpipe, cough or shortness of breath, and superior vena cava syndrome (compression of a large vein that causes swelling of the head, neck, and arms). Central nervous system involvement in children produces:
headache
nausea and vomiting
blurred vision
decline in school performance
seizures spread to the testicles can cause painless swelling in them.

Acute lymphocytic leukemia: Causes

2008-08-20T02:36:00.001-07:00

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Causes

While specific causes for ALL are not known, there are some known risk factors, including ionizing radiation. Exposure to certain chemicals, particularly benzene (used in the manufacture of plastics, rubber, and some medicines), has also been associated with an increased risk of developing ALL. ALL incidence in adults increases with age.

The causes of ALL in children are also unknown. Certain inherited genetic abnormalities, such as Down syndrome, increase the risk. Some studies have shown prenatal exposure to ionizing radiation increases a child's risk of ALL. Some contaminants of tap water, such as trihalomethanes, chloroform, zinc, cadmium, and arsenic are associated with an increased risk. A number of reports suggested an increased risk of ALL among children who lived in proximity to high voltage power lines, but several later analyses suggested that was not true. Studies continue in efforts to disprove or confirm this possible connection. ALL is more common in children who are not firstborn and among those whose mothers took antibiotics during their pregnancies. Breastfeeding has been found to be protective.

Acute lymphocytic leukemia: Demographics

2008-08-20T02:36:00.000-07:00

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Demographics

ALL is less common than AML in adults; about 1500 adults are diagnosed with ALL each year, compared to 10,000 diagnosed with AML. About 1000 adults die of ALL each year and the overall five-year survival rate for adults with ALL is 58%. About 1500 cases of ALL are diagnosed in children under 18 each year in the United States. ALL is by far the more common form of leukemia in children. The death rate for children with ALL has dropped nearly 60% in the last 30 years. The overall five-year survival rate for children with ALL is now 80%. Still, leukemia causes more deaths in children under 15, about 550 per year, than any other disease.

In the United States, ALL is highest among Caucasians and lowest among Asian-Americans. The incidence of ALL is about 50% higher for men than for women. Death rates in leukemia patients are highest in African-Americans and Caucasians and lowest in Asians. In children, the highest leukemia rates in the US occur among those of Filipino descent; next highest are white Hispanics, then non-Hispanic whites, and the lowest incidence in children is in African-Americans. Survival is higher for Caucasians than African-Americans. The survival rate for girls is slightly higher, in part due to the risk of relapse occurring in the testicles and in part because boys appear to have a slightly higher risk of bone marrow relapse.

Acute lymphocytic leukemia: description 4

2008-08-20T02:35:00.000-07:00

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Description continued from previous post;

B-cell ALL constitutes about 80% of all cases. The cancerous cells are either early pre-B cells, the most immature, pre-B cells, also somewhat immature, or Bcells. These B-lineage cells contain a variety of proteins called antigens. The presence of one of these antigens, called CALLA for common ALL antigen, carries a somewhat more favorable prognosis. T-cell ALL has a less favorable prognosis than Bcell ALL. The presence of an antigen called CD2 indicates a more favorable prognosis. ALL is also classified by karyotype, which is the number and composition of a cell's chromosomes. Normal human cells contain 46 chromosomes. One chromosomal abnormality often seen in ALL is a translocation, in which a piece of one chromosome becomes attached to a different chromosome. Different translocations carry different prognoses. One translocation, labeled t(9;22) is also called the Philadelphia chromosome and is found in 5% of childhood ALL and 20% of adult ALL cases. The Philadelphia chromosome carries a somewhat less favorable prognosis.

The number of chromosomes found in the leukemic cells, particularly in children, also impacts prognosis. The occurrence of more than 50 chromosomes in leukemic cells has a very favorable prognosis. Even the presence of one extra chromosome can be favorable. Children whose leukemic cells have fewer than 45 chromosomes are at highest risk of treatment failure.

Acute lymphocytic leukemia: description 3

2008-08-20T02:34:00.000-07:00

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Description of Acute lymphocytic leukemia, continued from previous post;

Cancerous lymphoblasts take over the bone marrow, reducing both the number and the effectiveness of all types of blood cells. The cancerous cells reduce the ability of healthy white cells to fight infection. Fewer red cells are produced, causing anemia, and fewer platelets increases the risk of bleeding and bruising. The presence of the cancerous white cells in the central nervous system can produce headaches, confusion and seizures. The type of treatment a person receives for ALL depends on the presence of risk factors for relapse. Children are at standard risk if they are between ages 1 and 9, have a total white cell count of less than 50,000 per microliter of blood, and have B-precursor cell leukemia. Children are at high risk if they are younger than 1 or older than 9, if their white blood cell count exceeds 50,000 per microliter, or if they have T-cell leukemia. Compared to children, adults are all at higher risk of relapse at the time of diagnosis, but younger adults (less than 25 years old) have a better prognosis.

Acute lymphocytic leukemia: description 2

2008-08-20T02:33:00.000-07:00

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Description of Acute lymphocytic leukemia, continued from previous post;

The main types of cells found in the blood are the red blood cells (RBCs), which carry oxygen and other materials to all tissues of the body; white blood cells (WBCs), which fight infection; and the platelets, which play a part in the clotting of the blood. The white blood cells can be further subdivided into three main types: granulocytes, monocytes, and lymphocytes. The granulocytes, as their name suggests, have particles (granules) inside them. These granules contain special proteins (enzymes) and several other substances that can break down chemicals and destroy microorganisms such as bacteria. Monocytes are the second type of white blood cell. They are also important in defending the body against pathogens. The lymphocytes form the third type of white blood cell. The two types of lymphocytes are Bcells, which make antibodies, and T-cells, which make other infection-fighting substances. Lymphocytic leukemia can arise in either B or T cells. B-cell leukemia occurs more frequently than T-cell leukemia. It is the most common form of leukemia in children, but also occurs in adults. At diagnosis, leukemic cells can be found throughout the body, in the bloodstream, the lymph nodes, spleen, liver, occasionally in the central nervous system, and in T-cell ALL, the thymus gland.

Acute lymphocytic leukemia

2008-08-20T02:31:00.000-07:00

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Definition

Acute lymphocytic leukemia is a cancer of the white blood cells known as lymphocytes.

Description

Leukemia is a cancer of white blood cells. In acute leukemia, the cancerous cells are immature forms called blasts that cannot properly fight infection; patients become ill in rapid fashion. The cells that make up blood are produced in the bone marrow and the lymph system. The bone marrow is the spongy tissue found in the large bones of the body. The lymph system includes the spleen (an organ in the upper abdomen), the thymus (a small organ beneath the breastbone), and the tonsils (an organ in the throat). In addition, the lymph vessels (tiny tubes that branch like blood vessels into all parts of the body) and lymph nodes (peashaped organs that are found along the network of lymph vessels) are also part of the lymph system. The lymph is a milky fluid that contains cells. Clusters of lymph nodes are found in the neck, underarm, pelvis, abdomen, and chest.

Acute leukemia

2008-08-20T02:30:00.000-07:00

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Definition

A rapidly progressing cancer that starts in the bloodforming cells of the bone marrow. Leukemia results from an abnormal development of leukocytes (white blood cells) and their precursors. Leukemia cells look different than normal cells and do not function properly.

Description

There are four main types of leukemia, which can be further divided into subtypes. When classifying the type of leukemia, the first steps are to determine whether the cancer is lymphocytic or myelogenous (cancer can occur in either the lymphoid or myeloid white blood cells) and whether it is acute or chronic (rapidly or slowly progressing).

In acute leukemia, the new or immature cells, called blasts, remain very immature and cannot perform their functions properly. The blasts rapidly increase in number and the disease progresses quickly. Major types of acute leukemia include acute lymphocytic leukemia (ALL) and acute myelocytic leukemia (AML; also known as acute myelogenous leukemia).

Acute erythroblastic leukemia: Prevention and Special concerns

2008-08-19T23:35:00.000-07:00

By About Cancer

Prevention

Since this form of cancer is very rare and its causes are largely unknown, no specific preventive measures can be recommended.

Special concerns

Patients diagnosed with acute erythroblastic leukemia require special support in that they must deal with having a rare form of cancer about which there is very little specific information available. This creates additional anxiety and special care must be taken to explain to the patient that an uncommon cancer is not an untreatable one.

Acute erythroblastic leukemia: Coping with cancer treatment

2008-08-19T23:34:00.001-07:00

By About Cancer

Coping with cancer treatment

Like all types of leukemias, patients with acute erythroblastic leukemia usually experience a number of specific complications and side effects resulting from treatment, as well as emotional concerns. They require supportive care to cope with these issues and to maintain their comfort and quality of life during treatment. As with every serious disease, psychological stress is increased and it is important for patients to be able to discuss their needs and concerns about tests, treatments, hospital stays, and financial consequences of the illness.

Family, friends, doctors, nurses, and other members of the health care team are the best sources of support, as well as social workers, counselors, and members of the clergy.

Acute erythroblastic leukemia: Clinical staging, treatments, and prognosis

2008-08-19T23:34:00.000-07:00

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Clinical staging, treatments, and prognosis

Acute erythroblastic leukemia is a very aggressive form of leukemia and does not respond well to the types of therapy used for a related type of cancer known as acute myelocytic leukemia. However, recent advances in chemotherapy protocols and bone marrow transplantation techniques, either allogeneic or autologous, have been identified as a means to increase the cure rate. The patient's cancerous bone marrow is first purged using drugs and radiation therapy before being replaced by healthy bone marrow that is obtained from a suitable donor (allogeneic) or from the patient himself (autologous). In the case of an autologous transplant, the bone marrow is treated outside the patient's body to remove the cancer cells before transplantation.

Acute erythroblastic leukemia: Treatment

2008-08-19T23:33:00.000-07:00

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Treatment

Treatment for acute erythroblastic leukemia depends on the features of the cancer cells present and on the extent of the disease, as well as on the age of the patient, his symptoms, and general health condition. This disease can have an indolent course and may only require observation in the early stages. The treatment strategy is based on chemotherapy and in some patients, bone marrow or cell transplantations are indicated as well. Chemotherapy is usually administered in combinations of two or more drugs. Post-remission therapy includes maintenance chemotherapy for most patients.

Acute erythroblastic leukemia: Diagnosis

2008-08-19T23:32:00.000-07:00

By About Cancer

Diagnosis

Patients seeking treatment usually report a vague history of chronic general fatigue. Blood tests are used to establish the diagnosis. A sample of blood is examined under a microscope to identify abnormal red cells— which are larger than healthy cells—and to count the number of mature cells and blasts present. Cancer red cell precursors predominate, myeloid blasts also are seen, and multinucleated red cell precursors are common. Bone marrow examinations are also performed, either by aspiration or biopsy to examine the cell types further.

Acute erythroblastic leukemia: Causes and symptoms

2008-08-19T23:31:00.000-07:00

By About Cancer

Causes and symptoms

The causes of acute erythroblastic leukemia are largely unknown. However, acute erythroblastic leukemia constitutes 10–20% of leukemias secondary to radiation, alkylator therapy, or overexposure to benzene. Patients with this type of leukemia have less than the normal amount of healthy red blood cells and platelets, which results in insufficient amounts of oxygen being carried through the body. This condition is called anemia, and causes patients to experience severe weakness and tiredness.

Patients may have less than the normal number of white blood cells as well. Other symptoms include fever, chills, loss of appetite and weight, easy bleeding or bruising (due to lower than normal platelet levels), bone or joint pain, headaches, vomiting, and confusion. In addition, patients with leukemia may have hepatosplenomegaly, an enlargement of the liver and spleen. Enlargement of these organs is noticed as a fullness or swelling in the abdomen, and can be felt by a doctor during a physical examination.

The occurrence of Sweet's syndrome, a rare skin disorder accompanied by fever, inflammation of the joints (arthritis), and the sudden onset of a rash, has also been associated with acute erythroblastic leukemia.

Acute erythroblastic leukemia

2008-08-19T23:27:00.000-07:00

By About Cancer

Definition

Acute erythroblastic leukemia, also called erythremic myelosis, DiGuglielmo syndrome, or erythroleukemia, results from uncontrolled proliferation of immature erythrocytes (red blood cells).

Description

Acute erythroblastic leukemia, a variant of acute myelocytic leukemia, originates in the blood and in the bone marrow. In this form of leukemia, a large number of abnormal, immature red blood cells are produced. The advanced phase is also called the blast crisis. At this stage, over 50% of the cells in the bone marrow are immature malignant cells (also called blast cells or promelocytes).

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2008-08-19T02:42:00.000-07:00

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