четверг, 4 апреля 2013 г.

Bone marrow transplant - discharge



You need to take care not to get infections for up to 1 year or more after your transplant.

Practice safe eating and drinking during cancer treatment.

Be careful what you eat. Do not eat or drink anything that may be undercooked or spoiled.
Make sure your water is safe.
Know how to cook and store foods safely.
Be careful when you eat out. Do not eat raw vegetables, meat, or fish, or anything else you are not sure is safe.
Wash your hands with soap and water often:

After being outdoors
After touching body fluids, such as mucus or blood
After changing a diaper
Before handling food
After using the telephone
After doing housework
After going to the bathroom
Keep your house clean. Stay away from crowds. Ask visitors who have a cold to wear a mask, or to not visit. Do not do yard work or handle flowers and plants.

Be careful with pets and animals.

If you have a cat, keep it inside.
Have someone else change the litter box every day.
Do not play rough with cats. Scratches and bites can get infected.
Stay away from puppies, kittens, and other very young animals.
Ask your doctor what vaccines you may need and when to get them.

Self-care

Know how to care for your central venous line or PICC line.

If your doctor or nurse tells you your platelet count is low, learn how to prevent bleeding during cancer treatment.

Start to walk. Slowly increase how far you go based on how much energy you have.

You need to eat enough protein and calories to keep your weight up.

Ask your doctor about liquid food supplements. These can help you get enough calories and nutrition.

Be very careful about being in the sun. Wear a hat with a wide brim. Use sunscreen with SPF 30 or higher on any exposed skin. Do not smoke.

Follow-up

You will need close follow-up care from your transplant doctor and nurse for at least 3 months.

When to Call the Doctor

If you have any of these symptoms, call your doctor:

Diarrhea that does not go away or is bloody
Severe nausea, vomiting, or loss of appetite
Inability to eat or drink
Extreme weakness
Redness, swelling, or draining from any place where you have an IV line inserted into your body
Pain in your stomach area
Fever, chills, or sweats. These may be signs of infection.
A new skin rash or blisters
Jaundice (the white part of eyes or skin looks yellow)
A very bad headache or a headache that does not go away
A cough that is getting worse
Trouble breathing when you are at rest or when you are doing simple tasks
Burning when you urinate
Alternate Names

Transplant - bone marrow - discharge; Stem cell transplant - discharge; Hematopoietic stem cell transplant - discharge; Reduced intensity, non-myeloablative transplant - discharge; Mini transplant - discharge; Allogenic bone marrow transplant - discharge; Autologous bone marrow transplant - discharge; Umbilical cord blood transplant - discharge

References

National Cancer Institute. Chemotherapy and you: support for people who have cancer (PDQ). June Accessed May 11, 2012.

Vose JM. Hematopoietic stem cell transplantation. In: Goldman L, Ausiello D. Goldman: Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 181.

Update Date: 6/5/2012

Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

Leukemia


Leukemia is a type of blood cancer that begins in the bone marrow. Bone marrow is the soft tissue in the center of the bones, where blood cells are produced.

The term "leukemia" means "white blood." White blood cells (leukocytes) are used by the body to fight off infections and other foreign substances. They are made in the bone marrow.

Leukemia leads to an uncontrolled increase in the number of white blood cells.

The cancerous cells prevent healthy red cells, platelets, and mature white cells (leukocytes) from being made. Life-threatening symptoms may then develop.

The cancer cells spread to the bloodstream and lymph nodes. They can also travel to the brain and spinal cord (the central nervous system) and other parts of the body.

Leukemias are divided into two major types:

Acute (which progresses quickly)
Chronic (which progresses more slowly)
For information about a specific type of leukemia, see the following:

Acute lymphocytic leukemia (ALL)
Acute myelogenous leukemia (AML)
Chronic lymphocytic leukemia (CLL)
Chronic myelogenous leukemia (CML)
Hairy cell leukemia
For information about leukemia support groups, see: Leukemia resources

References

Appelbaum FR. The acute leukemias. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 189.

Kantarjian H, O'Brien S. The chronic leukemias. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 190.

Update Date: 2/7/2012

Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

Testicular cancer


Testicular cancer is cancer that starts in the testicles, the male reproductive glands located in the scrotum.

Causes

The exact cause of testicular cancer is unknown. There is no link between vasectomy and testicular cancer. Factors that may increase a man's risk for testicular cancer include:

Abnormal testicle development
History of testicular cancer
History of undescended testicle
Klinefelter syndrome
Other possible causes include exposure to certain chemicals and HIV infection. A family history of testicular cancer may also increase risk.

Testicular cancer is the most common form of cancer in men between the ages of 15 and 35. It can occur in older men, and rarely, in younger boys.

White men are more likely than African-American and Asian-American men to develop this type of cancer.

There are two main types of testicular cancer: seminomas and nonseminomas. These cancers grow from germ cells, the cells that make sperm.

Seminoma: This is a slow-growing form of testicular cancer usually found in men in their 30s and 40s. The cancer is usually just in the testes, but it can spread to the lymph nodes. Seminomas are very sensitive to radiation therapy.

Nonseminoma: This more common type of testicular cancer tends to grow more quickly than seminomas. Nonseminoma tumors are often made up of more than one type of cell, and are identified according to these different cell types:

Choriocarcinoma (rare)
Embryonal carcinoma
Teratoma
Yolk sac tumor
A stromal tumor is a rare type of testicular tumor. They are usually not cancerous. The two main types of stromal tumors are Leydig cell tumors and Sertoli cell tumors. Stromal tumors usually occur during childhood.

Symptoms

There may be no symptoms. Symptoms that may occur can include:

Discomfort or pain in the testicle, or a feeling of heaviness in the scrotum
Pain in the back or lower abdomen
Enlargement of a testicle or a change in the way it feels
Excess development of breast tissue (gynecomastia), however, this can occur normally in adolescent boys who do not have testicular cancer
Lump or swelling in either testicle
Symptoms in other parts of the body, such as the lungs, abdomen, pelvis, back, or brain, may also occur if the cancer has spread.

Exams and Tests

A physical examination typically reveals a firm lump (mass) in one of the testicles. When the health care provider holds a flashlight up to the scrotum, the light does not pass through the lump.

Other tests include:

Abdominal and pelvic CT scan
Blood tests for tumor markers: alpha fetoprotein (AFP), human chorionic gonadotrophin (beta HCG), and lactic dehydrogenase (LDH)
Chest x-ray
Ultrasound of the scrotum
An examination of the tissue is usually done after the entire testicle is surgically removed.

Treatment

Treatment depends on the:

Type of testicular tumor
Stage of the tumor
Once cancer is found, the first step is to determine the type of cancer cell by examining it under a microscope. The cells can be seminoma, nonseminoma, or both.

The next step is to determine how far the cancer has spread to other parts of the body. This is called "staging."

Stage I cancer has not spread beyond the testicle.
Stage II cancer has spread to lymph nodes in the abdomen.
Stage III cancer has spread beyond the lymph nodes (it could be as far as the liver, lungs, or brain).
Three types of treatment can be used.

Surgical treatment removes the testicle (orchiectomy) and may also remove nearby lymph nodes (lymphadenectomy). This is usually performed in the case of both seminoma and nonseminomas.
Radiation therapy using high-dose x-rays or other high-energy rays may be used after surgery to prevent the tumor from returning. Radiation therapy is usually only used for treating seminomas.
Chemotherapy uses drugs such as cisplatin, bleomycin, and etoposide to kill cancer cells. This treatment has greatly improved survival for patients with both seminomas and nonseminomas.
Support Groups

Joining a support group where members share common experiences and problems can often help the stress of illness. Your local branch of the American Cancer Society may have a support group. See: www.cancer.org for more information.

The National Cancer Institute website also provides further information: www.cancer.gov

Outlook (Prognosis)

Testicular cancer is one of the most treatable and curable cancers.

The survival rate for men with early-stage seminoma (the least aggressive type of testicular cancer) is greater than 95%. The disease-free survival rate for Stage II and III cancers is slightly lower, depending on the size of the tumor and when treatment is begun.

Possible Complications

Testicular cancer may spread to other parts of the body. The most common sites include the:

Abdomen
Lungs
Retroperitoneal area (the area near the kidneys behind the other organs in the belly area)
Spine
Complications of surgery can include:

Bleeding and infection after surgery
Infertility (if both testicles are removed)
If you are of childbearing age, ask your doctor about methods to save your sperm for use at a later date.

When to Contact a Medical Professional

Call your health care provider if you have symptoms of testicular cancer.

Prevention

The United States Preventive Services Task Force recommends against routine screening for testicular cancer because there is no known effective screening technique. This recommendation does not apply if there is a personal history of an undescended testicle.

Alternative Names

Cancer - testes; Germ cell tumor; Seminoma testicular cancer; Nonseminoma testicular cancer

References

Einhorn LH. Testicular cancer. In Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 206.

National Comprehensive Cancer Network. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology:Testicular cancer. 2012. Version 1.2012.

Iontophoresis


Iontophoresis is the passage of an electrical current onto the skin. Iontophoresis has a variety of uses in medicine. This article discusses the use of iontophoresis to decrease sweating by turning off a sweat gland or glands.

Description
The area to be treated is placed into water. A gentle current of electricity passes through the water. A technician carefully and gradually increases the electrical current until you feel a light tingling sensation.

The therapy lasts about 10-20 minutes and requires several sessions.

How iontophoresis works isn't exactly known, but it's thought that the process somehow plugs the sweat glands and temporarily prevents you from sweating.

Iontophoresis units are also available for home use.

Why the Procedure is Performed
Iontophoresis may be used to treat excessive sweating (hyperhidrosis) of the hands, underarms, and feet. Iontophoresis has been effectively used to treat such sweating since the early 1950s.

Risks
Side effects are rare but may include skin irritation, dryness and blistering.

References
Thomas I. Palmoplantar hyperhidrosis: a therapeutic challenge. Am Fam Physician. Mar 1 2004; 69(5): 1117-20.

Goetz, CG. Textbook of Clinical Neurology. 2nd ed. St. Louis, Mo: WB Saunders; 2003.

Update Date: 5/13/2011
Updated by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Gastric cancer


Gastric cancer is cancer that starts in the stomach.

Causes
Several types of cancer can occur in the stomach. The most common type is called adenocarcinoma. It starts from one of the common cell types found in the lining of the stomach.

This article focuses on adenocarcinoma of the stomach.

Adenocarcinoma of the stomach is a common cancer of the digestive tract worldwide. It is uncommon in the United States. It occurs most often in men over age 40. This form of gastric cancer is common in eastern Asia, parts of South America, and eastern and central Europe.

The number of people in the United States who get this cancer has gone down over the years. Experts think the decrease may be because people are eating less salted, cured, and smoked foods.

You are more likely to get gastric cancer if you:

Have a family history of gastric cancer
Have an infection of the stomach by bacteria called Helicobacter pylori
Had a polyp larger than 2 centimeters in your stomach
Have inflammation and swelling of the stomach for a long time (chronic atrophic gastritis)
Have pernicious anemia
Smoke
Symptoms
Abdominal fullness or pain, which may occur after a small meal
Dark stools
Difficulty swallowing, which becomes worse over time
Excessive belching
General decline in health
Loss of appetite
Nause
Vomiting blood
Weakness or fatigue
Weight loss
Exams and Tests
Diagnosis is often delayed because symptoms may not occur in the early stages of the disease. Or, patients may self-treat symptoms that gastric cancer has in common with other, less serious gastrointestinal disorders (bloating, gas, heartburn, and fullness).

Tests that can help diagnose gastric cancer include:

Complete blood count (CBC) to check for anemia.
Esophagogastroduodenoscopy (EGD) with biopsy to examine the stomach tissue. EGD involves putting a tiny camera down the esophagus (food tube) to look at the inside of the stomach.
Stool test to check for blood in the stools.
Treatment
Surgery to remove the stomach (gastrectomy) is the only treatment that can cure the gastric adenocarcinoma. Radiation therapy and chemotherapy may help. Chemotherapy and radiation therapy after surgery may improve the chance of a cure.

For patients who cannot have surgery, chemotherapy or radiation can improve symptoms and may prolong survival, but will likely not cure the cancer. For some patients, a surgical bypass procedure may relieve symptoms.

Support Groups
You can ease the stress of illness by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone.


Outlook (Prognosis)
Outlook varies based on how much the cancer has spread by the time of diagnosis. Tumors in the lower stomach are cured more often than those in the higher stomach. Chance of a cure also depends on how far the tumor has invaded the stomach wall and whether lymph nodes are involved.

When the tumor has spread outside the stomach, a cure is not possible. In this case, the goal of treatment is to improve symptoms.

When to Contact a Medical Professional
Call your health care provider if symptoms of gastric cancer develop.

Prevention
Screening programs are successful in detecting disease in the early stages in parts of the world where the risk of gastric cancer is much higher than in the United States. The value of screening in the United States and other countries with lower rates of gastric cancer is not clear.

The following may help reduce your risk of gastric cancer:

Do not smoke.
Eat a healthy foods rich in fruits and vegetables.
Take medicines to treat reflux disease (heartburn), if you have it.
Take antibiotics if you are diagnosed with H. pylori infection.
Alternative Names
Cancer - stomach; Stomach cancer; Gastric carcinoma; Adenocarcinoma of the stomach

References
Gunderson LL, Donohue JH, Alberts SR. Cancer of the stomach. In: Abeloff MD, Armitage JO, Niederhuber JE et al., eds. Abeloff's Clinical Oncology. 4th ed. Philadelphia, PA: Elsevier Churchill-Livingstone; 2008:chap 79.

Rustgi AK. Neoplasms of the esophagus and stomach. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 198.

National Cancer Institute. PDQ Gastric cancer treatment. Bethesda, MD: National Cancer Institute. Date last modified 12/23/2011. Available at: http://cancer.gov/cancertopics/pdq/treatment/isletcell/HealthProfessional. Accessed November 16, 2012.

Update Date: 11/17/2012
Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

Hodgkin’s lymphoma



Hodgkin's lymphoma is a cancer of lymph tissue found in the lymph nodes, spleen, liver, bone marrow, and other sites.

Causes
The cause is not known. Hodgkin's lymphoma is most common among people ages 15 - 35 and 50 - 70. Past infection with the Epstein-Barr virus (EBV) is thought to contribute to some cases. Patients with HIV infection are more at risk than the general population.

Symptoms
Fatigue
Fever and chills that come and go
Itching all over the body that cannot be explained
Loss of appetite
Soaking night sweats
Painless swelling of the lymph nodes in the neck, armpits, or groin (swollen glands)
Weight loss that cannot be explained
Other symptoms that may occur with this disease:

Coughing, chest pains, or breathing problems if there are swollen lymph nodes in the chest
Excessive sweating
Pain or feeling of fullness below the ribs due to swollen spleen or liver
Pain in lymph nodes after drinking alcohol
Skin blushing or flushing
Note: Symptoms caused by Hodgkin's lymphoma may also occur also with other conditions. Talk to your doctor about the meaning of your specific symptoms.

Exams and Tests
The first sign of Hodgkin's lymphoma is often a swollen lymph node, which appears without a known cause. The disease can spread to nearby lymph nodes. Later it may spread to the spleen, liver, bone marrow, or other organs.

The disease may be diagnosed after:

Biopsy of suspected tissue, usually a lymph node biopsy
Bone marrow biopsy
If tests reveal that you do have Hodgkin's lymphoma, more tests will be done to see if the cancer has spread. This is called staging. Staging helps guide treatment and follow-up, and gives you some idea of what to expect in the future.

The following procedures will usually be done:

Blood chemistry tests including protein levels, liver function tests, kidney function tests, and uric acid level
Bone marrow biopsy
CT scans of the chest, abdomen, and pelvis
Complete blood count (CBC) to check for anemia and white blood count
PET scan
Some people may need abdominal surgery to take out a piece of the liver and remove the spleen. However, because the other tests are now so good at detecting the spread of Hodgkin's lymphoma, this surgery is usually not needed.

Treatment
Treatment depends on the following:

The type of Hodgkin's lymphoma (most people have classic Hodgkin's)
The stage (where the disease has spread)
Whether the tumor is more than 4 inches (10 cm) wide
Your age and other medical issues
Other factors, including weight loss, night sweats, and fever
Tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future. Staging is needed to determine your treatment plan. Stages of Hodgkin's lymphoma range from I to IV. The higher the staging number, the more advanced the cancer.

Treatment depends on your age and stage of the cancer.

Stages I and II (limited disease) can be treated with radiation therapy, chemotherapy, or both.
Stage III is treated with chemotherapy alone, or a combination of radiation therapy and chemotherapy.
Stage IV (extensive disease) is most often treated with chemotherapy alone.
People with Hodgkin's lymphoma that returns after treatment or does not respond to the first treatment may receive high-dose chemotherapy. That is followed by an autologous stem cell transplant (using stem cells from yourself).

What other treatments you have depend on your symptoms, but may include:

Transfusion of blood products, such as platelets or red blood cells, to fight low platelet counts and anemia
Antibiotics to fight infection, especially if a fever occurs
Support Groups
You can often ease the stress of illness by joining a support group of people who share common experiences and problems. See: Cancer - support group

Outlook (Prognosis)
Hodgkin's disease is considered one of the most curable forms of cancer, especially if it is diagnosed and treated early. Unlike other cancers, Hodgkin's disease is often very curable, even in its late stages.

With the right treatment, more than 90% of people with stage I or II Hodgkin's lymphoma survive for at least 10 years. If the disease has spread, the treatment may be more intense. However, 90% of people with advanced disease survive for at least 5 years.

Patients who survive 15 years after treatment are more likely to later die from other causes, including complications of the treatment, rather than from Hodgkin's disease.

People with Hodgkin's lymphoma whose disease returns within a year after treatment or who do not respond to the first treatment have a poorer outlook.

You will need to have regular exams and imaging tests for years after your treatment. This helps your doctor check for signs of the cancer returning, and for any long-term treatment effects.

Possible Complications
Treatments for Hodgkin's lymphoma can have complications. Long-term complications of chemotherapy or radiation therapy include:

Bone marrow diseases (such as leukemia)
Heart disease
Inability to have children (infertility)
Lung problems
Other cancers
Thyroid problems
Chemotherapy can cause low blood cell counts, which can lead to an increased risk of bleeding, infection, and anemia. To reduce bleeding, apply ice and pressure. Use a soft toothbrush and electric razor for personal hygiene.

Always take an infection seriously during cancer treatments. Contact your doctor right away if you develop fever or other signs of infection, especially if your white blood cell counts are low due to treatment. Planning rest periods during your daily activities may help prevent fatigue due to anemia.

When to Contact a Medical Professional
Call your health care provider if:

You have symptoms of Hodgkin's lymphoma
You have Hodgkin's lymphoma and you have side effects from the treatment
Alternative Names
Lymphoma - Hodgkin's; Hodgkin's disease; Cancer - Hodgkin's lymphoma

References
Eichenauer DA, Engert A, Dreyling M. ESMO Guidelines Working Group: Hodgkin's lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatmetn and follow-up. Ann Oncol. 2011 Sep 22 Suppl 6:vi55-58.

Horning SJ. Hodgkin's lymphoma. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 111.

Armitage JO. Early-stage Hodgkin's lymphoma. N Engl J Med. 2010 Aug 12;363(7):653-62.

Update Date: 2/7/2012
Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Inc.

Cancer



Cancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.

Causes
Cancer grows out of normal cells in the body. Normal cells multiply when the body needs them, and die when the body doesn't need them. Cancer appears to occur when the growth of cells in the body is out of control and cells divide too quickly. It can also occur when cells forget how to die.

There are many different kinds of cancer. Cancer can develop in almost any organ or tissue, such as the lung, colon, breast, skin, bones, or nerve tissue.

There are many causes of cancer, including:

Benzene and other chemicals
Drinking excess alcohol
Environmental toxins, such as certain poisonous mushrooms and a type of poison that can grow on peanut plants (aflatoxins)
Excessive sunlight exposure
Genetic problems
Obesity
Radiation
Viruses
However, the cause of many cancers remains unknown.

The most common cause of cancer-related death is lung cancer.

The three most common cancers in men in the United States are:

Prostate cancer
Lung cancer
Colon cancer
In women in the United States, the three most common cancers are:

Breast cancer
Colon cancer
Lung cancer
Some cancers are more common in certain parts of the world. For example, in Japan, there are many cases of stomach cancer, but in the United States, this type of cancer is unusual. Differences in diet or environmental factors may play a role.

Some other types of cancers include:

Brain cancer
Cervical cancer
Hodgkin's lymphoma
Kidney cancer
Leukemia
Liver cancer
Non-Hodgkin's lymphoma
Ovarian cancer
Skin cancer
Testicular cancer
Thyroid cancer
Uterine cancer
Symptoms
Symptoms of cancer depend on the type and location of the cancer. For example, lung cancer can cause coughing, shortness of breath, or chest pain. Colon cancer often causes diarrhea, constipation, and blood in the stool.

Some cancers may not have any symptoms at all. In certain cancers, such as pancreatic cancer, symptoms often do not start until the disease has reached an advanced stage.

The following symptoms can occur with most cancers:

Chills
Fatigue
Fever
Loss of appetite
Malaise
Night sweats
Weight loss
Exams and Tests
Like symptoms, the signs of cancer vary based on the type and location of the tumor. Common tests include the following:

Biopsy of the tumor
Blood tests (which look for chemicals such as tumor markers)
Bone marrow biopsy (for lymphoma or leukemia)
Chest x-ray
Complete blood count (CBC)
CT scan
Liver function tests
MRI scan
Most cancers are diagnosed by biopsy. Depending on the location of the tumor, the biopsy may be a simple procedure or a serious operation. Most patients with cancer have CT scans to determine the exact location and size of the tumor or tumors.

A cancer diagnosis is difficult to cope with. It is important, however, that you discuss the type, size, and location of the cancer with your doctor when you are diagnosed. You also will want to ask about treatment options, along with their benefits and risks.

It's a good idea to have someone with you at the doctor's office to help you get through the diagnosis. If you have trouble asking questions after hearing about your diagnosis, the person you bring with you can ask them for you.

Treatment
Treatment varies based on the type of cancer and its stage. The stage of a cancer refers to how much it has grown and whether the tumor has spread from its original location.

If the cancer is confined to one location and has not spread, the most common treatment approach is surgery to cure the cancer. This is often the case with skin cancers, as well as cancers of the lung, breast, and colon.
If the tumor has spread to local lymph nodes only, sometimes these can be removed.
If surgery cannot remove all of the cancer, the options for treatment include radiation, chemotherapy, or both. Some cancers require a combination of surgery, radiation, and chemotherapy.
Lymphoma, or cancer of the lymph glands, is rarely treated with surgery. Chemotherapy and radiation therapy are most often used to treat lymphoma.
Although treatment for cancer can be difficult, there are many ways to keep up your strength.

If you have radiation treatment, know that:

Radiation treatment is painless.
Treatment is usually scheduled every weekday.
You should allow 30 minutes for each treatment session, although the treatment itself usually takes only a few minutes.
You should get plenty of rest and eat a well-balanced diet during the course of your radiation therapy.
Skin in the treated area may become sensitive and easily irritated.
Side effects of radiation treatment are usually temporary. They vary depending on the area of the body that is being treated.
If you are going through chemotherapy, you should eat right. Chemotherapy causes your immune system to weaken, so you should avoid people with colds or the flu. You should also get plenty of rest, and don't feel as though you have to accomplish tasks all at once.

It will help you to talk with family, friends, or a support group about your feelings. Work with your health care providers throughout your treatment. Helping yourself can make you feel more in control.

Support Groups
The diagnosis and treatment of cancer often causes a lot of anxiety and can affect a person's entire life. There are many resources for cancer patients.

See: Cancer resources

Outlook (Prognosis)
The outlook depends on the type of cancer and the stage of the cancerr when diagnosed.

Some cancers can be cured. Other cancers that are not curable can still be treated effectively. Some patients can live for many years with cancer. Other tumors are quickly life threatening.

Possible Complications
Complications depend on the type and stage of cancer. The cancer may spread.

When to Contact a Medical Professional
Contact your health care provider if you develop symptoms of cancer.

Prevention
You can reduce the risk of getting a cancerous (malignant) tumor by:

Eating a healthy diet
Exercising regularly
Limiting alcohol
Maintaining a healthy weight
Minimizing your exposure to radiation and toxic chemicals
Not smoking or chewing tobacco
Reducing sun exposure, especially if you burn easily
Cancer screenings, such as mammography and breast examination for breast cancer and colonoscopy for colon cancer, may help catch these cancers at their early stages when they are most treatable. Some people at high risk for developing certain cancers can take medication to reduce their risk.

Alternative Names
Carcinoma; Malignant tumor

References
Moscow JA, Cowan KH. Biology of cancer. In Goldman L, SchaferAI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 185.

Thun MJ, Jemal A. Epidemiology of cancer. In Goldman L,Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 183.

Update Date: 9/3/2012
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

Atrial myxoma



An atrial myxoma is a noncancerous tumor in the upper left or right side of the heart. It grows on the wall that separates the two sides of the heart. This wall is called the atrial septum.

Causes
A myxoma is a primary heart (cardiac) tumor. This means that the tumor started within the heart. Most heart tumors start somewhere else.

Primary cardiac tumors are rare. Myxomas are the most common type of these rare tumors. About 75% of myxomas occur in the left atrium of the heart, usually beginning in the wall that divides the two upper chambers of the heart. The rest are in the right atrium. Right atrial myxomas are sometimes associated with tricuspid stenosis and atrial fibrillation.

Myxomas are more common in women. About 1 in 10 myxomas are passed down through families (inherited). Such tumors are called familial myxomas. They tend to occur in more than one part of the heart at a time, and often cause symptoms at a younger age.

Symptoms
Symptoms may occur at any time, but most often they go along with a change in body position.

Symptoms of a myxoma may include:

Breathing difficulty when lying flat
Breathing difficulty when asleep
Chest pain or tightness
Dizziness
Fainting
Sensation of feeling your heart beat (palpitations)
Shortness of breath with activity
The symptoms and signs of left atrial myxomas often mimic mitral stenosis. Right atrial myxomas rarely produce symptoms until they have grown to be at least 5 inches wide.

Other symptoms may include:

Blueness of skin, especially the fingers (Raynaud's phenomenon)
Cough
Curvature of nails accompanied with soft tissue swelling (clubbing) of the fingers
Fever
Fingers that change color upon pressure or with cold or stress
General discomfort (malaise)
Losing weight without trying
Joint pain
Swelling - any part of the body
Exams and Tests
The doctor or nurse will perform a physical exam and listen to your heart using a tool called a stethoscope. Abnormal heart sounds or a murmur may be heard. These sounds may change when you change body position.

Imaging tests may include:

Chest x-ray
CT scan of chest
ECG
Echocardiogram
Doppler study
Heart MRI
Left heart angiography
Right heart angiography
Blood tests:

A complete blood count may show anemia and increased white blood cells. The erythrocyte sedimentation rate (ESR) is increased.

Treatment
Surgery is needed to remove the tumor. Some patients will also need their mitral valve replaced. This can be done during the same surgery.

Myxomas may come back if surgery did not remove all of the tumor cells.

Outlook (Prognosis)
Although a myxoma is not cancer, complications are common.

Untreated, a myxoma can lead to an embolism (tumor cells breaking off and traveling with the bloodstream), which can block blood flow or cause the tumor to grow in another part of the body. Pieces of the tumor can move to the brain, eye, or limbs.

If the tumor grows inside the heart, it can block blood flow. This may require emergency surgery to prevent sudden death.

Possible Complications
Arrhythmias
Pulmonary edema
Peripheral emboli
Spread (metastasis) of the tumor
Blockage of the mitral heart valve
References
McManus B. Primary tumors of the heart. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap74.

McKenna W. Diseases of the myocardium and endocardium. In:Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 60.

Update Date: 6/7/2012
Updated by: Glenn Gandelman, MD, MPH, FACC Assistant Clinical Professor of Medicine at New York Medical College, and in private practice specializing in cardiovascular disease in Greenwich, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.