cancer

Spotting Leukemia Early

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by Oncologic Advisors

Spotting leukemia early on can be key in a patient’s fight against it. Diagnosing cancer early can have a significant impact on your chances of survival, response to treatment, and even your quality of life during treatment. (News Medical)

Unfortunately, in many cases spotting leukemia early can be difficult. People in the early stages of leukemia often show no obvious symptoms. So how can you tell early on if you or a loved one has leukemia? Read on for our tips on how to spot leukemia early.

What Is Leukemia?

Leukemia is a cancer of the blood. It’s the result of the DNA of a single cell in the bone marrow becoming damaged (which is also known as a mutation).

Unlike other cancers, it doesn’t produce a tumor but instead causes overproduction of abnormal white blood cells. Since white blood cells are meant to fight infection, abnormal leukemia cells aren’t up to that crucial task.

Hundreds of billions of new blood cells are produced in your bone marrow each day, which provides your body with a constant supply of fresh, healthy blood cells. In large numbers, leukemia cells begin to interfere with the production of other blood cells (Cleveland Clinic).

How Common Is Leukemia?

Even though it’s often considered a disease of children, leukemia affects far more adults. The frequency of certain types of leukemia actually increases with age (Cleveland Clinic). With nearly 30,000 cases diagnosed in the U.S. each year, it truly is important to learn what the warning signs are and catch leukemia early.

Symptoms and How to Catch It:

As we mentioned earlier, many patients with leukemia don’t exhibit any symptoms early on. Particularly in patients with chronic leukemia types, there can be no symptoms at first or just a slow development of symptoms over a long period of time.

In acute leukemia types, patients often very suddenly develop symptoms within a matter of days. It is very common for leukemia diagnoses to be made as an emergency.

Spotting Leukemia based on the following symptoms:
  • Anemia is caused by having a lower than necessary count of red blood cells, which slows down the delivery of oxygen to the body’s organs and muscles. It can cause a pale complexion and lack of energy in patients.
  • Bleeding can occur in a patient’s gums or nose, or in stool or urine.
  • Bruises may develop from very minor bumps.
  • Small spots of discoloration called petechiae may form under the skin.
  • Patients may be more susceptible to infections like a sore throat or bronchial pneumonia. A headache, or low-grade fever, mouth sores, or skin rash may accompany these infections. (Cleveland Clinic)
  • Coughing and trouble breathing can occur when certain types of leukemia cause swelling in structures in the chest, like lymph nodes or the thymus (a small organ in front of the trachea, the breathing tube that leads to the lungs). These enlarged structures can then press on the trachea, causing coughing or even trouble breathing. In some cases where the white blood cell count is unusually high, the leukemia cells can build up in the small blood vessels in the lungs, which can also cause trouble breathing.
  • Swelling of the face and arms can also be the result of an enlarged thymus. It can press on the SVC (the superior vena cava, a large vein that carries blood from the head and arms back to the heart). When this happens, it is called SVC Syndrome, which can be life-threatening, so it should be treated immediately. It can cause swelling in the face, neck, arms, and upper chest (sometimes with a bluish-red skin color). It can also cause headaches, dizziness, and a change in consciousness if it affects the brain. (American Cancer Society)
  • Swollen lymph nodes can also be a sign of spotting leukemia. Lymph nodes are small, bean-sized structures that contain clusters lymphocytes. Swollen nodes may be seen or felt as lumps under the skin in areas of the body like the sides of the neck, underarm areas, above the collarbone, or in the groin. Lymph nodes inside the chest or abdomen can also swell, but these can only be seen on imaging tests.
  • Headache, seizures, and vomiting can occur sometimes in children when the leukemia has already spread to the brain and spinal cord by the time it is diagnosed. Once it has reached the brain and spinal cord, leukemia symptoms can also include trouble concentrating, weakness, problems with balance, and blurred vision. (American Cancer Society)
  • A fever that lasts for more than 1 to 2 weeks can also be a warning sign of leukemia.
  • General loss of well-being may also occur in patients with undiagnosed leukemia. Patients may have loss of appetite and weight and a feeling of weakness or fatigue all the time. This sign can be especially hard to spot, since the symptoms are the same symptoms of just living a busy life.
Why Are People Delaying Diagnoses?

You may be surprised to learn that in most cases (83% of them, according to a recent survey) patients with these symptoms don’t expect them to be the warning signs for cancer. That 83% of patients reported that they wrote the symptoms off as part of getting older or just the consequences of a busy lifestyle.

A few of the symptoms above are more likely to be caused by something other than leukemia, so it can be easy to dismiss them. Especially if they develop slowly over time, which they sometime do. (American Cancer Society).

One teen in Pennsylvania went a full month playing varsity soccer with undiagnosed leukemia. Schyler Herman was a goalie, so she typically had lots of collisions with the ball and other players, but her parents noticed that she was getting unusually deep bruises from the hits.

She was in a game that went into double overtime one night when another player accidentally kicked her in the calf. A deep hematoma formed, and her parents took her to the emergency room the next day where the X-rays came back negative for a fracture, but Schyler still felt pain.

She went in for more blood work and once the results were in, the doctors suggested she see an oncologist, because they believed she had leukemia. Her blood levels were actually so critical that Schyler was rushed to the Children’s Hospital in Philadelphia for immediate treatment. Schyler couldn’t believe it — she’d been having headaches for the past month and was always fatigued, but she attributed that to the consequences of being an athlete. (Pocono Record)

Even with the symptoms present, it can seem crazy to jump to the conclusion that it’s leukemia that you have. Still, in many cases it is.

How Can You Protect Yourself?

Obviously you can’t assume that every headache and cough will lead to spotting leukemia. Still, there is one major step you can take in protecting yourself:

Often when patients go to their doctor with these symptoms, they either decline to take a blood test or their doctor doesn’t even offer it. Generally a blood test is enough to indicate the diagnosis, but often patients will go weeks (and in some cases even months) without getting a blood test. Instead they’re given antibiotics for the infections or pain killers to relieve the pain, but since they aren’t given a blood test, they’re just putting bandaids on the symptoms without finding the cause. (News Medical)

Which is why if you notice any of these symptoms, you should request a blood test to confirm that the cause isn’t a larger problem, like leukemia.

Sources

http://www.poconorecord.com/news/20171016/pv-freshman-goalkeeper-battles-leukemia

https://www.cancer.org/cancer/leukemia-in-children/detection-diagnosis-staging/signs-and-symptoms.html

https://my.clevelandclinic.org/health/articles/leukemia

https://www.news-medical.net/health/The-importance-of-spotting-leukemia-.aspx

Spotting Leukemia

Can IMRT be the cure for a cancer that was thought to be incurable?

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by Oncologic Advisors

There is new hope for some patients with prostate cancer, thanks to a joint study by the Institute of Cancer Research in London and the UK’s leading cancer hospital, the Royal Marsden. The study found that a treatment option called IMRT could cure thousands of men whose disease was before thought to be incurable.

For patients with prostate cancer, the following treatment options are usually advised (depending on how far the cancer has spread and how aggressive it is):
– Hormonal treatment
– Surgery
– Radiotherapy
– A combination of the above treatments

When a patient’s cancer spreads too far (meaning it spreads to the lymph nodes near the pelvis) doctors typically advise against radiation therapy, since radiation in that area can cause damage to the bowel, which could then prove to be fatal. (Telegraph)

So What is IMRT?

IMRT stands for Intensity Modulated Radiation Therapy. It’s a highly targeted form of radiation therapy that the Royal Marsden’s study claims can successfully eliminate cancer without causing fatal damage to surrounding organs.

For the treatment, your doctor uses a computer to plan the exact dose of radiation that will be aimed at the cancer. The computer then uses information about the size, shape, and location of the tumor to determine how much radiation is needed to kill the cancer cells.

The treatment uses the high amounts of radiation that are necessary to completely kill prostate cancer cells while still protecting the healthy cells that surround them. (UCLA) So IMRT can potentially be a safe option for patients whose cancer has spread to the pelvis.

Some newer radiation machines also have imaging scanners built into them to allow the doctor to take pictures of the prostate and make minor adjustments in aiming just before giving the radiation. This is called “image guided radiation therapy” or IGRT. It can help deliver radiation even more precisely, which could result in fewer side effects from the radiation. (American Cancer Society)

If you are considering going through IMRT, be sure to ask your physician about whether or not these additional options can be available to you.

Potential Side Effects of IMRT

Short term side effects of radiation can include:
– Skin damage (like a severe sunburn)
– Temporary diarrhea
– Rectal pain

Some possible long-term side effects can include:
– Painful or frequent urination
– Loose bowels
– Impotence

These problems could develop six months or more after the treatment ends and may be permanent. (Genomic Health) Again, be sure to consult your physician about the likelihood of these side effects and if there are options to help prevent them.

About the Study:

In the study mentioned above by the Institute of Cancer Research in London and the Royal Marsden, 447 men were treated with IMRT and monitored for five years. When the trail began in 2000, many of the patients were considered incurable.

The object of the study was to look at the long term effects of IMRT treatment as well as whether or not it could be used to treat those patients who were considered incurable before.

Study leader David Dearnaley, a professor of uro-oncology at the ICR and consultant clinical oncologist at the Royal Marsden said, “Our trial was one of the first of this revolutionary radiotherapy technique, which was pioneered by colleagues here at the ICR and The Royal Marsden.”

71% of the patients were alive and completely cancer free at the end of the five years. Just between eight and 16% of the patients in the trial suffered from issues with their bladder or bowel.

Ultimately, the trial found that IMRT can in fact be safely given to cancer cells that have spread to the pelvis to help stop the disease from spreading further.

Dearnaley calls the technique a “game-changer” for men with prostate cancer and says, “The work done here has already been carried forward into later-stage phase II and phase III trials. I’m excited to see this treatment become available to every man with prostate cancer who could benefit from it.”

The changes in use of IMRT have caused a “complete revolution” in the way it is delivered, with doses now delivered in only two minutes.

Professor Paul Workman, chief executive of the ICR says, “Radiotherapy is often seen as perhaps old-fashioned and crude compared with other cancer treatments — but nothing could be further from the truth.” With new advances in IMRT and the findings from this study, radiotherapy is now considered a highly precise and sophisticated treatment.

“It’s great to see this long-term evidence of the degree to which precision radiotherapy has transformed outcomes for men with prostate cancer,” Workman says.

How Big of An Impact Does This Study Have?

Prostate cancer affects tens of thousands of men in the U.S. each year, and those rates are rising. In 2017 there were about 161,360 new cases of prostate cancer and about 26,730 deaths from the disease.

Most men diagnosed with prostate cancer don’t die from it. When the disease is caught early, treatment is often successful. More than 2.9 million men in the U.S. who have been diagnosed with prostate cancer at some point in their lives are still alive today.

Still, about 1 man in 7 will be diagnosed with prostate cancer in his lifetime. And often, the cancer is not caught early enough.

Prostate cancer is the third leading cause of cancer death in American men, behind lung cancer and colorectal cancer. The American Cancer Society estimates that 1 man in 39 will die of prostate cancer. (American Cancer Society)

In Conclusion:

Still, even with the new findings from this study it is important to consider your options and decide whether or not IMRT is the right treatment for you.

Dr. Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK said that the findings were promising, but also called for larger randomized trials to confirm definitive answers about the benefits of IMRT and its suitability for different cases. (Telegraph)

IMRT still may not be for every patient, but this new study does provide hope for a number of men who were once considered incurable.

Sources:

http://www.telegraph.co.uk/news/2017/09/26/prostate-cancer-treatment-could-cure-men-no-hope/

http://urology.ucla.edu/body.cfm?id=523

https://www.cancer.org/cancer/prostate-cancer/treating/radiation-therapy.html

https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html

http://www.myprostatecancertreatment.org/en-US/Home/Prostate-Cancer-Treatment-Options/Radiation-For-Prostate-Cancer

http://www.express.co.uk/life-style/health/858891/prostate-cancer-symptoms-treatment-uk

 

Cure for Lung Cancer, Prevention, and Risks

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by Oncologic Advisors

Whats the best approach to finding a cure for lung cancer that works for you? Lung cancer is the most common cause of cancer death worldwide, accounting for approximately 1.69 million deaths annually (WHO). In the U.S. alone, it accounts for approximately 225,000 new diagnoses and causes 160,000 deaths every year. While these statistics are frightening, there’s plenty of reason to have hope for a cure for lung cancer: new treatments and a general reduction in the popularity of smoking mean that lung cancer mortality rates have begun to decline in recent years (UpToDate [1]). Here we’ll discuss the most common types of lung cancer and their treatments, along with some common-sense measures you can take to reduce your personal lung cancer risk.

ABOUT LUNG CANCER

Lung cancer is a type of cancer that begins in the lungs or airways. Most lung cancers fall into two main categories: small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC). These categories refer to the specific type of cell within the lungs in which the cancer originates. Identifying the type of cancer a patient has is a critical first step to a cure for lung cancer. (UpToDate [1]).

In an advanced state, lung cancer may metastasize (spread) to other parts of the body. You may also hear your doctor refer to lung cancer as “bronchogenic carcinoma” (UpToDate [1]).

LUNG CANCER RISK AND PREVENTION

You may be wondering if it’s possible to prevent lung cancer; for many people, the answer is yes. While some cases may be influenced by genetic factors or other pre-existing health conditions (such as HIV or pulmonary fibrosis), most lung cancers are caused by smoking, environmental toxins, and other external lifestyle factors (UpToDate [1]).

Smoking isn’t the only cause of lung cancer, but it is by far the leading one. An estimated 90 percent of all lung cancers are presumed to be caused by smoking, and smoking one pack a day over the course of 40 years increases your risk of developing lung cancer by 20 percent over someone who has never smoked. In short, your lung cancer risk increases the more frequently you smoke and the longer you smoke. The most effective way to reduce your personal lung cancer risk is to avoid smoking (UpToDate [1]).

Cigars, pipes, and menthol or “light” cigarettes are not safe alternatives to smoking traditional cigarettes, and smoking these products also puts you at risk for lung cancer. Secondhand smoke also presents a significant risk, and accounts for over 7,000 lung cancer deaths amongst nonsmokers every year (American Cancer Society [1]).

The good news is that you can radically reduce your chances of developing lung cancer by quitting smoking, even if you’ve been a smoker for many years. The longer you abstain, the greater the benefit; some studies indicate that former smokers saw an 80-90 percent reduction in their risk after remaining smoke-free for 15 years or more (UpToDate [2]). The American Cancer Society offers a wealth of resources if you or someone you love is trying to quit; call at 1-800-227-2345 for more information (American Cancer Society [2]).

Exposure to asbestos, radon, and diesel exhaust at home or work may also increase your chances of developing lung cancer. If you have to work around hazardous agents, be sure to carefully observe all recommended safety protocols in order to minimize your risk.

WHAT ARE THE SYMPTOMS OF LUNG CANCER?

As with most cancers, an early diagnosis will improve the prognosis for lung cancer patients. Unfortunately, many lung cancer cases go undetected until they are quite advanced, which makes them more difficult to treat. Many people don’t experience symptoms in the early stages of the disease, or may write them off as symptoms of other, more benign illnesses. For example, a habitual smoker may experience a persistent cough and presume it to be a natural side-effect of smoking (American Cancer Society [1]).

Chest pain, a cough, hemoptysis (coughing up blood), dyspnea (shortness of breath), and hoarseness in the voice may signal lung cancer. If you experience any of these symptoms, don’t ignore them and see your doctor right away (UpToDate [1]).

IMMUNOTHERAPY AND OTHER TREATMENTS FOR A CURE FOR LUNG CANCER

Like every person, every case of cancer is unique. Along with an individual’s medical and family history, doctors will consider the size, location, and molecular properties of a tumor in order to devise a personalized treatment strategy for each patient. Surgery, chemotherapy, targeted radiation therapy, and targeted pharmaceuticals (like bevacizumab) may all be employed to treat lung cancer. (UpToDate [3]).

Immunotherapy – a type of therapy that utilizes the body’s own immune system to fight cancer cells – may also be used to treat some forms of lung cancer. When you are healthy, your immune system is able to detect and avoid normal cells in the body while identifying and attacking those that are invasive. Unlike diseases caused by viruses and other pathogens, cancer is caused when normal cells that belong to the body grow out of control. Therefore, cancer cells are often able to multiply unchecked because your body doesn’t recognize them as intruders.

A newer class of drugs called immune checkpoint inhibitors may be used to “turn on” the body’s natural immune response to cancer cells. These drugs activate a chemical signal (or checkpoint) on immune cells that directs them to attack malignancies and prevent them from growing. Nivolumab (Opdivo), pembrolizumab (Keytruda), and atezolizumab (Tecentriq) are all targeted immunotherapy drugs that may be used as a cure for lung cancer (American Cancer Society [3]).

If you or a loved one is fighting lung cancer, you may wish to ask your doctor about immunotherapy as a possible cure for lung cancer strategy. Don’t be afraid to seek a second opinion if you’re struggling to understand your options; a consultation from a reputable source (like OncoLogic Advisors) may help to guide you.

IN CONCLUSION

Lung cancer is one of the deadliest and most common forms of cancer, but it is also preventable. While there is still no surefire cure for lung cancer, an early diagnosis can improve a patient’s chances of survival. Promising new therapies (like targeted immunotherapy) continue to offer new hope and more options for treatment, and are helping more lung cancer patients to live longer, healthier lives.

REFERENCES

WHO (World Health Organization) Media Centre – Cancer Fact Sheet. Februrary 2017.

http://www.who.int/mediacentre/factsheets/fs297/en/

UpToDate [1] – Overview of the risk factors, pathology, and clinical manifestations of lung cancer. David E. Midthun, MD. Topic Last Updated: 3 February 2017

https://www.uptodate.com/contents/overview-of-the-risk-factors-pathology-and-clinical-manifestations-of-lung-cancer?source=search_result&search=lung%20cancer&selectedTitle=1~150

American Cancer Society [1] – Lung Cancer Detection and Early Prevention.

https://www.cancer.org/cancer/lung-cancer/prevention-and-early-detection.html

UpToDate [2] – Cigarette smoking and other possible risk factors for lung cancer. David M. Manino, MD. Topic Last Updated: May 31, 2017

https://www.uptodate.com/contents/cigarette-smoking-and-other-possible-risk-factors-for-lung-cancer?source=see_link#H21309504

American Cancer Society [2] – How to Quit Smoking or Smokeless Tobacco.

https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking.html

UpToDate [3] – Overview of the treatment of advanced non-small cell lung cancer. Rogerio C Lilenbaum, MD, FACP. Topic Last Updated: June 2, 2017.

https://www.uptodate.com/contents/overview-of-the-treatment-of-advanced-non-small-cell-lung-cancer?source=search_result&search=lung%20cancer%20treatment&selectedTitle=2~150#H9

American Cancer Society [3] – Immunotherapy for Non-Small Cell Lung Cancer.

https://www.cancer.org/cancer/non-small-cell-lung-cancer/treating/immunotherapy.html

cure for lung cancer

Seeking a Cancer Second Opinion

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by Oncologic Advisors

When you or a loved one is diagnosed with cancer, you are bombarded with endless treatment decisions. Since cancer moves fast, you may accept the treatment suggestion from your doctor and start the process to becoming cancer-free. What if there is a better treatment? What if the suggested treatment was not the optimal choice? “One in two people will be diagnosed with cancer in their lifetime. It is estimated that up to one in five of those will be misdiagnosed or mistreated, which may result in increased chances for recurrence or sub-optimal treatment, leading to unnecessary side-effects and complications” (OncoLogic Advisors). Receiving a cancer second opinion ensures you that your diagnosis is correct and your treatment plan is optimal.

Reasons to receive a cancer second opinion:
  • You want to explore all the options
  • You want to ensure your diagnosis is correct
  • You want to learn about clinical trials
  • You have a rare cancer type
  • Many options exist for your cancer type
  • Your doctor is unsure of your treatment
  • You are unsure of your doctor
  • Your doctor is not a specialist in your cancer type
  • You want to be sure you are receiving the optimal treatment
How do I receive a cancer second opinion?

It is important to let your doctor know you wish to seek a second opinion. Most doctors will even recommend a cancer second opinion doctor. Make sure your cancer second opinion doctor has the necessary credentials, board certification, training, and experience. You can find a doctor through a referral, local hospital/clinics, medical associations, American Board of Medical Specialties, American Medical Association, American College of Surgeons, American Society of Clinical Oncology, and OncoLogic Advisors.

What do I bring to my appointment?

You will be asked to bring (or send over) necessary medical records, such as tests results (blood work or imaging tests). Many times the doctor providing the cancer second opinion will request tests or procedures you have already completed, eliminating the repeat process. The cancer second opinion doctor may also request images, such as computed tomography (CT) scan and pathology slides (from biopsy).

What do I discuss in my appointment?

Make sure to listen carefully to your options and take notes during the appointment. If you do not understand the diagnosis, ask questions. It is important that you feel comfortable and confident about the information that is being discussed. Bring a family member or close friend with you to the appointment.

After the appointment:

Now that you have received a second opinion, it is time to find the optimal treatment plan. Make an appointment with your first doctor and discuss the second opinion results. If necessary, arrange for the two doctors to speak and review the case together. Seek a third opinion, if necessary.

Remember – When diagnosed with cancer, time is of the essence. Make sure you receive a timely appointment, to avoid a long interruption time before treatment. At Oncologic Advisors, we understand your time is valuable and provide fast and objective second opinions.

About our service:

OncoLogic Advisors are a group of dedicated, objective oncologists providing navigational assistance to patients who have been diagnosed with cancer. If necessary, we arrange for second or multiple opinions from leading physicians—regionally or nationwide. As objective patient advocates, our approach is revolutionary. We cast a wide net and do the analysis and research, enabling patients to make confident decisions about doctors, treatment centers, and methods of treatment.  We review the risks and benefits of each of those treatments—all while providing support and guidance through each decision point—from work-up and beyond. We prepare patients to ask relevant and necessary questions during their doctor visits. Our current healthcare system lacks objective, expert, oncologist advocates for cancer patients. OncoLogic Advisors, a logical, revolutionary service, is changing the paradigm.