Monday, May 24, 2010

Leukaemia (Blood Cancer)

Leukaemia is generally known as Blood Cancer.

Q. 1: What is leukemia?
Ans.: Leukemia is a type of cancer. Cancer is a group of many related diseases. All cancers begin in cells, which make up blood and other tissues. Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells replace them.

Sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. Leukemia is cancer that begins in blood cells.

Normal blood cells

Blood cells form in the bone marrow. Bone marrow is the soft material in the center of most bones.

Immature blood cells are called stem cells and blasts. Most blood cells mature in the bone marrow and then move into the blood vessels. Blood that flows through the blood vessels and heart is called the peripheral blood.


Q. 2: What are the types of leukemia?
Ans.: The types of leukemia are grouped by how quickly the disease develops and gets worse. Leukemia is either chronic (gets worse slowly) or acute (gets worse quickly):

* Chronic leukemia—Early in the disease, the abnormal blood cells can still do their work, and people with chronic leukemia may not have any symptoms. Slowly, chronic leukemia gets worse. It causes symptoms as the number of leukemia cells in the blood rises.


* Acute leukemia—The blood cells are very abnormal. They cannot carry out their normal work. The number of abnormal cells increases rapidly. Acute leukemia worsens quickly.

The types of leukemia are also grouped by the type of white blood cell that is affected. Leukemia can arise in lymphoid cells or myeloid cells. Leukemia that affects lymphoid cells is called lymphocytic leukemia. Leukemia that affects myeloid cells is called myeloid leukemia or myelogenous leukemia.


Q. 3: Who is at risk for Leukemia?
Ans. : No one knows the exact causes of leukemia. Doctors can seldom explain why one person gets this disease and another does not. However, research has shown that people with certain risk factors are more likely than others to develop leukemia. A risk factor is something that increases a person's chance of developing a disease.

Studies have found the following risk factors for leukemia:

* Very high levels of radiation —People exposed to very high levels of radiation are much more likely than others to develop leukemia. Very high levels of radiation have been caused by atomic bomb explosions (such as those in Japan during World War II) and nuclear power plant accidents (such as the Chernobyl [also called Chornobyl] accident in 1986).

Medical treatment that uses radiation can be another source of high-level exposure. Radiation used for diagnosis, however, exposes people to much lower levels of radiation and is not linked to leukemia.

* Working with certain chemicals—Exposure to high levels of benzene in the workplace can cause leukemia. Benzene is used widely in the chemical industry. Formaldehyde is also used by the chemical industry. Workers exposed to formaldehyde also may be at greater risk of leukemia.

* Chemotherapy—Cancer patients treated with certain cancer-fighting drugs sometimes later develop leukemia. For example, drugs known as alkylating agents are associated with the development of leukemia many years later.

* Down syndrome and certain other genetic diseases—Some diseases caused by abnormal chromosomes may increase the risk of leukemia.

* Human T-cell leukemia virus-I (HTLV-I)—This virus causes a rare type of chronic lymphocytic leukemia known as human T-cell leukemia. However, leukemia does not appear to be contagious.

* Myelodysplastic syndrome—People with this blood disease are at increased risk of developing acute myeloid leukemia.

In the past, some studies suggested exposure to electromagnetic fields as another possible risk factor for leukemia. Electromagnetic fields are a type of low-energy radiation that comes from power lines and electric appliances. However, results from recent studies show that the evidence is weak for electromagnetic fields as a risk factor.


Q. 4: Does leukaemia run in families?
Ans.: An increased risk of leukaemia can run in families. If one person in the family has leukaemia, the other members have three times the normal risk of getting the same type of leukaemia.

Q. 5 : What are symptoms of leukemia?
Ans.: Like all blood cells, leukemia cells travel through the body. Depending on the number of abnormal cells and where these cells collect, patients with leukemia may have a number of symptoms.

Common symptoms of leukemia:

* Fever or night sweat

* Frequent infections

* Feeling weak or tired

* Headache

* Bleeding and bruising easily (bleeding gums, purplish patches in the skin, or tiny red spots under the skin)

* Pain in the bones or joints

* Swelling or discomfort in the abdomen (from an enlarged spleen)

* Swollen lymph nodes, especially in the neck or armpit

* Weight loss


Q. 6: How many common types of leukaemia?
Ans.: There are four common types of leukemia:

* Chronic lymphocytic leukemia (chronic lymphoblastic leukemia, CLL) accounts for about 7,000 new cases of leukemia each year. Most often, people diagnosed with the disease are over age 55. It almost never affects children.

* Chronic myeloid leukemia (chronic myelogenous leukemia, CML) accounts for about 4,400 new cases of leukemia each year. It affects mainly adults.

* Acute lymphocytic leukemia (acute lymphoblastic leukemia, ALL) accounts for about 3,800 new cases of leukemia each year. It is the most common type of leukemia in young children. It also affects adults.

* Acute myeloid leukemia (acute myelogenous leukemia, AML) accounts for about 10,600 new cases of leukemia each year. It occurs in both adults and children.


Q. 7: Is leukaemia a children's cancer?
Ans.: About half of all cases of acute lymphocytic leukaemia are in children under 10 years old, with another quarter of cases occurring in adolescents. However, the other main types of leukaemia normally occurr in people over 50. There are many cases of leukaemia in the Asian subcontinent each year amongst children, with many of higher age groups,as well.

Cervix Cancer

Q. 1: What is cervix?

Ans.: Cervix is the lowest part of uterus which is an organ that only women have, and it is where a baby grows and develops when a woman is pregnant. During pregnancy, the uterus has an enormous increase in size. When a woman is not pregnant, the uterus is a small, pear-shaped organ that sits between a womans rectum and her bladder. The cervix connects the uterus with the birth canal (the vagina). The cervix can both be visualized and sampled by your doctor during a routine pelvic examination in his or her office.



Q. 2: What is cervical cancer?

Ans.: Cervical cancer starts in a woman's cervix, which is the lower, narrow part of the uterus. The uterus holds the growing fetus during pregnancy. The cervix connects the lower part of the uterus to the vagina and, with the vagina, forms the birth canal.

Cervical cancer develops when normal cells on the surface of the cervix begin to change, grow uncontrollably, and eventually form a mass of cells called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous).

At the outset, the changes in a cell are abnormal, not cancerous. Researchers believe, however, some of these abnormal changes are the first step in a series of slow changes that can lead to cancer. Some of the abnormal cells go away without treatment, but others can become cancerous. This phase of the disease is called dysplasia (an abnormal growth of cells). The precancerous tissue needs to be removed to stop cancer from developing. Often, the precancerous tissue can be removed or destroyed without harming healthy tissues, but in some cases, a hysterectomy (removal of the uterus and cervix) is needed to prevent cervical cancer. Treatment of a lesion (a precancerous area) depends on the following factors:

* How big the lesion is, and what type of changes have occurred in the cells

* If the woman wants to have children in the future

* The woman's age

* The woman's general health

* The preference of the woman and her doctor

If the precancerous cells change into true cancer cells and spread deeper into the cervix or to other tissues and organs, the disease is then called cervical cancer.

There are two main types of cervical cancer, named for the type of cell where the cancer started.

* Squamous cell carcinoma, which makes up about 80% to 90% of all cervical cancers

* Adenocarcinoma, which makes up 10% to 20% of all cervical cancers




Q. 3: What are the signs of cervical cancer?

Ans.: Women with cervical cancer may experience the following symptoms. Sometimes, women with cervical cancer do not show any of these symptoms. Or these symptoms may be caused by a medical condition that is not cancer.

Most women do not have any signs or symptoms of a precancer or early stage cervical cancer. Symptoms usually do not appear until the cancer has spread to other tissues and organs.

Any of the following could be signs or symptoms of cervical dysplasia or cancer:

* Blood spots or light bleeding between or following periods

* Menstrual bleeding that is longer and heavier than usual

* Bleeding after intercourse, douching, or a pelvic examination

* Pain during sexual intercourse

* Bleeding after menopause

* Increased vaginal discharge

Testing for Cancer with a Biopsy

A biopsy is a medical procedure in which a tissue sample or a group of cells is removed for laboratory examination. There are several types of biopsies available, designed to compliment an array of different conditions and parts of the body. Many of these procedures are performed with a needle and syringe, requiring no sedation. In some cases, the removal of tissue will necessitate surgery. Biopsies are typically conducted alongside other diagnostic processes. This will yield a more accurate diagnosis. A microscopic evaluation of biopsied cells can definitively determine the presence of cancer, but imaging tests are usually needed to determine the stage and behavior of the cancer.

Biopsy Types


Needle Biopsy

Needle biopsies are frequently performed to analyze growths that can be felt through the skin. Such growths may include lumps in the breasts or testes. There are four main types of needle biopsy:

  • Fine-Needle Aspiration (FNA): In this procedure, a long, fine needle pierces the skin and is inserted into the suspicious tissue. A syringe is then used to extract cells from the tissue. Typically, the cells will be sent to a laboratory for a microscopic evaluation. When a cyst is drained with FNA, and the material is not sent away for laboratory evaluation, the procedure is called a cyst aspiration. FNA is relatively painless and can be performed in minutes.
  • Core Needle Biopsy: When solid tissue is biopsied, or when larger amounts of tissue are needled for evaluation, a hollow core needle is used to perform the procedure. This needle will extract a column of tissue from the suspect area. Sometimes, a small incision must be made in order to make way for this larger needle. When biopsy necessitates an incision, local anesthesia is used.
  • Vacuum-Assisted Biopsy: This procedure is similar to a normal core needle biopsy. However, in a vacuum-assisted biopsy, a special machine is used to draw even more cells from the suspect tissue.
  • Image-Guided Biopsy: When the suspect tissue cannot be felt through the skin, but is still a candidate for a needle biopsy, an image-guided biopsy is performed. In this procedure, the standard needle biopsy is guided with the aid of various imaging technologies, such as computed tomography (CT scan) or ultrasound.

Skin (Cutaneous) Biopsy

A skin biopsy is performed to remove cells from the skin, or other tissues on the body’s surface. Most skin cancers are diagnosed with a skin biopsy. There are several types of skin biopsy procedures available:

  • Shave Biopsy: This procedure can be performed with a small scalpel or a curved razor blade. With the tool, cells are scraped form the surface of the skin, after which they are sent away for analysis. You will not need stitches after this procedure. Shaving the skin is not the same as making an incision through the skin.
  • Punch Biopsy: In a punch biopsy, a physician will use rounded knife, ranging in size from 1mm to 8mm, to remove sections of the skin below the surface. Most punch biopsies are performed to extract tissues located about ¼ of an inch into the skin. Following a punch biopsy, the wound is usually stitched to ensure proper healing.
  • Incisional Biopsy: This procedure is performed to extract tissues located below the skin, into the subcutaneous fat. To extract these tissues, an incision is made with an elliptical scalpel, after which the wound will be stitched.
  • Excisional Biopsy: This procedure is a type of incisional biopsy in which the entire lesion or tumor is removed. In most biopsy procedures, only a portion of the suspect tissue is removed for analysis. Because an excisional biopsy removes all of the suspect tissue, it can sometimes provide curative, as well as diagnostic results. Many melanomas, though, are located on the face and cannot be completely excised in such a manner.

Curretage

In this procedure, the suspect tissue is scraped using a round curette blade. Sometimes this tool is used in a skin biopsy, but it can also be used to scrape cells from bone and other internal tissues.

Surgery

When suspect tissues are inaccessible using common biopsy procedures, a surgical biopsy is required. During a surgical biopsy, an incision is made through the skin, allowing the physician to access suspicious cells located within the body. This procedure is essentially the same thing as a needle, skin, or curretage biopsy; however, it utilizes a surgical incision as a means to penetrate the suspect tissue.

A Brief History of the Biopsy


  • Ernest Henri Besnier, the famed French dermatologist, introduced the word “biopsy” to the medical community in 1879.
  • The first biopsy used to diagnose a disease was performed in Russia in 1875 by M.M. Rudnev.
  • Historical evidence suggests that the Arabs may have been performing diagnostic biopsies as early as the 12th century AD. The Arab physician Abulcasim reportedly used a needle to extract material from a goiter (a swelling of the neck due to thyroid gland abnormalities). He used this material to characterize, or primitively diagnose the goiter.