Specialties

Cancer Treatments

Cancer Treatment Options

A number of options are available for treating cancer. These treatments depend on location in the body, stage, type and extent of the cancer. The most common therapies include

  • Surgery: Surgical removal of the tumor, if it is limited to its origin site. Also lymph nodes and nearby tissue can also be removed by the means of surgery. This surgical procedure can either use laser or conventional instruments.
  • Radiation TherapyIn this therapy, cancer and certain diseases are treated with ionizing radiation. The cancer cells and their genetic substance are destroyed by ionizing radiation in the area being treated. This therapy makes it impossible for these cells to grow further.
  • Hormone Therapy This treatment use hormones, for changing the way hormones helps the cancer grow in the body. This therapy is mostly used in breast cancer and prostate cancer.
  • Chemotherapy Chemotherapy uses anti-cancer drug cells. These drugs help in destroying the cancer cells by stopping multiplication or growth at a certain point in their life cycles. These drugs are given by injecting into a muscle, applied to the skin, by mouth (orally) or into the vein (intravenously). This depends on the drug and also on the cancer type. This therapy is usually provided in cycles of alternating treatments and rest periods.
  • Biological Therapy (Immunotherapy) This therapy indirectly or directly uses the immune system of the body in order to fight cancer. This therapy also reduces the side effects that have developed due to some other cancer treatments.
  • Stem cell transplant Stem cell transplant is also known as bone marrow transplant. Bone marrow is the material inside the bones that makes blood cells from blood stem cells. A stem cell transplant can use your own stem cells or stem cells from a donor. New stem cells grow into mature disease-free cells.

Blood Cancer Treatment

Types of Blood Cancer
Myeloma

Plasma cells are targeted by this type of blood cancer. Infection and disease fighting antibodies in the body are produced by plasma cells that are basically white blood cells. The normal production of these antibodies is prevented by myeloma that causes a weak immune system.

Leukemia

This type of blood cancer is due to rapid production of abnormal white blood cells. Leukemia can be found in bone marrow and in blood. These abnormal cells are no more able to fight off infection and also impair the bone marrow’s ability to produce platelets and red blood cells.

Lymphoma

Lymphatic system that produces immune cells and also removes excess fluids from the body gets affected by lymphoma blood cancer. Lymphocytes are considered as a type of white blood cell that helps in fighting off infection. Abnormal lymphocytes results in lymphoma cells that gets multiplied and collected in other tissues and lymph nodes. After a certain period of time, the immune system gets weakened due to these cancerous cells.

Causes of Blood Cancer

A number of factors are associated with the development of blood cancer. Older adults are commonly affected by blood cancer. Some of the causes include

  • Smoking
  • Advanced age
  • History of blood disorders
  • Some types of infections
  • Family history of blood cancer
  • Exposure to some specific chemicals
  • History of some genetic disorders
  • Exposure to some types of chemotherapy or radiation therapy
  • Weak immune system caused by AIDS/HIV conditions, by organ transplant or by taking corticosteroids
Symptoms of Blood Cancer
  • Unexplained weight loss
  • Abdominal pain specifically in the upper abdomen
  • Frequent irritation
  • Joint or bone pain
  • Night sweats
  • Bruising or easy bleeding
  • Nausea can result in the feeling of queasiness, upset stomach, retching, wooziness, car-sickness or sea-sickness
  • Chills and fever
  • Enlarged glands and liver that include lymph nodes and the spleen
  • Frequent urination
  • Fatigue
Some of the serious symptoms include
  • Heavy and uncontrolled bleeding
  • Bluish coloration of the fingernails or lips
  • Seizure
  • Rapid heart rate
  • Severe abdominal pain
  • Change in the level of alertness or consciousness that include unresponsiveness or passing out
  • Breathing or respiratory problems like wheezing, shortness of breath, labored breathing and difficulty in breathing
  • High fever
  • Sudden behavior or mental status change such as delusions, confusion, hallucinations, lethargy and delirium
  • Palpitations, chest tightness, chest pain and chest pressure
Diagnosis of Blood Cancer

A number of tests are performed for diagnosing blood cancer they include

  • Blood Test The number of some specific blood cells is determined by performing a blood test
  • Spinal Tap Certain amount of clear fluid is taken that surrounds the spinal cord and brain. This test is done for checking the presence of cancer cells.
  • Chest X-ray This x-ray helps in determining the presence of swollen lymph nodes, bone damage or tumors growing in the bone marrow.
  • Physical Exam Swollen lymph nodes can be determined with the help of this test. Growth of tumors in the bone marrow or damage to the bone can also be determined with the help of a physical examination.
  • Biopsy The presence of cancer cells is determined by taking a sample of a bone marrow while performing a biopsy. This can be done through a bone needle biopsy or bone marrow aspiration.
  • Cytogenetics The change in the genetic material is determined by this test.
  • Urine Test High level of protein known as Bence Jones protein is determined by taking urine samples. Some specific cancers may have high level of protein.
Treatment of Blood Cancer

Leukemia blood cancer treatment is very complex. The treatment of leukemia not only depends on its type but also depends on the factors such as whether any leukemia treatment has been done before, leukemia cells and the extent of the disease. The treatment also depends on other factors such as general health, symptoms and age of a patient. There are three options of blood cancer treatment that include

  • Biological Therapy Biological therapy, also referred to as immunotherapy, involves the treatment with those substances that affect the ability of an immune system to kill cancer cells. Monoclonal antibodies and interferon are the two types of biological therapy. The purpose of monoclonal antibodies is to stick to cancer cells in order to draw the attention of the immune system to these cancer cells. On the other hand, interferon helps in stimulating the immune system so as to destroy the cancer cells. These two options are generally used for chronic leukemia instead of acute leukemia.
  • Radiotherapy Radiotherapy, also known as radiation therapy, makes use of energy rays such as X-rays for stopping the growth and multiplication of the cancer cells. This energy is directed at any particular part of the body such as the spleen or also to the entire body.
  • Bone Marrow Transplantation The cancerous cells are destroyed by using very big doses of radiotherapy and chemotherapy in this treatment procedure. Bone marrow transplant, also referred to as a stem cell transplant, is performed for replacing a damaged bone marrow with healthy bone marrow stem cells. In this procedure, healthy stem cells are taken from the bone marrow of one person and then transferring them to the bone marrow of another person. The conditions of damaged bone marrow are treated with the help of this procedure.

Bone Cancer/ Bone Tumor Treatment

Types of Bone Cancer

Primary Bone Sarcoma: This tumor first develops in the bone. There is no exact cause of bone sarcoma but heredity can be considered as one of the causes. Bone cancer can be categorized into different types that include

  • Chondrosarcoma: This type is most commonly seen in those people who are in between the age of 40-70. This cancer starts in cartilage cells and its common sites include leg, shoulder, hip, arm and pelvis.
  • Ewing’s Sarcoma: This type is most commonly seen in young people who are in between the age of 5-20. The most common sites of this cancer include the upper arm, ribs, leg and pelvis.
  • Osteosarcoma: This type is most common in the upper arm and knee and it starts from the bone cells. Osteosarcoma is usually seen in young adults and teens.
Benign Bone Tumors

The most common types of benign tumors include

  • Enchondroma: This type appears in the bones of the feet and hand. This usually involves no symptoms and is also considered as the most common type of hand tumor.
  • Giant Cell Tumor: This tumor is a benign tumor that affects the leg.
  • Osteoblastoma: This is a single tumor that takes place in the feet and the hand. This is usually seen in young adults.
  • Osteochondroma: This is considered as the most benign bone tumor and is mostly people who are under 20 years of age are afflicted with it.
  • Osteoid Osteoma: This usually occurs in the long bones that is seen commonly in those people who are in their early 20s.
Metastatic Cancer

Metastatic cancer is the cancer that spreads to the bones from elsewhere in the body. Metastatic cancer spreads to a bone but it is still not known as bone cancer as the tumor cells are from the primary cancer.

The cancers that spread to the bone are

  • Lung Cancer
  • Prostate Cancer
  • Breast Cancer
Causes of Bone Cancer

The causes of bone cancer are unknown. The patients, who are suffering from chronic inflammatory diseases such as Paget’s disease, have more chances of developing a bone cancer. The bone cancer starts due to an error in the DNA of a cell. This error tells a cell to divide and grow in an abnormal way. The cells then go on multiplying instead of dying at a given time. The build-up of these mutated cells creates a tumor that can affect surrounding structures or can also spread to different body areas.

Symptoms of Bone Cancer
  • Unintended weight loss
  • Bone pain
  • Broken bone
  • Tenderness and swelling close to the affected area
  • Fatigue
Diagnosis of Bone Cancer

A number of imaging tests are performed in evaluating the area of concern that include

  • X-ray
  • Bone Scan
  • Magnetic Resonance Imaging (MRI)
  • Positron Emission Tomography (PET)
  • Computerized Tomography (CT)

Different biopsy procedures are used for diagnosing bone cancer such as

  • Surgery for removing a tissue sample for testing: An incision is made through the skin in this surgical biopsy procedure. Through this incision, a portion of the tumor (incisional biopsy) or the complete tumor (excisional biopsy) is removed.
  • Inserting a needle through the skin and inside the tumor: A thin needle is inserted through the skin in this needle biopsy procedure. This needle is then advanced inside the tumor for removing small pieces of tissue from it.
Treatment of Bone Cancer

Bone cancer can be treated with the help of different treatment options that include

Chemotherapy This treatment makes use of certain chemicals for destroying cancer cells. This is usually given through a vein that travels in the entire body. Radiation therapy is often combined with chemotherapy for shrinking the cancer to a manageable size so as to enable a surgeon to carry out a limb-sparing surgery. This therapy is used in those people who have bone cancer that has spread to different body parts.

Surgery A surgery entirely removes the bone cancer. There are different types of surgery for treating bone cancer such as

  • Surgery for cancer that does not affect the limbs : The surgical procedure is performed for removing bone and some nearby tissue if the bone cancer takes place in the bones apart from legs and arms. This removed bone is then replaced with a part of bone from a different area of the body or can also be replaced with the help of special metal prosthesis.
  • Surgery for removing the cancer while sparing the limb : The surgical procedure can be performed for removing the bone cancer while sparing the limb if the bone cancer can be separated from other tissue and nerves. The lost bone is then replaced with some other bone from a different area of the body or can also be replaced with the help of a special prosthesis.
  • Surgery for removing a limb : The surgical procedure is required for removing a part or all part of a limb when the bone cancer is very large and is located on a complicated point on the bone.

Radiation Therapy : High-powered beams of energy are used in this therapy for destroying cancer cells. The high-powered beams of energy are targeted at precise points in the body. This therapy is meant for those people who are suffering from bone cancer that cannot be removed with the help of surgery. The radiation therapy may control symptoms and signs that include pain in those people who have advanced bone cancer.

Brachytherapy

What is Brachytherapy ?

Brachytherapy, also known as internal radiation therapy, is considered as one of the type of radiation therapy for treating cancer. A radioactive material is placed within the tumor or close to the tumor. The technique of Brachytherapy is used for delivering a higher dose of radiation for treating a small area in a very less time as compared with external beam radiation treatment.

The different types of cancers throughout the body are treated by Brachytherapy that may include

  • Eye
  • Prostate
  • Vagina
  • Head and Neck
  • Rectum
  • Uterus
  • Skin
  • Gallbladder
  • Cervix
  • Breast
  • Lung
Equipment’s used in Brachytherapy

The placement of a radioactive material is done on the tumor site by using a special delivery device in the case of permanent implants. The placement of specialized accelerators, needles, temporary implants or plastic catheters are done on the site of the treatment. Iridium, Iodine, Cesium and Palladium are the radiation sources that are used in Brachytherapy. The radiation source in every case of Brachytherapy is encapsulated that helps in preventing the radioactive material from entering into the body of a patient.

The insertion of the radiation sources are then done when it is confirmed that the devices are accurately positioned. The radioactive material can either be inserted or removed after inserting radiation sources using a computer-controlled remote after loading machine or by placing the delivery device. The radioactive material can be positioned in a better way so as to treat the tumor effectively. This is done by performing MRI, X-rays, CT or ultrasound scans. The time required for delivering radiation dose to the tumor and position of the source is calculated by using a computer.

Brachytherapy Types
  • Unsealed Internal Radiation Therapy : An injection of a medication having radioactive materials is done into a body cavity or a vein.
  • Interstitial Treatment : The placement of the radioactive implants is done inside the tumor that can stay permanently inside the patient.
  • Intracavitary Treatment : The placement of radioactive implants is then done within the body cavities like uterus or the vagina.

Temporary Brachytherapy : This type involves the removal of the implants after the completion of the treatment. Balloons filled with fluid, hollow needles and catheters are the different types of implants that are used at the time of treatment that are removed after the completion of the treatment. Low dose or high dose Brachytherapy can also be used.
Permanent Brachytherapy : Seeds or pellets small size implants are used in permanent Brachytherapy. The insertion of these implants is then done in the tumor through the hollow needles. The small-sized implants are then left in place as they do not result in any discomfort or pain.

Procedure of Brachytherapy

The placement of thin catheters is done in the tumor in the case of high-dose rate (HDR). HDR afterloader is then attached with the catheters. A single radioactive iridium pellet is contained inside the HDR afterloader at the end of a wire. The computer then controls the pushing of the pellet one by one into each of the catheters. The time required by a pellet to stay inside every catheter controlled by the computer and also the catheter must pause to release its radiation. High-dose rate Brachytherapy offers an accurate treatment that takes very less time. The removal of catheters and the radioactive seeds is then after the completion of the treatment.

Benefits of Brachytherapy
  • Simplified Palliative Treatment Option
  • Highly targeted conformal treatment for improved sparing of healthy tissue and increased efficacy.
  • Brachytherapy can be considered as an alternative treatment for several challenging cases
  • Brachytherapy has the potential to avoid prostatectomy
  • The duration of the treatment is reduced for several types of cancer

Retinoblastoma (Eye Cancer) Treatment

Types of Retinoblastoma
Unilateral Retinoblastoma
This type of retinoblastoma accounts for almost 75% of cases and it usually affects only one eye. Unilateral retinoblastoma can be either sporadic or hereditary. Sporadic generally happens in those children who are over age 1 and accounts for almost 75-80% of unilateral retinoblastoma cases.
Bilateral Retinoblastoma
Bilateral retinoblastoma is an indication of a genetic influence and it affects not one but both the eyes. This disease can be inherited from a parent who are having it but at the same time does not show any symptoms. This condition can be diagnosed early at a young age as compared to unilateral disease.
Trilateral Retinoblastoma
Intracranial tumor also develops in those children who have inherited retinoblastoma. This tumor originates in primitive nerve cells and is considered as rare that accounts for only 5% of patients having bilateral retinoblastoma.
Symptoms of Retinoblastoma

The first or the initial sign of retinoblastoma is the appearance of cloudy white pupil that looks like yellow or silvery white in the bright light and is known as cat’s eye reflex or leukocoria. Some other symptoms are

  • Decreased vision or poor vision
  • Wandering or poorly aligned eye called as strabismus
  • Large than normal pupil
  • Reddish pupil that is associated with pain
  • Different colored irises
Diagnosis of Retinal Cancer
Biopsy and Bone Marrow Aspiration
This test involves the insertion of a hollow needle into the breastbone or hipbone for removing a small piece of bone, bone marrow and blood. The bone, bone marrow and blood are examined under a microscope in order to observe signs of cancer.
Eye Exam with Dilated Pupil
This eye exam involves the use of medicated eye drops for dilating the pupil so as to enable the doctor to see through the pupil and lens to the retina. A light is used for examining the eye from within that also includes the optic nerve and the retina. This eye exam is performed under anesthesia and this test depends on the age of the child.
Lumbar Puncture
Lumbar puncture is a medical procedure that is used for collecting cerebrospinal fluid from the spinal column. A needle is placed in the spinal column for this purpose and this entire process is known as spinal tap or LP. When the cancer has spread out from the eye then the procedure of lumbar puncture is required.
CT scan (CAT scan)
This test helps in making detailed images of the areas within the body including the eye that are taken from many angles. The computer prepares these pictures that are linked to an x-ray. The tissues or organs can be seen more clearly by swallowing or injecting a dye into a vein. This process is also known by computerized axial tomography, computed tomography and computerized tomography.
Ultrasound Exam
Sound waves are used in the ultrasound exam for creating images of the eye. The placement of a device is then done on the eye to receive and emit sound waves. High-frequency waves then enters into the eye and bounces off the tissue. A picture is then created when these echoes are read by the ultrasound. An enlarged retinoblastoma tumor can be best examined by this test.
Magnetic Resonance Imaging (MRI)
A computer, magnet and radio waves are used in this procedure for making detailed images of the areas within the body like the eye. Nuclear magnetic resonance imaging (NMRI) is the other name of this procedure.
Treatment of Retinoblastoma Cancer

A number of treatment options are available for retinoblastoma that include

Surgery
The surgical procedure is performed when the tumor has grown so much that cannot be treated with any other means. This procedure helps to prevent the spreading of the cancer to different areas of the body. A surgeon removes the eyeball and places an eye implant into the eye socket. This eye implant is then attached with the eye muscles. The implanted eyeball will be moved by the eye muscles just like it moves the natural eye. This implanted eye cannot see. The placement of a custom-made artificial eye is done on the eye implant after some weeks of the surgery. This artificial eye is matched with the healthy eye of a child. Gradually, it sits at the back of the eyelids and is clipped on the eye implant. When the eye implant is moved by the eye muscles then it will look as if the child is moving this artificial eye.
Radiation Therapy
This therapy makes use of high-energy radiation beams for destroying cancer cells. This therapy can be delivered internally that uses a small disc of radioactive material which is stitched near or in the tumor. This then radiate the tumor when it is being left for a specific period of time. External beam radiation is primarily used in the case of advanced retinoblastoma. High-energy beams of radiation are given by using a machine that is placed outside the body. This powerful radiation is directed onto the tumor for destroying it.
Thermotherapy (a heat treatment)
This procedure makes use of ultrasound, microwaves or laser devices for delivering extreme heat on the cancer cells for destroying them.
Chemotherapy
Specific types of drugs are used for killing the cancer cells. The injection of these drugs is done into a vein that travels in the entire body. It also helps in shrinking the tumor of retinoblastoma that has spread to the other areas of the body or outside the eyeball.
Cryotherapy (a cold treatment)
Extreme cold is used in this procedure for destroying cancer cells. Liquid nitrogen (a very cold substance) is placed near or in the cancer cells. The liquid nitrogen is removed when the cells freeze that softens the cells. These cancerous cells eventually die when this process is repeated for few times.
Laser Photocoagulation (laser therapy)
Blood vessels that are responsible for supplying nutrients and oxygen to the tumor are destroyed by using a laser. Cancer cells will gradually die as they are not getting any oxygen and nutrients.

Pancreatic Cancer Treatment and Surgery

Types of Pancreatic Cancer

Pancreatic cancer can be categorized into different types that depend on whether or not the cancer began in the endocrine or exocrine component. Pancreatic cancer types include

Endocrine Tumors :Endocrine tumors also referred to as pancreatic neuroendocrine tumors (PNETs) or islet cell tumors are not so common as compared to exocrine tumors. A pancreatic neuroendocrine tumor could be non-functioning that means it does not make any hormones or it could also be functioning that means it can make hormones. The base of a functioning neuroendocrine tumor is on the hormone that cells usually make

  • PPomas
  • Insulinoma
  • VIPomas
  • Gastrinoma
  • Glucagonoma
  • Somatostatinoma

Exocrine Tumors: They are considered as the most common type of pancreatic cancer. Adenocarcinoma that begins in gland cells is mostly seen in around 95% people who are suffering from pancreatic cancer. Ductal Adenocarcinoma is the ducts of the pancreas from where the tumor typically begins. Rarely when tumor starts in the acini then it is termed as acinar Adenocarcinoma. Some of the other rare tumors of the pancreas are

  • Lymphoma
  • Acinar Cell Carcinomas
  • Cystic Tumors
  • Neuroendocrine tumors
Treatment of Pancreatic Cancer

There are different types of surgeries that help in removing the pancreatic cancer. These surgeries are further categorized into

  • Curative that helps in treating the cancer by removing it
  • Palliative that helps in easing the symptoms
Curative Surgeries for pancreatic cancer

Pancreaticoduodenectomy: This is considered as the most common surgery for removing a pancreatic tumor. This surgery is also termed as Whipple procedure that removes

  • Part of the common bile duct
  • Head of the pancreas
  • Gallbladder
  • Duodenum
  • Body of the pancreas
  • Lymph nodes close to the pancreas
  • Part of the stomach
  • A small part of the jejunum

Total Pancreatectomy: This procedure involves the removal of the spleen and the complete pancreas.

Distal Pancreatectomy: This procedure involves the removal of a part of the body of the pancreas and tail of the pancreas. It also removes the spleen. This procedure is more commonly used with islet cell tumors.

Palliative Surgeries for pancreatic cancer

Gastric Bypass: When the stomach has been blocked by the cancer then it is sewn with the small intestine. This process allows a patient to eat normally.

Stent Placement: In order to avoid blockage, the insertion of the metal tubes is done that helps in keeping the bile duct open.

Biliary Bypass: A small surgical cut is made in the bile duct or gallbladder that is then sewed to the small intestine. This surgical procedure is helpful when the tumor has blocked small intestine and has caused bile to accumulate in the gallbladder. Pain is also relieved by the means of this procedure.

Ablative Techniques for pancreatic cancer

Ablative techniques help in treating exocrine pancreatic cancer when some tumors have spread. These include

  • Cryoablation or Cryosurgery: This procedure involves the freezing of the tissue for destroying it.
  • Microwave Thermotherapy: This procedure makes use of microwaves for heating and destroying cancer.
  • Radiofrequency Ablation (RFA): The radio waves are used for heating and destroying the tissue.

Radiation Therapy : In this, a great amount of radiation is delivered for destroying cancer tumors more precisely. This radiation does not damage any surrounding healthy cells.

Chemoembolization or Embolization : Chemotherapy or radiation therapy is delivered to the blood vessels around the tumor by cutting off the blood supply to the pancreatic cancer.

Chemotherapy : Pancreatic cancer is most commonly treated with the help of chemotherapy. Chemotherapy is used in many ways for treating pancreatic cancer that include

  • Alone or in combination with radiotherapy
  • Before or after surgery for removing the cancer
  • When the cancer has spread to different parts of the body
  • When the cancer is localized but untreatable
Causes of Pancreatic Cancer

There is no known cause of pancreatic cancer but this cancer is seen more common in

  • Smokers
  • Diabetic people
  • People with long-term inflammation of the pancreas (chronic pancreatitis)

It has also been noticed that pancreatic cancer is common in women as compared to men. Genetic syndromes passing down through families can also be considered as one of the cause.

Symptoms of Pancreatic Cancer

Pancreatic cancer in its initial stage is painless and silent. Pancreatic cancer develops outside the pancreas when it becomes large and also resulting in some symptoms. The symptoms depends on the location of the cancer inside the pancreas

  • Back or belly pain and weight loss are the symptoms when the pancreatic cancer is there in the tail or body of the pancreas.
  • Enlarged lymph nodes in the neck, nausea, dark urine, weight loss, itching, back pain, vomiting, jaundice and abdominal pain are the different symptoms when pancreatic cancer in the head of the pancreas happens.
Pancreatic Cancer Skin Symptoms
  • Itching
  • Jaundice
Pancreatic Cancer Gastrointestinal Symptoms
  • Pale-colored stools
  • Abdominal pain
  • Nausea
  • Bloating
  • Diarrhea
Pancreatic Cancer Whole Body Symptoms
  • Elevated blood sugars
  • Malaise
  • Weight loss
  • Loss of appetite
Diagnosis of Pancreatic Cancer

The diagnosis of pancreatic cancer involves performing a number of imaging studies that include

  • Positron Emission Tomography (PET): This imaging test helps in determining the degree of pancreatic cancer spread. This is done by injecting radioactive glucose into the veins that is absorbed by the cancer cells.
  • Computer Tomography (CT): The detailed images of within the abdomen are constructed for making pancreatic cancer diagnosis.
  • Ultrasound: The sound waves that are reflected from the organs into the belly help in creating images for diagnosing pancreatic cancer.
  • Magnetic Resonance Imaging (MRI): A scanner creates detailed images of the abdomen by using magnetic waves.

If a mass in detected in the pancreas then only a biopsy can help in diagnosing pancreatic cancer. There are different ways by which biopsies can be performed that include

  • Laparoscopy : Small incisions are used in this surgical procedure. Tissue for biopsy can be collected by using laparoscopy and it also helps in viewing the inside of the abdomen for determining the spread of pancreatic cancer.
  • Percutaneous Needle Biopsy: A needle is inserted in the mass in order to capture some tissue. Fine needle aspiration (FNA) is the name given to this procedure.
  • Endoscopic Ultrasound: The advancement of an endoscope is done close to the pancreas. The mass is located by an ultrasound probe on the endoscope. Then some tissue is plucked from the mass with the help of a needle on the endoscope.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP): Here some tools at the end of an endoscope and a flexible tube along with camera is put from the mouth into the small intestine, close to the pancreas. This helps in collecting images of the area along with a small biopsy with help of a brush.

Ovarian Cancer Treatment

Types of Ovarian Tumors

There are a number of tumors that may start in the ovaries. These tumors can be benign (non-cancerous) or malignant (cancerous). These tumors can be categorized into three types

  • Stromal Tumors: These tumors begin from those cells that are responsible for holding the ovary together and also for making female hormones.
  • Germ Cell Tumors: These tumors begin from those cells that are responsible for producing the eggs.
  • Epithelial Tumors: These tumors begin from those cells which cover the outer surface of the ovary. A majority of ovarian tumors are epithelial tumors. Serous is considered as the most common type of epithelial cancers.
Causes of Ovarian Cancer

Ovarian cancer is considered as one of the most common cancer among women. Some of its major causes include

  • The usage of hormone replacement therapy for more than five years especially when only estrogen is used
  • Inherited gene mutation
  • Women who are 50 years or above
  • Obesity
  • Family history of breast cancer or ovarian cancer
  • Having never been pregnant
  • Having had cancer before such as colon, breast or uterine
Early Symptoms of Ovarian Cancer
  • Changes in bowel habits like constipation
  • Pelvic pain
  • Heartburn or indigestion
  • Pain on the lower side of the body
  • Feeling full rapidly while eating
  • Pain during sexual intercourse
  • Back pain
  • Urgent and more frequent urination
  • Pain in the lower stomach

The progression of ovarian cancer may result into following symptoms that include

  • Loss of appetite
  • Nausea
  • Breathlessness
  • Weight loss
  • Fatigue
Diagnosis of Ovarian Cancer

A pelvic exam is performed for examining rectum, vagina and lower abdomen for growths or masses. If the growths are visible on ovaries then certain other tests are also performed for producing detailed images of the ovaries. Some of the tests include

  • Exploratory Surgery : This surgery is performed for confirming the diagnosis of ovarian cancer.
  • Ultrasound : High-frequency sound waves are produced in order to get precise images of the structures inside the body.
  • Blood Tests: CA 125 blood test is performed for those women who are suspected of having ovarian cancer or previously had ovarian cancer. This blood test helps in detecting a protein antigen that can be found at abnormally high levels in the blood serum of those women who have ovarian cancer.
  • Positron Emission Tomographic Scan (PET) : This test helps in defining those areas that altered blood supply and also helps in identifying cancer.
  • Upper G.I. and Lower G.I. Scopy: It helps in ruling out the primary cancer present in G.I. tract.
  • CT scan: This helps in generating two dimensional images of the body that may show whether the cancer has spread.
  • Mammography: Metastatic tumors can be ruled out with this test.
  • Magnetic Resonance Imaging (MRI): Magnetic energy is used for generating highly detailed images of the anatomy such as tumors.
Treatment of Ovarian Cancer

Radiation therapy, surgery and chemotherapy are the treatment options for treating ovarian cancer.

Radiation Therapy: This therapy makes use of high-energy beams for destroying cancer cells. This therapy helps in eliminating cancer that may be encompassed inside a radiation field. This therapy can be either internally or externally delivered. Internal radiation (Brachytherapy) is delivered by implanting a small amount of radioactive material surrounding the cancer. High-energy rays are delivered in external radiation that is directed to the tumor site through a machine outside the body.

Surgery: Three types of surgeries are involved in treating ovarian cancer such as

  • Laparoscopy: The use of this minimally invasive surgery depends on the extent of the cancer.
  • Frozen Section Tissue Analysis: The rapid analysis of the tissue is done under a microscope. The nature of the tumor is determined as whether it is cancerous or non-cancerous that also helps surgeons to perform a suitable procedure during the first surgery.
  • Laparotomy: This procedure is used by making a large abdominal incision. This incision is done for removing uterus, ovaries, Fallopian tubes surrounding lymph glands, omentum (a fold of fatty tissue) and tumor. Cytoreductive or debulking surgery is another name for this surgery.

Chemotherapy: Anticancer drugs are used for destroying the remaining cancer cells after surgery. Women who have advanced ovarian cancer may be given chemotherapy as the initial treatment. The injection of these drugs can be done in a vein or directly into the abdominal cavity. These drugs can be either used alone or in combination.

Gallbladder Cancer Treatment

Symptoms of Gallbladder Cancer

There are no visible symptoms of gallbladder cancer in its early stages. Some of the later symptoms include

  • Jaundice
  • Pain in the upper right side of the abdomen
  • Weight loss
  • Feeling sick or feeling of vomiting
  • Enlarged gallbladder
  • Bloating
  • Fever
Diagnosis of Gallbladder Cancer

A doctor carefully examines the symptoms and medical history of a patient. A number of tests are performed for diagnosing gallbladder cancer that include

  • Keyhole surgery (a laparoscopy) is performed by making a small incision in the abdomen for viewing the surrounding tissue and the gallbladder. Small samples are then taken and are further examined in the laboratory. A laparoscopy is done under general anesthesia.
  • A scan that includes MRI scan or CT scan helps in producing images of the gallbladder.
  • Endoscopic Retrograde Cholangio-Pancreatography (ERCP) helps in determining the blockage or narrowing of the pancreatic or bile duct. A patient is required to swallow a flexible and narrow tube having a telescopic camera known as an endoscope that will be further passed into the bile duct.
  • A blood test helps in determining the liver functioning and general health of a patient. Bilirubin levels can also be checked with the help of a blood test.
Treatment of Gallbladder Cancer

The treatment of gallbladder cancer has been categorized into surgical and non-surgical treatments.

Surgical Treatments : Surgery is considered as the best treatment for gallbladder cancer. A Cholecystectomy operation is performed for removing the gallbladder when the cancer has not spread beyond the wall of the gallbladder. Sometimes it is also required to remove tissues if the cancer has spread beyond the gallbladder. The surgical procedure also helps in relieving the symptoms and also aims at preventing jaundice when the cancer has spread to the nearby tissues such as lymph nodes, liver or stomach. Palliative therapy is the name given to this procedure. A stent may also be inserted in order to drain the bile properly into the digestive system.

Non-Surgical Treatments
  • Photodynamic Therapy : A laser and a light sensitive medicine are used in this therapy for destroying the cancer cells. The different gallbladder symptoms can also be relieved by the means of this therapy. The injection of the medicine is done into a vein that will travel through the body which is then taken up by the cells. A laser is then passed over the cells for activating the drug that will eventually kill all the cancer cells.
  • Radiotherapy : Radiation is used in this therapy for destroying the cancer cells. The shrinking of the tumor is done by targeting a beam of radiation on the cancer cells. This therapy is used for providing relief from the symptoms when there is advanced stage of gallbladder cancer. Remaining cancer cells can also be destroyed by the means of this therapy. Many times chemotherapy is also combined with radiotherapy.
  • Chemotherapy : Chemotherapy is used when the surgery was not able to remove the gallbladder cancer or it has spread to other body part. The goal of this therapy is to slow down the growth of the cancer or to shrink the tumor.
  • Stent Insertion : The insertion of a small tube is done at the time of ERCP (Endoscopic Retrograde Cholangio-Pancreatography) when there is a blockage in the bile duct caused by the gallbladder cancer. This helps in relieving jaundice without performing any surgical procedure.