Types of cancer Treatment

The type of cancer treatment recommended by your doctor depends on the cancer types, size and location of the tumor, whether the cancer has spread and your general health.

The treatment of cancer most common are surgery, radiotherapy and chemotherapy. These treatments can be used alone or in combination with other therapies. Other treatment options include anti-cancer therapies, immunotherapy, hormone therapy and bone marrow or hematopoietic stem cells selectively. In addition, patients are asked to make clinical trials on treatment decisions to be taken into account. A clinical trial is a study to test a new treatment to show that safe, effective and perhaps better than standard therapy. Your doctor can help you all the options for clinical trials. Learn more about clinical trials.

The first treatment of a person is given as first-line treatment. Adjuvant therapy is administered after the first treatment (eg chemotherapy after surgery). Neoadjuvant therapy is treatment before the initial treatment (like chemotherapy before surgery) administered.

As cancer treatments become more specialized, many people are now a team of doctors, nurses and specialists treated in health care. Usually, a doctor, often an oncologist, leading to the coordination of personal care. Find out more about the oncology team. It is recommended also important for people with cancer and their families feel comfortable with your doctor and your treatment plan. It is always advisable to seek a second opinion.

Before beginning treatment, consider asking the doctor about the goals of treatment, how long the treatment will take, and the potential side effects. Knowing what to expect before treatment begins can reduce any fear and anxiety you may be feeling about your cancer treatment plan..
Below is an overview of the most common cancer treatments. For more details about treatment for a specific type of cancer, be sure to review the individual Cancer

Surgery

Surgery involves the removal of cancerous tissue from the body. It is the primary treatment for many types of cancer, and some cancers can be completely removed with surgery alone. Surgery can also confirm a diagnosis (such as with a surgical biopsy), determine the extent of the cancer (called staging), and relieve side effects (such as removing an obstruction to ease pain). Some types of surgery are performed in a clinic or doctor's office instead of the hospital, and the patient returns home the same day. This is called outpatient surgery. Most cancer surgeries, though, are performed in a hospital and the patient must stay at the hospital at least overnight; this is called in-patient surgery. Before any type of surgery, consider preparing a list of questions for the surgeon to discuss beforehand. Carefully review with your doctor any preparation you may need before surgery and learn what to expect when you are scheduled for surgery.
The side effects of surgery depend on the type of surgery and the overall health of the person before surgery. One of the more common side effects is pain, but doctors have ways to provide relief when pain and other side effects occur in most people. Refer to individual Cancer Type sections for more information about surgical procedures for specific cancers. Learn more about the side effects of cancer surgery.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body.
Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication. Some people may receive chemotherapy in their doctor's office; others may go to the hospital. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a specific time. For example, some drugs are given continuously over several days; some are given several times a week. Learn more about what chemotherapy is and preparing for treatment.

Side effects of chemotherapy

Chemotherapy can cause a variety of side effects. However, doctors have made major strides in recent years in reducing many side effects. The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. Depending on the drug, some people may also experience tingling or numbness in the arms and legs, hair loss, and mouth sores. Because some drugs can damage blood cells, a person may experience anemia (low red blood cell counts) and/or an increased risk of infection (low white blood cell counts). These side effects usually go away once treatment is finished. Find out more about the side effects of chemotherapy.
During chemotherapy, a person may lose his or her appetite or develop an aversion to the taste or smell of food. Consider talking with a registered dietitian, who can give suggestions about meal planning and managing side effects through simple nutritional changes. And, learn about using nutrition to manage side effects.
Fortunately, many new drugs do not cause the same, severe side effects as some older chemotherapy. And, medications that reduce side effects caused by chemotherapy are available. Before treatment begins, talk with your doctor or nurse about the possible side effects of the specific type and dose of chemotherapy you’ve been prescribed and how to prevent or relieve side effects if they do occur. Find ways to manage common side effects.

Many people are concerned about the side effects of chemotherapy, both during treatment and many years later (called long-term or late effects). Once treatment is finished, ask your doctor or nurse for a summary of your treatment, such as the drugs and doses used, and any side effects you experienced. Having this information will help a doctor determine if a future health problem is related to the cancer treatment. Learn more about the late effects of cancer treatment.

Radiation treatment

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells.
The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. Proton therapy is a type of radiation therapy that uses protons instead of x-rays to treat cancer. Learn more about understanding radiation therapy.
Radiation therapy is considered a local treatment, as it only affects one part of the body. The goals of radiation therapy can include shrinking the tumor before surgery, keeping the tumor from returning after surgery, eliminating cancer cells in other parts of the body, and relieving pain.
Before beginning external-beam radiation therapy, the doctor will plan where to aim the radiation. The goal is to hit as much of the tumor as possible while minimizing the exposure of healthy tissue. A person's skin may be marked to show where the radiation will be directed. New computerized techniques help pinpoint the best place to give the radiation.

Side effects of radiation treatment

Radiation therapy can cause a variety of side effects. However, similar to the side effects of chemotherapy, there are now often many ways to reduce or avoid side effects. Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements. Other side effects may include swelling, redness or irritation of the skin, hair loss, cough or shortness of breath (if the radiation is given to the neck or chest area), mouth sores (if the radiation is given to the head), and digestive problems (if the radiation is given to the abdominal area). These side effects go away once treatment is finished. Internal radiation therapy may cause bleeding, infection, or irritation after the implant is removed. Radiation treatment does not make a person radioactive..
In addition, external-beam radiation therapy may have long-term side effects that can affect a person for many years. For this reason, people who receive radiation therapy should keep a record of their radiation treatment schedule (including the dose and location of the radiation) and report it as part of their medical history; this is particularly important for children and young adults. Long-term side effects can include the risk of a second cancer, infertility (the inability to father a child or maintain a pregnancy), heart problems (from radiation to the chest), gastrointestinal problems (from radiation to the abdominal area), lung fibrosis (scarring or thickening of the lung tissue), neurologic problems, thyroid problems, or osteoporosis. Also, people who have had previous radiation to the chest should be aware that they are at higher risk of developing breast and lung cancers.
Today, most people who receive radiation therapy now receive smaller doses than what was given in years past. And, side effects have been reduced since there are ongoing advancements in how to better direct the radiation beam to affect only the tumor and not the healthy tissue surrounding it. Each person considering radiation therapy should discuss the risks versus benefits of the treatment with his or her doctor before treatment begins. Read some frequently asked questions about radiation therapy and see the American Society for Therapeutic Radiology and Oncology's (ASTRO) website, www.rtanswers.org.

Targeted therapy

Targeted therapy is a treatment that targets faulty genes or proteins that contribute to cancer growth and development. Targeted therapy is usually given along with another type of treatment, such as chemotherapy. Because these drugs target specific genes or proteins, a test may be needed to find out if the drug will work for a specific type of tumor. Although there aren’t a wide variety of tests available now, many more may be available in the future or as part of a clinical trial as doctors seek to give patients the best possible treatment for their type of cancer.
Generally, targeted treatments do not have the same side effects as traditional chemotherapy. However, depending on the drug and the dosage, a person may experience nausea, vomiting, muscle cramps, heart problems, rash, and/or diarrhea. Each drug has specific side effects; talk with your doctor about what side effects to expect and how to manage them..

Immunotherapy

Immunotherapy (also called biologic therapy) is designed to boost the body's natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to bolster, target, or restore immune system function. Interferon and colony-stimulating factor are two examples of immunotherapy. The side effects of immunotherapy generally include flu-like symptoms, such as chills, nausea, and fever. Immunotherapy also includes cancer vaccines—an investigational approach to helping the immune system fight cancer..

Hormone therapy

Several types of cancer, including some breast and prostate cancers, can only grow and spread in the presence of natural chemicals in the body called hormones. Hormone therapy fights cancer by changing the amounts of hormones in the body. It is usually used to treat cancers of the prostate, breast, thyroid, and reproductive system. For example, many women take the hormone treatment tamoxifen (Nolvadex) for breast cancer.
Like any treatment, hormone therapy has side effects, and most go away once treatment is finished. The side effects depend on the drug and affect men and women differently. Refer to individual Cancer Type sections for more information about hormone therapy and specific side effects.

Bone marrow and stem cell transplantation

Blood and marrow transplantation is a medical (not a surgical) procedure, lasting weeks to months from start to finish, in which diseased marrow (a spongy, fatty tissue found on the inside of larger bones) or immune system is replaced by a healthier one. For people with cancer, the goal is to destroy every remaining cancer cell. To learn more about this procedure, read the four-part series on Understanding Bone Marrow and Stem Cell Transplantation.

A Guide to the B Complex Vitamins

There is a lot of discussion about the B complex vitamin and how it is essential for the body to perform a multitude of functions. However, the B complex vitamin is not simply one very complicated vitamin, as the name might suggest. There are actually eight B vitamins that are in the B complex vitamin as well as a few other related substances. The eight vitamins that make up the B complex vitamin are thiamine or vitamin B1, riboflavin or vitamin B2, niacin or vitamin B3, pyridoxine or vitamin B6, cobalamine or vitamin B12, folic acid, pantothenic acid and biotin.  The other related substances that are also in the B complex vitamin include choline, inositol and para-aminobenzoic acid.

Every part of the B complex vitamin performs its own individual function within the body but it is when they work together as the B complex vitamin that they provide essential maintenance for the body to remain healthy. The B vitamin complex comprises B vitamins which are water soluble and it is essential that enough of these vitamins are consumed on a daily basis. The body cannot store water soluble vitamins such as the B complex vitamin and this leads to a regular intake being required.

The B complex vitamins are extremely beneficial for a number of conditions and may be needed in additional quantities at certain times in a person’s life. Of course, there is a recommended daily allowance for the B complex vitamins that varies according to the sex and age of a person. However, doctors and other health professionals have discovered the benefits of increasing the intake of the B complex vitamin to help overcome certain illnesses.

Many people suffer from anxiety and stress at one time or another and research has found that the B complex vitamin can be beneficial in helping alleviate the symptoms of anxiety and stress. If a person has been unwell the B complex vitamin can be extremely valuable in aiding the recovery process. Fatigue can be a symptom of a multitude of illnesses as well as simply overdoing things but the B complex vitamin can help alleviate general tiredness and lethargy.
Interestingly, some skin conditions, such as dermatitis, can also benefit from addition B complex vitamin intake. In fact, a number of creams and other skin preparations contain added vitamin B complex that can be absorbed by the skin to alleviate the condition. The condition of a person’s hair will also be greatly improved with sufficient B complex vitamin intake.

What is Symptom | Swine flu, what are the symptoms

Symptoms - this post will examine more deeply what is meant by Symptom and all information about the Symptom in relation to the swine flu, and here I give the sense Symptom Symptom according to wikipedia and viruses associated with pig flus, other than that I also gave FAQ's about Symptom I get from www.telegraph.co.uk
Symptom, is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality. A symptom is subjective, observed by the patient, and not measured,
Types
Symptoms may be chronic, relapsing or remitting. They also may progressively worsen or progressively become better (convalescence). Conditions may also be classified as symptomatic (present and demonstrating symptoms) or asymptomatic (present but without symptoms). Asymptomatic conditions and asymptomatic infections can exist for many years undiagnosed and may only be found upon medical testing (such as high blood pressure).
Constitutional or general symptoms are those that are related to the systemic effects of a disease (e.g., fever, malaise, anorexia, weight loss). They affect the entire body rather than a specific organ or location.
The terms "chief complaint", "presenting symptom", or "presenting complaint" are used to describe the initial concern which brings a patient to a doctor. The symptom that ultimately leads to a diagnosis is called a "cardinal symptom

Non-specific symptoms are those self-reported symptoms that do not indicate a specific disease process or involve an isolated body system. For example, fatigue is a feature of an enormous number of medical conditions, and is a documented feature of both acute and chronic medical conditions, both physical and mental disorders, and as both a primary and secondary symptom. Fatigue is also a normal, healthy condition when experienced after exertion or at the end of a day.
Swine flu: what are the symptoms
Q: What are the symptoms?
A: The symptoms of swine influenza in people are similar to the symptoms of regular human seasonal influenza infection and include fever, fatigue, lack of appetite, coughing and sore throat.

some people with swine flu have also reported vomiting and diarrhoea.

Q: What is swine flu?
A: It is a contagious respiratory disease of pigs caused by type A influenza viruses.
Pigs are hit by regular outbreaks.
There are many different types of swine flu and the current cases involve the H1N1 strain of type A influenza virus.
Q: How do humans catch it?
A: While people do not normally catch it, humans can contract the virus, usually if they have been in close contact with pigs.
It is also possible for the constantly changing infection to spread from person to person, which has happened in the latest outbreak.
Experts believe it spreads in the same way as seasonal flu – through coughing and sneezing. You cannot catch it through eating pork.
Q: What is the difference between swine flu, avian flu and the flu commonly seen in the UK during the winter?
A: Influenza viruses are commonly circulating in the human and animal environment, with different strains causing illness in humans, bird and pigs.
Seasonal influenza is caused by viruses that are adapted to spread in humans.
Humans have some natural immunity to the strains that are in common circulation, and this immunity can be boosted by immunisation with a vaccine.
Avian influenza is caused by influenza viruses adapted for infection in birds.
Similarly, swine influenza is caused by influenza viruses adapted for infection in pigs.
These illnesses all cause the same respiratory symptoms in sufferers and can be passed between one another.
Q: How dangerous is it?
A: More than 150 people have died and thousands made ill,.
However, testing has shown that the antiviral drugs oseltamavir (Tamiflu) and zanamivir (Relenza) appear to be effective against the human swine influenza H1N1 strain,
Q: Why should we be worried about it?
A: The World Health Organisation warned the outbreak had "pandemic potential" and countries were advised to step up surveillance and preparation in case the infection spreads rapidly.
Flu viruses have the ability to change and mutate, making it difficult for drugs manufacturers to ensure effective vaccines are available.
The new version of the H1N1 virus is a mix of different animal and human versions of the disease. Mixing can lead to the development of changed viruses to which humans have little immunity.
Q: What is a pandemic?
A: If the flu spreads over a wide geographic area and affects a large proportion of the population it goes beyond an epidemic and becomes a pandemic.
According to the Health Protection Agency, an influenza pandemic is defined as a new or novel influenza virus that spreads easily between humans.
When new influenza viruses are introduced into the environment, humans do not have any natural immunity to protect against them.
Therefore, there is a risk that new influenza viruses could develop into a pandemic if the virus passes easily from human-to-human.
Q: Is it in the UK?
A: Swine flu has already spread to the UK.
Anyone who has recently returned from affected countries should consult a doctor if they notice flu-like symptoms.
Q: What is being done in the UK to prevent the infection?
A: The HPA said it is working with the UK government to review the current incident and any threat it poses to UK public health.
It advised people to follow general infection control practices and good hygiene to reduce transmission of all viruses.
This includes covering their nose and mouth when coughing or sneezing, disposing of dirty tissues promptly and carefully, washing hands frequently with soap and water and cleaning surfaces which are regularly touched

Good Food Health Vitamin Intake

It is essential that a person is aware of what constitutes good food health vitamin intake. The federal drug administration produces a recommended daily allowance for the majority of vitamins which it regards as a good food health vitamin intake. These figures vary according to a person’s age, sex and some other factors so that the good food health vitamin intake for a young woman is going to be different to that of a man in his seventies.

The food health vitamin intake amounts of certain foods are included in the nutritional labelling. This labelling is important for a person to consider and helps ensure that they are receiving the correct food health vitamin intake from the foods that they eat. The nutritional information is often represented as a percentage of the recommended daily allowance of each vitamin and mineral and can help assess the value of the foods in the quest for good food health vitamin intake.

There are also a number of items that a person may want to restrict in their diet as part of their good food health vitamin intake. Again, the nutritional labelling of certain foods can help a person to see how high a product is in these undesirable contents. Salt and fat, for example, may be items that a person wants to consider limiting as part of their good food health vitamin intake even though they are not strictly vitamins. The majority of people actually refer to nutrients when they use the word vitamin and food manufacturers are aware that a person is looking at minerals and other items when they are considering their good food health vitamin intake. Fiber is another element that many people are more aware of as forming an essential part of a balanced diet and is necessary for good food health vitamin intake.

If a person is on a restricted diet for any reason then they need to pay even more attention to their good food health vitamin intake. Obviously, some foods contain different nutrients to others and this is applicable to vitamins as well and it may be more difficult for a person to achieve their good food health vitamin intake if they are unable to eat certain foods. Vitamin supplements can form an essential part of a good food health vitamin intake for people who are unable to obtain their vitamins from their normal diet. It is also worth remembering that the good food health vitamin intake for a person varies throughout their life depending on their general health.

The Genetics of Breast Cancer

After we talked about The Genetics of Cancer, it is time we will provide the posting about The Genetics of Breast Cancer, Genes carry small individual collections of information in each cell of the human body. Each gene consists of a unique DNA sequence. Researchers in the Human Genome Project is estimated that nearly 30,000 different genes in each cell. The genes are packaged into chromosomes. There are 23 pairs of chromosomes in each cell. One chromosome of each pair inherited from the father of the person and the other from the mother of the person.

Genes control how a cell, including how fast it grows, how often they divide, and how long you live. To control these functions, genes produce proteins that lead to specific tasks and act as messengers in the cell. Therefore, it is important that each gene is the proper instructions or "code" for the production of its protein-protein can be so the proper functioning of the cell has to fulfill

What role do genes play in breast cancer?

Cancer begins when one or more genes in a cell are mutated (changed), creating an abnormal protein or no protein at all. The information provided by an abnormal protein is different from that of a normal protein, which can cause cells to multiply uncontrollably and become cancerous.
A person may either be born with a genetic mutation in all of their cells (germline mutation) or acquire a genetic mutation in a single cell during his or her lifetime. An acquired mutation is passed on to all cells that develop from that single cell (called a somatic mutation). Somatic mutations can sometimes be caused by environmental factors, such as cigarette smoke. Most breast cancers (about 90% to 95%) are considered sporadic, meaning that the damage to the genes occurs by chance after a person is born. Inherited breast cancers are less common (5% to 10%) and occur when gene mutations are passed within a family, from one generation to the next. Genetic mutations in certain types of genes are more likely to cause cancer. The most common gene mutations that can increase breast cancer risk occur in tumor suppressor genes. A tumor suppressor gene makes proteins that prevent tumor formation by limiting cell growth. Mutations in a tumor suppressor gene cause a loss of the ability to restrict tumor growth and, as a result, cancer can develop.

What are the chances a mutated gene is inherited?

Every cell usually has two copies of each gene: one inherited from the mother and one inherited from the father. Breast cancer usually follows an autosomal dominant inheritance pattern, in which a mutation needs to happen in only one copy of the gene for the person to have an increased risk of getting the disease. This means that a parent with a gene mutation may pass on a copy of the normal gene or a copy of the gene with a mutation. Therefore, a child who has a parent with a mutation has a 50% chance of inheriting that mutation. A brother, sister, or parent of a person who has a gene mutation also has a 50% chance of having the same mutation.

What is a woman's average risk for breast cancer?

A woman with an average risk of breast cancer has about a 12% chance of developing breast cancer.

How common is breast cancer?

Breast cancer is the most common cancer among women, excluding cancers of the skin, and the second most common cause of death from cancer among women. In 2009, an estimated 192,370 women in the United States will be diagnosed with invasive breast cancer, and 62,280 women will be diagnosed with in situ breast cancer. An estimated 1,910 men in the United States will be diagnosed with breast cancer. It is estimated that 40,610 deaths (40,170 women, 440 men) from this disease will occur this year.

How can a woman know if she has inherited a genetic mutation that increases her risk of breast cancer?

Only genetic testing can determine whether a person has a genetic mutation. Most experts strongly recommend that people considering genetic testing first consult a genetic counselor. Genetic counselors are trained to explain the risks and benefits of genetic testing.

For more information, read Genetic Testing and What to Expect When Meeting With a Genetic Counselor.

How does a woman know if breast cancer runs in the family?

Breast cancer may run in the family if first-degree relatives (mothers, sisters, children) or many close relatives (first-degree relatives, grandmothers, aunts, nieces, granddaughters, cousins) have been diagnosed with breast cancer, especially before age 50.

What is a woman's risk if breast cancer runs in the family?

If a woman's first-degree relative developed breast cancer, the woman’s risk is double the average woman's risk. If two first-degree relatives developed breast cancer, the woman’s risk is 5 times the average risk. It is uncertain how much a woman's risk of breast cancer is increased when a man in the family has breast cancer.

Which inherited genetic mutations raise the risk of breast cancer?

There are several genes linked to an increased risk of breast cancer. Some of the most common hereditary cancer syndromes associated with breast cancer risk are described below.

Hereditary breast and ovarian cancer (HBOC) syndrome. The two genes are associated with HBOC, BRCA1 and BRCA2 (BRCA stands for BReast CAncer), are tumor suppressor genes. Women who inherit a BRCA mutation have a 50% to 85% chance of developing breast cancer and a 15% to 40% chance of developing ovarian cancer. Men with BRCA1 and BRCA2 mutations may have an increased risk of breast and prostate cancers. Both women and men with BRCA2 mutations may be at increased risk of breast cancer or other types of cancer. Approximately one in 40 women with Ashkenazi Jewish heritage carry a mutation in BRCA1 or BRCA2 genes that increases their risk of breast cancer to between 50% and 85%. Their risk of ovarian cancer is also increased to about 40%. About 80% of hereditary (inherited) breast cancer is caused by mutations in BRCA1 or BRCA2.

For more information, read the Cancer.Net Cancer.Net Guide to Hereditary Breast and Ovarian Cancer.

Ataxia telangiectasia (A-T). Ataxia-telangiectasia (A-T) is a rare recessive disorder characterized by progressive neurological problems that lead to difficulty walking. Signs of A-T develop in childhood. Children may begin staggering and appear unsteady shortly after learning to walk. Most people with A-T will eventually need to use a wheelchair. Slurred speech and difficulty with writing and other tasks develop over time. Red marks that are caused by dilated capillaries (tiny blood vessels), called telangiectases, often appear on the skin and eyes. People with A-T also have a weakened immune system and are prone to infections.

There is about a 40% risk of cancer for people with A-T. The most common cancers associated with A-T are leukemia and lymphoma. As the lifespan of individuals with A-T increases, other types of cancer, including melanoma, sarcoma, and breast, ovarian, and stomach cancers, are being reported in adults. However, it is too early to determine if there is truly an increased risk for these cancers that is caused by A-T, or whether these are sporadic cancers developing in adults who also happen to have A-T.

A-T is inherited as an autosomal recessive condition. In autosomal recessive inheritance, a person needs to have two copies of a gene mutation in order to have the disease. This means that each parent must have one mutated gene and one normal gene. If both parents carry a gene mutation for A-T, each of their children will have a 25% chance of inheriting both gene mutations and having A-T. The gene associated with AT is called ATM. For people who have one altered copy of the gene, there may be a somewhat increased risk of melanoma and breast, ovarian, and stomach cancers. Genetic testing for the ATM gene is available.

For more information, read the Cancer.Net Guide to Ataxia-Telangiectasia.

Li-Fraumeni syndrome (LFS). People with LFS have up to a 50% chance of developing cancer by age 40 and a 90% chance of developing cancer by age 60. Some of the cancers most commonly associated with LFS are osteosarcoma (a type of bone cancer), soft tissue sarcoma, leukemia, breast cancer, brain cancer, and adrenal cortical tumors. An adrenal cortical tumor begins in the adrenal cortex, which is the outer layer of the adrenal glands. The adrenal glands are located on top of each kidney and are a part of the body’s endocrine (hormonal) system.

LFS is a rare condition. The gene associated with LFS, called p53, is a tumor suppressor gene. Testing for p53 gene mutations is available for families who may have LFS. Another gene, CHEK2, may cause LFS for some families. Testing for mutations in the CHEK2 gene is only available as part of a research study.

For more information, read the Cancer.Net Guide to Li-Fraumeni syndrome.

Cowden syndrome (CS). Women with CS have a 25% to 50% risk of developing breast cancer and a 65% risk of developing noncancerous breast changes. CS is a rare genetic condition caused by a mutation on the PTEN gene. People with CS also have a high risk of both noncancerous and cancerous tumors of the thyroid and endometrium (lining of the uterus). Also, people with CS often have small growths on the face or in the mouth and a larger than average head size. Genetic testing for the PTEN gene is available.

For more information, read the Cancer.Net Guide to Cowden Syndrome.


Peutz-Jeghers syndrome (PJS). Women with PJS have approximately a 50% risk of developing breast cancer. Women with PJS also have about a 20% risk of developing ovarian cancer. People with PJS often have multiple hamartomatous polyps, which are normal-appearing growths in the digestive tract that become a noncancerous tumor. These polyps cause an increased risk of colorectal cancer. People with PJS also have increased pigmentation (dark spots on the skin) on the face and hands. The increased pigmentation often appears in childhood and fades over time. Families with PJS also have an increased risk of uterine and lung cancers. The gene associated with PJS is called STK11. The STK11 is a tumor suppressor gene, and genetic testing for the STK11 gene is available.

For more information, read the Cancer.Net Guide to Peutz-Jeghers Syndrome.


Other genes. Other genes may cause hereditary breast cancer. However, more research is needed to understand how gene mutations can increase breast cancer risk and to find other genes that may increase a person’s risk of breast cancer.

What is a person's risk level?

In addition to family history, other environmental and lifestyle factors may increase the risk of breast cancer. Discussing family history and personal risk factors with a doctor can help a person better understand his or her risk. People with a higher than average risk may benefit from genetic counseling and early detection strategies.

A risk factor is anything that increases a person's risk of developing cancer. Having a particular genetic mutation linked to breast cancer cannot predict that a person will develop cancer. Controllable risk factors, such as eating a balanced diet, maintaining a healthy weight, exercising, limiting alcoholic beverages, and avoiding tobacco products also play a role. Most people who develop breast cancer have few known risk factors. Research to better understand the link between genetic mutations and breast cancer is ongoing. Talk with a doctor for more information about risk factors, prevention, and screening for breast cancer.
source : http://www.cancer.net/patient/All+About+Cancer/Genetics/The+Genetics+of+Breast+Cancer

The Genetics of Cancer

The ancient Greeks believed that cancer by excess fluid, they "black bile caused." Doctors in the seventeenth and eighteenth centuries, has suggested that parasites cause cancer. Today, doctors understand that cancer is genetic, which means that changes in different genes in the body can cause cancer.

Genes and Chromosomes

Genes are the functional units and physical basis of heredity passed from parents to offspring. You are the deoxyribonucleic acid (DNA) and are found in structures called chromosomes in every cell of the body is a person. Genes provide the instructions to keep to work the body. Most people are familiar with a person's eye color with the genes for their role in determining the physical properties.

The human body contains about 30,000 genes. They are located in 46 chromosomes arranged into 23 pairs. Pairs of chromosome 1 numbered to 22 and are called autosomes. The other two chromosomes (pair 23) are the sex chromosomes that determine whether a person is born, male or female. Since genes come in pairs, taking a person, a gene from each pair of mother and father

The role of genes in cancer

In a person’s body, cells are continually dying and being replaced. For example, cells in the skin, liver, and intestines are replaced every few weeks. The body makes new cells by copying the old cells, and in this process (called cell division), there may be mistakes in how the genetic material is copied. These are called mutations. Some mutations have no effect on a cell, while other mutations are harmful or helpful to the cell. If a mutation is not corrected, and it occurs in a critical part of the gene, it may lead to cancer. However, the chance of one mutation leading to cancer is rare. Usually it takes multiple mutations over a lifetime to produce a cancer cell. This is why cancer occurs more often in older people—there have been more opportunities for mutations to accumulate.

There are two basic kinds of genetic mutations. If the mutation is directly passed from a parent to a child, it is called a germline mutation. This means that the mutation is present in every cell of the child’s body, including the reproductive sperm and egg cells. Because the mutation affects reproductive cells, it is passed from generation to generation. Germline mutations are responsible for 5% to 10% of cancer cases, which is called familial (occurring in families) cancer.

Acquired mutations occur during a person’s life and are not passed from parent to child. These mutations are caused by tobacco, UV radiation, viruses, age, and other factors. Cancer caused by this type of mutation is called sporadic cancer, which is much more common than familial cancer.

Most scientists believe that cancer happens when several genes of a particular group of cells become mutated. Some people may have more inherited mutations than others, and even with the same amount of environmental exposure, some people are simply more likely to develop cancer.

Genes that play a role in cancer

The following types of genes contribute to cancer:

* Tumor suppressor genes are protective genes. Normally, they suppress (limit) cell growth by monitoring the rate at which cells divide into new cells, repairing mismatched DNA (a cause of mutations), and controlling cell death. When a tumor suppressor gene is mutated (due to heredity or environmental factors), cells continue to grow and can eventually form a tumor. BRCA1, BRCA2, and p53 are examples of tumor suppressor genes. In fact, nearly 50% of all cancers involve a missing or damaged p53 gene.

* Oncogenes turn a healthy cell into a cancerous one. HER2/neu and ras are two common oncogenes.

* DNA repair genes fix any mistakes made when DNA is replicated (copied). Mistakes that aren’t fixed become mutations, which may eventually lead to cancer, especially if the mutation occurs in a tumor suppressor gene or oncogene.

Cancer develops when several genes in a cell become mutated in a way that overrides the checks and balances of the cell. However, many cancers cannot be tied to a specific gene, and some genes may interact in unpredictable ways with other genes or factors in the environment to cause cancer. In the future, doctors hope to learn more about the role of genetic changes in the development of cancer, which may lead to improved cancer treatment and prevention strategies.

Health Disparities and Cancer

The U.S. Department of Health and Human Services defines health disparities as differences in the incidence, prevalence, death and burden of disease and other conditions prejudicial to the health that exist among specific population groups including racial and ethnic minorities.

These differences in racial and ethnic minorities

In March 2002 the Institute of Medicine released a report that found "overwhelming evidence" that racial and ethnic minorities suffer disparities in health care. Factors, the differences in health are poverty, lack of access to medical care, lack of health insurance, language barriers and competence, and the expectations of the ill-treatment outcome of cancer, doctors and / or health. Although there are many causes which are access to care, racial and ethnic disparities in health care contribute significantly to this problem in the United States. The research shows that minorities are less healthy, will experience greater barriers to care, more likely to be insured and are more likely to receive poor quality care than other Americans.

The recent National Healthcare disparities report by the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ) found that limited progress in eliminating disparities in health care have been made and there are not many significant gaps in the quality and access addressed

Areas of disparity in cancer care

Issues related to disparity in cancer care can be broken down into several areas, including prevention, diagnosis, and treatment.

Prevention

People from minority populations participate much less often in cancer prevention programs than do white people. They also may be less likely to use genetic testing to identify whether they have an increased cancer risk.

* In the AHRQ report mentioned above, 23% of Hispanic women reported that they have never had a Pap test, compared with 17% of non-Hispanic white women.

* Minority women tend to be more reluctant to undergo testing for the breast cancer genes 1 and 2 (BRCA 1 and BRCA 2), even when they have a family history of breast or ovarian cancer, according to a 2005 report in the Journal of the American Medical Association.

Diagnosis

Diagnosis of cancer is often delayed in people from minority groups.

* The Medical Expenditure Panel Survey from the AHRQ found that nearly 30% of Hispanic people and 20% of African American people lack a usual source of health care, compared with less than 16% of white people.

* Uninsured, African American, Hispanic, and low-income patients are less likely than white, high-income, and insured patients to receive recommended care and are more likely to be admitted to the hospital for potentially preventable conditions, according to a 2006 report from The Commonwealth Fund.

Treatment

Differences in the result of cancer treatment are not only because of delays from lack of access to care and problems with prevention and diagnosis, but may also reflect the lower quality of medical services in some underprivileged areas, according to a 2005 article in the journal Medical Care. For example, physicians treating African American patients are less likely to be board certified, and these doctors have less access to specialists and other technology resources.

How health care disparities affect people of different races/ethnic groups

Overall, minority populations have a higher risk of developing cancer and a higher total death rate. According to data from the National Cancer Institute (NCI), African American people have the most numbers of new cases of cancer and the highest death rates from cancer, even though they make up a minority of the U.S. population.

The section below highlights examples of these health care disparities, using data from the NCI and the American Cancer Society’s publication, Cancer Facts and Figures. These data demonstrate the disparities in health care faced by racial and ethnic minority groups in the United States:

African Americans

* African American people are less likely than white people to survive five years after being diagnosed with most types of cancer, at any stage of diagnosis.

* African American women are diagnosed less often with breast cancer than white women, but are more likely to die of breast cancer than white women. The risk of the less treatable, more deadly type of breast cancer is twice as high in African American women.

* African American men have the highest risk of developing prostate cancer. They also tend to have cancers that are more aggressive and have more than twice the death rate when compared to other racial and ethnic groups.

* Despite its preventable nature, colorectal cancer continues to kill a disproportionate number of African American people each year. New diagnoses of colorectal cancer among African American men and women are about 17% higher than in white men and women.

Hispanic Americans

* Cancer is the second leading cause of death for Hispanic people in the United States, accounting for about 20% of all deaths.

* Hispanic people have lower numbers of new cancers for all cancers combined when compared with white people, but generally have higher rates of uterine, cervix, liver, gallbladder, and stomach cancers, which are associated with certain infections.

* Liver cancer rates are twice as high in Hispanic men and women compared with white men and women.

* Colorectal cancer is the second-most commonly diagnosed cancer in both Hispanic men and women.

Asian Americans

* Cancer affects Asian American people in very different ways, based on country of origin. According to a study of the five largest Asian American groups – Chinese, Filipino, Vietnamese, Korean, and Japanese – colorectal cancer rates are highest among Chinese Americans; prostate cancer is more common and more often deadly among Filipino men; and Vietnamese women have the highest number of new cancers and death rates from cervical cancer of all Asian American women.

* A significant number of Korean American women are not familiar with the Pap test, a decades-old standard for cervical cancer screening.

Native American/Alaska Natives

* For all cancers combined and various site-specific cancers, the five-year cancer survival rate (the percentage of patients who survive at least five years after the cancer is detected) for American Indian women is significantly lower than that for white women.

* Alaska Native women have the highest death rate of all ethnic groups for all cancers combined, and for colorectal and lung cancers specifically.

Contributing factors to health disparities among racial/ethnic minorities

People from minority groups are more likely than white people to lack health insurance. The following statistics come from a March 2008 Commonwealth Fund article and a 2006 U.S. Census Bureau report:

* In 2006, the uninsured rate for non-Hispanic white people remained unchanged at 11%.

* The uninsured rate for African American people increased in 2006 to 21% up from 19% in 2005.

* The uninsured rate for Asian people decreased to 16% in 2006, down from 17% in 2005.

* Among Hispanic people, the rate of the uninsured increased in 2006 to 34%, up from 32% in 2005.

* About one in three people who are from the American Indian/Alaska Native population do not have health insurance.

In addition, 16% of African American people and 13% of Hispanic people rely on hospitals or clinics for their usual source of care, compared with 8% of white Americans.
source : http://www.cancer.net