Determining the extent (stage) of stomach cancer

The stage of your stomach cancer helps your doctor decide which treatments may be best for you. Tests and procedures used to determine the stage of cancer include:

• Imaging tests. Tests may include CT, positron emission tomography (PET) and X-ray.

Exploratory surgery. Exploratory surgery is usually done laproscopically. This means the surgeon makes several small incisions in your abdomen and inserts a special camera that transmits images to a monitor in the operating room.

Breast cancer

Breast cancer refers to cancers originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas. There are many different types of breast cancer, with different stages (spread), aggressiveness, and genetic makeup; survival varies greatly depending on those factors.

The first noticeable symptom of breast cancer is typically a lump that feels different from the rest of the breast tissue. More than 80% of breast cancer cases are discovered when the woman feels a lump. By the time a breast lump is noticeable, it has probably been growing for years. The earliest breast cancers are detected by a mammogram. Lumps found in lymph nodes located in the armpits can also indicate breast cancer.

Indications of breast cancer other than a lump may include changes in breast size or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain is an unreliable tool in determining the presence or absence of breast cancer, but may be indicative of other breast health issues.

Another reported symptom complex of breast cancer is Paget's disease of the breast. This syndrome presents as eczematoid skin changes such as redness and mild flaking of the nipple skin. As Paget's advances, symptoms may include tingling, itching, increased sensitivity, burning, and pain. There may also be discharge from the nipple. Occasionally, breast cancer presents as metastatic disease, that is, cancer that has spread beyond the original organ. Metastatic breast cancer will cause symptoms that depend on the location of metastasis. Common sites of metastasis include bone, liver, lung and brain. Unexplained weight loss can occasionally herald an occult breast cancer, as can symptoms of fevers or chills. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms.

Breast cancer screening refers to testing otherwise-healthy women for breast cancer in an attempt to achieve an earlier diagnosis. The assumption is that early detection will improve outcomes. A number of screening test have been employed including: clinical and self breast exams, mammography, genetic screening, ultrasound, and magnetic resonance imaging.

Breast cancer is treated first with surgery, and then with drugs, radiation, or both. Treatments are given with increasing aggressiveness according to the prognosis and risk of recurrence.

Drugs used in addition to surgery are called adjuvant therapy. There are currently 3 main groups of medications used for adjuvant breast cancer treatment: hormone blocking therapy, chemotherapy and monoclonal antibodies.

Pancreatitis

Pancreatitis is inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum - the first part of the small intestine. The pancreas secretes digestive juices, or enzymes, into the duodenum through a tube called the pancreatic duct. Pancreatic enzymes join with bile - a liquid produced in the liver and stored in the gallbladder - to digest food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body regulate the glucose it takes from food for energy.

Normally, digestive enzymes secreted by the pancreas do not become active until they reach the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the tissues that produce them.

Pancreatitis can be acute or chronic. Either form is serious and can lead to complications. In severe cases, bleeding, infection, and permanent tissue damage may occur.

While asking about a person's medical history and conducting a thorough physical examination, the doctor will order a blood test to assist in the diagnosis. During acute pancreatitis, the blood contains at least three times the normal amount of amylase and lipase, digestive enzymes formed in the pancreas. Changes may also occur in other body chemicals such as glucose, calcium, magnesium, sodium, potassium, and bicarbonate. After the person's condition improves, the levels usually return to normal.

Treatment for acute pancreatitis requires a few days' stay in the hospital for intravenous (IV) fluids, antibiotics, and medication to relieve pain. The person cannot eat or drink so the pancreas can rest. If vomiting occurs, a tube may be placed through the nose and into the stomach to remove fluid and air.

Unless complications arise, acute pancreatitis usually resolves in a few days. In severe cases, the person may require nasogastric feeding - a special liquid given in a long, thin tube inserted through the nose and throat and into the stomach - for several weeks while the pancreas heals.

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a specialized technique used to view the pancreas, gallbladder, and bile ducts and treat complications of acute and chronic pancreatitis - gallstones, narrowing or blockage of the pancreatic duct or bile ducts, leaks in the bile ducts, and pseudocysts -accumulations of fluid and tissue debris.

Soon after a person is admitted to the hospital with suspected narrowing of the pancreatic duct or bile ducts, a physician with specialized training performs ERCP.

After lightly sedating the patient and giving medication to numb the throat, the doctor inserts an endoscope - a long, flexible, lighted tube with a camera -through the mouth, throat, and stomach into the small intestine. The endoscope is connected to a computer and screen. The doctor guides the endoscope and injects a special dye into the pancreatic or bile ducts that helps the pancreas, gallbladder, and bile ducts appear on the screen while x -rays are taken.

Hepatitis

The word hepatitis means inflammation of the liver. It can be caused by one of many things, including a bacterial infection, liver injury caused by a toxin (poison), and even an attack on the liver by the body's own immune system. However, the condition is usually caused by a virus. The three most common hepatitis viruses are hepatitis A, hepatitis B, or hepatitis C.

The hepatitis A virus is transmitted through the faeces (poop) of infected individuals. People usually get hepatitis A by eating food or drinking water that's been contaminated with faeces. As disgusting as that sounds though, hepatitis A is actually considered less destructive than some other hepatitis viruses.

Hepatitis В is a more serious infection. It may lead to a condition called cirrhosis (permanent scarring of the liver) or liver cancer, both of which cause severe illness and even death. Hepatitis В virus is transmitted from person to person through blood or other body fluids.

The hepatitis С virus (HCV) is transmitted from person to person through blood or other body fluids. Like hepatitis B, hepatitis С can lead to cirrhosis or liver cancer.

Hepatitis С is the most serious type of hepatitis. It's now one of the most common reasons for liver transplants in adults. And there's no cure and no vaccine.

Hepatitis infection causes inflammation of the liver, which means that the liver becomes swollen and damaged and begins losing its ability to function. People with hepatitis often get symptoms similar to those caused by other virus infections, such as weakness, tiredness, and nausea. Because the symptoms of hepatitis are similar to other conditions, it's easy for someone who has it to confuse it with another illness.

In addition, people with hepatitis A may not show any symptoms, so the infection can go undiagnosed. People with hepatitis В or С infection also may not show symptoms right away, but can develop health problems from the infection many years later. Even when infected people don't have any symptoms, they can still pass the disease on to others.

Symptoms of hepatitis include: yellowing of the skin and eyes, known as jaundice, fever, nausea, vomiting, and lack of appetite, abdominal pain (on the upper right side), light-coloured bowel movements, dark-coloured urine, etc.

A blood test is usually needed to determine if a person has hepatitis.

Doctors don't prescribe medications to treat hepatitis A; they usually recommend resting until any fever and jaundice are gone and the person's appetite has returned to normal. It is also important to stay well hydrated by drinking lots of fluids.

Hepatitis В and С can sometimes be treated with medications, although some forms of medication used to treat hepatitis С are only approved for use in adults. Although treatments for hepatitis В and С are becoming more effective, a cure cannot be guaranteed.

HIV/AIDS

HIV stands for human immunodeficiency virus. AIDS stands for acquired immunodeficiency syndrome. HIV is actually the virus that causes the disease AIDS. This condition progressively reduces the effectiveness of the immune system and leaves individuals susceptible to opportunistic infections and tumours.

People who are HIV positive have been tested and found to have signs of the human immunodeficiency virus in their blood. HIV destroys part of the immune system. Specifically, it affects a type of white blood cell called the T lymphocyte, or T cell. T cells are one type of "fighter" cell in the blood that helps the body fight off all kinds of germs and diseases.

Someone who is infected with the virus is called HIV positive. But it may take years for the virus to damage enough T cells for that person to get sick and develop AIDS. And thanks to new medications, someone infected with HIV can stay relatively healthy and symptom-free for many years. But these medications are very expensive and not available to everyone in the world.

The majority of people get infected with HIV: by having sexual contact with a person who has HIV; sharing needles or syringes (used to inject illegal drugs) with a person who has HIV; an infected pregnant woman passes it to her unborn child; a person has a blood transfusion from a fairly large volume of blood.

The symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals with healthy immune systems. Most of these conditions are infections caused by bacteria, viruses, fungi and parasites that are normally controlled by the elements of the immune system that HIV damages.

An HIV-positive person will eventually begin to feel sick. The person might start to have swollen lymph nodes, weight loss, fevers that come and go, infections in the mouth, diarrhoea, or he or she might feel tired for no reason all of the time. Eventually, the virus can infect all of the body's organs, including the brain, making it hard for the person to think and remember things. When a person's T cell count gets very low, the immune system is so weak that many different diseases and infections by other germs can develop. Other infections can affect the eyes, the organs of the digestive system, the kidneys, the lungs, and the brain. Some people develop rare kinds of cancers of the skin or immune system.

Right now there is no cure for HIV or AIDS, but new medicines can help people live longer lives. Scientists are also researching vaccines that may one day help to prevent HIV infection, but it's a very tough assignment, and no one knows when these vaccines might become available. It's up to everyone to prevent AIDS by avoiding the behaviours that lead to HIV infection.

People can help stop the spread of HIV by avoiding sexual contact with infected people and by not sharing needles or syringes.

Health care workers (such as doctors, nurses, and dentists) help prevent the spread of HIV by wearing plastic gloves when working on a patient. Hospitals have strict procedures for handling samples of blood and other body fluids to prevent others from coming in contact with HIV.

Hormonal disorders

Hormonal disorders, also called endocrine disorders, are illnesses that occur when the body releases too many or too few hormones.

Too much or too little of any hormone can be harmful to the body. For example, if the pituitary gland produces too much growth hormone, a child may grow excessively tall. If it produces too little, a child may be abnormally short.

Controlling the production of or replacing specific hormones can treat many endocrine disorders in children and adolescents, some of which include:

Adrenal insufficiency. This condition is characterized by decreased function of the adrenal cortex and the consequent underproduction of adrenal corticosteroid hormones. The symptoms of adrenal insufficiency may include weakness, fatigue, abdominal pain, nausea, dehydration, and skin changes. Doctors treat adrenal insufficiency by giving replacement corticosteroid hormones.

Cushing syndrome. Excessive amounts of glucocorticoid hormones in the body can lead to Cushing syndrome. Symptoms may take years to develop and include obesity, growth failure, muscle weakness, easy bruising of the skin, acne, high blood pressure, and psychological changes. Depending on the specific cause, doctors may treat this condition with surgery, radiation therapy, chemotherapy, or drugs that block the production of hormones.

Growth hormone problems. Too much growth hormone in children who are still growing will make their bones and other body parts grow excessively, resulting in gigantism. This rare condition is usually caused by a pituitary tumour and can be treated by removing the tumour. In contrast, when the pituitary gland fails to produce adequate amounts of growth hormone, a child's growth in height is impaired. Hypoglycaemia (low blood sugar) may also occur in kids with growth hormone deficiency, particularly in infants and young children with the condition.

Hyperthyroidism. Hyperthyroidism is a condition in which the levels of thyroid hormones in the blood are excessively high. Symptoms may include weight loss, nervousness, tremors, excessive sweating, increased heart rate and blood pressure, protruding eyes, and a swelling in the neck from an enlarged thyroid gland (goitre). In kids the condition is usually caused by Graves' disease, an autoimmune disorder in which specific antibodies produced by the immune system stimulate the thyroid gland to become overactive. The disease may be controlled with medications or by removal or destruction of the thyroid gland through surgery or radiation treatments.

Hypothyroidism. Hypothyroidism is a condition in which the levels of thyroid hormones in the blood are abnormally low. Thyroid hormone deficiency slows body processes and may lead to fatigue, a slow heart rate, dry skin, weight gain, constipation, and, in kids, slowing of growth and delayed puberty. Hashimoto's thyroiditis, which results from an autoimmune process that damages the thyroid and blocks thyroid hormone production, is the most common cause of hypothyroidism in kids. Infants can also be born with an absent or underdeveloped thyroid gland, resulting in hypothyroidism. It can be treated with oral thyroid hormone replacement.