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Cancer Diagnosis &Treatments Laboratory Test Some cancers excrete enzymes or protein marker that can be detected in blood work Example: CEA Carcinoembryonic antigen Bloodstream of tumors of gastrointestinal origin PSA prostate specific antigen Protein produced by prostate cancer cells Laboratory Tests Alpha-fetoprotein antigen Excreted by tumors of liver and testicular cancer Imaging Ultrasound: using sound waves Computed Tomography Magnetic Resonance Imaging Positron Emission Tomography Bone Scan Ultrasound High Frequency sound waves which produce echoes Computer interprets these images into pictures Can be used to diagnosis: Soft tissue abnormalities Pregnancy CT Scan Creates multiple picture slices Combines multiple images to produce cross sectional views Can create three dimensional views Define normal and abnormal structures Can be used to accurately guide placement of treatment or instruments Detect soft and hard tissue abnormalities Contrast dyes can be used MRI Magnetism, radio waves and a computer The magnetic field aligns the protons of hydrogen atoms The hydrogen atoms are then exposed to radio waves which causes spinning of the atoms This faint signal is picked up by the computer to create images Produces images of body structures Detailed pictures are created and tiny changes can be detected Contrast agents can be used PET Small amount of radioactive material is injected, inhaled or swallowed The energy from this material is detected and images created Detects cancer, blood flow obstructions, brain abnormality including seizures Actual cellular functioning can be seen Blood flow Oxygen use Glucose metabolism Bone Scan Radioactive tracer is injected into arm Travels to the bone Areas of lack of blood supply, cancer or bone loss show up as dark or cold spots Areas of increased bone growth or repair show up as bright or hot spots: Arthritis Tumors Infection fractures Clinical Procedures: Diagnosis Bone marrow biopsy Small amount of bone marrow aspirated and examined Exfoliated cytology Cells scraped from the region of disease and examined: pap test Clinical diagnosis con’t Lymphangiography Contrast dye injected into the lymphatic vessels of the feet and x-rays are taken to detect enlarged lymph nodes, blockages, and the presence of tumors . Needle biopsy Needle inserted into tissue in question and core of tissue removed the cells are examined under a microscope to be graded Aspiration (suction) may be used to withdraw fluid Peritoneoscopy (Laparoscopy) Inspect the peritoneal cavity for tumors Small incision in abdominal wall Staging laparotomy Wide surgical incision of the abdominal cavity to determine the extent of metastases Treatments Surgery Tumor is diagnosed before it metastasized Cure or reduce Examples: Stomach, Breast, Uterus, Bone Generally Carcinomas or Mixed Tissue and limited Sarcomas (why?) Grade 1 to 111 T1-2 N may or may not be present Mo Radiation Therapy Maximal dose of ionizing radiation to the tumor and minimal dose to the surrounding normal tissue Do you see the difficulty? Used to shrink tumor Used as adjunct to surgery Used when surgery not possible Chemotherapy Drugs that target rapidly dividing cells Think of what normal cells rapidly divide. Given as an adjunct to other treatments Purpose is to block the replication and/or decrease the growth. Used in T1-4N1-4M1-3 Carcinomas, Sarcomas & Mixed-Tissue Tumors Biological Agents Using bodies own defense system NKCells Research aimed at restoring, enhancing, mimicking or manipulating immune system to destroy cancerous cells Hormones: Estrogen is used to treat prostate cancer Complementary and Alternative Massage Meditation Therapeutic touch Aromatherapy Traditional Chinese medicine Herbal preparations Special Diets Acupuncture Acupressure Estimated rates of cancer and death rates for 2008 by site and sex Lung Cancer: Most Preventable Man & Woman Diagnosed: 23,900 yearly 460 weekly Death: 20,200 388 will die per week Man: 1 in 12 will develop 1 in 13 will die Woman 1 in 16 will develop 1 in 18 will die Colorectal Cancer: Second leading cause of death Man & Woman Diagnosed 21,500 413 per week Death 8,900 171 will die per week Man 1 in 14 will develop 1 in 27 will die Woman 1 in 16 will develop 1 in 31 will die Breast Cancer: Most common for woman Since 1993 rates have stabilized and decreased Diagnosed Woman: 22,400 with 431 diagnosed weekly Man: 170 Deaths Woman: 5,300 yearly with 102 dying per week Men: 50 over the year Breast cancer 1 in 9 women will develop 1 in 28 will die Based on woman living to 80 Prostate: Most common for men Diagnosed 24,700 yearly 475 per week Deaths 4,300 yearly 83 will die every week Stats 1 in 7 will develop (mostly after 60) 1 in 27 will die