Colon Polyps

Colon polyps refer to a medical condition in which a small group of cells develop on the lining of the colon or large intestine. However, most of the colon polyps are harmless but, in some cases, these could turn to colon cancer. Colon cancer, if diagnosed in the later stages, can prove fatal for the person. Colon polyps are also known as colorectal polyps and often do not cause any symptoms or pain. These are mostly detected via routine medical examinations.

Typically, there are two types of colon polyps:

  • Non-neoplastic: This category of polyps often does not become cancerous and includes hyperplastic, inflammatory and hamartomatous polyps.
  • Neoplastic: These are large polyps than are riskier to become cancerous eventually. These include adenomas and serrated types.

Even though any person can develop polyps, the risk is higher for a person in their 50s or older. Moreover, overweight people, smokers, or people with a family history of colon polyps can be more prone to this medical condition.

Symptoms of Colon Polyps

As specified, colon polyps do not show any symptoms or pain. These can only be diagnosed via a regular exam of the bowel. However, in some cases, where people experience symptoms, these include:

  • Bleeding in the rectal
  • Red streaks of blood in the stool or black-coloured stool
  • An extreme change in bowel movements, including constipation, diarrhoea, that lasts for more than a week
  • Abdominal pain caused because of a large polyp that obstructs the bowel
  • Extreme deficiency of iron caused because of chronic bleeding from the polyps

However, when the patient experiences the below symptoms, immediate medical help must be sought:

  • Abdominal pain
  • Blood streaks in the stool
  • A sudden change in bowel movements that have been consistent for a week

That said, some people are more prone to developing colon polyps and hence, must get themselves regularly screened to avoid complications. These include:

  • People above the age of 50 years
  • People with a family history of colon polyps or colon cancer. These people should begin their preventive screening before the age of 50.

Causes of Colon Polyps

In a normal human body, the cells grow and divide in a set manner. However, mutations can cause specific genes to continue dividing themselves, even when there are no requirements for new cells. Such a state in the colon or the rectum of a person can lead to the development of colon polyps. These polyps can develop anywhere in the large intestine.

That said, colon polyps alone are not a threatening issue. However, if these advance further to become cancerous, they can prove fatal, if not treated within time. Typically, the larger the size of the polyp, the greater is its chance to turn cancerous.

Risk Factors of Colon Polyps

The below factors can cause the development of colon polyps in some people:

  • People over the age of 50 years
  • People with an existing inflammatory intestinal condition, such as Crohn’s disease
  • People that have a family history of colon polyps or colon cancer. These people typically include siblings, parents, etc.
  • People that consume a lot of tobacco and alcohol
  • Patients of Type-2 diabetes
  • People that are obese or excessively overweight
  • People of the African-American race are more prone to the issue

Moreover, patients with specific hereditary polyp disorder such as Lynch syndrome, Gardner’s syndrome, Serrated Polyposis syndrome, etc.

Complications of Colon Polyps

Even though the normal existence of colon polyps is not harmful. But these can intensify to cause colon cancer, if not treated within time.

Prevention of Colon Polyps

A person can greatly reduce the overall risk of colon polyps and related cancer through regular medical examinations and screenings. Moreover, a few lifestyle modifications can also help prevent colon polyps, such as:

  • Limiting alcohol and tobacco intake
  • Focusing on eating a healthy diet including fruits, vegetables, whole grains, etc.
  • Ensuring to stay physically active and maintain a healthy body weight
  • Maintain appropriate levels of calcium and Vitamin D
  • Regular medical examinations to check for colon polyps or colon cancer, at later stages.

Diagnosis of Colon Polyps

Diagnosing colon polyps at the right time can prevent risk and complications. Screening tests, such as below, improve the chances of effective diagnosis.

  • Colonoscopy
  • Virtual colonoscopy, also known as CT colonoscopy
  • Flexible sigmoidoscopy
  • Stool-based tests

Treatment of Colon Polyps

All polyps diagnosed during a bowel exam are generally removed by the doctor though methods such as below:

Polypectomy: This involves removing the polyps through forceps or a wire loop.In case the polyp is more than 0.4 inches in size, the doctor will inject a special liquid under the polyp to lift it and separate it from the nearby tissues, for easy removal.

Minor Surgery: A form of minimally invasive surgery can be used to effectively remove colon polyps.These are particularly those polyps that could not be removed during the screening or are too large. The doctor uses a laparoscope and inserts it into the bowel to remove the polyps.

Surgery: In rare cases, where the patient has an inherited syndrome, the doctor might need to perform surgery to remove the colon and the rectum altogether.

That said, the patient needs to do follow-up care, especially in case the type of polyps were adenomatous or serrated, which are more prone to become cancerous. In such a case, the doctor wills suggest some follow-up screenings:

  • Every five to ten years in case there were two polyps
  • Every three years in case there were more than two polyps of a specific large size
  • Within three years for complicated cases with more than 10 polyps
  • Within 6 months of the polyp removed was excessively large and hence, had to be removed in pieces.

Overall, regular medical check-ups can help avoid the development of normal colon polyps into cancerous ones.

Know about Targeted Therapy for Cancer

Targeted therapy is a type of cancer which uses specific drugs to target cancer cells without causing any harm to the normal cells. Typically, these drugs target particular parts of cancer cells, like proteins or genes, which particularly promote the growth of cancer in the body. In some cases of cancer, target therapy proves very useful. 

Types of Targeted Therapies

There are essentially two types of target therapies, including small molecule medicines and monoclonal antibodies. Some of the most common small molecule and monoclonal antibodies that are increasingly used to treat cancer include:

Hormone therapy: In this type of therapy, the focus in to stop thebody from producing hormones that support the growth of breast and prostate cancer or keep the other healthy hormones from working efficiently.

Signal transduction inhibitors: These are the mostcommon types of targeted therapies. In this particular treatment, the doctors restrict the signals which promote the cells to divide abnormally. 

Gene expression modulators: This particular type of targeted therapy is more focussed on changing the proteins that control how instructions in the cancer cells are carried out since they are abnormal.

Apoptosis inducers:  Apoptosis is the natural process by which healthy cells die when they become old or damaged. However, in apoptosis inducer targeted therapy aims to find a way around this natural procedure of the body. This causes the cancer cells to follow the natural process of apoptosis.

Angiogenesis inhibitors: In this form of targeted therapy,the blood vessels that supply nutrients and oxygen to the cancer cells are blocked.

Immunotherapies: This particular treatment uses the body’s immune system to end cancer cells. In some cases, the immune system is made stronger to fight the cancer cells. Alternatively, the immune system can be trained to recognise cancer cells and fight them.

That said, targeted therapy is best suited for cancers that have a target origin on which the treatment can be focussed. Hence, in many cases, the doctor would need to test the tumour to confirm if there are any targets. In most cases, the doctor conducts a biopsy to check for cancer. Targeted therapy is often given along with other treatments.

Complications of Targeted Therapy

 Targeted therapies are fairly new and can cause some significant complications. Some of the common issues include diarrhoea, live infections such as hepatitis, and modifications to the hair, skin and nails. 

In some cases, the therapy causes skin issues, which are very difficult to bear. This is major because the targeted therapy attacks the growth elements, which promote healthy skin. That said, some of the major complications of targeted therapy include:

  • A rash that typically looks like acne on the areas such as neck, face, chest, back and scalp. The rash can cause burning, stinging or itching. However, sometimes it can get infected.
  • A feeling of sunburn even before any symptoms appear on the skin
  • Increases sensitivity to sunlight
  • Cracks in the skin, making it look dry. This particularly happens in the feet and hands, making it hard for a person to use hands or feet properly
  • Sores on the finger and toenails that become swollen and painful
  • Sores on the head, hair loss and often baldness. 
  • Swollen and red eyelids that often turn inward or outward. This can in many severe cases damage the cornea, the clear layers in front of the eye

To minimise complications, it is best to start using soaps and other skin products that are chemical-free and also do not have a strong fragrance. In cases, there are any skin changes, the patient must inform the doctor immediately to avoid infection. In case of severe skin infections, the patient might need to stop the targeted treatment. 

Limitations of Targeted Therapies

Targeted therapies are not completely successful in all cases. They also have specific limitations. One limitation is that the cancer cells can eventually grow resistant to the therapy. Resistance can occur basically in two forms – first when the target modifies the mutation to block the interaction of target therapy. Alternatively, it can also find a new pathway to build the tumour, which does not rely on a target. Because of this limitation, targeted therapies are often considered to provide the best results when combined with a different treatment plan. 

Another limitation of targeted therapy is that the drugs used in some specific targets are very hard to develop because of the structure of the target or the way it is engraved in the cell. 

Difference between Targeted Therapies and Standard Chemotherapies

Targeted therapies are different from standard chemotherapies in many ways, including:

  • Targeted therapies base their treatment on certain molecular targets, which are linked to cancer. On the other hand, standard chemotherapies, act on the cells that rapidly divide.
  • Targeted therapies are specifically chosen or structured to interact with the target. However, chemotherapies aim to kill cancer cells.
  • Targeted therapies aim to block cell proliferation of the tumour cells, implying that they are cytostatic. However, standard chemotherapy is cytotoxic. 

Overall, targeted therapies have become increasingly popular; however, the area is being researched to minimise complications and improve effectiveness. The applicability of the targeted therapy depends on the patient’s case and the final decision is taken by the healthcare professional.

Laryngeal Cancer – An Overview

Laryngeal cancer is a type of throat cancer that occurs in the tissue of the larynx or voice box. The larynx is about two inches wide and contains – vocal cords, muscles, and cartilages that help you to talk. Laryngeal cancer can develop in any part of the larynx but it mostly starts in the squamous cells or flat cells lining the inside of the larynx.

Besides, laryngeal cancer can permanently damage your voice. If not treated quickly, the cancer can spread to other parts of the body; from the back of the tongue, sections of throat and neck, to the lungs.

Symptoms

The symptoms of laryngeal cancer are relatively easy to detect. Some of the most common signs and symptoms include:

· Persistent sore throat

· Ear pain

· Neck pain

· Breathing difficulties

· Sudden weight loss

· Hoarse voice

· Cough with blood

· Neck lumps

· Excessive coughing

· Difficulty in swallowing food

These signs and symptoms can also occur with other conditions. Nonetheless, to make sure, you should see the doctor if these symptoms last over a week.

Risk factors

Throat cancer is caused by damaged cells that start to overgrow and become tumors. In laryngeal cancer, such tumors normally originate in the larynx or voice box. But various risk factors – anything that increases the chance of developing a disease – can mutate these damaged cells.

For laryngeal cancer, common risk factors include excess smoking and heavy alcohol consumption. Those who smoke and consume one or more alcoholic drinks every day are more likely to develop laryngeal cancer. Prolonged exposure to second-hand smoke is also a major risk factor.

Other risk factors may include:

· A family history of throat cancer

· Poor nutrition and vitamin deficiency

· Previous history of neck or head cancer

· Aged 40 years or above

· Low immunity

· Excessive consumption of processed foods

Besides, exposure to high levels of dangerous fumes and chemical substances for longer periods can also increase the cancer risk. Harmful substances such as:

· Sulphuric acid fumes

· Paint or diesel fumes

· Coal or wood dust

· Nickel

How is laryngeal cancer diagnosed?

To diagnose laryngeal cancer, doctors start with your medical history and then, a series of tests are performed. The tests vary based on the symptoms shown. However, the first test is usually a laryngoscopy.

In a laryngoscopy, a laryngoscope – a thin tube with a camera and light at the end – is used to examine your mouth and throat, particularly your larynx. If your doctor finds any abnormalities, he may perform a biopsy in which a small tissue sample is examined under a microscope to test for cancer. Doctors usually rely on biopsy results to make the final diagnosis.

Moreover, doctors also use imaging tests to diagnose laryngeal cancer. They use an MRI or CT scan of the neck and head to assess the size of the tumor. These tests also help in determining if the cancer has spread to lymph nodes in the neck.

In case your test reports come out positive, the doctor will order additional tests to determine the spread of the cancer. Nonetheless, an early diagnosis of laryngeal cancer can help support a successful treatment.

Available treatments

Treatment for laryngeal cancer will depend on the stage of cancer. But like most cancers, laryngeal cancer is also treated with surgery, chemotherapy, or radiation therapy. Moreover, survival rates will depend on the location of the cancer and how early it is diagnosed. However, survival rates usually decrease if the cancer has metastasized or reached your lymph nodes.

For the early stages, doctors treat laryngeal cancer with surgery or radiation therapy. Cancer surgery includes the removal of the cancerous tumor and nearby tissue. However, cancer surgery involves certain risks. You may experience:

· Loss or change of voice

· Permanent neck scars

· Swallowing difficulty

· Breathing difficulty

After the surgery, radiation therapy is used to kill the remaining cancer cells and shrink tumors. Or your doctor can only use radiation therapy to treat laryngeal cancer, provided it is small.

Another common cancer treatment is chemotherapy that uses a combination of drugs to kill cancer cells. Chemotherapy also amplifies the effects of radiation therapy. Your doctor may use pills or an infusion to medicate you.

The chemotherapy will enter your bloodstream and kill rapidly increasing cancerous cells and even healthy cells. Chemotherapy is also used to treat symptoms of advanced cancer that cannot be fully removed with surgery.

Furthermore, a combination of surgery, chemotherapy, and radiation therapy is used to treat the advanced stages of laryngeal cancer.

Prevention

The easiest way to prevent the cancer of the larynx is to quit smoking and excessive alcohol consumption. Also, by eliminating the consumption of tobacco in any form. Follow a healthy diet, include food rich in anti-oxidants to keep the cancer risk at bay.

You can significantly reduce the risk of laryngeal cancer with these lifestyle changes. As the adage goes, “prevention is better than cure”.

Retinoblastoma

Retinoblastoma is a type of eye cancer, which primarily begins in the retina of the eye. The retina is the innermost, sensitive layer of tissue inside the eye. The retina comprises of nerve tissue which senses the light when it reaches the eye. The retina then sends signals to the brain via the optic nerve. The brain, in turn, understands the signals and interprets the images.

Retinoblastoma typically impacts children; however, it can also impact adults. It is a very uncommon form of cancer. But in children, it is the most common form of cancer. Cancer can occur in both or one eye.

Symptoms of retinoblastoma

As retinoblastoma generally impacts children and infants, the symptoms are often hard to understand. However, some possible signs will include:

  • Red eyes
  • Swelling in the eyes
  • An issue where the eyes appear to be focussed in different directions
  • A white dot in the centre of the eye (pupil), which is clear when the light is reflected upon it

However, if a parent notices any abnormal changes in the eyes of the child, immediate medical attention should be sought. Moreover, since retinoblastoma is a very rare form of cancer, the healthcare provider may examine other causes for the issue.

Causes of retinoblastoma

This form of cancer develops when the nerve cells in the retina form abnormal genetic mutations. These mutations lead to a condition where the cells continue to grow and multiply when ideally, they should die. This abnormal number of cells form a mass, known as a tumour.

Retinoblastoma can also spread to other parts of the eyes or the nearby structures. It can also impact other areas of the body, such as the brain and spine. In most cases, the actual cause of mutations is not clear. However, children can inherit an abnormal genetic mutation from their parents.

In the case of inherited gene mutation, it is possible to pass it on to children, even if one parent has the issue. Each parent carries a 50 per cent chance to increase the risk of genetic mutation in the child. Children that have this inherited condition, tend to develop this condition at an early age. Moreover, hereditary retinoblastoma impacts both the eyes, rather than just one.

Complications of retinoblastoma

Children with an inherited form of retinoblastoma, are more prone to develop other types of cancer in other body parts. This can happen even after the retinoblastoma is treated. This could be prevented by regular medical examinations to diagnose any other types of cancer or issue.

Prevention of retinoblastoma

Since the actual cause of retinoblastoma is not known, there is no definitive way to prevent this issue. However, some measures can help prevent retinoblastoma.

For families that have a risk of retinoblastoma, prevention may not be possible. But genetic testing can provide an advantage to families to know which child is at a higher risk of developing the issue. The parents can then resort to regular eye exams to help diagnose the condition early. This can help to treat the issue and minimise complications.

Diagnosis of retinoblastoma

The doctor will conduct a few exams to diagnose retinoblastoma. These tests include:

  • Eye exam: The doctor will conduct an exhaustive eye exam to understand the symptoms and underlying causes. For a clearer picture, the child could be placed under the influence of mild anaesthetics to keep the child still.

Imaging tests: Imaging tests such as ultrasound, CT scans or MRI can be used by doctors to understand the retinoblastoma has grown to impact other structuresnearby the eyes.In some cases, the doctor may also refer the patient to other specialists, such as an oncologist, or a genetic counsellor for diagnosis or confirmation of condition.

Treatment of retinoblastoma

The treatment for retinoblastoma depends on the general health of the patient, the cause of retinoblastoma, the size and location of the tumour, and if cancer has spread to other structures. The main objective of the treatment is to cure cancer. However, the procedure could impact the vision.

Some treatments for retinoblastoma include:

Chemotherapy: Chemotherapy through blood vessels or pill can be used to kill the cancer cells. The drug used in chemotherapy travels through the body to attack the cancer cells. Specifically, for children, chemotherapy may be used to shrink the size of the tumour. Once, the tumour has shrunk, another form of treatment such as radiation therapy, cryotherapy, laser therapy, etc. can be used to eliminate other cancer cells. Chemotherapy is very useful in cases, where cancer has spread to nearby structures.

Radiation therapy: In radiation therapy, X-rays, protons, and other high-energy beams can be used to destroy cancer. Radiation therapy is of two kinds:

  • Internal radiation is also known as brachytherapy where the device is placed near or in the tumour. This minimises damage to nearby tissues.
  • External beam radiation directs high-powered beams to the tumour from an external device. This can have side effects since the radiation can also impact nearby tissues.

Laser therapy: In this form of treatment, a laser is used to damage blood vessels, which provide the primary supply of oxygen and nutrients to the tumour.

Cryotherapy: This form of treatment uses an extremely cold temperature to kill cancer cells.

Surgery: When all other non-invasive or minimally invasive formsof treatment fail to provide any relief or if the tumour is too large, the doctor may recommend surgery to cure cancer. This could involve removing the affected eye, an eye implant, or placing an artificial eye.

Overall, retinoblastoma is rare but cannot be prevented. However, it is possible to reduce complications and improve the quality of life through regular eye exams.

Types of cancer, syndrome & stages wise treatment

Cancer is one of the most common health problems today, which has claimed millions of lives across the world. Cancer is formed when there is a change in the DNA mutations of cells, causing abnormal growth and multiplication of cells in the body. These cells can form in any part of the body such as lungs, brain, breast, uterus, pancreas, etc. Cancer cells originate in one part of the body but can spread to other body parts. Although some tumours are benign and non-cancerous, while others are malignant and can be fatal.

Causes of Cancer

The exact cause of cancer cannot be identified and also varied per the location of the tumour. However, some reasons that increase the risk of a person developing cancer are:

  • Genetics
  • Increasing age
  • Exposure to radiation
  • Tobacco
  • Exposure to certain chemicals
  • Sunlight
  • Pathogens
  • Overweight or obesity
  • Physical inactivity
  • Unhealthy diet
  • Physical inactivity
  • Unhealthy diet

Types of Cancer

The type of cancer depends on the part of the body it originates in. Essentially, cancer can develop in any part of the body and is named after the organ or tissue in which it first develops. There are more than 100 types of cancer, some of the most common ones include:

  • Gallbladder cancer
  • Breast cancer
  • Colon and rectal cancer
  • Leukaemia or blood cancer
  • Lung cancer
  • Liver cancer
  • Thyroid cancer
  • Pancreatic cancer
  • Kidney cancer
  • Cervical cancer
  • Oral cancer
  • Gastrointestinal cancer
  • Stomach cancer
  • Prostate cancer
  • Skin cancer
  • Endometrial
  • Melanoma

Cancer Syndromes

The symptoms of cancer depend on the type of cancer and hence, vary per case. That said, some of the common syndromes of cancer include:

  • Fatigue
  • Lump
  • Weight changes
  • Thickening under the skin
  • Difficulty in swallowing
  • Problems after food
  • Indigestion
  • Unexplained muscle pain
  • Redness or skin rash
  • Bowel changes
  • Consistent cough
  • Shortness of breath
  • Hoarseness
  • Pale skin
  • Changes to existing moles
  • Unexplained bleeding
  • Unexplained bruising
  • Persistent night sweats
  • Fever

Symptoms of cancer also depend on the intensity and progression of cancer in the body.

Stages of Cancer and Stage-wise Treatment

Knowing the stage of cancer is critical for the surgeon to decide the course and intensity of the treatment. The stages of cancer are defined by the TNM system which implies:

  • T (tumour) – the size of the tumour
  • N (node) – the presence of tumour in lymph nodes
  • M (metastasis) – the spread of cancer to other body parts

Based on this analysis obtained through several diagnostic tests, there are typically four stages of any type of cancer. These include:

Stage 0: Often referred to as ‘carcinoma-in-situ’ – stage 0 cancer implies that the cancer cells are in the place of their origin and have not spread to any other part of the body. This stage is also sometimes referred to as the pre-cancerous stage, which contains cells that could become cancerous in the near future. This type of cancer is more localised and contained, and has higher chances of being treated successfully. The best course of treatment opted for this stage of cancer is surgery or radiation therapy. The type of surgery will depend on the type of cancer, position of the cancer cells, and the intensity of cancer growth. 

Stage 1: Often referred to as early-stage cancer, this cancer is more localised and very small in size. This stage of cancer implies that the tumour is in the body part where it originated and has only spread to the surrounding/close lymph nodes, but has not extended beyond that area to other body parts. In general, early-stage cancers can be easily treated through surgery chemotherapy, radiation and targeted drug treatment.

Stage 2: This stage of cancer is characterised by a regional spread of the cancerous cells. In this stage, cancer has penetrated the surrounding tissues and also affected other nearby lymph nodes but has not spread to distant lymph nodes or other body parts.This is also a form of localised cancer though this is a slightly advanced stage.This stage of cancer is treated with local therapies such as surgery or radiation therapy. 

Stage 3: Similar to the Stage 2 cancer but slightly more advanced where cancer has penetrated the walls of the surrounding tissue and also impacted other close lymph nodes, though it has not affected any other distant part of the body.This is often referred to as locally advanced cancer. In some cases of Stage 3 cancer, the tumour may have grown to a significant size and contain multiple tumours.These types of cancers are metastatic cancers – implying they spread beyond their area of origin. This stage of cancer is treated by surgery, radiation therapy, chemotherapy or targeted drug treatment. A combination of these methods can also be used to improve effectiveness.

Stage 4: This is the most severe stage of cancer where the tumour has gained a reasonable size and has spread to areas beyond its origin into other distant organs and lymph nodes.This is a metastatic and an advanced stage of cancer in which cancer has metastasised to other parts of the body to form secondary cancers (metastases). This stage of cancer is very difficult to treat, though common treatment options include surgery, chemotherapy and radiation therapy. In a general sense, these cancers are unlikely to be cured in the long-term although treatment could help shrink the size of the tumour, control the spread of the tumour and relieve symptoms. 

Today, cancer is one of the top two leading causes of death worldwide majorly because of lack of awareness of its causes, symptoms and treatment. Hence, awareness about cancer needs to spread so that one knows when to seek medical help.

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