Cancer Articles

Cheat Sheet / Updated 09-18-2023

Breast cancer is a particularly devastating and intimate disease. Although not as deadly as some other forms of cancer — five-year survival rates in the United States are between 80 percent and 90 percent — the toll that breast cancer takes on the body, mind, and psychology make it an especially difficult disease to contend with. The good news is that it is a relatively easy cancer to detect early, and usually the earlier it is caught, the better the prognosis. Breast cancer survivors have several treatment avenues, including chemotherapy, radiation, therapy, hormonal therapy, and a few different surgery options, including different mastectomies.

Cheat Sheet / Updated 03-27-2016

Screening and testing for prostate cancer are important for early detection and treatment. You can talk with your doctor about any concerns you may have, like prostate cancer treatment and side effects, finding a good specialist, and support from your partner, family and friends.

Cheat Sheet / Updated 03-27-2016

If you're dealing with breast cancer, know that fellow patients and medical professionals can do a deal to ease your journey. This cheat sheet offers advice on when to see a doctor about breast issues; has tips on how to get ready for a mammogram and biopsy; introduces the members of your treatment team; and suggests contact numbers to keep on hand as you undergo treatment.

Article / Updated 03-26-2016

When men who have prostate cancer talk to each other, they sometimes exchange their Gleason scores or their cancer stages with an intensity that two combat veterans might use when exchanging the name of a battle they both served in. They say such things as "I'm a Gleason 6," or maybe "I'm a Gleason 4" — rather than saying that they were at the battle of Khe San in Vietnam or in the Gulf War. This new prostate cancer identity is now more important than where these cancer veterans are from, how much money they make, or even what type of job they have. Cancer trumps everything. "So what is the Gleason score, and how does it work?" you ask. Read on! Getting the scoop on the score The Gleason score was invented in 1966 by Dr. Donald Gleason, a pathologist. He based the score on information derived from studies of the biopsies of nearly 3,000 patients who had been diagnosed with prostate cancer. Pathologists worldwide rely on the Gleason score. The score provides an effective measurement that helps your doctor determine how severe your prostate cancer is, based on the appearance of the cancer cells when viewed under a microscope. All cancer looks abnormal to a pathologist, but low-grade cancers have cells that often look similar to healthy cells from the gland or organ that has been affected by the cancer. As a result, the pathologist can recognize that she's looking at prostate cells under the microscope. But when the cancer is aggressive, the cancer cells look less and less like normal prostate cells (or any other kind of cells). Pathologists find the Gleason grading system to be very reliable. For example, if the Gleason score indicates that the cancer is an intermediate risk cancer (a Gleason score of 7) it nearly always is an intermediate risk. As a result, doctors can make predictions from Gleason grades. The more distorted and aggressive the cancer looks, the higher the Gleason grade, and the more aggressive the cancer behaves in the body. Understanding how it works The lowest number on the Gleason grade scale is 1, and the highest is 5. Two Gleason grade numbers are actually determined and then added up to get the final Gleason score. Here's how it works: The pathologist looks at the biopsied tissue samples through a microscope to determine where the cancer is the most prominent (the primary grade) and then where it's next most prominent (the secondary grade). Next, he assigns a score from 1 to 5 to each area: one score for the primary grade and one score for the secondary grade. The Gleason score is the sum of the primary and secondary grades. As a result, the total score can be anything from a 2 (1 + 1) to a 10 (5 + 5). Interpreting the results The lower the score, the better. A combined Gleason score of 10 is very bad (although there are still many treatments that doctors can offer men with high Gleason scores). Here's how the scores break down: Scores from 2 to 4 are very low on the cancer aggression scale. Scores from 5 to 6 are mildly aggressive. A score of 7 indicates that the cancer is moderately aggressive. Scores from 8 to 10 indicate that the cancer is highly aggressive. Here's a tricky little feature of the Gleason score for you to keep in mind: The Gleason score usually is reported with the primary cancer number given first, and the secondary cancer number reported second. For example, if Jack Sprat's Gleason score is reported as a 4 + 3 = 7, the primary cancer number is a 4, and the secondary cancer number is a 3. Add them up, and they equal a total Gleason score of 7. But remember, not all Gleason scores are equal. It may sound strange, but if the pathologist classifies Clark Kent with Gleason scale numbers of 3 and 4, which gives him a Gleason total score of 7, Clark is actually in a little better shape, cancerwise, than Jack. Here's why: When the primary grade (the first number) is 3, it means that the cancer has not advanced as far with cellular deterioration as cancer with a primary grade of 4 (such as is the case with Jack's score). Even though their total scores still equal 7, Jack and Clark's Gleason scores aren't exactly the same. So if you want to know the real deal on your Gleason score, get a breakdown of the two numbers that comprise the score. Ask your doctor for your Gleason score, starting with the primary grade first, followed by the secondary grade and then the total. The Gleason score from the prostate biopsy (which is just a few slivers of tissue from the cancer) may not be exactly the same as the score the pathologist calculates after surgery, when he's able to look at all the cancer in the entire prostate. Sometimes the score goes up a little, and sometimes it goes down a little.

Article / Updated 03-26-2016

If you have any questions about the results of your biopsy, whether it's positive or negative for cancer, be sure to write them down so that you can remember to discuss them with your doctor. If the biopsy is positive for cancer Here are some questions to ask your doctor in the event that the findings are positive for prostate cancer: What is the stage of the cancer? The urologist will assess how far the cancer has extended, and whether it has spread beyond the prostate gland or is still localized to the prostate. Most doctors use the Tumor Node Metastasis (TNM) system to determine the stage of the cancer. The doctor may have to do more tests before he can tell you the correct stage. What is the grade of the cancer in the biopsies? The grade of the cancer is determined by the pathologist, who looks at the biopsies through a microscope. He uses a special scale (usually the Gleason scale) to determine the grade. Grading is basically a process that provides an estimate of how chaotic or aggressive the cancer is. What is the amount of cancer in the biopsies? The amount of cancer in the biopsies can give your doctor some indication of how much space or volume the cancer takes up inside your prostate. Tumor volume has some importance in estimating how serious the cancer is, although it's not as important as stage, grade, or PSA level. The doctor can't obtain an exact reading on the volume of the cancer in your prostate with a biopsy. To obtain an exact reading, the doctor needs to remove your prostate. When the prostate is removed with surgery, the pathologist calculates the actual cancer volume in the removed prostate. However, before surgery or any other type of treatment, your urologist can get a better idea of how big your cancer is by looking at how many biopsy cores are positive and/or how much of each core contains cancer. How much time do I have before I need to start getting treated for prostate cancer? Using the grading and staging information as well as other basic information, such as your age and your overall health, your doctor gives you a recommendation for what treatment you should receive for your prostate cancer (whether it's surgery, radiation, hormone therapy, another form of treatment, or even a combination of several treatments) and when you should receive it. In some cases, the doctor may recommend no current treatment, which is also referred to as watchful waiting. This approach is generally advised when a person has less than a ten-year life expectancy or is in poor health, or the cancer is very low risk. If the biopsy is negative for cancer You're much more likely to have many questions if the biopsy is positive, but you may also have some questions if the test comes out negative. For example, you may wonder if a negative test means that you're safe forever from the scourge of prostate cancer. Sadly, the answer isn't always yes. A negative biopsy means that you don't have cancer or that you don't have a very big cancer — but biopsies are only slivers of tissue, and sometimes cancer can be missed. Whether to biopsy you again is a very complicated issue that has to do with family history (you have a greater chance of having prostate cancer when you have relatives with it, the level of your PSA and whether it's rising, and what your prostate feels like in a rectal examination. Your urologist knows about all these issues, so he can form a follow-up plan with you.

Article / Updated 03-26-2016

Chemotherapy can be a life-saving cancer destroyer. Unfortunately, the drugs don’t take aim solely at cancer. They can also kill hair, skin, and reproductive tract cells. This collateral damage leaves some chemotherapy patients with thinning hair, nail loss, uncomfortably dry skin, and permanent reproductive damage. If your chemotherapy (commonly called chemo) is causing you to suffer from embarrassing and uncomfortable hair and skin changes, or changes in sexuality, there are coping mechanisms you can try to help you get through your time in treatment. Everyone responds to chemo differently and not all chemotherapy side effects are the same. You may experience some of the symptoms listed here, but not all of them. To help you prepare for the road ahead, be sure and ask your doctor which side effects are common to the particular chemotherapy you’ll be undergoing. Thinning hair: Hair loss can occur anywhere on the body during chemo, but the hair usually grows back when treatment ends. In the interim, you can wear wigs, hats, and turbans to hide your hair loss. Carefully applied make up can fill in lost eyebrows. Some cancer patients decide to forego the cosmetics and proudly display their bald pates as a show of survivorship. Skin irritation: You can soothe dry, itchy, rash-prone skin by taking quick, warm (not hot) baths. Use mild soaps and apply lotion right after you bathe to help seal in moisture. Pat, don’t rub, your skin dry. Avoid perfumes, colognes, and aftershaves. Stay out of direct sunlight unless you’re wearing protective clothing and a high SPF sunscreen. Some people can have an allergic reaction to their chemotherapy. If your skin begins to itch severely or if you notice any rashes or hives, tell your doctor right away. Nail changes: If your treatments have left you with fewer nails, or nails that are yellow and brittle, you can protect them by wearing gloves when you’re doing housework or gardening. Applying nail strengtheners might also help. If your nail bed becomes red and starts to hurt, be sure and tell your doctor. It may be a sign of infection. Reproductive damage: Chemotherapy can alter eggs and sperm and cause birth defects; you shouldn’t reproduce while you’re being treated. Some types of chemo can also cause permanent infertility. If you hope to have children after your cancer treatment is through, but you’re about to undergo a chemo which is likely to leave you sterile, you should talk with your doctor about harvesting your eggs or sperm. Decreased sexual desire: Whether you’re male or female, waning libido is a common chemotherapy side effect. Additionally, if you’re a man, you may experience impotence. If you’re a woman, you may develop symptoms that mimic peri-menopause. These include hot flashes, vaginal dryness, mood swings, and irregular periods. Other than vaginal moisturizers to help women combat dryness, there isn’t much on the medication front that can help couples during treatment. Patience, open communication, and lots of love may be the best medicine. If you’d like some hands-on advice on how to overcome chemotherapy’s cosmetic side effects, consider attending a Look Good. . .Feel Better workshop. These sessions are held throughout the country and are a joint venture of The American Cancer Society and the Personal Care Products Council Foundation.

Article / Updated 03-26-2016

The same properties that make chemotherapy drugs effective cancer killers also cause them to damage healthy cells in your bone marrow, blood and nervous system. The damage, although often temporary, can make cancer patients vulnerable to a series of side effects and secondary conditions, including bleeding, anemia, infections, numbness in the extremities, and memory loss. If you’re experiencing blood or nervous system problems as a result of undergoing chemotherapy (commonly called chemo), there are steps you and your doctor can take to weather the negative aspects of cancer treatment. Everyone responds to chemo differently and not all chemotherapy will cause the side effects listed here. Each drug interacts with normal cells in its own unique way. To help you prepare for your treatment, be sure and ask your doctor which side effects are common to the chemotherapy you’ll be undergoing. Bleeding: The cells that make sure you stop bleeding when you’ve been cut or bruised are called platelets. Chemotherapy can lower the number of platelets you have, making you more susceptible to bruising, nose bleeds, and clotting failure. If your platelet count becomes dangerously low, your doctor may prescribe a drug that will help your body produce new platelets. While you’re undergoing chemo, you should avoid contact sports or other physical activity that greatly increases your risk of cuts and bruises. Bleeding gums are common, so use a very soft-bristle toothbrush and stay away from floss and toothpicks. Opt for an electric razor instead of a manual. When using knives or scissors, wear gloves to protect your hands from sharp blades. Because internal tissue can be especially prone to injury, avoid using tampons, suppositories, rectal thermometers, and enemas. Fatigue and anemia: Chemotherapy can lower the number of red blood cells, pushing you into anemia and the extreme fatigue that is characteristic of the condition. Listen to your body. Rest and limit your activities. If you are also experiencing shortness of breath, dizziness, fainting, leg pain or swelling, or rapid heartbeat, call your doctor right away. She may prescribe iron-rich vitamins or medication to promote red blood cell growth. You may need to undergo a blood transfusion to replace your lost red blood cells. Increased infections: Some chemotherapies destroy the white blood cells that help your body fight infection, leaving you vulnerable to illness. While you’re in treatment, it’s important that you wash your hands and use hand sanitizer throughout the day. Keep your hands away from your nose and mouth. Avoid crowds and keep your distance from people suffering from colds and flu. Your doctor will keep an eye on your white blood count, but developing an infection during chemo is serious business. If you have a fever of more than 100 degrees, chills, sweats, or any other sign of infection such as cough, headache, or sinus pain, call your doctor right away. Loss of sensation: You may be experiencing tingling, numbness or pain in your feet or hands that is affecting your mobility and agility. Most of these nerve problems disappear within a year of completing chemo or when the dose of chemo is lowered. In the meantime, wear flat, comfortable shoes with rubber soles for traction. Use a cane to steady your stance. Wear gripper gloves when working with kitchen utensils or gardening tools. Install rubber bath mats or shower hand rails to make getting in and out of the tub easier. If your sense of hot and cold has been compromised, be sure and use a thermometer to measure water temperature in the bath before you get in. Cognitive difficulties: Confusion and recall problems are common enough that cancer patients have nicknamed the experience “chemobrain.” Although chemobrain usually clears when treatment ends, you may find that you have to change your behaviors a bit in the interim to help you manage your day-to-day life. Keep a notebook handy and write down as many appointments, tasks, names, and numbers as you need to for easy reference later on. When you need to focus on a task, eliminate as many distractions as you can. Retire to a quiet room. Turn off the TV and mute the phone. Give your brain the fuel it needs by eating healthy foods and getting enough sleep. The effects of chemo therapy on your blood and nervous system not only can have detrimental effects on your quality of life, but can also be dangerous. Getting emotional support and practical advice from fellow cancer patients and cancer professionals can help you cope with these challenges. The National Cancer Institute has a directory of organizations that provide assistance to cancer patients.

Article / Updated 03-26-2016

The same properties that make chemotherapy drugs effective cancer killers also cause them to wreak havoc on normal cells, including those that make up your digestive system. The damage, although usually temporary, can cause cancer patients to experience a host of problems, including aversions to certain foods, constipation, incontinence, nausea and vomiting. If you’re experiencing problems at the dinner table and in the bathroom as a result of undergoing chemotherapy (commonly called chemo), there are steps you and your doctor can take to lessen the side effects of your treatment. Everyone responds to chemo differently and not all chemotherapy will cause the digestive problems listed here. Each drug interacts with normal cells in its own, unique way. To help you prepare for your treatment, be sure and ask your doctor which side effects are common to your chemotherapy. Appetite changes: Most chemo will cause you to lose your appetite to some degree and certain medications will cause changes in the way food tastes. You might develop an aversion to beef and pork, sweets, or tomato products. You may also have a constant metallic taste in your mouth. Eating several smaller meals each day might be easier than eating the customary big three. Liquid foods such as soup, juice, smoothies, and milkshakes are often more palatable than solid foods. Using plastic utensils can reduce the metal taste. It’s important to keep up your weight, so concentrate on eating high calorie foods, such as protein shakes. Your doctor may recommend that you take extra vitamins and nutritional supplements. Constipation: If constipation is a problem, drinking coffee, tea, or prune juice may kick your system into gear. You should also make sure you drink at least eight cups of water a day and incorporate high fiber foods into your diet if your appetite allows it. Diarrhea: Diarrhea calls for a different dietary approach. Seek out foods that will help you retain or regain fluids, such as those low in fiber and high in salt, sodium, and potassium. Stay away from alcohol, diary, and anything greasy, spicy, or high in fiber. If your diarrhea isn’t being helped by careful dieting, your doctor may be able to prescribe medication that will help. Urination: Your doctor will probably carefully monitor your kidney and bladder function during your treatment, but you may experience frequent or uncontrollable urination, or an inability to urinate. Eliminating the chemotherapy drugs from your kidneys and bladder is the best defense against urinary side effects. Drink lots of water and other clear liquids to flush out your system. Stay away from caffeine. Nausea and vomiting: There is a long list of chemotherapy drugs which are known to prompt nausea and vomiting. Heavy alcohol use, anxiety and being a woman of menstrual age are also known to exacerbate the problem. There are medications that can help lessen the severity and occurrence of these symptoms. If your type of chemo is known to induce stomach upset, your doctor will prescribe an anti-nausea and vomiting drug (called an anti-emetic) before your therapy begins. Getting emotional support and practical advice from fellow cancer patients and cancer professionals can help you cope with chemotherapy’s digestive difficulties. The National Cancer Institute has a directory of organizations that provide assistance to cancer patients.

Article / Updated 03-26-2016

Because radiation therapy involves focusing strong beams of radioactive energy directly on the cancerous tumor and not throughout the body, most side effects occur in the immediate area where the radiation was directed. If your radiation is targeted to a cancer in your pelvis or sex organs, you’ll likely experience some changes in your sexuality and fertility. Some of these changes are temporary and will go away when your treatment ends, but some are permanent. There are different types of radiation therapy. Some are administered from the outside and some are implanted inside the body. Also, the radioactive chemicals used can vary according to the treatment. Be sure to ask your doctor what type of side effects you can expect from your particular type of radiation therapy. Sexuality changes following radiation therapy Both men and woman who undergo radiation therapy in the pelvic area are at risk for experiencing some level of sexual dysfunction. If you’re a man, you may experience impotence. If you’re a woman, you may develop symptoms that mimic peri-menopause. These include hot flashes, vaginal dryness, and irregular periods. You may also experience a loss of vaginal elasticity, called stenosis. Most sexual problems clear up when radiation therapy is done. In the meantime, men may find relief by taking an erectile dysfunction drug. Vaginal moisturizers and dilators can relieve discomfort for women. However, if you’ve developed stenosis, it will probably be with you for life. Fertility challenges from cancer treatment Radiation therapy and pregnancy don’t mix. Women shouldn’t get pregnant while going through treatments. Radiation can harm the fetus. If you’re pre-menopausal, your doctor can recommend an appropriate birth control method. Women who are pregnant need to tell their doctor before beginning therapy. Radiation in the pelvic region can cause permanent infertility. If you hope to have children someday, but your doctor has told you your radiation treatments will leave you sterile, you should talk with her about harvesting your eggs or sperm. If you’re still able to have children after your cancer treatment, your treatment shouldn’t have any effect on your child’s health. Many cancer patients receive both chemotherapy and radiation. If you’re one of them, you also need to consider that you may experience additional side effects from the chemotherapy.

Article / Updated 03-26-2016

We all go outside, which means we’re all at risk for developing skin cancer. Fortunately, skin cancer is usually successfully treated when it’s found in its early stages. Along with making sure a skin cancer screening is part of your annual check-up, a key to early detection is monthly self exam. By knowing what your skin normally looks like, and how to spot the various types of skin cancer, you’ll be able to alert your doctor at the first sign of a skin abnormality so you can get the treatment you need. Skin cancer can grow on parts of your body where the sun doesn’t shine. Be sure to look at every inch of your skin, from your scalp, to your genitals, to the soles of your feet. Make a note of any scars, moles, freckles, or other marks so you know what’s ordinary for you. Use a full-length mirror, hand-held mirror, and a magnifying glass to make sure you don’t miss a mark. The four most prevalent skin cancers are basal cell, melanoma, merkel cell, and squamous cell. Each carries its own set of symptoms. Basal cell carcinoma has many faces This is the most common and easily treatable skin cancer. While it’s the least likely to spread, if you’ve had one basal cell growth, you have a high likelihood of developing another one within five years. Basal cell carcinoma has a multi-faceted appearance. Here’s what to look for: A pearly white, firm bump that gradually gets larger. It may bleed, crust over or develop a depression in the middle. The bump may be brown or black in darker-skinned people. Tiny blood vessels might be visible on the surface of the bump. A bleeding sore that scabs and heals but then comes back and starts bleeding again. Pink or red lesions that have a rough appearance and bleed easily. A flat area that looks brown and crusty but can also be flesh-colored. A waxy scar that is skin colored, white, or yellow. Melanoma often targets moles Melanoma is the most deadly form of skin cancer because it’s the most likely to invade other parts of your body. Even so, with early detection and proper treatment, it too is highly curable. The 5-year survival rate for localized melanoma is 95 percent. Melanomas can develop on any part of your skin, including moles you’ve had since childhood. Moles are the starting place for 20 to 40 percent of all melanomas. To help you remember what to look for when examining your moles, the medical community has developed an easy technique called the ABCDE rule. A is for asymmetry. One half of your mole looks different from the other half. B is for border. The edges of your mole are uneven, notched or not well defined. C is for color. Healthy moles have consistent color throughout. Melanoma moles have a mixture of colors, including brown, black, red, blue, tan, and/or white. D is for diameter. If your mole has grown by a quarter-inch or more, melanoma may be present. E is for evolving. Moles should stay the same color, shape, and size throughout our adult lives. If yours has changed or suddenly starts bleeding or itching, it’s time to see your doctor. Other melanoma warning signs include: The area around the mole assumes the same color and appearance as the mole or becomes red and swollen; the mole seems to spread. Any new growth on your skin (although most melanomas are pigmented black, gray, deep blue, or brown, some are not). Any sore that won’t heal. Itchiness, tenderness, scaling, or pain in one particular area of your skin. A black streak or bruised appearance under your fingernail or toenail that won’t go away. Merkel cell carcinoma is on the rise Although this is still a rare form of cancer, affecting only 1,500 Americans a year, its numbers are increasing. It develops mostly in fair-skinned people over the age of 50. Merkel cell cancer can spread quickly, but if treated early, the survival rate is 90 percent. It develops as a shiny, firm nodule or nodules on your skin. The painless growths are flesh-colored, red, blue, or purple. They may look like a pimple, cyst, stye, or bug bite. Squamous cell carcinoma can spread This is the second most common form of skin cancer. Like melanoma and merkel cancers, it will spread if left untreated. However, the survival rate is 95 percent if found early. Here are signs of squamous cell growth: A scab-like or scaly area. An area that’s red, raised, and firm. An ulcerated sore that won’t close and heal. Visit What Skin Cancer Looks Like to see photos of these four cancers.