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Modern external beam radiotherapy to the prostate relies on intensity modulated technologies (IMRT), technology that can alter the “fluence” across the radiation field during treatment, thereby allowing the most exact deposition to the contours of an individual’s prostate (bespoke conformity), at the edge of which the dose gradient gives a sharp “fall-off” in dose. CT scanning is used to plan the treatment and daily CT verification scan (low dose scan) ensures accuracy of patient positioning. Unlike most other IMRT techniques, Tomotherapy accuracy does not depend and does not require implanted fiducials into the prostate, giving it a real advantage over other IMRT techniques.
Axial CT scan through pelvis with an IMRT isodosimetric plan superimposed and the high dose regions dose-washed in turquoise and red.
There is no risk of incontinence following radiotherapy and two thirds of men maintain potency (but not fertility). Elderly patients and those with capsular breach (T3 disease) are usually advised to receive this therapy. This service may include material from Agence France-Presse (AFP), APTN, Reuters, AAP, CNN and the BBC World Service which is copyright and cannot be reproduced. The fight against cancer continues to wage, boosted by Harris’ announcement this week of a partnership with Cancer Treatment Services International.
The partnership seeks to bring quality, cost-effective cancer treatments to patients across the globe. Founded by Pittsburgh-based physicians and healthcare professionals, CTSI’s provides treatments to patients in areas where cancer treatment is minimal or nonexistent. Founded in May 2009, GovCon Executive is a news blog published by Executive Mosaic Media that covers the dedicated individuals who serve our government through private industry and the officials who affect the government contracting industry at the federal and state levels. So, after all we’ve discussed this week, this is what it comes down to: the one in eight lifetime risk has landed at your doorstep. One more pitch for early detection: if breast cancer is detected prior to spread to the lymph nodes, the 5-year survival rate (with appropriate treatment) is as high as 98%. I wish all of you breast cancer survivors or those with family members affected all the best with this. My goal today is to offer an understanding for the different components of treatment, not to get into the nuances of individual treatment regimens. Breast cancer is treated in several ways, including surgery, chemotherapy, hormonal therapy, biologic therapy, and radiation. Surgery: Under certain circumstances, the cancer has only advanced to a level where it can be surgically removed. Radiotherapy (radiation therapy): High energy rays can be aimed at the cancer cells in an effort to kill them. Hormonal therapy: As mentioned in this post, certain cancer cells are stimulated by hormones to grow. Biological therapy: Biological therapy serves to boost the body's immune system to better help it fight the cancer. Targeted drugs: An additional treatment modality is the use of targeted drugs, which attack specific abnormalities within cancer cells.
Complications and side effects of breast cancer treatment are plentiful, and they vary based on the treatment given. Surgery carries a risk of bleeding and infection.
The teams of medical, radiological and surgical cancer specialists who treat breast and other cancers do phenomenal work. Here's a post focusing on demographic information and discussing risk factors relating to breast cancer. Here's a post that should make you feel empowered; it gives you the tools to self-assess for breast cancer and providing detailed instructions on how to perform the breast self-exam. Here's a post detailing the actual signs, symptoms and long-term prognosis for breast cancer.
Breast cancer disturbs me deeply, and if it doesn't affect you as well, you haven't been paying attention. I appreciate the sentiment behind a National Breast Cancer Awareness Month, but if I could offer you anything on this, it would be a plea to be 'aware' every month, and use this month as a (re)commitment to take basic steps that will reduce your risk, a charge to maintain steps for early evaluation and a prod to point you toward prompt treatment if and when needed. Beginning in their 20s, women should be aware of the benefits and limitations of breast self-exam (BSE). A woman can notice changes by being aware of how her breasts normally look and feel and by feeling her breasts for changes (breast awareness), or by choosing to use a step-by-step approach (with a BSE) and using a specific schedule to examine her breasts. Use the finger pads of the 3 middle fingers on your left hand to feel for lumps in the right breast. Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone).
There is some evidence to suggest that the up-and-down pattern (sometimes called the vertical pattern) is the most effective pattern for covering the entire breast, without missing any breast tissue. Repeat the exam on your left breast, putting your left arm behind your head and using the finger pads of your right hand to do the exam. While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour, or dimpling, or redness or scaliness of the nipple or breast skin.
Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area. I need to acknowledge and thank the multiple sources that continue to compile and disseminate information to the public, including the Centers for Disease Control and Prevention, the American Cancer Society and the Susan G.
Most cases of skin cancer are detected and addressed effectively before they have the opportunity to spread to other parts of the body.
For localized cases of squamous cell carcinomas or basal cell carcinomas, standard treatments include surgically removing small tumors with a scalpel, scraping away the rest, and then finishing the area either by cauterizing it or by applying liquid nitrogen or radiation.


Small carcinomas may also respond to the daily application of an ointment that contains a chemotherapeutic ingredient to the surface of the tumor for several weeks. Chemotherapy and radiation may also be used, particularly in situations in which the cancer is suspected to have spread to other parts of the body.
It is critical to remember that the only real way to hold skin care at bay is through knowledge and through making sure that the doctor knows when something is going on.
If you have questions about skin cancer treatment options contact your local doctor, who will arrange for you to see a dermatologist. Our Speech Pathologist, Dietitian and Skincare Nurse offer 15min free health screening consults. Where the rectum is intruding into the prostate volume, IMRT allows a concavity in the high dose volume to the prostate to minimise collateral damage to the rectum. Tomotherapy has been used for all prostate radiotherapy treatments at the BUPA Cromwell Hospital for the last eight years. Note the ability of the IMRT technique to cause a concavity in the high dose region such that the rectum (pink) is spared from the high dose radiotherapy. The patient lies on the treatment couch, the position is verified by CT and then treatment delivered. Those with T3 disease, usually have anti-hormone therapy first (for 1-3 months) to shrink the tumour back inside the gland prior to radiotherapy and often continue the anti-hormone therapy after radiotherapy for two years.
Harris will provide technology for CTSI’s oncology clinics and work to develop healthcare IT and clinical solutions.
The most common symptom of breast cancer is a new lump, but you should be in tune with any new change or irregularity, including pain, swelling, redness, irritation, nipple inversion or other irregularity. If it’s reached the lymph nodes, that drops to approximately 84%, and if it has spread to other body parts (e.g.
Unfortunately, survivors must live with the uncertainties of possible recurrent cancer and some risk for complications from the treatment itself.
Tumor markers are proteins released from cancer cells that are able to be identified during the disease. I hope these posts have again pointed out the importance of lowering your risk profile and early detection and treatment.
Of course, there is no universal treatment of 'breast cancer'; everything is based on the specific type of breast cancer and the extent of progression upon diagnosis.
I certainly recommend you engage your personal physician and resources such as the Center for Disease Control and Prevention and the American Cancer Society, which will provide you with any and all additional details you may desire. Hormonal therapy blocks cancer cells from getting the specific hormones that assist growth.
It also is of assistance in addressing immune-reducing side effects other cancer treatments may create. The most notable example of such an abnormality is the presence of a human growth factor receptor 2 (HER2), a protein that helps breast cancer cells grow and survive.. Risks of radiation therapy include fatigue and a red, sunburn-like rash where the radiation is aimed. Do your part in reducing your risks and engaging in practices (breast self-exam and mammograms) that allow for early detection. I'm encouraged that so many of you are aware that men can develop breast cancer as well as women.
Although breast cancer is scary and deadly in many cases, be encouraged that nearly 3 million survivors are with us in the U.S.
We've found the way to eradicate certain cancers and have made remarkable progress on others. Women should know how their breasts normally look and feel and report any new breast changes to a health professional as soon as they are found. It may be helpful to have the surgeon help identify the edges of the implant so that you know what you are feeling. Women who choose not to do BSE should still be aware of the normal look and feel of their breasts and report any changes to their doctor right away. Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle).
Raising your arm straight up tightens the tissue in this area and makes it harder to examine.
These changes represent an extensive review of the medical literature and input from an expert advisory group. Finding out that you have skin cancer will immediately make you wonder about the different treatment options that are available to you, and which one may be the most appropriate for your particular type of skin cancer.
Once skin cancer has spread to other parts of the body; however, which is often the case with melanoma, the treatment options become much more limited. External beam radiotherapy is also treatment of choice in the elderly, as it is the least invasive method of curing the cancer and has equivalent cure chance. The treatment is not “sensed” by the body and after the treatment is over (10 minutes)the patient departs hospital unaware of any therapy related effects.
The ability to recognize and obtain early treatment for breast cancer (or not) will determine the length and quality of the rest of your life. Remember, breast tissue extends into the armpit (axilla), and you may find swollen and tender lymph nodes in the axilla or near the collarbone (clavicle). When that’s the case, these cells are called hormone receptor-positive; if not, they’re called hormone receptor negative.


This is another illustration of the shortcomings of our typical approach to health care; relying on medical care is not the same as comprehensive healthcare.
Management usually involves a team approach in order to balance multiple considerations, which often leads to different treatment modalities being used together. Chemotherapy may be given before surgery to reduce tumor size, after surgery or with other therapy to reduce the risk of recurrence, or as a primary treatment option. Different drugs in this class act in a variety of different ways, both direct and indirect, with the same end result of diminishing the ability of hormones to stimulate tumor growth. Yes, this treatment option would be better named hormonal blocking therapy.
Remember, the days of increasing rates of breast cancer are behind us, and breast cancer survivors abound, with approximately 2.8 million survivors in the US. IMPORTANT: The evidence is very clear that your survival rates directly relate to early detection and evaluation.
It's more likely than not that every single one of us has been affected by this, either directly or through a friend or family member. In the meantime, please share this or other information about breast cancer to any and all females in your life. Women who examine their breasts should have their technique reviewed during their periodic health exams by their health care professional. There is some thought that the implants push out the breast tissue and may actually make it easier to examine. This is because when lying down the breast tissue spreads evenly over the chest wall and is as thin as possible, making it much easier to feel all the breast tissue. It is normal to feel a firm ridge in the lower curve of each breast, but you should tell your doctor if you feel anything else out of the ordinary. There is evidence that this position (lying down), the area felt, pattern of coverage of the breast, and use of different amounts of pressure increase a woman's ability to find abnormal areas.
I have used these and other sources over the course of the week to integrate my practices and have distilled their information in many cases.
This is the case with melanoma tumors which need to be addressed quickly before they have the opportunity to spread to other organs. Essentially through this treatment the body is taught to be immune to that particular type of skin cancer.
Passionate about health and wellbeing, we write about issues relevant to our clinical practice. However, towards the end of the 7.5 weeks, urinary frequency and slowing occur and often some tiredness and increased call to stool. My bottom line: you be responsible for diligently assessing any abnormalities, and your healthcare team will determine the cause and if it’s cancer. About 25% of recurrences and 50% of new cancers in the opposite breast occur after 5 years. When cancer cells are hormone receptor positive, they are responsive to certain medications (such as tamoxifen and others). The one I will mention (yes, there are others) is the HER2 marker, which is especially quick-growing and aggressive. The time to engage the fight against breast cancer is not in the midst of advanced disease. Efforts to spare skin and tissue and to retain a cosmetic appearance are important considerations. Hormonal therapy also can be used as a primary treatment option or after other treatment options to reduce the chance of recurrence. You now have the tools to be included in those numbers should (heaven forbid) you find yourself afflicted by breast cancer. Unlike so many of the things I address as an emergency physician, breast cancer isn't like trauma, STDs and many other conditions, where one is often directly suffering the consequences of their behavior.
I also hope you choose to engage your family, friends and others in conversations geared to improving breast cancer awareness.
Women who are pregnant or breastfeeding can also choose to examine their breasts regularly. During such a procedure the surgeon will fully cut out the tumor as well as a portion of the surrounding tissue just to make sure that it is all gone.
Sometimes decisions to remove the other breast is made if the risk of breast cancer in that breast is sufficiently high.
Common side effects of chemotherapy include hair loss, nausea, vomiting, fatigue and an increased risk of developing infection.
It is vital that you appreciate the need and value for early detection to give yourself the best possible chance for the best possible outcomes.
The combination of breast self-exams and widespread use of screening mammograms has increased the number of breast cancers found before they cause any symptoms. Additional surgical considerations include breast reconstruction after surgery, which may include one's own tissue or a synthetic breast implant. Rare side effects can include premature menopause, damage to the heart and kidneys, nerve damage, and, very rarely, blood cell cancer. Unfortunately, many others go undetected because of the limitations or failure to engage those two modalities.



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