Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos. In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the heart, the pericardium (a sac that surrounds the heart) or tunica vaginalis.
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can also put a person at risk for developing mesothelioma. Unlike lung cancer, there is no association between mesothelioma and smoking. Compensation via asbestos funds or lawsuits is an important issue in mesothelioma (see asbestos and the law).
The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall) or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan, and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy (inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis), which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing.
Signs and symptoms
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
* chest wall pain
* pleural effusion, or fluid surrounding the lung
* shortness of breath
* fatigue or anemia
* wheezing, hoarseness, or cough
* blood in the sputum (fluid) coughed up (hemoptysis)
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
* abdominal pain
* ascites, or an abnormal buildup of fluid in the abdomen
* a mass in the abdomen
* problems with bowel function
* weight loss
In severe cases of the disease, the following signs and symptoms may be present:
* blood clots in the veins, which may cause thrombophlebitis
* disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
* jaundice, or yellowing of the eyes and skin
* low blood sugar level
* pleural effusion
* pulmonary emboli, or blood clots in the arteries of the lungs
* severe ascites
A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs.
Diagnosis
CT scan of a patient with mesothelioma, coronal section (the section follows the plane the divides the body in a front and a back half). The mesothelioma is indicated by yellow arrows, the central pleural effusion (fluid collection) is marked with a yellow star. Red numbers: (1) right lung, (2) spine, (3) left lung, (4) ribs, (5) descending part of the aorta, (6) spleen, (7) left kidney, (8) right kidney, (9) liver.
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Sunday, December 28, 2008
Leukemia,Acute leukemia,Chronic leukemia,lymphocytic leukemias,myelogenous leukemias,human T-lymphotropic virus
Leukemia (Greek leukos λευκός, "white"; aima αίμα, "blood") is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation (production by multiplication) of blood cells, usually white blood cells (leukocytes). Leukemia is a broad term covering a spectrum of diseases. In turn, it is part of the even broader group of diseases called hematological neoplasms.
Classification
Leukemia is clinically and pathologically subdivided into several large groups. The first division is between its acute and chronic forms:
* Acute leukemia is characterized by the rapid increase of immature blood cells. This crowding makes the bone marrow unable to produce healthy blood cells. Immediate treatment is required in acute leukemias due to the rapid progression and accumulation of the malignant cells, which then spill over into the bloodstream and spread to other organs of the body. Acute forms of leukemia are the most common forms of leukemia in children.
* Chronic leukemia is distinguished by the excessive build up of relatively mature, but still abnormal, blood cells. Typically taking months or years to progress, the cells are produced at a much higher rate than normal cells, resulting in many abnormal white blood cells in the blood. Whereas acute leukemia must be treated immediately, chronic forms are sometimes monitored for some time before treatment to ensure maximum effectiveness of therapy. Chronic leukemia mostly occurs in older people, but can theoretically occur in any age group.
Additionally, the diseases are subdivided according to which kind of blood cell is affected. This split divides leukemias into lymphoblastic or lymphocytic leukemias and myeloid or myelogenous leukemias:
* In lymphoblastic or lymphocytic leukemias, the cancerous change takes place in a type of marrow cell that normally goes on to form lymphocytes, which are infection-fighting immune system cells.
* In myeloid or myelogenous leukemias, the cancerous change takes place in a type of marrow cell that normally goes on to form red blood cells, some other types of white cells, and platelets.
Within these main categories, there are typically several subcategories. Finally, hairy cell leukemia and T-cell prolymphocytic leukemia are usually considered to be outside of this classification scheme.
* Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in young children. This disease also affects adults, especially those age 65 and older. Standard treatments involve chemotherapy and radiation. The survival rates vary by age: 85% in children and 50% in adults. Subtypes include precursor B acute lymphoblastic leukemia, precursor T acute lymphoblastic leukemia, Burkitt's leukemia, and acute biphenotypic leukemia.
* Chronic lymphocytic leukemia (CLL) most often affects adults over the age of 55. It sometimes occurs in younger adults, but it almost never affects children. Two-thirds of affected people are men. The five-year survival rate is 75%. It is incurable, but there are many effective treatments. One subtype is B-cell prolymphocytic leukemia, a more aggressive disease.
* Acute myelogenous leukemia (AML) occurs more commonly in adults than in children, and more commonly in men than women. AML is treated with chemotherapy. The five-year survival rate is 40%. Subtypes of AML include acute promyelocytic leukemia, acute myeloblastic leukemia, and acute megakaryoblastic leukemia.
* Chronic myelogenous leukemia (CML) occurs mainly in adults. A very small number of children also develop this disease. Treatment is with imatinib (Gleevec) or other drugs. The five-year survival rate is 90%. One subtype is chronic monocytic leukemia.
* Hairy cell leukemia (HCL) is sometimes considered a subset of CLL, but does not fit neatly into this pattern. About 80% of affected people are adult men. There are no reported cases in young children. HCL is incurable, but easily treatable. Survival is 96% to 100% at ten years.
Symptoms
Damage to the bone marrow, by way of displacing the normal bone marrow cells with higher numbers of immature white blood cells, results in a lack of blood platelets, which are important in the blood clotting process. This means people with leukemia may become bruised, bleed excessively, or develop pinprick bleeds (petechiae).
White blood cells, which are involved in fighting pathogens, may be suppressed or dysfunctional. This could cause the patient's immune system to be unable to fight off a simple infection or to start attacking other body cells. Because leukemia prevents the immune system from working normally, some patients experience frequent infection, ranging from infected tonsils, sores in the mouth, or diarrhea to life-threatening pneumonia or opportunistic infections.
Finally, the red blood cell deficiency leads to anemia, which may cause dyspnea and pallor.
Some patients experience other symptoms. These symptoms might include feeling sick, such as having fevers, chills, night sweats and other flu-like symptoms, or feeling fatigued. Some patients experience nausea or a feeling of fullness due to an enlarged liver and spleen; this can result in unintentional weight loss. If the leukemic cells invade the central nervous system, then neurological symptoms (notably headaches) can occur.
All symptoms associated with leukemia can be attributed to other diseases. Consequently, leukemia is always diagnosed through medical tests.
The word leukemia, which means 'white blood', is derived from the disease's namesake high white blood cell counts that most leukemia patients have before treatment. The high number of white blood cells are apparent when a blood sample is viewed under a microscope. Frequently, these extra white blood cells are immature or dysfunctional. The excessive number of cells can also interfere with the level of other cells, causing a harmful imbalance in the blood count.
Some leukemia patients do not have high white blood cell counts visible during a regular blood count. This less-common condition is called aleukemia. The bone marrow still contains cancerous white blood cells which disrupt the normal production of blood cells. However, the leukemic cells are staying in the marrow instead of entering the bloodstream, where they would be visible in a blood test. For an aleukemic patient, the white blood cell counts in the bloodstream can be normal or low. Aleukemia can occur in any of the four major types of leukemia, and is particularly common in hairy cell leukemia.
Numbers
Nearly 44,000 people are diagnosed with leukemia every year in the United States, with an average of 22,000 deaths every year.
Causes and risk factors
There is no single known cause for all of the different types of leukemia. The different leukemias likely have different causes, and very little is certain about what causes them. Researchers have strong suspicions about four possible causes:
* natural or artificial ionizing radiation
* certain kinds of chemicals
* some viruses
* genetic predispositions
Leukemia, like other cancers, results from somatic mutations in the DNA which activate oncogenes or deactivate tumor suppressor genes, and disrupt the regulation of cell death, differentiation or division. These mutations may occur spontaneously or as a result of exposure to radiation or carcinogenic substances and are likely to be influenced by genetic factors. Cohort and case-control studies have linked exposure to petrochemicals, such as benzene, and hair dyes to the development of some forms of leukemia.
Viruses have also been linked to some forms of leukemia. For example, certain cases of ALL are associated with viral infections by either the human immunodeficiency virus or human T-lymphotropic virus (HTLV-1 and -2, causing adult T-cell leukemia/lymphoma). However, one report suggests exposure to certain germs may offer children limited protection against leukemia.
Fanconi anemia is also a risk factor for developing acute myelogenous leukemia.
Until the cause or causes of leukemia are found, there is no way to prevent the disease. Even when the causes become known, they may not be readily controllable, such as naturally occurring background radiation, and therefore not especially helpful for prevention purposes.
Treatment
Most forms of leukemia are treated with pharmaceutical medications. Some are also treated with radiation therapy. In some cases, a bone marrow transplant is useful.
Acute lymphoblastic leukemia (ALL)
Management of ALL focuses on control of bone marrow and systemic (whole-body) disease. Additionally, treatment must prevent leukemic cells from spreading to other sites, particularly the central nervous system (CNS) e.g. monthly lumbar punctures. In general, ALL treatment is divided into several phases:
* Induction chemotherapy to bring about bone marrow remission. For adults, standard induction plans include prednisone, vincristine, and an anthracycline drug; other drug plans may include L-asparaginase or cyclophosphamide. For children with low-risk ALL, standard therapy usually consists of three drugs (prednisone, L-asparaginase, and vincristine) for the first month of treatment.
* Consolidation therapy or intensification therapy to eliminate any remaining leukemia cells. There are many different approaches to consolidation, but it is typically a high-dose, multi-drug treatment that is undertaken for a few months. Patients with low- to average-risk ALL receive therapy with antimetabolite drugs such as methotrexate and 6-mercaptopurine (6-MP). High-risk patients receive higher drug doses of these drugs, plus additional drugs.
* CNS prophylaxis (preventive therapy) to stop the cancer from spreading to the brain and nervous system in high-risk patients. Standard prophylaxis may include radiation of the head and/or drugs delivered directly into the spine.
* Maintenance treatments with chemotherapeutic drugs to prevent disease recurrence once remission has been achieved. Maintenance therapy usually involves lower drug doses, and may continue for up to three years.
* Alternatively, allogeneic bone marrow transplantation may be appropriate for high-risk or relapsed patients.
Chronic lymphocytic leukemia (CLL)
Decision to treat
Hematologists base CLL treatment upon both the stage and symptoms of the individual patient. A large group of CLL patients have low-grade disease, which does not benefit from treatment. Individuals with CLL-related complications or more advanced disease often benefit from treatment. In general, the indications for treatment are:
* falling hemoglobin or platelet count
* progression to a later stage of disease
* painful, disease-related overgrowth of lymph nodes or spleen
* an increase in the rate of lymphocyte production
Typical treatment approach
CLL is probably incurable by present treatments. The primary chemotherapeutic plan is combination chemotherapy with chlorambucil or cyclophosphamide, plus a corticosteroid such as prednisone or prednisolone. The use of a corticosteroid has the additional benefit of suppressing some related autoimmune diseases, such as immunohemolytic anemia or immune-mediated thrombocytopenia. In resistant cases, single-agent treatments with nucleoside drugs such as fludarabine, pentostatin, or cladribine may be successful. Younger patients may consider allogeneic or autologous bone marrow transplantation.
Acute myelogenous leukemia (AML)
Many different anti-cancer drugs are effective for the treatment of AML. Treatments vary somewhat according to the age of the patient and according to the specific subtype of AML. Overall, the strategy is to control bone marrow and systemic (whole-body) disease, while offering specific treatment for the central nervous system (CNS), if involved.
In general, most oncologists rely on combinations of drugs for the initial, induction phase of chemotherapy. Such combination chemotherapy usually offers the benefits of early remission and a lower risk of disease resistance. Consolidation and maintenance treatments are intended to prevent disease recurrence. Consolidation treatment often entails a repetition of induction chemotherapy or the intensification chemotherapy with additional drugs. By contrast, maintenance treatment involves drug doses that are lower than those administered during the induction phase.
Chronic myelogenous leukemia (CML)
There are many possible treatments for CML, but the standard of care for newly diagnosed patients is imatinib (Gleevec) therapy. Compared to most anti-cancer drugs, it has relatively few side effects and can be taken orally at home. With this drug, more than 90% of patients will be able to keep the disease in check for at least five years,[7] so that CML becomes a chronic, manageable condition.
In a more advanced, uncontrolled state, when the patient cannot tolerate imatinib, or if the patient wishes to attempt a permanent cure, then an allogeneic bone marrow transplantation may be performed. This procedure involves high-dose chemotherapy and radiation followed by infusion of bone marrow from a compatible donor. Approximately 30% of patients die from this procedure.
Hairy cell leukemia (HCL)
Decision to treat
Patients with hairy cell leukemia who are symptom-free typically do not receive immediate treatment. Treatment is generally considered necessary when the patient shows signs and symptoms such as low blood cell counts (e.g., infection-fighting neutrophil count below 1.0 K/µL), frequent infections, unexplained bruises, anemia, or fatigue that is significant enough to disrupt the patient's everyday life.
Typical treatment approach
Patients who need treatment usually receive either one week of cladribine, given daily by intravenous infusion or a simple injection under the skin, or six months of pentostatin, given every four weeks by intravenous infusion. In most cases, one round of treatment will produce a prolonged remission.
Other treatments include rituximab infusion or self-injection with Interferon-alpha. In limited cases, the patient may benefit from splenectomy (removal of the spleen). These treatments are not typically given as the first treatment because their success rates are lower than cladribine or pentostatin.
Research
Significant research into the causes, diagnosis, treatment, and prognosis of leukemia is being done. Hundreds of clinical trials are being planned or conducted at any given time. Studies may focus on effective means of treatment, better ways of treating the disease, improving the quality of life for patients, or appropriate care in remission or after cures.
Epidemiology
As of 1998, it is estimated that each year, approximately 30,800 individuals will be diagnosed with leukemia in the United States and 21,700 individuals will die of the disease. This represents about 2% of all forms of cancer.
Classification
Leukemia is clinically and pathologically subdivided into several large groups. The first division is between its acute and chronic forms:
* Acute leukemia is characterized by the rapid increase of immature blood cells. This crowding makes the bone marrow unable to produce healthy blood cells. Immediate treatment is required in acute leukemias due to the rapid progression and accumulation of the malignant cells, which then spill over into the bloodstream and spread to other organs of the body. Acute forms of leukemia are the most common forms of leukemia in children.
* Chronic leukemia is distinguished by the excessive build up of relatively mature, but still abnormal, blood cells. Typically taking months or years to progress, the cells are produced at a much higher rate than normal cells, resulting in many abnormal white blood cells in the blood. Whereas acute leukemia must be treated immediately, chronic forms are sometimes monitored for some time before treatment to ensure maximum effectiveness of therapy. Chronic leukemia mostly occurs in older people, but can theoretically occur in any age group.
Additionally, the diseases are subdivided according to which kind of blood cell is affected. This split divides leukemias into lymphoblastic or lymphocytic leukemias and myeloid or myelogenous leukemias:
* In lymphoblastic or lymphocytic leukemias, the cancerous change takes place in a type of marrow cell that normally goes on to form lymphocytes, which are infection-fighting immune system cells.
* In myeloid or myelogenous leukemias, the cancerous change takes place in a type of marrow cell that normally goes on to form red blood cells, some other types of white cells, and platelets.
Within these main categories, there are typically several subcategories. Finally, hairy cell leukemia and T-cell prolymphocytic leukemia are usually considered to be outside of this classification scheme.
* Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in young children. This disease also affects adults, especially those age 65 and older. Standard treatments involve chemotherapy and radiation. The survival rates vary by age: 85% in children and 50% in adults. Subtypes include precursor B acute lymphoblastic leukemia, precursor T acute lymphoblastic leukemia, Burkitt's leukemia, and acute biphenotypic leukemia.
* Chronic lymphocytic leukemia (CLL) most often affects adults over the age of 55. It sometimes occurs in younger adults, but it almost never affects children. Two-thirds of affected people are men. The five-year survival rate is 75%. It is incurable, but there are many effective treatments. One subtype is B-cell prolymphocytic leukemia, a more aggressive disease.
* Acute myelogenous leukemia (AML) occurs more commonly in adults than in children, and more commonly in men than women. AML is treated with chemotherapy. The five-year survival rate is 40%. Subtypes of AML include acute promyelocytic leukemia, acute myeloblastic leukemia, and acute megakaryoblastic leukemia.
* Chronic myelogenous leukemia (CML) occurs mainly in adults. A very small number of children also develop this disease. Treatment is with imatinib (Gleevec) or other drugs. The five-year survival rate is 90%. One subtype is chronic monocytic leukemia.
* Hairy cell leukemia (HCL) is sometimes considered a subset of CLL, but does not fit neatly into this pattern. About 80% of affected people are adult men. There are no reported cases in young children. HCL is incurable, but easily treatable. Survival is 96% to 100% at ten years.
Symptoms
Damage to the bone marrow, by way of displacing the normal bone marrow cells with higher numbers of immature white blood cells, results in a lack of blood platelets, which are important in the blood clotting process. This means people with leukemia may become bruised, bleed excessively, or develop pinprick bleeds (petechiae).
White blood cells, which are involved in fighting pathogens, may be suppressed or dysfunctional. This could cause the patient's immune system to be unable to fight off a simple infection or to start attacking other body cells. Because leukemia prevents the immune system from working normally, some patients experience frequent infection, ranging from infected tonsils, sores in the mouth, or diarrhea to life-threatening pneumonia or opportunistic infections.
Finally, the red blood cell deficiency leads to anemia, which may cause dyspnea and pallor.
Some patients experience other symptoms. These symptoms might include feeling sick, such as having fevers, chills, night sweats and other flu-like symptoms, or feeling fatigued. Some patients experience nausea or a feeling of fullness due to an enlarged liver and spleen; this can result in unintentional weight loss. If the leukemic cells invade the central nervous system, then neurological symptoms (notably headaches) can occur.
All symptoms associated with leukemia can be attributed to other diseases. Consequently, leukemia is always diagnosed through medical tests.
The word leukemia, which means 'white blood', is derived from the disease's namesake high white blood cell counts that most leukemia patients have before treatment. The high number of white blood cells are apparent when a blood sample is viewed under a microscope. Frequently, these extra white blood cells are immature or dysfunctional. The excessive number of cells can also interfere with the level of other cells, causing a harmful imbalance in the blood count.
Some leukemia patients do not have high white blood cell counts visible during a regular blood count. This less-common condition is called aleukemia. The bone marrow still contains cancerous white blood cells which disrupt the normal production of blood cells. However, the leukemic cells are staying in the marrow instead of entering the bloodstream, where they would be visible in a blood test. For an aleukemic patient, the white blood cell counts in the bloodstream can be normal or low. Aleukemia can occur in any of the four major types of leukemia, and is particularly common in hairy cell leukemia.
Numbers
Nearly 44,000 people are diagnosed with leukemia every year in the United States, with an average of 22,000 deaths every year.
Causes and risk factors
There is no single known cause for all of the different types of leukemia. The different leukemias likely have different causes, and very little is certain about what causes them. Researchers have strong suspicions about four possible causes:
* natural or artificial ionizing radiation
* certain kinds of chemicals
* some viruses
* genetic predispositions
Leukemia, like other cancers, results from somatic mutations in the DNA which activate oncogenes or deactivate tumor suppressor genes, and disrupt the regulation of cell death, differentiation or division. These mutations may occur spontaneously or as a result of exposure to radiation or carcinogenic substances and are likely to be influenced by genetic factors. Cohort and case-control studies have linked exposure to petrochemicals, such as benzene, and hair dyes to the development of some forms of leukemia.
Viruses have also been linked to some forms of leukemia. For example, certain cases of ALL are associated with viral infections by either the human immunodeficiency virus or human T-lymphotropic virus (HTLV-1 and -2, causing adult T-cell leukemia/lymphoma). However, one report suggests exposure to certain germs may offer children limited protection against leukemia.
Fanconi anemia is also a risk factor for developing acute myelogenous leukemia.
Until the cause or causes of leukemia are found, there is no way to prevent the disease. Even when the causes become known, they may not be readily controllable, such as naturally occurring background radiation, and therefore not especially helpful for prevention purposes.
Treatment
Most forms of leukemia are treated with pharmaceutical medications. Some are also treated with radiation therapy. In some cases, a bone marrow transplant is useful.
Acute lymphoblastic leukemia (ALL)
Management of ALL focuses on control of bone marrow and systemic (whole-body) disease. Additionally, treatment must prevent leukemic cells from spreading to other sites, particularly the central nervous system (CNS) e.g. monthly lumbar punctures. In general, ALL treatment is divided into several phases:
* Induction chemotherapy to bring about bone marrow remission. For adults, standard induction plans include prednisone, vincristine, and an anthracycline drug; other drug plans may include L-asparaginase or cyclophosphamide. For children with low-risk ALL, standard therapy usually consists of three drugs (prednisone, L-asparaginase, and vincristine) for the first month of treatment.
* Consolidation therapy or intensification therapy to eliminate any remaining leukemia cells. There are many different approaches to consolidation, but it is typically a high-dose, multi-drug treatment that is undertaken for a few months. Patients with low- to average-risk ALL receive therapy with antimetabolite drugs such as methotrexate and 6-mercaptopurine (6-MP). High-risk patients receive higher drug doses of these drugs, plus additional drugs.
* CNS prophylaxis (preventive therapy) to stop the cancer from spreading to the brain and nervous system in high-risk patients. Standard prophylaxis may include radiation of the head and/or drugs delivered directly into the spine.
* Maintenance treatments with chemotherapeutic drugs to prevent disease recurrence once remission has been achieved. Maintenance therapy usually involves lower drug doses, and may continue for up to three years.
* Alternatively, allogeneic bone marrow transplantation may be appropriate for high-risk or relapsed patients.
Chronic lymphocytic leukemia (CLL)
Decision to treat
Hematologists base CLL treatment upon both the stage and symptoms of the individual patient. A large group of CLL patients have low-grade disease, which does not benefit from treatment. Individuals with CLL-related complications or more advanced disease often benefit from treatment. In general, the indications for treatment are:
* falling hemoglobin or platelet count
* progression to a later stage of disease
* painful, disease-related overgrowth of lymph nodes or spleen
* an increase in the rate of lymphocyte production
Typical treatment approach
CLL is probably incurable by present treatments. The primary chemotherapeutic plan is combination chemotherapy with chlorambucil or cyclophosphamide, plus a corticosteroid such as prednisone or prednisolone. The use of a corticosteroid has the additional benefit of suppressing some related autoimmune diseases, such as immunohemolytic anemia or immune-mediated thrombocytopenia. In resistant cases, single-agent treatments with nucleoside drugs such as fludarabine, pentostatin, or cladribine may be successful. Younger patients may consider allogeneic or autologous bone marrow transplantation.
Acute myelogenous leukemia (AML)
Many different anti-cancer drugs are effective for the treatment of AML. Treatments vary somewhat according to the age of the patient and according to the specific subtype of AML. Overall, the strategy is to control bone marrow and systemic (whole-body) disease, while offering specific treatment for the central nervous system (CNS), if involved.
In general, most oncologists rely on combinations of drugs for the initial, induction phase of chemotherapy. Such combination chemotherapy usually offers the benefits of early remission and a lower risk of disease resistance. Consolidation and maintenance treatments are intended to prevent disease recurrence. Consolidation treatment often entails a repetition of induction chemotherapy or the intensification chemotherapy with additional drugs. By contrast, maintenance treatment involves drug doses that are lower than those administered during the induction phase.
Chronic myelogenous leukemia (CML)
There are many possible treatments for CML, but the standard of care for newly diagnosed patients is imatinib (Gleevec) therapy. Compared to most anti-cancer drugs, it has relatively few side effects and can be taken orally at home. With this drug, more than 90% of patients will be able to keep the disease in check for at least five years,[7] so that CML becomes a chronic, manageable condition.
In a more advanced, uncontrolled state, when the patient cannot tolerate imatinib, or if the patient wishes to attempt a permanent cure, then an allogeneic bone marrow transplantation may be performed. This procedure involves high-dose chemotherapy and radiation followed by infusion of bone marrow from a compatible donor. Approximately 30% of patients die from this procedure.
Hairy cell leukemia (HCL)
Decision to treat
Patients with hairy cell leukemia who are symptom-free typically do not receive immediate treatment. Treatment is generally considered necessary when the patient shows signs and symptoms such as low blood cell counts (e.g., infection-fighting neutrophil count below 1.0 K/µL), frequent infections, unexplained bruises, anemia, or fatigue that is significant enough to disrupt the patient's everyday life.
Typical treatment approach
Patients who need treatment usually receive either one week of cladribine, given daily by intravenous infusion or a simple injection under the skin, or six months of pentostatin, given every four weeks by intravenous infusion. In most cases, one round of treatment will produce a prolonged remission.
Other treatments include rituximab infusion or self-injection with Interferon-alpha. In limited cases, the patient may benefit from splenectomy (removal of the spleen). These treatments are not typically given as the first treatment because their success rates are lower than cladribine or pentostatin.
Research
Significant research into the causes, diagnosis, treatment, and prognosis of leukemia is being done. Hundreds of clinical trials are being planned or conducted at any given time. Studies may focus on effective means of treatment, better ways of treating the disease, improving the quality of life for patients, or appropriate care in remission or after cures.
Epidemiology
As of 1998, it is estimated that each year, approximately 30,800 individuals will be diagnosed with leukemia in the United States and 21,700 individuals will die of the disease. This represents about 2% of all forms of cancer.
Brain tumor,Signs and symptoms,Diagnosis,Treatment and prognosis
A brain tumor (brain tumour in the UK and Canada; see spelling differences) is any intracranial tumor created by abnormal and uncontrolled cell division, normally either in the brain itself (neurons, glial cells (astrocytes, oligodendrocytes, ependymal cells), lymphatic tissue, blood vessels), in the cranial nerves (myelin-producing Schwann cells), in the brain envelopes (meninges), skull, pituitary and pineal gland, or spread from cancers primarily located in other organs (metastatic tumors). Primary (true) brain tumors are commonly located in the posterior cranial fossa in children and in the anterior two-thirds of the cerebral hemispheres in adults, although they can affect any part of the brain. In the United States in the year 2005, it was estimated that there were 43,800 new cases of brain tumors (Central Brain Tumor Registry of the United States, Primary Brain Tumors in the United States, Statistical Report, 2005–2006), which accounted for 1.4 percent of all cancers, 2.4 percent of all cancer deaths, and 20–25 percent of pediatric cancers. Ultimately, it is estimated that there are 13,000 deaths per year in the United States alone as a result of brain tumors.
In infants and children
In the US, approximately 2000 children and adolescents younger than 20 years of age are diagnosed with malignant brain tumors each year. Higher incidence rates were reported in 1985–94 than in 1975–84. There is some debate as to possible reasons; one theory is that the trend is the result of improved diagnosis and reporting, since the jump occured at the same time as MRIs became available widely, and since there was no coincident jump in mortality. The CNS cancer survival rate in children is approximately 60%. The rate varies with the age of onset (younger has higher mortality) and cancer type.
In children under 2, about 70% of brain tumors are medulloblastoma, ependymoma, and low-grade glioma. Less commonly, and seen usually in infants, are teratoma and atypical teratoid rhabdoid tumor. Germ cell tumors, including teratoma, make up just 3% of pediatric primary brain tumors, but the worldwide incidence varies significantly.
Signs and symptoms
Symptoms of brain tumors may depend on two factors: tumor size (volume) and tumor location. The time point of symptom onset in the course of disease correlates in many cases with the nature of the tumor ("benign", i.e. slow-growing/late symptom onset, or malignant, fast growing/early symptom onset).
Many low-grade (benign) tumors can remain asymptomatic (symptom-free) for years and they may accidentally be discovered by imaging exams for unrelated reasons (such as a minor trauma).
New onset of epilepsy is a frequent reason for seeking medical attention in brain tumor cases.
Large tumors or tumors with extensive perifocal swelling edema inevitably lead to elevated intracranial pressure (intracranial hypertension), which translates clinically into headaches, vomiting (sometimes without nausea), altered state of consciousness (somnolence, coma), dilatation of the pupil on the side of the lesion (anisocoria), papilledema (prominent optic disc at the funduscopic examination). However, even small tumors obstructing the passage of cerebrospinal fluid (CSF) may cause early signs of increased intracranial pressure. Increased intracranial pressure may result in herniation (i.e. displacement) of certain parts of the brain, such as the cerebellar tonsils or the temporal uncus, resulting in lethal brainstem compression. In young children, elevated intracranial pressure may cause an increase in the diameter of the skull and bulging of the fontanelles.
Depending on the tumor location and the damage it may have caused to surrounding brain structures, either through compression or infiltration, any type of focal neurologic symptoms may occur, such as cognitive and behavioral impairment, personality changes, hemiparesis, hypesthesia, aphasia, ataxia, visual field impairment, facial paralysis, double vision, tremor etc. These symptoms are not specific for brain tumors - they may be caused by a large variety of neurologic conditions (e.g. stroke, traumatic brain injury). What counts, however, is the location of the lesion and the functional systems (e.g. motor, sensory, visual, etc.) it affects.
A bilateral temporal visual field defect (bitemporal hemianopia—due to compression of the optic chiasm), often associated with endocrine disfunction—either hypopituitarism or hyperproduction of pituitary hormones and hyperprolactinemia is suggestive of a pituitary tumor.
Diagnosis
Although there is no specific clinical symptom or sign for brain tumors, slowly progressive focal neurologic signs and signs of elevated intracranial pressure, as well as epilepsy in a patient with a negative history for epilepsy should raise red flags. However, a sudden onset of symptoms, such as an epileptic seizure in a patient with no prior history of epilepsy, sudden intracranial hypertension (this may be due to bleeding within the tumour, brain swelling or obstruction of cerebrospinal fluid's passage) is also possible.
Glioblastoma multiforme and anaplastic astrocytoma have been associated in case reports on Pubmed with the genetic acute hepatic porphyrias, including positive testing associated with drug refractory seizures. Unexplained complications associated with drug treatments with these tumors should alert physicians to an undiagnosed neurological porphyria.
Imaging plays a central role in the diagnosis of brain tumors. Early imaging methods—invasive and sometimes dangerous—such as pneumoencephalography and cerebral angiography, have been abandoned in recent times in favor of non-invasive, high-resolution modalities, such as computed tomography (CT) and especially magnetic resonance imaging (MRI). Benign brain tumors often show up as hypodense (darker than brain tissue) mass lesions on cranial CT-scans. On MRI, they appear either hypo- (darker than brain tissue) or isointense (same intensity as brain tissue) on T1-weighted scans, or hyperintense (brighter than brain tissue) on T2-weighted MRI. Perifocal edema also appears hyperintense on T2-weighted MRI. Contrast agent uptake, sometimes in characteristic patterns, can be demonstrated on either CT or MRI-scans in most malignant primary and metastatic brain tumors. This is because these tumors disrupt the normal functioning of the blood-brain barrier and lead to an increase in its permeability.
Electrophysiological exams, such as electroencephalography (EEG) play a marginal role in the diagnosis of brain tumors.
The definitive diagnosis of brain tumor can only be confirmed by histological examination of tumor tissue samples obtained either by means of brain biopsy or open surgery. The histological examination is essential for determining the appropriate treatment and the correct prognosis. This examination, performed by a pathologist, typically has three stages: interoperative examination of fresh tissue, preliminary microscopic examination of prepared tissues, and followup examination of prepared tissues after immunohistochemical staining or genetic analysis.
Another possible diagnonsis would be Neurofibromatosis which can be in type one or type two.
Treatment and prognosis
Many meningiomas, with the exception of some tumors located at the skull base, can be successfully removed surgically. In more difficult cases, stereotactic radiosurgery, such as gamma knife radiosurgery, remains a viable option.
Most pituitary adenomas can be removed surgically, often using a minimally invasive approach through the nasal cavity and skull base (trans-nasal, trans-sphenoidal approach). Large pituitary adenomas require a craniotomy (opening of the skull) for their removal. Radiotherapy, including stereotactic approaches, is reserved for the inoperable cases.
Although there is no generally accepted therapeutic management for primary brain tumors, a surgical attempt at tumor removal or at least cytoreduction (that is, removal of as much tumor as possible, in order to reduce the number of tumor cells available for proliferation) is considered in most cases. However, due to the infiltrative nature of these lesions, tumor recurrence, even following an apparently complete surgical removal, is not uncommon. Several current research studies aim to improve the surgical removal of brain tumors by labeling tumor cells with a chemical (5-aminolevulinic acid) that causes them to fluoresce [9]. Postoperative radiotherapy and chemotherapy are integral parts of the therapeutic standard for malignant tumors. Radiotherapy may also be administered in cases of "low-grade" gliomas, when a significant tumor burden reduction could not be achieved surgically.
Survival rates in primary brain tumors depend on the type of tumor, age, functional status of the patient, the extent of surgical tumor removal, to mention just a few factors.
UCLA Neuro-Oncology publishes real-time survival data for patients with this diagnosis. They are the only institution in the United States that shows how brain tumor patients are performing on current therapies. They also show a listing of chemotherapy agents used to treat high grade glioma tumors.
Patients with benign gliomas may survive for many years, while survival in most cases of glioblastoma multiforme is limited to a few months after diagnosis if treatment is ignored.
The main treatment option for single metastatic tumors is surgical removal, followed by radiotherapy and/or chemotherapy. Multiple metastatic tumors are generally treated with radiotherapy and chemotherapy. Stereotactic radiosurgery, such as Gamma Knife radiosurgery, remains a viable option. However, the prognosis in such cases is determined by the primary tumor, and it is generally poor.
A shunt operation is used not as a cure but to relieve the symptoms. The hydrocephalus caused by the blocking drainage of the cerebrospinal fluid can be removed with this operation.
Research to treatment with the vesicular stomatitis virus
In 2000, researchers at the University of Ottawa, led by John Bell M.D., have discovered that the vesicular stomatitis virus, or VSV, can infect and kill cancer cells, without affecting healthy cells if coadministered with interferon.
The initial discovery of the virus' oncolytic properties were limited to only a few types of cancer. Several independent studies have indentified many more types susceptible to the virus, including glioblastoma multiforme cancer cells, which account for the majority of brain tumors.
In 2008, researchers at Yale University, led by Dr. Anthony van den Pol, artificially engineered strains of VSV that were less cytotoxic to normal cells. This advance allows administration of the virus without coadministration with interferon. Consequently administration of the virus can be given intravenously or through the olfactory nerve. In the research, a human brain tumor was implanted into mice brains. The VSV was injected via their tails and within 3 days all tumor cells were either dead or dying.
Research on virus treatment like this has been conducted for some years, but no other viruses have been shown to be as efficient or specific as the VSV mutant strains. Future research will focus on the risks of this treatment, before it can be applied to humans.
In infants and children
In the US, approximately 2000 children and adolescents younger than 20 years of age are diagnosed with malignant brain tumors each year. Higher incidence rates were reported in 1985–94 than in 1975–84. There is some debate as to possible reasons; one theory is that the trend is the result of improved diagnosis and reporting, since the jump occured at the same time as MRIs became available widely, and since there was no coincident jump in mortality. The CNS cancer survival rate in children is approximately 60%. The rate varies with the age of onset (younger has higher mortality) and cancer type.
In children under 2, about 70% of brain tumors are medulloblastoma, ependymoma, and low-grade glioma. Less commonly, and seen usually in infants, are teratoma and atypical teratoid rhabdoid tumor. Germ cell tumors, including teratoma, make up just 3% of pediatric primary brain tumors, but the worldwide incidence varies significantly.
Signs and symptoms
Symptoms of brain tumors may depend on two factors: tumor size (volume) and tumor location. The time point of symptom onset in the course of disease correlates in many cases with the nature of the tumor ("benign", i.e. slow-growing/late symptom onset, or malignant, fast growing/early symptom onset).
Many low-grade (benign) tumors can remain asymptomatic (symptom-free) for years and they may accidentally be discovered by imaging exams for unrelated reasons (such as a minor trauma).
New onset of epilepsy is a frequent reason for seeking medical attention in brain tumor cases.
Large tumors or tumors with extensive perifocal swelling edema inevitably lead to elevated intracranial pressure (intracranial hypertension), which translates clinically into headaches, vomiting (sometimes without nausea), altered state of consciousness (somnolence, coma), dilatation of the pupil on the side of the lesion (anisocoria), papilledema (prominent optic disc at the funduscopic examination). However, even small tumors obstructing the passage of cerebrospinal fluid (CSF) may cause early signs of increased intracranial pressure. Increased intracranial pressure may result in herniation (i.e. displacement) of certain parts of the brain, such as the cerebellar tonsils or the temporal uncus, resulting in lethal brainstem compression. In young children, elevated intracranial pressure may cause an increase in the diameter of the skull and bulging of the fontanelles.
Depending on the tumor location and the damage it may have caused to surrounding brain structures, either through compression or infiltration, any type of focal neurologic symptoms may occur, such as cognitive and behavioral impairment, personality changes, hemiparesis, hypesthesia, aphasia, ataxia, visual field impairment, facial paralysis, double vision, tremor etc. These symptoms are not specific for brain tumors - they may be caused by a large variety of neurologic conditions (e.g. stroke, traumatic brain injury). What counts, however, is the location of the lesion and the functional systems (e.g. motor, sensory, visual, etc.) it affects.
A bilateral temporal visual field defect (bitemporal hemianopia—due to compression of the optic chiasm), often associated with endocrine disfunction—either hypopituitarism or hyperproduction of pituitary hormones and hyperprolactinemia is suggestive of a pituitary tumor.
Diagnosis
Although there is no specific clinical symptom or sign for brain tumors, slowly progressive focal neurologic signs and signs of elevated intracranial pressure, as well as epilepsy in a patient with a negative history for epilepsy should raise red flags. However, a sudden onset of symptoms, such as an epileptic seizure in a patient with no prior history of epilepsy, sudden intracranial hypertension (this may be due to bleeding within the tumour, brain swelling or obstruction of cerebrospinal fluid's passage) is also possible.
Glioblastoma multiforme and anaplastic astrocytoma have been associated in case reports on Pubmed with the genetic acute hepatic porphyrias, including positive testing associated with drug refractory seizures. Unexplained complications associated with drug treatments with these tumors should alert physicians to an undiagnosed neurological porphyria.
Imaging plays a central role in the diagnosis of brain tumors. Early imaging methods—invasive and sometimes dangerous—such as pneumoencephalography and cerebral angiography, have been abandoned in recent times in favor of non-invasive, high-resolution modalities, such as computed tomography (CT) and especially magnetic resonance imaging (MRI). Benign brain tumors often show up as hypodense (darker than brain tissue) mass lesions on cranial CT-scans. On MRI, they appear either hypo- (darker than brain tissue) or isointense (same intensity as brain tissue) on T1-weighted scans, or hyperintense (brighter than brain tissue) on T2-weighted MRI. Perifocal edema also appears hyperintense on T2-weighted MRI. Contrast agent uptake, sometimes in characteristic patterns, can be demonstrated on either CT or MRI-scans in most malignant primary and metastatic brain tumors. This is because these tumors disrupt the normal functioning of the blood-brain barrier and lead to an increase in its permeability.
Electrophysiological exams, such as electroencephalography (EEG) play a marginal role in the diagnosis of brain tumors.
The definitive diagnosis of brain tumor can only be confirmed by histological examination of tumor tissue samples obtained either by means of brain biopsy or open surgery. The histological examination is essential for determining the appropriate treatment and the correct prognosis. This examination, performed by a pathologist, typically has three stages: interoperative examination of fresh tissue, preliminary microscopic examination of prepared tissues, and followup examination of prepared tissues after immunohistochemical staining or genetic analysis.
Another possible diagnonsis would be Neurofibromatosis which can be in type one or type two.
Treatment and prognosis
Many meningiomas, with the exception of some tumors located at the skull base, can be successfully removed surgically. In more difficult cases, stereotactic radiosurgery, such as gamma knife radiosurgery, remains a viable option.
Most pituitary adenomas can be removed surgically, often using a minimally invasive approach through the nasal cavity and skull base (trans-nasal, trans-sphenoidal approach). Large pituitary adenomas require a craniotomy (opening of the skull) for their removal. Radiotherapy, including stereotactic approaches, is reserved for the inoperable cases.
Although there is no generally accepted therapeutic management for primary brain tumors, a surgical attempt at tumor removal or at least cytoreduction (that is, removal of as much tumor as possible, in order to reduce the number of tumor cells available for proliferation) is considered in most cases. However, due to the infiltrative nature of these lesions, tumor recurrence, even following an apparently complete surgical removal, is not uncommon. Several current research studies aim to improve the surgical removal of brain tumors by labeling tumor cells with a chemical (5-aminolevulinic acid) that causes them to fluoresce [9]. Postoperative radiotherapy and chemotherapy are integral parts of the therapeutic standard for malignant tumors. Radiotherapy may also be administered in cases of "low-grade" gliomas, when a significant tumor burden reduction could not be achieved surgically.
Survival rates in primary brain tumors depend on the type of tumor, age, functional status of the patient, the extent of surgical tumor removal, to mention just a few factors.
UCLA Neuro-Oncology publishes real-time survival data for patients with this diagnosis. They are the only institution in the United States that shows how brain tumor patients are performing on current therapies. They also show a listing of chemotherapy agents used to treat high grade glioma tumors.
Patients with benign gliomas may survive for many years, while survival in most cases of glioblastoma multiforme is limited to a few months after diagnosis if treatment is ignored.
The main treatment option for single metastatic tumors is surgical removal, followed by radiotherapy and/or chemotherapy. Multiple metastatic tumors are generally treated with radiotherapy and chemotherapy. Stereotactic radiosurgery, such as Gamma Knife radiosurgery, remains a viable option. However, the prognosis in such cases is determined by the primary tumor, and it is generally poor.
A shunt operation is used not as a cure but to relieve the symptoms. The hydrocephalus caused by the blocking drainage of the cerebrospinal fluid can be removed with this operation.
Research to treatment with the vesicular stomatitis virus
In 2000, researchers at the University of Ottawa, led by John Bell M.D., have discovered that the vesicular stomatitis virus, or VSV, can infect and kill cancer cells, without affecting healthy cells if coadministered with interferon.
The initial discovery of the virus' oncolytic properties were limited to only a few types of cancer. Several independent studies have indentified many more types susceptible to the virus, including glioblastoma multiforme cancer cells, which account for the majority of brain tumors.
In 2008, researchers at Yale University, led by Dr. Anthony van den Pol, artificially engineered strains of VSV that were less cytotoxic to normal cells. This advance allows administration of the virus without coadministration with interferon. Consequently administration of the virus can be given intravenously or through the olfactory nerve. In the research, a human brain tumor was implanted into mice brains. The VSV was injected via their tails and within 3 days all tumor cells were either dead or dying.
Research on virus treatment like this has been conducted for some years, but no other viruses have been shown to be as efficient or specific as the VSV mutant strains. Future research will focus on the risks of this treatment, before it can be applied to humans.
Sunday, December 14, 2008
List of cancer types (alphebetical order)
A
* Acute lymphoblastic leukemia
* Acute myeloid leukemia
* Adrenocortical carcinoma
* AIDS-related cancers
* AIDS-related lymphoma
* Anal cancer
* Appendix cancer
* Astrocytoma, childhood cerebellar or cerebral
B
* Basal cell carcinoma
* Bile duct cancer, extrahepatic
* Bladder cancer
* Bladder cancer, childhood
* Bone cancer, Osteosarcoma/Malignant fibrous histiocytoma
* Brain stem glioma, childhood
* Brain tumor, adult
* Brain tumor, brain stem glioma, childhood
* Brain tumor, cerebellar astrocytoma, childhood
* Brain tumor, cerebral astrocytoma/malignant glioma, childhood
* Brain tumor, ependymoma, childhood
* Brain tumor, medulloblastoma, childhood
* Brain tumor, supratentorial primitive neuroectodermal tumors, childhood
* Brain tumor, visual pathway and hypothalamic glioma, childhood
* Brain tumor, childhood (other)
* Breast cancer
* Bronchial adenomas/carcinoids, childhood
* Burkitt lymphoma
C
* Carcinoid tumor, childhood
* Carcinoid tumor, gastrointestinal
* Carcinoma of unknown primary
* Central nervous system lymphoma, primary
* Cerebellar astrocytoma, childhood
* Cerebral astrocytoma/Malignant glioma, childhood
* Cervical cancer
* Childhood cancers
* Chronic lymphocytic leukemia
* Chronic myelogenous leukemia
* Chronic myeloproliferative disorders
* Colon Cancer
* Cutaneous T-cell lymphoma
D
* Desmoplastic small round cell tumor
E
* Endometrial cancer
* Ependymoma
* Esophageal cancer
* Ewing's sarcoma in the Ewing family of tumors
* Extracranial germ cell tumor, Childhood
* Extragonadal Germ cell tumor
* Extrahepatic bile duct cancer
* Eye Cancer, Intraocular melanoma
* Eye Cancer, Retinoblastoma
G
* Gallbladder Cancer
* Gastric (Stomach) Cancer
* Gastric (Stomach) Cancer, Childhood
* Gastrointestinal Carcinoid Tumor
* Gastrointestinal Stromal Tumor (GIST)
* Germ Cell Tumor, Extracranial, Childhood
* Germ Cell Tumor, Extragonadal
* Germ Cell Tumor, Ovarian
* Gestational Trophoblastic Tumor
* Glioma, Adult
* Glioma, Childhood Brain Stem
* Glioma, Childhood Cerebral Astrocytoma
* Glioma, Childhood Visual Pathway and Hypothalamic
* Gastric Carcinoid
H
* Hairy cell leukemia
* Head and neck cancer
* Hepatocellular (liver) cancer
* Hodgkin lymphoma
* Hypopharyngeal cancer
* Hypothalamic and visual pathway glioma, childhood
I
* Intraocular Melanoma
* Islet Cell Carcinoma (Endocrine Pancreas)
K
* Kaposi sarcoma
* Kidney cancer (renal cell cancer)
L
* Laryngeal Cancer
* Leukemias
* Leukemia, acute lymphoblastic (also called acute lymphocytic leukemia)
* Leukemia, acute myeloid (also called acute myelogenous leukemia)
* Leukemia, chronic lymphocytic (also called chronic lymphocytic leukemia)
* Leukemia, chronic myelogenous (also called chronic myeloid leukemia)
* Leukemia, hairy cell
* Lip and Oral Cavity Cancer
* Liver Cancer (Primary)
* Lung Cancer, Non-Small Cell
* Lung Cancer, Small Cell
* Lymphomas
* Lymphoma, AIDS-related
* Lymphoma, Burkitt
* Lymphoma, cutaneous T-Cell
* Lymphoma, Hodgkin
* Lymphomas, Non-Hodgkin (an old classification of all lymphomas except Hodgkin's)
* Lymphoma, Primary Central Nervous System
M
* Macroglobulinemia, Waldenström
* Malignant Fibrous Histiocytoma of Bone/Osteosarcoma
* Medulloblastoma, Childhood
* Melanoma
* Melanoma, Intraocular (Eye)
* Merkel Cell Carcinoma
* Mesothelioma, Adult Malignant
* Mesothelioma, Childhood
* Metastatic Squamous Neck Cancer with Occult Primary
* Mouth Cancer
* Multiple Endocrine Neoplasia Syndrome, Childhood
* Multiple Myeloma/Plasma Cell Neoplasm
* Mycosis Fungoides
* Myelodysplastic Syndromes
* Myelodysplastic/Myeloproliferative Diseases
* Myelogenous Leukemia, Chronic
* Myeloid Leukemia, Adult Acute
* Myeloid Leukemia, Childhood Acute
* Myeloma, Multiple (Cancer of the Bone-Marrow)
* Myeloproliferative Disorders, Chronic
N
* Nasal cavity and paranasal sinus cancer
* Nasopharyngeal carcinoma
* Neuroblastoma
* Non-Hodgkin lymphoma
* Non-small cell lung cancer
O
* Oral Cancer
* Oropharyngeal cancer
* Osteosarcoma/malignant fibrous histiocytoma of bone
* Ovarian cancer
* Ovarian epithelial cancer (Surface epithelial-stromal tumor)
* Ovarian germ cell tumor
* Ovarian low malignant potential tumor
P
* Pancreatic cancer
* Pancreatic cancer, islet cell
* Paranasal sinus and nasal cavity cancer
* Parathyroid cancer
* Penile cancer
* Pharyngeal cancer
* Pheochromocytoma
* Pineal astrocytoma
* Pineal germinoma
* Pineoblastoma and supratentorial primitive neuroectodermal tumors, childhood
* Pituitary adenoma
* Plasma cell neoplasia/Multiple myeloma
* Pleuropulmonary blastoma
* Primary central nervous system lymphoma
* Prostate cancer
R
* Rectal cancer
* Renal cell carcinoma (kidney cancer)
* Renal pelvis and ureter, transitional cell cancer
* Retinoblastoma
* Rhabdomyosarcoma, childhood
S
* Salivary gland cancer
* Sarcoma, Ewing family of tumors
* Sarcoma, Kaposi
* Sarcoma, soft tissue
* Sarcoma, uterine
* Sézary syndrome
* Skin cancer (nonmelanoma)
* Skin cancer (melanoma)
* Skin carcinoma, Merkel cell
* Small cell lung cancer
* Small intestine cancer
* Soft tissue sarcoma
* Squamous cell carcinoma – see Skin cancer (nonmelanoma)
* Squamous neck cancer with occult primary, metastatic
* Stomach cancer
* Supratentorial primitive neuroectodermal tumor, childhood
T
* T-Cell lymphoma, cutaneous – see Mycosis Fungoides and Sézary syndrome
* Testicular cancer
* Throat cancer
* Thymoma, childhood
* Thymoma and Thymic carcinoma
* Thyroid cancer
* Thyroid cancer, childhood
* Transitional cell cancer of the renal pelvis and ureter
* Trophoblastic tumor, gestational
U
* Unknown primary site, carcinoma of, adult
* Unknown primary site, cancer of, childhood
* Ureter and renal pelvis, transitional cell cancer
* Urethral cancer
* Uterine cancer, endometrial
* Uterine sarcoma
V
* Vaginal cancer
* Visual pathway and hypothalamic glioma, childhood
* Vulvar cancer
W
* Waldenström macroglobulinemia
* Wilms tumor (kidney cancer), childhood
* Acute lymphoblastic leukemia
* Acute myeloid leukemia
* Adrenocortical carcinoma
* AIDS-related cancers
* AIDS-related lymphoma
* Anal cancer
* Appendix cancer
* Astrocytoma, childhood cerebellar or cerebral
B
* Basal cell carcinoma
* Bile duct cancer, extrahepatic
* Bladder cancer
* Bladder cancer, childhood
* Bone cancer, Osteosarcoma/Malignant fibrous histiocytoma
* Brain stem glioma, childhood
* Brain tumor, adult
* Brain tumor, brain stem glioma, childhood
* Brain tumor, cerebellar astrocytoma, childhood
* Brain tumor, cerebral astrocytoma/malignant glioma, childhood
* Brain tumor, ependymoma, childhood
* Brain tumor, medulloblastoma, childhood
* Brain tumor, supratentorial primitive neuroectodermal tumors, childhood
* Brain tumor, visual pathway and hypothalamic glioma, childhood
* Brain tumor, childhood (other)
* Breast cancer
* Bronchial adenomas/carcinoids, childhood
* Burkitt lymphoma
C
* Carcinoid tumor, childhood
* Carcinoid tumor, gastrointestinal
* Carcinoma of unknown primary
* Central nervous system lymphoma, primary
* Cerebellar astrocytoma, childhood
* Cerebral astrocytoma/Malignant glioma, childhood
* Cervical cancer
* Childhood cancers
* Chronic lymphocytic leukemia
* Chronic myelogenous leukemia
* Chronic myeloproliferative disorders
* Colon Cancer
* Cutaneous T-cell lymphoma
D
* Desmoplastic small round cell tumor
E
* Endometrial cancer
* Ependymoma
* Esophageal cancer
* Ewing's sarcoma in the Ewing family of tumors
* Extracranial germ cell tumor, Childhood
* Extragonadal Germ cell tumor
* Extrahepatic bile duct cancer
* Eye Cancer, Intraocular melanoma
* Eye Cancer, Retinoblastoma
G
* Gallbladder Cancer
* Gastric (Stomach) Cancer
* Gastric (Stomach) Cancer, Childhood
* Gastrointestinal Carcinoid Tumor
* Gastrointestinal Stromal Tumor (GIST)
* Germ Cell Tumor, Extracranial, Childhood
* Germ Cell Tumor, Extragonadal
* Germ Cell Tumor, Ovarian
* Gestational Trophoblastic Tumor
* Glioma, Adult
* Glioma, Childhood Brain Stem
* Glioma, Childhood Cerebral Astrocytoma
* Glioma, Childhood Visual Pathway and Hypothalamic
* Gastric Carcinoid
H
* Hairy cell leukemia
* Head and neck cancer
* Hepatocellular (liver) cancer
* Hodgkin lymphoma
* Hypopharyngeal cancer
* Hypothalamic and visual pathway glioma, childhood
I
* Intraocular Melanoma
* Islet Cell Carcinoma (Endocrine Pancreas)
K
* Kaposi sarcoma
* Kidney cancer (renal cell cancer)
L
* Laryngeal Cancer
* Leukemias
* Leukemia, acute lymphoblastic (also called acute lymphocytic leukemia)
* Leukemia, acute myeloid (also called acute myelogenous leukemia)
* Leukemia, chronic lymphocytic (also called chronic lymphocytic leukemia)
* Leukemia, chronic myelogenous (also called chronic myeloid leukemia)
* Leukemia, hairy cell
* Lip and Oral Cavity Cancer
* Liver Cancer (Primary)
* Lung Cancer, Non-Small Cell
* Lung Cancer, Small Cell
* Lymphomas
* Lymphoma, AIDS-related
* Lymphoma, Burkitt
* Lymphoma, cutaneous T-Cell
* Lymphoma, Hodgkin
* Lymphomas, Non-Hodgkin (an old classification of all lymphomas except Hodgkin's)
* Lymphoma, Primary Central Nervous System
M
* Macroglobulinemia, Waldenström
* Malignant Fibrous Histiocytoma of Bone/Osteosarcoma
* Medulloblastoma, Childhood
* Melanoma
* Melanoma, Intraocular (Eye)
* Merkel Cell Carcinoma
* Mesothelioma, Adult Malignant
* Mesothelioma, Childhood
* Metastatic Squamous Neck Cancer with Occult Primary
* Mouth Cancer
* Multiple Endocrine Neoplasia Syndrome, Childhood
* Multiple Myeloma/Plasma Cell Neoplasm
* Mycosis Fungoides
* Myelodysplastic Syndromes
* Myelodysplastic/Myeloproliferative Diseases
* Myelogenous Leukemia, Chronic
* Myeloid Leukemia, Adult Acute
* Myeloid Leukemia, Childhood Acute
* Myeloma, Multiple (Cancer of the Bone-Marrow)
* Myeloproliferative Disorders, Chronic
N
* Nasal cavity and paranasal sinus cancer
* Nasopharyngeal carcinoma
* Neuroblastoma
* Non-Hodgkin lymphoma
* Non-small cell lung cancer
O
* Oral Cancer
* Oropharyngeal cancer
* Osteosarcoma/malignant fibrous histiocytoma of bone
* Ovarian cancer
* Ovarian epithelial cancer (Surface epithelial-stromal tumor)
* Ovarian germ cell tumor
* Ovarian low malignant potential tumor
P
* Pancreatic cancer
* Pancreatic cancer, islet cell
* Paranasal sinus and nasal cavity cancer
* Parathyroid cancer
* Penile cancer
* Pharyngeal cancer
* Pheochromocytoma
* Pineal astrocytoma
* Pineal germinoma
* Pineoblastoma and supratentorial primitive neuroectodermal tumors, childhood
* Pituitary adenoma
* Plasma cell neoplasia/Multiple myeloma
* Pleuropulmonary blastoma
* Primary central nervous system lymphoma
* Prostate cancer
R
* Rectal cancer
* Renal cell carcinoma (kidney cancer)
* Renal pelvis and ureter, transitional cell cancer
* Retinoblastoma
* Rhabdomyosarcoma, childhood
S
* Salivary gland cancer
* Sarcoma, Ewing family of tumors
* Sarcoma, Kaposi
* Sarcoma, soft tissue
* Sarcoma, uterine
* Sézary syndrome
* Skin cancer (nonmelanoma)
* Skin cancer (melanoma)
* Skin carcinoma, Merkel cell
* Small cell lung cancer
* Small intestine cancer
* Soft tissue sarcoma
* Squamous cell carcinoma – see Skin cancer (nonmelanoma)
* Squamous neck cancer with occult primary, metastatic
* Stomach cancer
* Supratentorial primitive neuroectodermal tumor, childhood
T
* T-Cell lymphoma, cutaneous – see Mycosis Fungoides and Sézary syndrome
* Testicular cancer
* Throat cancer
* Thymoma, childhood
* Thymoma and Thymic carcinoma
* Thyroid cancer
* Thyroid cancer, childhood
* Transitional cell cancer of the renal pelvis and ureter
* Trophoblastic tumor, gestational
U
* Unknown primary site, carcinoma of, adult
* Unknown primary site, cancer of, childhood
* Ureter and renal pelvis, transitional cell cancer
* Urethral cancer
* Uterine cancer, endometrial
* Uterine sarcoma
V
* Vaginal cancer
* Visual pathway and hypothalamic glioma, childhood
* Vulvar cancer
W
* Waldenström macroglobulinemia
* Wilms tumor (kidney cancer), childhood
Cancer
When normal cells are damaged beyond repair, they are eliminated by apoptosis (A). Cancer cells avoid apoptosis and continue to multiply in an unregulated manner (B).
DiseasesDB 28843
MedlinePlus 001289
MeSH D009369
Mastectomy specimen containing a large cancer of the breast (in this case, an invasive ductal carcinoma).
Colectomy specimen containing an invasive colorectal carcinoma (the crater-like, reddish, irregularly-shaped tumor).
Pneumonectomy specimen containing a lung cancer, here a squamous cell carcinoma (the whitish tumor near the bronchi).
Nephrectomy specimen containing a renal cell carcinoma (the yellowish, spongy-looking tumor in the lower left).
Cancer (medical term: malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize. Most cancers form a tumor but some, like leukemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology.
Cancer may affect people at all ages, even fetuses, but the risk for most varieties increases with age. Cancer causes about 13% of all deaths. According to the American Cancer Society, 7.6 million people died from cancer in the world during 2007. Cancers can affect all animals.
Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells. These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents. Other cancer-promoting genetic abnormalities may be randomly acquired through errors in DNA replication, or are inherited, and thus present in all cells from birth. The heritability of cancers are usually affected by complex interactions between carcinogens and the host's genome. New aspects of the genetics of cancer pathogenesis, such as DNA methylation, and microRNAs are increasingly recognized as important.
Genetic abnormalities found in cancer typically affect two general classes of genes. Cancer-promoting oncogenes are typically activated in cancer cells, giving those cells new properties, such as hyperactive growth and division, protection against programmed cell death, loss of respect for normal tissue boundaries, and the ability to become established in diverse tissue environments. Tumor suppressor genes are then inactivated in cancer cells, resulting in the loss of normal functions in those cells, such as accurate DNA replication, control over the cell cycle, orientation and adhesion within tissues, and interaction with protective cells of the immune system.
Diagnosis usually requires the histologic examination of a tissue biopsy specimen by a pathologist, although the initial indication of malignancy can be symptoms or radiographic imaging abnormalities. Most cancers can be treated and some cured, depending on the specific type, location, and stage. Once diagnosed, cancer is usually treated with a combination of surgery, chemotherapy and radiotherapy. As research develops, treatments are becoming more specific for different varieties of cancer. There has been significant progress in the development of targeted therapy drugs that act specifically on detectable molecular abnormalities in certain tumors, and which minimize damage to normal cells. The prognosis of cancer patients is most influenced by the type of cancer, as well as the stage, or extent of the disease. In addition, histologic grading and the presence of specific molecular markers can also be useful in establishing prognosis, as well as in determining individual treatments.
DiseasesDB 28843
MedlinePlus 001289
MeSH D009369
Mastectomy specimen containing a large cancer of the breast (in this case, an invasive ductal carcinoma).
Colectomy specimen containing an invasive colorectal carcinoma (the crater-like, reddish, irregularly-shaped tumor).
Pneumonectomy specimen containing a lung cancer, here a squamous cell carcinoma (the whitish tumor near the bronchi).
Nephrectomy specimen containing a renal cell carcinoma (the yellowish, spongy-looking tumor in the lower left).
Cancer (medical term: malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize. Most cancers form a tumor but some, like leukemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology.
Cancer may affect people at all ages, even fetuses, but the risk for most varieties increases with age. Cancer causes about 13% of all deaths. According to the American Cancer Society, 7.6 million people died from cancer in the world during 2007. Cancers can affect all animals.
Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells. These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or infectious agents. Other cancer-promoting genetic abnormalities may be randomly acquired through errors in DNA replication, or are inherited, and thus present in all cells from birth. The heritability of cancers are usually affected by complex interactions between carcinogens and the host's genome. New aspects of the genetics of cancer pathogenesis, such as DNA methylation, and microRNAs are increasingly recognized as important.
Genetic abnormalities found in cancer typically affect two general classes of genes. Cancer-promoting oncogenes are typically activated in cancer cells, giving those cells new properties, such as hyperactive growth and division, protection against programmed cell death, loss of respect for normal tissue boundaries, and the ability to become established in diverse tissue environments. Tumor suppressor genes are then inactivated in cancer cells, resulting in the loss of normal functions in those cells, such as accurate DNA replication, control over the cell cycle, orientation and adhesion within tissues, and interaction with protective cells of the immune system.
Diagnosis usually requires the histologic examination of a tissue biopsy specimen by a pathologist, although the initial indication of malignancy can be symptoms or radiographic imaging abnormalities. Most cancers can be treated and some cured, depending on the specific type, location, and stage. Once diagnosed, cancer is usually treated with a combination of surgery, chemotherapy and radiotherapy. As research develops, treatments are becoming more specific for different varieties of cancer. There has been significant progress in the development of targeted therapy drugs that act specifically on detectable molecular abnormalities in certain tumors, and which minimize damage to normal cells. The prognosis of cancer patients is most influenced by the type of cancer, as well as the stage, or extent of the disease. In addition, histologic grading and the presence of specific molecular markers can also be useful in establishing prognosis, as well as in determining individual treatments.
Friday, December 12, 2008
Health care
Health care, or healthcare, is the prevention, treatment, and management of illness and the preservation of health through the services offered by the medical, dental, nursing, and allied health professions. Health care embraces all the goods and services designed to promote health, including “preventive, curative and palliative interventions, whether directed to individuals or to populations”. The organised provision of such services may constitute a health care system. This can include specific governmental organizations such as, in the UK, the National Health Service or a cooperation across the National Health Service and Social Services as in Shared Care. Before the term health care became popular, English-speakers referred to medicine or to the health sector and spoke of the treatment and prevention of illness and disease.
In most developed countries and many developing countries health care is provided to everyone regardless of their ability to pay. The National Health Service, established in 1948 by Clement Atlee's Labour government in the United Kingdom, was the world's first universal health care system provided by government and paid for from general taxation. Alternatively, compulsory government funded health insurance with nominal fees can be provided, as in Italy. Other examples are Medicare in Australia, established in the 1970s by the Labor government, and by the same name Medicare was established in Canada between 1966 and 1984. Universal health care contrasts to the systems like health care in the United States or South Africa, though South Africa is one of the many countries attempting health care reform. The United States is the only wealthy, industrialized nation that does not provide universal health care
Health Care In India
India has both private health care system and a public, universal health care system. The universal health care system run by the local (state or territorial) governments. The "government hospitals", some of which are among the best hospitals in India, provide treatment at taxpayer cost. Most drugs are offered free of charge in these hospitals.
Most government hospitals do not require payment from people below poverty line, proof of citizenship or residency. Government hospitals in some parts of the country and some private non-profit (including teaching) hospitals charge a nominal fee to prevent abuse of the system. Most hospitals are operated on an annual budget allocated by the government, and do not rely on individual billing. These hospitals also provide better amenities (such as private air-conditioned rooms) if the patient can afford to pay. However, they charge less than comparable private hospitals.
The private clinics and hospitals are owned and operated by private individuals, small corporations and large hospital chain corporations. The private health care in many modernised hospitals in Indian cities are comparable to their counterparts in developed countries. However, the public health care system, except for the teaching hospitals, is often not as good or fast as the private hospitals.
In most developed countries and many developing countries health care is provided to everyone regardless of their ability to pay. The National Health Service, established in 1948 by Clement Atlee's Labour government in the United Kingdom, was the world's first universal health care system provided by government and paid for from general taxation. Alternatively, compulsory government funded health insurance with nominal fees can be provided, as in Italy. Other examples are Medicare in Australia, established in the 1970s by the Labor government, and by the same name Medicare was established in Canada between 1966 and 1984. Universal health care contrasts to the systems like health care in the United States or South Africa, though South Africa is one of the many countries attempting health care reform. The United States is the only wealthy, industrialized nation that does not provide universal health care
Health Care In India
India has both private health care system and a public, universal health care system. The universal health care system run by the local (state or territorial) governments. The "government hospitals", some of which are among the best hospitals in India, provide treatment at taxpayer cost. Most drugs are offered free of charge in these hospitals.
Most government hospitals do not require payment from people below poverty line, proof of citizenship or residency. Government hospitals in some parts of the country and some private non-profit (including teaching) hospitals charge a nominal fee to prevent abuse of the system. Most hospitals are operated on an annual budget allocated by the government, and do not rely on individual billing. These hospitals also provide better amenities (such as private air-conditioned rooms) if the patient can afford to pay. However, they charge less than comparable private hospitals.
The private clinics and hospitals are owned and operated by private individuals, small corporations and large hospital chain corporations. The private health care in many modernised hospitals in Indian cities are comparable to their counterparts in developed countries. However, the public health care system, except for the teaching hospitals, is often not as good or fast as the private hospitals.
Health, Physical health, Mental health, Determinants of health, Health maintenance,Nutrition,Exercise,Hygiene
In 1948, the World Health Assembly defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This definition is still widely referenced, but is often supplemented by other World Health Organization (WHO) reports such as the Ottawa Charter for Health Promotion which in 1986 stated that health is “a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.”
Classification systems describe health. The WHO’s Family of International Classifications (WHO-FIC) is comprised of the International Classification of Functioning, Disability and Health (ICF) and the International Classification of Diseases (ICD).
Aspects of health
Physical health
Physical fitness is good bodily health, and is the result of regular exercise, proper diet and nutrition, and proper rest for physical recovery.
A strong indicator of the health of localized population is their height|weight, which generally increases with improved nutrition and health care. This is also influenced by the standard of living and quality of life. Genetics also plays a major role in people's height. The study of human growth, its regulators, and implications is known as Auxology.
Mental health
Mental health refers to an individual's emotional and psychological well-being. Merriam-Webster defines mental health as "A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life."
According to the World Health Organization, there is no single "official" definition of mental health. Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined. In general, most experts agree that "mental health" and "mental illness" are not opposites. In other words, the absence of a recognized mental disorder is not necessarily an indicator of sound mental health.
One way to think about mental health is by looking at how effectively and successfully a person functions. Feeling capable and competent; being able to handle normal levels of stress, maintain satisfying relationships, and lead an independent life; and being able to "bounce back," or recover from difficult situations, are all signs of mental health.
A combination of physical, emotional, social and most importantly mental well-being is necessary to achieve overall health.
Determinants of health
The LaLonde report suggested that there are four general determinants of health including human biology, environment, lifestyle, and healthcare services. Thus, health is maintained and improved not only through the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society.
A major environmental factor is water quality, especially for the health of infants and children in developing countries.
Studies show that in developed countries, the lack of neighborhood recreational space that includes the natural environment leads to lower levels of neighborhood satisfaction and higher levels of obesity; therefore, lower overall well being. Therefore, the positive psychological benefits of natural space in urban neighborhoods should be taken into account in public policy and land use.
Health maintenance
Achieving health and remaining healthy is an active process. Effective strategies for staying healthy and improving one's health include the following elements:
Nutrition
Nutrition is the science that studies how people eat affects their health and performance, such as foods or food components that cause diseases or deteriorate health (such as eating too many calories, which is a major contributing factor to obesity, diabetes, and heart disease). The field of nutrition also studies foods and dietary supplements that improve performance, promote health, and cure or prevent disease, such as eating fibrous foods to reduce the risk of colon cancer, or supplementing with vitamin C to strengthen teeth and gums and to improve the immune system.
Personal health depends partially on the social structure of one’s life. The maintenance of strong social relationships is linked to good health conditions, longevity, productivity, and a positive attitude. This is due to the fact that positive social interaction as viewed by the participant increases many chemical levels in the brain which are linked to personality and intelligence traits. Essentially this means that positive reinforcement from a third party make one more socially adept, in control, and relaxed physically and mentally, all of which are proven to affect the nervous system (UHF).
Sports nutrition
Sports nutrition focuses the link between dietary supplements and athletic performance. One goal of sports nutrition is to maintain glycogen levels and prevent glycogen depletion. Another is to optimize energy levels and muscle tone. An athlete's strategy for winning an event may include a schedule for the entire season of what to eat, when to eat it, and in what precise quantities (before, during, after, and between workouts and events). Participants in endurance sports such as the full-distance triathlon actually eat during their races. Sports nutrition works hand-in-hand with sports medicine.
Exercise
Exercise is the performance of movements in order to develop or maintain physical fitness and overall health. It is often directed toward also honing athletic ability or skill. Frequent and regular physical exercise is an important component to prevention of some of the diseases of affluence such as cancer, heart disease, cardiovascular disease, Type 2 diabetes, obesity and back pain.
Exercises are generally grouped into three types depending on the overall effect they have on the human body:
* Flexibility exercises such as stretching improve the range of motion of muscles and joints.
* Aerobic exercises such as walking and running focus on increasing cardiovascular endurance and muscle density.
* Anaerobic exercises such as weight training or sprinting increase muscle mass and strength.
Physical exercise is considered important for maintaining physical fitness including healthy weight; building and maintaining healthy bones, muscles, and joints; promoting physiological well-being; reducing surgical risks; and strengthening the immune system.
Proper nutrition is just as, if not more, important to health as exercise. When exercising it becomes even more important to have good diet to ensure the body has the correct ratio of macronutrients whilst providing ample micronutrients; this is to aid the body with the recovery process following strenuous exercise. When the body falls short of proper nutrition, it gets into starvation mode developed through evolution and depends onto fat content for survival. Research suggest that the production of thyroid hormones can be negatively affected by repeated bouts of dieting and calorie restriction. Proper rest and recovery is also as important to health as exercise, otherwise the body exists in a permanently injured state and will not improve or adapt adequately to the exercise.
The above two factors can be compromised by psychological compulsions (eating disorders such as exercise bulimia, anorexia, and other bulimias), misinformation, a lack of organization, or a lack of motivation. These all lead to a decreased state of health.
Delayed Onset Muscle Soreness can occur after any exercise, particularly if the body is in an unconditioned state relative to that exercise and the exercise involves repetitive eccentric contractions.
Hygiene
Hygiene is the practice of keeping the body clean to prevent infection and illness, and the avoidance of contact with infectious agents. Hygiene practices include bathing, brushing and flossing teeth, washing hands especially before eating, washing food before it is eaten, cleaning food preparation utensils and surfaces before and after preparing meals, and many others. This may help prevent infection and illness. By cleaning the body, dead skin cells are washed away with the germs, reducing their chance of entering the body.
Stress management
Prolonged psychological stress may negatively impact health, such as by weakening the immune system. See negative effects of the fight-or-flight response. Stress management is the application of methods to either reduce stress or increase tolerance to stress. Certain nootropics do both. Exercising to improve physical fitness, especially cardiovascular fitness, boosts the immune system and increases stress tolerance. Relaxation techniques are physical methods used to relieve stress. Examples include progressive relaxation and fractional relaxation. Psychological methods include cognitive therapy, meditation, and positive thinking which work by reducing response to stress. Improving relevant skills and abilities builds confidence, which also reduces the stress reaction to situations where those skills are applicable. Reducing uncertainty, by increasing knowledge and experience related to stress-causing situations, has the same effect. Learning to cope with problems better, such as improving problem solving and time management skills, may also reduce stressful reaction to problems. Repeatedly facing an object of one's fears may also desensitize the fight-or-flight response with respect to that stimulus -- e.g., facing bullies may reduce fear of bullies.
Health care
Health care is the prevention, treatment, and management of illness and the preservation of mental and physical well being through the services offered by the medical, nursing, and allied health professions. According to the World Health Organization, health care embraces all the goods and services designed to promote health, including “preventive, curative and palliative interventions, whether directed to individuals or to populations”. The organized provision of such services may constitute a health care system. This can include a specific governmental organization such as the National Health Service in the UK, or a cooperation across the National Health Service and Social Services as in Shared Care.
Workplace wellness programs
Workplace wellness programs are recognized by an increasingly large number of companies for their value in improving the health and well-being of their employees, and for increasing morale, loyalty, and productivity. Workplace wellness programs can include things like onsite fitness centers, health presentations, wellness newsletters, access to health coaching, tobacco cessation programs and training related to nutrition, weight and stress management. Other programs may include health risk assessments, health screenings and body mass index monitoring. Mostly overseen or not mentioned is a group of determinants of health which could be called coincidence, hazard, luck or bad luck. These factors are quite important determinants of health but difficult to calculate.
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organizations, public and private, communities and individuals." It is concerned with threats to the overall health of a community based on population health analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of several continents (for instance, in the case of a pandemic). Public health has many sub-fields, but is typically divided into the categories of epidemiology, biostatistics and health services. Environmental, social and behavioral health, and occupational health, are also important fields in public health.
The focus of public health intervention is to prevent rather than treat a disease through surveillance of cases and the promotion of healthy behaviors. In addition to these activities, in many cases treating a disease can be vital to preventing it in others, such as during an outbreak of an infectious disease. Vaccination programs and distribution of condoms are examples of public health measures.
Classification systems describe health. The WHO’s Family of International Classifications (WHO-FIC) is comprised of the International Classification of Functioning, Disability and Health (ICF) and the International Classification of Diseases (ICD).
Aspects of health
Physical health
Physical fitness is good bodily health, and is the result of regular exercise, proper diet and nutrition, and proper rest for physical recovery.
A strong indicator of the health of localized population is their height|weight, which generally increases with improved nutrition and health care. This is also influenced by the standard of living and quality of life. Genetics also plays a major role in people's height. The study of human growth, its regulators, and implications is known as Auxology.
Mental health
Mental health refers to an individual's emotional and psychological well-being. Merriam-Webster defines mental health as "A state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life."
According to the World Health Organization, there is no single "official" definition of mental health. Cultural differences, subjective assessments, and competing professional theories all affect how "mental health" is defined. In general, most experts agree that "mental health" and "mental illness" are not opposites. In other words, the absence of a recognized mental disorder is not necessarily an indicator of sound mental health.
One way to think about mental health is by looking at how effectively and successfully a person functions. Feeling capable and competent; being able to handle normal levels of stress, maintain satisfying relationships, and lead an independent life; and being able to "bounce back," or recover from difficult situations, are all signs of mental health.
A combination of physical, emotional, social and most importantly mental well-being is necessary to achieve overall health.
Determinants of health
The LaLonde report suggested that there are four general determinants of health including human biology, environment, lifestyle, and healthcare services. Thus, health is maintained and improved not only through the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society.
A major environmental factor is water quality, especially for the health of infants and children in developing countries.
Studies show that in developed countries, the lack of neighborhood recreational space that includes the natural environment leads to lower levels of neighborhood satisfaction and higher levels of obesity; therefore, lower overall well being. Therefore, the positive psychological benefits of natural space in urban neighborhoods should be taken into account in public policy and land use.
Health maintenance
Achieving health and remaining healthy is an active process. Effective strategies for staying healthy and improving one's health include the following elements:
Nutrition
Nutrition is the science that studies how people eat affects their health and performance, such as foods or food components that cause diseases or deteriorate health (such as eating too many calories, which is a major contributing factor to obesity, diabetes, and heart disease). The field of nutrition also studies foods and dietary supplements that improve performance, promote health, and cure or prevent disease, such as eating fibrous foods to reduce the risk of colon cancer, or supplementing with vitamin C to strengthen teeth and gums and to improve the immune system.
Personal health depends partially on the social structure of one’s life. The maintenance of strong social relationships is linked to good health conditions, longevity, productivity, and a positive attitude. This is due to the fact that positive social interaction as viewed by the participant increases many chemical levels in the brain which are linked to personality and intelligence traits. Essentially this means that positive reinforcement from a third party make one more socially adept, in control, and relaxed physically and mentally, all of which are proven to affect the nervous system (UHF).
Sports nutrition
Sports nutrition focuses the link between dietary supplements and athletic performance. One goal of sports nutrition is to maintain glycogen levels and prevent glycogen depletion. Another is to optimize energy levels and muscle tone. An athlete's strategy for winning an event may include a schedule for the entire season of what to eat, when to eat it, and in what precise quantities (before, during, after, and between workouts and events). Participants in endurance sports such as the full-distance triathlon actually eat during their races. Sports nutrition works hand-in-hand with sports medicine.
Exercise
Exercise is the performance of movements in order to develop or maintain physical fitness and overall health. It is often directed toward also honing athletic ability or skill. Frequent and regular physical exercise is an important component to prevention of some of the diseases of affluence such as cancer, heart disease, cardiovascular disease, Type 2 diabetes, obesity and back pain.
Exercises are generally grouped into three types depending on the overall effect they have on the human body:
* Flexibility exercises such as stretching improve the range of motion of muscles and joints.
* Aerobic exercises such as walking and running focus on increasing cardiovascular endurance and muscle density.
* Anaerobic exercises such as weight training or sprinting increase muscle mass and strength.
Physical exercise is considered important for maintaining physical fitness including healthy weight; building and maintaining healthy bones, muscles, and joints; promoting physiological well-being; reducing surgical risks; and strengthening the immune system.
Proper nutrition is just as, if not more, important to health as exercise. When exercising it becomes even more important to have good diet to ensure the body has the correct ratio of macronutrients whilst providing ample micronutrients; this is to aid the body with the recovery process following strenuous exercise. When the body falls short of proper nutrition, it gets into starvation mode developed through evolution and depends onto fat content for survival. Research suggest that the production of thyroid hormones can be negatively affected by repeated bouts of dieting and calorie restriction. Proper rest and recovery is also as important to health as exercise, otherwise the body exists in a permanently injured state and will not improve or adapt adequately to the exercise.
The above two factors can be compromised by psychological compulsions (eating disorders such as exercise bulimia, anorexia, and other bulimias), misinformation, a lack of organization, or a lack of motivation. These all lead to a decreased state of health.
Delayed Onset Muscle Soreness can occur after any exercise, particularly if the body is in an unconditioned state relative to that exercise and the exercise involves repetitive eccentric contractions.
Hygiene
Hygiene is the practice of keeping the body clean to prevent infection and illness, and the avoidance of contact with infectious agents. Hygiene practices include bathing, brushing and flossing teeth, washing hands especially before eating, washing food before it is eaten, cleaning food preparation utensils and surfaces before and after preparing meals, and many others. This may help prevent infection and illness. By cleaning the body, dead skin cells are washed away with the germs, reducing their chance of entering the body.
Stress management
Prolonged psychological stress may negatively impact health, such as by weakening the immune system. See negative effects of the fight-or-flight response. Stress management is the application of methods to either reduce stress or increase tolerance to stress. Certain nootropics do both. Exercising to improve physical fitness, especially cardiovascular fitness, boosts the immune system and increases stress tolerance. Relaxation techniques are physical methods used to relieve stress. Examples include progressive relaxation and fractional relaxation. Psychological methods include cognitive therapy, meditation, and positive thinking which work by reducing response to stress. Improving relevant skills and abilities builds confidence, which also reduces the stress reaction to situations where those skills are applicable. Reducing uncertainty, by increasing knowledge and experience related to stress-causing situations, has the same effect. Learning to cope with problems better, such as improving problem solving and time management skills, may also reduce stressful reaction to problems. Repeatedly facing an object of one's fears may also desensitize the fight-or-flight response with respect to that stimulus -- e.g., facing bullies may reduce fear of bullies.
Health care
Health care is the prevention, treatment, and management of illness and the preservation of mental and physical well being through the services offered by the medical, nursing, and allied health professions. According to the World Health Organization, health care embraces all the goods and services designed to promote health, including “preventive, curative and palliative interventions, whether directed to individuals or to populations”. The organized provision of such services may constitute a health care system. This can include a specific governmental organization such as the National Health Service in the UK, or a cooperation across the National Health Service and Social Services as in Shared Care.
Workplace wellness programs
Workplace wellness programs are recognized by an increasingly large number of companies for their value in improving the health and well-being of their employees, and for increasing morale, loyalty, and productivity. Workplace wellness programs can include things like onsite fitness centers, health presentations, wellness newsletters, access to health coaching, tobacco cessation programs and training related to nutrition, weight and stress management. Other programs may include health risk assessments, health screenings and body mass index monitoring. Mostly overseen or not mentioned is a group of determinants of health which could be called coincidence, hazard, luck or bad luck. These factors are quite important determinants of health but difficult to calculate.
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organizations, public and private, communities and individuals." It is concerned with threats to the overall health of a community based on population health analysis. The population in question can be as small as a handful of people or as large as all the inhabitants of several continents (for instance, in the case of a pandemic). Public health has many sub-fields, but is typically divided into the categories of epidemiology, biostatistics and health services. Environmental, social and behavioral health, and occupational health, are also important fields in public health.
The focus of public health intervention is to prevent rather than treat a disease through surveillance of cases and the promotion of healthy behaviors. In addition to these activities, in many cases treating a disease can be vital to preventing it in others, such as during an outbreak of an infectious disease. Vaccination programs and distribution of condoms are examples of public health measures.
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