The following information gives an idea about Symptoms of breast cancer.Early breast cancer usually does not cause pain. Most often, these symptoms are not due to cancer.The first symptom, or subjective sign, of breast cancer is typically a lump that feels different from the surrounding breast tissue. According to the surveys, more than 80% of breast cancer cases are discovered when the woman feels a lump.
Any woman with these symptoms should tell her doctor so that problems can be diagnosed and treated as early as possible.

• Lumps found in lymph nodes located in the armpits can also indicate breast cancer.
• Indications of breast cancer other than a lump may include changes in breast size or shape, skin dimpling, nipple inversion,
  
• A change in how the breast or nipple feels
1. A lump or thickening in or near the breast or in the underarm area.
2. Nipple tenderness.
• A change in how the breast or nipple looks
1. A change in the size or shape of the breast
2. A nipple turned inward into the breast
3. The skin of the breast, areola, or nipple may be scaly, red, or swollen. It may have ridges or pitting so that it looks like the skin of an orange.
• Spontaneous single-nipple discharge.
• Pain ("mastodynia") is an unreliable tool in determining the presence or absence of breast cancer, but may be indicative of other breast health issues.
• Symptoms of inflammatory breast cancer include pain, swelling, warmth and redness throughout the breast, as well as an orange-peel texture to the skin referred to as peau d'orange.
• Another reported symptom complex of breast cancer is Paget's disease of the breast. This syndrome presents as eczematoid skin changes such as redness and mild flaking of the nipple skin. As Paget's advances, symptoms may include tingling, itching, increased sensitivity, burning, and pain. There may also be discharge from the nipple. Approximately half of women diagnosed with Paget's also have a lump in the breast.
• Occasionally, breast cancer presents as metastatic disease, that is, cancer that has spread beyond the original organ. Metastatic breast cancer will cause symptoms that depend on the location of metastasis. Common sites of metastasis include bone, liver, lung and brain. Unexplained weight loss can occasionally herald an occult breast cancer, as can symptoms of fevers or chills. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms. These symptoms are "non-specific", meaning they can also be manifestations of many other illnesses.
• Most symptoms of breast disorder do not turn out to represent underlying breast cancer. Benign breast diseases such as mastitis and fibroadenoma of the breast are more common causes of breast disorder symptoms. The appearance of a new symptom should be taken seriously by both patients and their doctors, because of the possibility of an underlying breast cancer at almost any age.

Ovarian Cancer Treatment:Chemotherapy uses anticancer drugs to kill cancer cells. Most women have chemotherapy for ovarian cancer after surgery. Some women have chemotherapy before surgery.

Usually, more than one drug is given. Drugs for ovarian cancer can be given in different ways:

• By vein (IV): The drugs can be given through a thin tube inserted into a vein.



• By vein and directly into the abdomen: Some women get IV chemotherapy along with intraperitoneal (IP) chemotherapy. For IP chemotherapy, the drugs are given through a thin tube inserted into the abdomen.



• By mouth: Some drugs for ovarian cancer can be given by mouth.

Chemotherapy is given in cycles. Each treatment period is followed by a rest period. The length of the rest period and the number of cycles depend on the anticancer drugs used.

You may have your treatment in a clinic, at the doctor's office, or at home. Some women may need to stay in the hospital during treatment.

The side effects of chemotherapy depend mainly on which drugs are given and how much. The drugs can harm normal cells that divide rapidly:

• Blood cells: These cells fight infection, help blood to clot, and carry oxygen to all parts of your body. When drugs affect your blood cells, you are more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team checks you for low levels of blood cells. If blood tests show low levels, your health care team can suggest medicines that can help your body make new blood cells.



• Cells in hair roots: Some drugs can cause hair loss. Your hair will grow back, but it may be somewhat different in color and texture.



• Cells that line the digestive tract: Some drugs can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Ask your health care team about medicines that help with these problems.

Some drugs used to treat ovarian cancer can cause hearing loss, kidney damage, joint pain, and tingling or numbness in the hands or feet. Most of these side effects usually go away after treatment ends.

Ovarian CancerTreatment:Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. A large machine directs radiation at the body.

Radiation therapy is rarely used in the initial treatment of ovarian cancer, but it may be used to relieve pain and other problems caused by the disease. The treatment is given at a hospital or clinic. Each treatment takes only a few minutes.

Side effects depend mainly on the amount of radiation given and the part of your body that is treated. Radiation therapy to your abdomen and pelvis may cause nausea, vomiting, diarrhea, or bloody stools. Also, your skin in the treated area may become red, dry, and tender. Although the side effects can be distressing, your doctor can usually treat or control them. Also, they gradually go away after treatment ends.

NCI provides a booklet called Radiation Therapy and You: A Guide to Self-Help During Cancer Treatment.

Treatment methods of Ovarian Cancer :Surgical treatment may be sufficient for malignant tumors that are well-differentiated and confined to the ovary. Addition of chemotherapy may be required for more aggressive tumors that are confined to the ovary. Cancer treatment can affect cancer cells in the pelvis, in the abdomen, or throughout the body.For patients with advanced disease a combination of surgical reduction with a combination chemotherapy regimen is standard. Borderline tumors, even following spread outside of the ovary, are managed well with surgery, and chemotherapy is not seen as useful.You may want to know how treatment may change your normal activities. You and your doctor can work together to develop a treatment plan that meets your medical and personal needs.

• Local therapy Treatment-Ovarian Cancer: Surgery and radiation therapy are local therapies. They remove or destroy ovarian cancer in the pelvis. When ovarian cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.Surgery is the preferred treatment and is frequently necessary to obtain a tissue specimen for differential diagnosis via its histology. Surgery performed by a specialist in gynecologic oncology usually results in an improved result. survival is attributed to more accurate staging of the disease and a higher rate of aggressive surgical excision of tumor in the abdomen by gynecologic oncologists as opposed to general gynecologists and general surgeons.

  The type of surgery depends upon how widespread the cancer is when diagnosed (the cancer stage), as well as the presumed type and grade of cancer. The surgeon may remove one (unilateral oophorectomy) or both ovaries (bilateral oophorectomy), the fallopian tubes (salpingectomy), and the uterus (hysterectomy). For some very early tumors (stage 1, low grade or low-risk disease), only the involved ovary and fallopian tube will be removed (called a "unilateral salpingo-oophorectomy," USO), especially in young females who wish to preserve their fertility.

  In advanced malignancy, where complete resection is not feasible, as much tumor as possible is removed (debulking surgery). In cases where this type of surgery is successful (i.e. <> 1 cm in diameter) are left behind. Minimally invasive surgical techniques may facilitate the safe removal of very large (greater than 10 cm) tumors with fewer complications of surgery.



• Intraperitoneal chemotherapy Treatment-Ovarian Cancer: Chemotherapy can be given directly into the abdomen and pelvis through a thin tube. The drugs destroy or control cancer in the abdomen and pelvis.

  Chemotherapy is used after surgery to treat any residual disease, if appropriate. This depends on the histology of the tumor; some kinds of tumor (particularly teratoma) are not sensitive to chemotherapy. In some cases, there may be reason to perform chemotherapy first, followed by surgery.

  For patients with stage IIIC epithelial ovarian adenocarcinomas who have undergone successful optimal debulking, a recent clinical trial demonstrated that median survival time is significantly longer for patient receiving intraperitoneal (IP) chemotherapy. Patients in this clinical trial reported less compliance with IP chemotherapy and fewer than half of the patients received all six cycles of IP chemotherapy. Despite this high "drop-out" rate, the group as a whole (including the patients that didn't complete IP chemotherapy treatment) survived longer on average than patients who received intravenous chemotherapy alone.




• Systemic chemotherapy Treatment-Ovarian Cancer: When chemotherapy is taken by mouth or injected into a vein, the drugs enter the bloodstream and destroy or control cancer throughout the body.

Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each woman, and they may change from one treatment session to the next. Before treatment starts, your health care team will explain possible side effects and suggest ways to help you manage them.

Ovarian Cancer Stages:Ovarian cancer staging is by the FIGO staging system and uses information obtained after surgery, which can include a total abdominal hysterectomy, removal of (usually) both ovaries and fallopian tubes, (usually) the omentum, and pelvic (peritoneal) washings for cytology. The AJCC stage is the same as the FIGO stage.To plan the best treatment, your doctor needs to know the grade of the tumor the extent (stage) of the disease. The stage is based on whether the tumor has invaded nearby tissues, whether the cancer has spread, and if so, to what parts of the body.These are the stages of ovarian cancer:
Ovarian Cancer Stage I: Cancer cells are found in one or both ovaries. Cancer cells may be found on the surface of the ovaries or in fluid collected from the abdomen.limited to one or both ovaries

• Stage IA - involves one ovary; capsule intact; no tumor on ovarian surface; no malignant cells in ascites or peritoneal washings
• Stage IB - involves both ovaries; capsule intact; no tumor on ovarian surface; negative washings
• Stage IC - tumor limited to ovaries with any of the following: capsule ruptured, tumor on ovarian surface, positive washings

Ovarian Cancer Stage II: Cancer cells have spread from one or both ovaries to other tissues in the pelvis. Cancer cells are found on the fallopian tubes, the uterus, or other tissues in the pelvis. Cancer cells may be found in fluid collected from the abdomen.
pelvic extension or implants

• Stage IIA - extension or implants onto uterus or fallopian tube; negative washings
• Stage IIB - extension or implants onto other pelvic structures; negative washings
• Stage IIC - pelvic extension or implants with positive peritoneal washings

Ovarian Cancer Stage III: Cancer cells have spread to tissues outside the pelvis or to the regional lymph nodes. Cancer cells may be found on the outside of the liver.
microscopic peritoneal implants outside of the pelvis; or limited to the pelvis with extension to the small bowel or omentum

• Stage IIIA - microscopic peritoneal metastases beyond pelvis
• Stage IIIB - macroscopic peritoneal metastases beyond pelvis less than 2 cm in size
• Stage IIIC - peritoneal metastases beyond pelvis > 2 cm or lymph node metastases

Ovarian Cancer Stage IV: Cancer cells have spread to tissues outside the abdomen and pelvis. Cancer cells may be found inside the liver, in the lungs, or in other organs.distant metastases to the liver or outside the peritoneal cavity

Ovarian Cancer Symptoms Consensus Statement:Early ovarian cancer may not cause obvious symptoms. Ovarian cancer is called a “silent killer” because symptoms were not thought to develop until the disease had advanced and the chance of cure or remission poor. However, the following symptoms are much more likely to occur in women with ovarian cancer than women in the general population. But, as the cancer grows, these symptoms may include:

• Bloating:A swollen or bloated abdomen
• Pelvic or abdominal pain
• Pain or Pressure in the back or legs, pain in the abdomen, pelvis.
  
• Diarrhea, gas, nausea, constipation, indigestion
• Difficulty eating or feeling full quickly
• Feeling very tired all the time
• Urinary symptoms (urgency or frequency)
• Pain during sex
• Abnormal vaginal bleeding
• Trouble breathing

Ovarian cancer may grow to a size of about 12 centimeters (5 inches) before it start encroaching to other organs, and produce more distinctive symptoms like increased urinary frequency and rectal pressure or fluid in the abdomen. Physicians may detect early ovarian cancer at the time of a routine pelvic examination or on a routine CT scan or ultrasound examination done for some other purpose.

Women with ovarian cancer report that symptoms are persistent and represent a change from normal for their bodies. The frequency and/or number of such symptoms are key factors in the diagnosis of ovarian cancer. Several studies show that even early stage ovarian cancer can produce these symptoms. Women who have these symptoms almost daily for more than a few weeks should see their doctor, preferably a gynecologist. Prompt medical evaluation may lead to detection at the earliest possible stage of the disease. Early stage diagnosis is associated with an improved prognosis.

Several other symptoms have been commonly reported by women with ovarian cancer. These symptoms include fatigue, indigestion, back pain, pain with intercourse, constipation and menstrual irregularities. However, these other symptoms are not as useful in identifying ovarian cancer because they are also found in equal frequency in women in the general population who do not have ovarian cancer. Most often these symptoms are not due to cancer, but only a doctor can tell for sure. Any woman with these symptoms should tell her doctor.

Symptoms of advanced ovarian cancer
In the later stages of ovarian cancer patients may present with symptoms of abdominal bloating or swelling. Large ovarian cancer may cause symptoms due to pressure on the adjacent structures. This may cause bladder or rectal symptoms. Some patients may develop fluid in the chest and this may cause difficulty in breathing.

The treatment of bladder cancer depends on how deep the tumor invades into the bladder wall. Superficial tumors (those not entering the muscle layer) can be "shaved off" using an electrocautery device attached to a cystoscope. Immunotherapy in the form of BCG instillation is also used to treat and prevent the recurrence of superficial tumors. BCG immunotherapy is effective in up to 2/3 of the cases at this stage. Instillations of chemotherapy, such as valrubicin (Valstar) into the bladder can also be used to treat BCG-refractory CIS disease when cystectomy is not an option^.
Epidemiology-Bladder Cancer:In the United States, bladder cancer is the fourth most common type of cancer in men and the ninth most common cancer in women. More than 50,000 men and 16,000 women are diagnosed with bladder cancer each year. One reason for its higher incidence in men is that the androgen receptor, which is much more active in men than in women, plays a major part in the development of the cancer.

• You may want to talk to more than one urologist to find the one with whom you feel most comfortable. Clinical experience in treating bladder cancer is of the utmost importance.
  
  
• Talk to family members, friends, and your health-care provider to get referrals. Many communities, medical societies, and cancer centers offer telephone or Internet referral services.

After you have chosen a urologist to treat your cancer, you will have ample opportunity to ask questions and discuss the treatments available to you.

• Your doctor will describe each type of treatment, give you the pros and cons, and make recommendations based on published treatment guidelines and his or her own experience.
  
  
• Treatment for bladder cancer depends on the type of cancer and its stage. Factors such as your age, your overall health, and whether you have already been treated for the cancer before are included in the treatment decision-making process.
  
  
• The decision of which treatment to pursue is made with your doctor (with input from other members of your care team) and your family members, but the decision is ultimately yours.
  
  
• Be certain you understand exactly what will be done and why, and what you can expect from your choices. With bladder cancer, understanding the side effects of treatment is especially important.

Like all cancers, bladder cancer is most likely to be cured if it is diagnosed early and treated promptly.

• A combination of radiation and chemotherapy can also be used to treat invasive disease. It has not yet been determined how the effectiveness of this form of treatment compares to that of radical ablative surgery.
  
  
• Immunotherapy or biological therapy, which takes advantage of the body's innate cancer-fighting ability, is used in some cases, especially for patients with stages Ta, T1, and CIS.
  
  
• The hemocyanin found in Concholepas concholepas blood has immunotherapeutic effects against bladder and prostate cancer. In a research made in 2006 mice were primed with C. concholepas before implantation of bladder tumor (MBT-2) cells. Mice treated with C. concholepas showed a significant antitumor effect as well. The effects included prolonged survival, decreased tumor growth and incidence and lack of toxic effects.

Tests that examine the urine, vagina, or rectum are used to help detect (find) and diagnose bladder cancer.

The following tests and procedures may be used:

• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.
• Internal exam: An exam of the vagina and/or rectum. The doctor inserts gloved fingers into the vagina and/or rectum to feel for lumps.
• Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to find out if cancer is present in these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages.
• Cystoscopy: A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
• Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. A biopsy for bladder cancer is usually done during cystoscopy. It may be possible to remove the entire tumor during biopsy.
• Urine cytology: Examination of urine under a microscope to check for abnormal cells.

Bladder Cancer Symptoms:Bladder cancer characteristically causes blood in the urine; this may be visible to the naked eye (frank hematuria) or detectable only by microscope (microscopic hematuria). Other possible symptoms of bladder cancer include pain during urination, frequent urination (Polyuria) or feeling the need to urinate without results. These signs and symptoms are not specific to bladder cancer, and are also caused by non-cancerous conditions, including prostate infections and cystitis. Kidney cancer also can cause hematuria.

• Blood in the urine {hematuria}:Usually Blood in the urine is the first sign of bladder cancer.The urine may have a slightly pink or orange hue, or it may be bright red with or without clots.If there any changes in urine color, then that person need to take health check up as soon as possible.
  
  
• Pain or burning during urination without evidence of urinary tract infection
  
  
• Change in bladder habits, such as having to urinate more often or feeling the strong urge to urinate without producing much urine.

If anyone have any of these symptoms, they should check up with the doctor right away. People who can see blood in their urine, especially older males who smoke, are considered to have a high likelihood of bladder cancer until proven otherwise.

Bladder cancer often causes no symptoms until it reaches an advanced state that is difficult to cure. Therefore, you may want to talk to your health-care provider about screening tests if you have risk factors for bladder cancer. Screening is testing for cancer in people who have never had the disease and have no symptoms but who have one or more risk factors.

In Brief........
Possible signs of bladder cancer include blood in the urine or pain during urination.

These and other symptoms may be caused by bladder cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• Blood in the urine (slightly rusty to bright red in color).
• Frequent urination, or feeling the need to urinate without being able to do so.
• Pain during urination.
• Lower back pain.

Stages of Bladder Cancer

The following stages are used to classify the location, size, and spread of the cancer, according to the TNM (tumor, lymph node, and metastasis) staging system:

• Stage 0: Cancer cells are found only on the inner lining of the bladder.

• Stage I: Cancer cells have proliferated to the layer beyond the inner lining of the urinary bladder but not to the muscles of the urinary bladder.

• Stage II: Cancer cells have proliferated to the muscles in the bladder wall but not to the fatty tissue that surrounds the urinary bladder.

• Stage III: Cancer cells have proliferated to the fatty tissue surrounding the urinary bladder and to the prostate gland, vagina, or uterus, but not to the lymph nodes or other organs.

• Stage IV: Cancer cells have proliferated to the lymph nodes, pelvic or abdominal wall, and/or other organs.

• Recurrent: Cancer has recurred in the urinary bladder or in another nearby organ after having been treated.

Bladder TCC is staged according to the 1997 TNM system:

• Ta Non-invasive papillary tumour
• T1 Invasive but not as far as the muscular bladder layer
• T2 Invasive into the muscular layer
• T3 Invasive beyond the muscle into the fat outside the bladder
• T4 Invasive into surrounding structures like the prostate, uterus or pelvic wall

The nomenclature "G1", "G2" and "G3" refers to the degree of differentiation, or histopathological grade. "G1" superficial tumour is well differentiated, while a "G3" tumour is poorly differentiated.

Bladder cancer causes::There are many causes for Bladder cancer, the following factors increase a person's risk of developing a bladder cancer:

• Smoking is the single greatest risk factor for bladder cancer,it is the main known cause of urinary bladder cancer: in most populations, smoking causes over half of bladder cancer cases in men and a sizeable proportion in women. Smokers have more than twice the risk of developing bladder cancer as nonsmokers. There is a linear relationship between smoking and risk, and quitting smoking reduces the risk. In a 10-year study involving almost 48,000 men, researchers found that men who drank 1.5L of water a day had a significantly reduced incidence of bladder cancer when compared with men who drank less than 240mL (around 1 cup) per day. The authors proposed that bladder cancer might partly be caused by the bladder directly contacting carcinogens that are excreted in urine. It is postulated, therefore, that by drinking higher quantities of water, urine is more dilute, thereby reducing the chance of disease. Thirty percent of bladder tumors probably result from occupational exposure in the workplace to carcinogens such as benzidine. 2-Naphthylamine, which is found in cigarette smoke, has also been shown to increase bladder cancer risk. Occupations at risk are metal industry workers, rubber industry workers, workers in the textile industry, and people who work in printing. Some studies also suggest that auto mechanics have an elevated risk of bladder cancer due to their frequent exposure to hydrocarbons and petroleum-based chemicals. Hairdressers are thought to be at risk as well because of their frequent exposure to permanent hair dyes. It has been proposed that hair dyes are a risk factor, and some have shown an odds ratio of 2.1 to 3.3 for risk of developing bladder cancer among women who use permanent hair dyes, while others have shown no correlation between the use of hair dyes and bladder cancer. Certain drugs such as cyclophosphamide and phenacetin are known to predispose to bladder TCC. bladder irritation (infection, bladder stones, catheters, bilharzia) predisposes to squamous cell carcinoma of the bladder. Approximately 20% of bladder cancers occur in patients without predisposing risk factors.
• Chemical exposures at work: People who regularly work with certain chemicals or in certain industries have a greater risk of bladder cancer than the general population. Organic chemicals called aromatic amines are particularly linked with bladder cancer. These chemicals are used in the dye industry. Other industries linked to bladder cancer include rubber and leather processing, textiles, hair coloring, paints, and printing. Strict workplace protections can prevent much of the exposure that is believed to cause cancer.

Smoking, gender, and diet can affect the risk of developing bladder cancer.

Anything that increases your chance of getting a disease is called a risk factor. Risk factors for bladder cancer include the following:

• Smoking.
• Being exposed to certain substances at work, such as rubber, certain dyes and textiles, paint, and hairdressing supplies.
• A diet high in fried meats and fat.
• Being older, male, or white.
• Having an infection caused by a certain parasite.

• Diet: People whose diets include large amounts of fried meats and animal fats are thought to be at higher risk of bladder cancer.
  
  
• Aristolochia fangchi: This herb is used in some dietary supplements and Chinese herbal remedies. People who took this herb as part of a weight loss program had higher rates of bladder cancer and kidney failure than the general population. Scientific studies on this herb have shown that it contains chemicals that can cause cancer in rats.

These are factors you can do something about. You can stop smoking, learn to avoid workplace chemical exposures, or change your diet. You cannot do anything about the following risk factors for bladder cancer:

• Age: Seniors are at the highest risk of developing bladder cancer.
  
  
• Sex: Men are three times more likely than women to have bladder cancer.
  
  
• Race: Whites have a much higher risk of developing bladder cancer than other races.
  
  
• History of bladder cancer: If you have had bladder cancer in the past, your risk of developing another bladder cancer is higher than if you had never had bladder cancer.
  
  
• Chronic bladder inflammation: Frequent bladder infections, bladder stones, and other urinary tract problems that irritate the bladder increase the risk of developing a cancer, more commonly squamous cell carcinoma.
  
  
• Birth defects: Some people are born with a visible or invisible defect that connects their bladder with another organ in the abdomen or leaves the bladder exposed to continual infection. This increases the bladder's vulnerability to cellular abnormalities that can lead to cancer.

Adrenal cancer is a rare disease that originates in the adrenal glands. The adrenal glands are located on top of the kidneys and consist of two parts that function separately. The first part is referred to as the cortex (outer layer). The second part is referred to as the medulla (inner area). Nearly all adrenal tumors are benign (non-cancerous) and therefore do not require treatment.

The most common type of adrenal cancer is called adrenocortical carcinoma. Adrenocortical carcinoma develops in the adrenal cortex and may produce symptoms related to increased hormone production, if it is a functioning tumor. Non-functioning adrenal cancer tumors do not produce hormones and may cause pain from pressure applied to the abdominal organs.

A second type of adrenal cancer is called pheochromocytoma which is an extremely rare type of cancer that originates in cells that produce epinephrine and norepinephrine. This form of adrenal cancer is most prevalent among those in their 30's and 40's.

Neuroblastoma is the third type of adrenal cancer. This adrenal cancer develops in the adrenal medulla and typically originates in undeveloped nerve cells. Abdominal pain and bone pain are usually symptoms experienced with neuroblastoma. This type of cancer generally appears in infants and children.

Approximately 1 out of 1 million people worldwide develop adrenal cancer. What causes adrenal cancer is unknown. It is believed that sometimes heredity plays a role, so if there is a diagnosis of adrenal gland cancer in your family, you may want to consider genetic testing.

Causes adrenal cortical cancers ?

Each year, there are approximately 500 cases of adrenal cortical cancers in the United States. These most commonly occur in patients between the ages of 30 and 50; however, children under the age of 5 develop adrenal cortical cancers at a higher rate than the rest of the population. Males are more likely to develop non-functioning adrenal carcinomas, while females are more likely to develop functioning adrenal carcinomas. In general, causes of adrenal cortical cancers are unknown. They are not associated with smoking, and do not run in families. Despite this, certain genetic mutations have been associated with adrenal cortical cancers, and research is ongoing in attempt to identify the causes of these cancers.

Adrenal cancer - Signs and Symptoms

Although highly unlikely, because those diagnosed rarely exhibit symptoms, it is possible to experience the following:

• Fever
• Abdominal mass
• Weight loss
• Abdominal pain
• Always feeling full

Syndromes Associated with Adrenal Cancer

If you have a functioning adrenocortical tumor that produces excess cortisol, it could develop into Cushing's syndrome. Cortisol, also referred to as hydrocortisone, is the main circulating steroid hormone of the cortex. Cushing's syndrome is a hormonal disorder that is caused by prolonged exposure to high levels of cortisol. Cortisol performs vital tasks in the body such as maintaining blood pressure and controlling the function of your cardiovascular system. In addition, it makes fatty acids available for metabolic use.

Adrenal cancer symptoms associated with Cushing's syndrome include:

• Severe acne
• High blood pressure
• Weakness
• Hirsutism
• Amenorrhea
• Slowed growth rate in children
• Osteoporosis
• Abdominal stretch marks

Another syndrome that can develop is called Conn's syndrome. Conn's syndrome is a disease that involves excessive production of aldosterone. Aldosterone is a steroid that is secreted by the adrenal gland. It regulates your electrolyte balance and is considered the most potent hormone. Conn's syndrome is caused by increased aldosterone production.

Adrenal cancer symptoms associated with this may include:

• Low potassium levels
• High blood pressure
• Frequent urination
• Excessive thirst

Adrenal Cancer Treatment Options

There are various treatment options for adrenal cancer. One of the most commonly used treatment options for adrenal cancer is surgery. There are four types of surgery that can be performed to remove both benign and malignant adrenal cancer tumors. The procedure your doctor will use will depend on the type and size of the tumor and also your individual needs.

• Posterior Surgery - typically used to remove small, benign tumors, your doctor will make an incision in your back just above the kidneys.
• Transabdominal Surgery - in this procedure, an incision is made in your abdomen so the doctor can inspect nearby blood vessels and organs for any signs of cancer. It also allows your doctor to remove any nearby tissue that might be directly involved with the tumor.
• Thoracoabdominal Surgery - this is usually the procedure of choice if you a large, malignant adrenal tumors. Your doctor will make a large incision around the cancerous area so he/she has an expanded view of the tissue that surrounds the tumor.
• Laparoscopic Adrenalectomy - in this procedure, a fiber optic scope is inserted through a tiny incision made by your doctor in your abdominal cavity. It is a less invasive procedure and therefore generally causes less pain than other approaches. Thankfully most adrenal cancers can be removed using this technique.

Radiation therapy is also a treatment option for some adrenal cancer patients. The high-energy rays used in radiation therapy destroy cancerous cells and reduce the tumor's size. It is most often utilized for adrenal cancer that has already started to spread. It is also a treatment that be used in conjunction with chemotherapy.

Adrenal Cancer Treatment at CTCA

The doctors and caregivers at Cancer Treatment Centers of America know how emotionally devastating a diagnosis of adrenal cancer can be, and make it our goal to ensure that you are as comfortable and informed as possible during this difficult time. We work with you to enrich your adrenal cancer treatment by not only offering the most up-to-date traditional treatments, but also by complementing them with new therapies designed to treat adrenal cancer using a whole-body approach.

At CTCA you and your healing are at the center of our hearts, minds and actions every day. If you are looking for an adrenal cancer treatment center that treats more than just your cancer, Cancer Treatment Centers of America may be exactly what you are looking for. To learn more about our integrated approach to cancer treatment, contact us today at 800-931-0599 and speak with one of our Oncology Information Specialists. They can help you decide if CTCA is the right treatment facility for you.

More Information about Adrenal Cancer

What are the adrenal glands?

The adrenal glands are small glands that are located just above each kidney (they are sometimes called the suprarenal glands for that reason). They are triangular in shape and consist of several distinct parts:

The central part of the gland is called the adrenal medulla and produces the chemicals epinephrine (also called adrenaline) and norepinephrine. Both of these chemicals are involved in regulation of the nervous system. Epinephrine controls the short-term stress response (aka fight-or-flight response). While norepinephrine also plays a role in short-term stress response, it functions in regulating mood and attention, as well.

The outside part of the gland surrounding the medulla is the adrenal cortex. This part of the adrenal gland is largely responsible for producing steroid hormones in the body. There are several types of steroid hormones that are produced by the adrenal glands. Mineralocorticoids (such as aldosterone) are steroid hormones that help regulate the salt levels in the body by controlling the absorption and excretion of salt and water in the kidneys. This in turn helps to regulate blood pressure. Glucocorticoids (such as cortisol) are steroid hormones that play a critical role in the regulation of sugar within the body. These hormones also help to regulate the fat stores within the body, act as a strong anti-inflammatory force, and play an important role in fetal development, particularly in lung maturation. The adrenal cortex also produces several sex steroid hormones, including androgens (critical for male sexual development) and precursors to estrogen (critical for female sexual development).

What are adrenal tumors, and what types of adrenal tumors are there?

Normally, cells in the body will grow and divide to replace old or damaged cells. This growth is highly regulated, and once enough cells are produced to replace the old ones, normal cells will stop dividing. Tumors occur when there is an error in this process, and cells continue to grow in an uncontrolled manner. Tumors can either be benign or malignant. Although benign tumors can grow in an uncontrolled way, they do not spread to other parts of the body (metastasize), nor do they invade surrounding tissues. Malignant tumors (also known as cancers) will grow uncontrolled in such a way that they invade and damage other tissues around them. They also gain the ability to break off from where they start and spread to other parts of the body, usually through the blood stream or through the lymphatic system where the lymph nodes are located (a process known as metastasis).

The most common tumor of the adrenal gland is actually a benign tumor called an adrenal adenoma. In most patients, these benign tumors never cause a patient to have any symptoms and do not need to be treated. They are usually found when a patient has a CT (or CAT) scan of the body for an unrelated reason, and are thus sometimes called “incidentalomas”. The most common malignant tumors found in the adrenal gland are tumors that come from cancer cells that have metastasized (or spread) from other parts of the body to the adrenal gland through the blood stream. Several different types of cancer may spread to the adrenal glands, most commonly melanomas, lung cancers, and breast cancers. The adrenal glands are the fourth most common site in the body for cancer cells to metastasize to, after the lungs, liver, and bone.

Cancers can arise directly within the adrenal glands themselves; however, these are relatively rare. Cancers may arise directly from the adrenal cortex, and are called adrenal cortical cancers. These cancers can either be functioning (meaning they secrete excess steroid hormones) or non-functioning (meaning they do not secrete steroids). Functioning adrenal cortical cancers are more common than non-functioning cancers. Cancers can also arise within the adrenal medulla, the most common of which are pheochromocytomas. In children, neuroblastoma tumors can develop within the adrenal medulla. Pheochromocytomas and neuroblastomas are discussed elsewhere individually, will not be discussed further in this review.

Other types of adrenal cancers can occur, such as lymphoma; however, these cases are rare.

What are the signs of adrenal cortical tumors?

Both adrenal adenomas and adrenal cortical cancers can produce excess steroid hormones. Symptoms vary depending on the steroid that is produced. If too much aldosterone, which is a type of steroid hormone, is produced, Conn's syndrome (also known as primary hyperaldosteronism) can develop. Conn’s syndrome most commonly occurs with pituitary adenomas, but it can also occur in the setting of adrenal hyperplasia (an overgrowth of normal adrenal cortical tissue) and adrenal cortical cancers. Signs of Conn's syndrome include elevated blood pressure, decreased levels of potassium in the blood, and decreased levels of a chemical produced by the kidneys called renin in the blood. In most cases of Conn’s syndrome, elevations in blood pressure are mild to moderate. Other symptoms include weakness, muscle cramps, increased thirst, and increased frequency of urination.

Cortisol is a separate steroid hormone produced within the adrenal cortex. If a tumor produces excess cortisol, Cushing's syndrome (also known as hypercortisolism) can develop. This syndrome is seen not only with adrenal tumors, but can also be the result of excessive levels of adrenal cortical stimulating hormone (also known as ACTH, a hormone that is responsible for stimulating the adrenal glands to produce cortisol) produced by the pituitary gland or another tumor in the body. Cushing’s syndrome may also develop in patients who are taking steroids as medication for other disorders. The symptoms of Cushing's syndrome can vary greatly from patient to patient and involve a number of different parts of the body. Symptoms include weight gain and water retention resulting in a round face and collection of fat on the back of the shoulders and neck (so-called “buffalo hump”). Red streaks can appear on the skin known as striae. Excessive hair growth (called hirsutism) can also be seen. Excessive cortisol levels can interfere with the body's immune system predisposing a patient to unusual infections. Patients with Cushing's syndrome are at high risk for development of diabetes. Patients may also have mental changes, including mood swings, irritability, and in the worst case, psychotic episodes. In children, excessive cortisol can lead to premature sexual development and maturation (also called precocious puberty).

Adrenal tumors may also cause excess production of sexual hormones. If excess testosterone is produced, virilization can occur in either men or women. Virilization causes increased masculine characteristics, resulting in deepened voice, loss of hair, and increase in the size of the clitoris in women. Feminization may occur in men with excess estrogen production, and may cause sexual impotence and/ or breast growth (gynecomastia).

Adrenal tumors may also cause symptoms by occupying space in the abdomen. Patients with large adrenal tumors may experience feelings of abdominal fullness or localized pain. Patients may feel as though they are quickly full when eating and may experience weight loss. In some cases of large adrenal tumors, patients may actually feel a mass in their abdomen.

Adrenal cortical cancers stages.

In addition to diagnosing adrenal cortical cancers, the radiographic imaging performed also helps to determine the stage of the patient. In general, patients with adrenal cortical cancer are divided into one of four stages.

Stage I: The cancer is smaller than 5 cm and has not spread outside of the adrenal gland.

Stage II: The cancer is larger than 5 cm and has not spread outside of the adrenal gland.

Stage III: The cancer has spread into the fat surrounding the adrenal gland or has spread to lymph nodes or other organs near the adrenal gland.

Stage IV: The cancer has spread to other parts of the body.

These stages may vary slightly based on the system that a patient’s physician chooses to use; the staging system described above is the most recent way of staging designed by the French Association of Endocrine Surgeons Study Group.

Acortical cancers treatments?

Surgery treatment for Adrenal Cancer

Currently, the only known way to cure adrenal cortical cancers is complete surgical removal of the tumor. Unfortunately, this is only possible for some patients with this disease. At least half of patients with adrenal cortical cancers have metastases or cancer invading into other organs, so that complete removal of the tumor is not possible. The best results with surgical resection have been with an en bloc resection, meaning that the entire tumor is removed in one piece. This also includes removing the entire kidney on the same side as the adrenal cancer. Because of this, it is unusual for adrenal cancers to be removed using a laparoscopic procedure, although as techniques of laparoscopic resection improve, more patients are being treated with this method. Occasionally, adrenal cancers will grow into the large blood vessel that carries blood back from the lower body to the heart (the vena cava). Even in these cases, complete removal of the cancer can sometimes be performed, but will require input from a general surgeon, an urologist, and a vascular surgeon.

Even in cases where the tumor cannot be removed in its entirety, surgical removal of as much tumor as possible can improve symptoms, particularly if they are due to excessive steroid secretion.

Chemotherapy treatmetn for Adrenal Cancer

Chemotherapy refers to a group of medications that are given intravenously or orally as a pill. These drugs travel throughout the body to kill cancer cells. This is one of the big advantages of chemotherapy. If cancer cells have broken off from the tumor and are somewhere else inside the body, chemotherapy has the chance of killing them. A number of different chemotherapeutic agents exist, each with its own side effects. You should discuss the potential side effects of any chemotherapy you may receive with your medical oncologist.

The most common chemotherapy used in treatment of adrenal cortical cancers is mitotane. Mitotane acts to block the hormones produced by the cancer and can also kill adrenal cancer cells. Mitotane or other chemotherapy is almost always used when surgery is not possible, or if surgery is done, but some tumor remains in the body. In many cases, Mitotane is also used for patients after surgery even if every visible cancer cell has been removed. Streptozosin is a second chemotherapy drug that has been shown to work in combination with mitotane. Mitotane with or without streptozosin has been shown in clinical trial to reduce the risk of adrenal cortical cancers growing back after they are removed surgically. Even if cancers cannot be removed surgically because they have spread to other parts of the body, mitotane may cause tumors to shrink and reduce symptoms.

There are a number of other types of chemotherapy used for adrenal cancers. Exactly which chemotherapeutic agents are given varies according to the physician giving them. Based on your own health status and the risks of side effects that you are willing to accept, the choice of chemotherapy can vary.

Radiation Therapy for Adrenal Cancer

Radiation therapy is used in a number of cancers as both the main method of killing cancer cells or in combination with surgery (either before or after). The radiation comes in the form of high-energy x-rays that are delivered to the patient only in the areas at highest risk for cancer. These x-rays are similar to those used for diagnostic x-rays, only of a much higher energy. The high-energy of x-rays in radiation therapy results in damage to the DNA of cells, causing tumor cells to die.

Radiation therapy is not part of the routine management of adrenal cancers, particularly in cases where the cancer is completely removed by surgery. Radiation has been tried in cases where surgical removal of the cancer is incomplete or in cases where the cancer comes back after surgery. In these cases, the radiation is usually delivered daily, Monday through Friday, 5 days a week, for a total of 5 to 7 weeks. In general, the side effects associated with this treatment include fatigue, skin redness and irritation, nausea, and diarrhea.

Other Drug Treatments for Adrenal Cancer

Patients who are treated for adrenal cortical cancers may have symptoms that are due to levels of hormones that are either too high or too low. Physicians may recommend other medications, such as ketoconazole or metyrapone, to treat these symptoms.

Impacts of other cancer on adrenal gland ?

In most cases, when other cancers spread to the adrenal glands, they are treated with chemotherapy that is known to be effective against the original cancer type. In some cases, if the adrenal gland is the only site in the body where the cancer appears to have spread, surgical resection of metastatic cancer and the adrenal gland can be performed, followed by treatment to the primary site where the cancer started. This has been shown to be curative in a small number of patients, particularly in the case of lung cancer.

Cancer survivor is an individual with cancer of any type, current or past, who is still living.Many cancer survivors describe the process of living with and beating cancer as a life-changing experience. It is not uncommon for this experience to bring about a personal epiphany, which the person uses as motivation to meet goals of great personal importance, such as climbing a mountain or reconciling with an estranged family member.

Famous cancer survivors:

Lance Armstrong

In 1996 Lance found that he had testicular cancer. Since early warning signs were ignored, by the time he was diagnosed the cancer had spread throughout his stomach, lungs and brain. If testicular cancer is discovered early, a man is usually given a 70% chance of survival.
Because, Armstrong says he ignored warning signals, his chances of survival dropped as low as 40%. He had chemotherapy and surgery followed by a physical treatment program. With the help of his competitive spirit and support system he was declared cancer free.

Kylie Minogue

Kylie Minogue, 37, was diagnosed with an aggressive type of breast cancer in May 2005.
Kylie went through eight months of surgeries and chemotherapy but regained her strength and won over the disease with her optimistic outlook.
In addition to the conventional medical treatments for breast cancer, Minogue used a variety of alternative therapies, including visualization practices, nutrition, massage and Reiki.

Sheryl Crow

Singer Sheryl Crow had been diagnosed with breast cancer in 2006. She underwent a minimally invasive surgery and had radiation treatments as a precaution.
Crow is no stranger to cancer, especially with her previous relationship with cancer survivor/cyclist Lance Armstrong. She also participated in the ‘Rock Against Breast Cancer’ concert in 2000.

Christina Applegate

Christina Applegate underwent treatment for breast cancer in 2008. The disease was caught early and the actress recovered fully. However, the ‘Samantha Who?’ star said she had a double mastectomy and underwent reconstructive surgery over the next eight months.
The Emmy winner's cancer was detected through an MRI ordered by a doctor and was not life-threatening.

Steve Jobs

Steve Jobs was diagnosed with liver cancer in October 2003 during a routine scan. While a biopsy revealed that the cancer was a rare but treatable form, Jobs opted to try and treat the cancer with a special diet. Surgery is very effective for this type of cancer and most patients live 10 years or more after treatment. Jobs tried treating the cancer with the special diet for nine months until follow-up scans showed the tumor was growing. He recently started work again after a liver transplant.

Robert De Niro

Two-time Oscar-winner Robert De Niro had been diagnosed with prostate cancer in 2003. The 60-year-old actor was confident of beating the disease as it was discovered early.
In the course of his 40-year career in movies, Robert has become one of the most revered character actors of all time.
De Niro underwent prostate surgery in December 2003 at the Sloan-Kettering Memorial Hospital.

Nelson Mandela

Former South African president Nelson Mandela was diagnosed with prostate cancer.
A spokeswoman had revealed shortly after that the tumour was microscopic and should not reduce Mr Mandela's life expectancy. Initially no surgery was contemplated for the 83-year-old elder statesman and he received a seven-week course of radiotherapy.
The Nobel peace prize winner was probably the world's best known political prisoner, spending 27 years in jail. In 1985, while in prison, Mr Mandela was hospitalised for prostate surgery and had some tumours removed. They proved to be benign. He then returned to jail, where he remained until his release in February 1990.

Colin L. Powell

US Secretary of State Colin L. Powell underwent surgery to remove a cancerous prostate gland in 2003.
The cancer was localized, the surgery was without complication, and Powell was in recovery soon. Powell chose to be secretive about the disease and keep it away from the press in contrast with other famous personalities who chose to use their illness as an opportunity to spread awareness.

Olivia Newton John

Singer/actress Olivia Newton John was diagnosed with breast cancer in 1992. She compared her battle with the disease to climbing the Great Wall of China.
The Grease star has become a health advocate since fighting off the disease following her 1992 diagnosis. And Newton-John - who led an inspirational three-week walk along the Great Wall of China in April, 2008 - insists her efforts have awakened a fighting spirit in herself.

Cancer Survivors~Lung Cancer Survivor Stories

Franklin Whatley-Thirty-three years being married was not enough, was it?" That was the comment I made to my wife as the doctor left the examination room after telling me that I had lung cancer in my left lung, that it was not operable, and that my life expectancy was probably in the neighborhood of six months.

The time was March, 1993 and the place, Albuquerque, N.M. My oldest son Jim, his wife Kari, and their 22-month-old son, along with my wife Nellie, had accompanied me to Albuquerque from Gallup, N.M. where Nellie and I were both teachers at Gallup High School. We were enjoying our teaching jobs and had no idea that the horrible "BIG C" was playing havoc in my body. Jim and his family had stopped in Gallup on their way from Ft. Lewis, Washington to Ft. Benning, Georgia.

The doctor scheduled a bronchoscopy for the following morning. Our daughter and other son arrived in Albuquerque just minutes before I went in for the test on Tuesday. It confirmed the previous day’s diagnosis. My family sprang into action, rented a truck, and we were packed up and on our way back to Tulsa by Thursday. That was a trip to remember, from snow and ice to a temperamental rental truck that did not run unless it wanted to. Including the rental truck driven by Jim, we had five vehicles in that caravan and we all communicated by CB radios. We found a channel that had no one else on it and we tried to keep up our sagging spirits with jokes, songs and games all the way across New Mexico, Texas and Oklahoma.

We arrived in Tulsa where our family doctor had made an appointment with a cardiovascular surgeon and a pulmonologist. The surgeon felt confident he could operate and take the lung, thus removing the cancer. Surgery revealed a ten centimeter primary tumor in the left lower lobe which was a squamous cell carcinoma. One hilar lymph node and two parabronchial lymph nodes were positive for metastatic disease. The surgeon reported that the tumor was attached to the heart sac and he peeled it from the sac like peeling an orange. I came through the surgery with no complications and by mid afternoon I was sitting up in ICU drinking a cup of coffee. And did it taste good.

Because of the positive lymph nodes the doctors agreed that I should have chemotherapy and radiation. We talked to the team of doctors at the hospital and they answered our questions but not to our satisfaction. I would add here that our daughter, La Nell is a nurse and she had coached us on the important questions to ask such as, "Is the chemotherapy administered through a port?" and "How is the body not being radiated protected?" and "What diet should be followed and what supplements should be taken?" There would be no port and there would be little protection from the radiation for the body. I could eat anything I wanted and supplements and vitamins were not needed.

This is where Cancer Treatment Centers of America (CTCA) at Southwestern Regional Medical Center (Southwestern) entered the picture. As I said, La Nell was a nurse and acquainted with CTCA. She made and appointment for me to meet some of CTCA's doctors. When I left the conference with the doctors at Soutwestern I had the reassurance that my body would be protected from radiation, a port would be installed prior to chemotherapy and I went home with diets and a sack full of supplements.

The following week, I began my radiation with Dr. Flynn. I was followed closely with examinations weekly and blood work each Monday morning. I finished six weeks of radiation. Minor tiredness was the only side effect I experienced. I was given a lotion to administer to the radiated spots just in case the skin was burned, but of course, it was not.

After completion of radiation, the port was inserted and I began my chemotherapy. To my great surprise, I gained 35 pounds, the most I had ever weighed, while receiving chemotherapy. I did not suffer nausea because medication was administered along with the chemo to prevent it. After the first dose of chemo, which was a giant one, I did have to have a platelet transfusion and had to stay in the hospital until my platelet count had risen. During the whole eight months of chemo, that was the only bad side effect I encountered other than suffering some loss of hair. I did not let the loss of hair affect me negatively. Nellie brought clippers to the hospital and we had a party while she shaved my head so I would quit getting hair in my mouth when I turned over in the bed. Then I had a friend paint me a cap that read, "CHEMO HEAD, NOT A SKIN HEAD." That brought comments, I might add.

If one has to suffer through cancer, then Cancer Treatment Centers of America is the place to be. Not only were the doctors great but the nursing staff was superb. The housekeeping staff could not do enough for my family and me while I was in the hospital and the dietary staff went out of their way to see that I had what I wanted to eat. Today when I return to Southwestern, I am treated as family and not just a mere patient.

At the first meeting with the doctors at CTCA, the five-year survivor tree planting ceremony was explained to me. My reply to that was, "Get my tree ready!" On May 7, 1999, I planted that tree and I remain cancer free thanks to God, the doctors and all the staff at CTCA.

Breast Cancer Survivors

I want to let you know, once again, how grateful I am that your organization exists. In January 1999, I was diagnosed with breast cancer. I underwent surgery, chemotherapy and radiation treatment at Cancer Treatment Centers of America (CTCA) at Midwestern Regional Medical Center (Midwestern). I actually saw an advertisement for your center several months before I was diagnosed and said to myself, "If I ever get cancer I will go there," never suspecting that I would need your services so soon. Three months later, I arrived at your doorstep.

I feel that God lead me to CTCA. As a former medical doctor in Australia and now a minister, I was so relieved to find a center that offered the best of medical care, while paying attention to the whole person. As part of my medical practice years ago, I looked after patients with cancer. I know the grueling side effects and inconsiderate care that can often be found within cancer hospitals. In fact, I used to think that I would never undergo chemotherapy. I changed my mind when I saw the way that you administer chemotherapy in your hospitals.

In addition, I was able to integrate and apply all that I had learned about complementary and spiritual medicine in recent years. I used the vitamins, naturopathy, the nutrition program and the mind-body programs which you offer as support for my treatment and integrated these with other alternative therapies which I used. I also availed myself of every program that you offer: mind-body medicine, physical therapy, massage therapy, spiritual counseling, and image enhancement. They all were a tremendous assistance to gaining and keeping a sense of well-being in all areas of my life. My friends, family and coworkers were surprised and delighted that I looked so well while undergoing cancer treatment.

I want to thank everyone who looked after me. Wherever I went at Midwestern, I always knew that I was cared for and was not just a name on a chart. Truly, your people are your greatest asset and I am so grateful to them because so many thoughtful and kind things happened to me while I was there. I know that your atmosphere of love and caring helps to heal.

By the grace of God, I will be seeing you for years to come for follow up. Please share this letter with everyone—doctors, nurses, therapists, technicians, pharmacy, food services, volunteers, medical records, patient care coordinators, security, drivers. Everyone whom I contacted looked like embodied angels to me.

July 21, 2008

Cancer Survivors ~ Pancreatic Cancer Survivor Stories

“You have two months to live. Go home and get your things in order.” Those were the words I heard in July 2001. Just days before, I had walked 18 holes in a golf tournament and that evening I thought I might have food poisoning. After a few days, I still didn’t feel any better. A friend told me that my eyes looked yellow, so I went to the doctor. I soon heard the word “CANCER”—not just cancer—but stage IV pancreatic cancer with metastasis to my liver. My first thought was, “OK, let’s get it fixed.” But my doctors replied, “You don’t understand, it is inoperable and incurable.” That’s when I was told I had just two months to live.

To relieve my pain and jaundice, a tube was inserted into my side to drain backed-up bile. They put a leg bag on me and said I would live with that for the rest of my life. The doctor told me to go home and get my affairs in order.

My family and I decided that I needed a second opinion. My sister Pam and my caregiver Jana were busy searching the Internet and making phone calls, trying to find some place that would offer hope. That’s when my younger sister Beth called and told me that her in-laws had a friend who had been treated for pancreatic cancer at Cancer Treatment Centers of America (CTCA) and that they had saved his life. Pam got on the phone right away and called CTCA’s 800-number and talked to an Oncology Information Specialist. They seemed to know exactly what we were going through, were very informative and answered all of our questions. I was scheduled for an appointment within the week. I needed to get help as soon as possible as I was losing weight, could not eat and I was in terrible pain. Not knowing I was full of infection from the insertion of the biliary tube, I was able to get some pain medication. Pam and Jana put me in a wheelchair and accompanied me on a plane to the CTCA in Zion, Illinois. The first thing I remember was entering the lobby of CTCA and seeing the tree of survivors. I said I’m going to get my name on that tree!

CTCA began treating me right away for my infection, got my pain under control and confirmed the diagnosis. I could not believe how fast they were able to do all the tests. They did more in one day at CTCA than my hospital back home did in a week. When they scheduled me for an X-ray at 10 a.m., I had my X-ray at 10 a.m. I thought, WOW, these people know what they are doing.

After three days of tests, I asked Dr. Mellijor how long I had to live. He said he could not give me my “expiration date” …that date was “in greater hands than his.” It was at that moment that I realized someone had offered me HOPE! If I was willing to fight, they would fight with me.

The doctors then explained a very aggressive treatment plan, which began immediately and consisted of five days of FUDR leucovorin with one day of intra-arterial mitomycin platinum. I spent 26 days in the hospital fighting an infection in my body, along with a collapsed lung. During my stay in the hospital, I felt like I was surrounded by friends and people who really cared and who gave me hope. Everyone was so pleasant, from the person who cleaned my room to all the nurses, doctors, kitchen staff—everyone.

Each morning at 10, the group of CTCA healthcare professionals would come into my room to see me. By doing this, they could all hear at the same time how I felt and could answer any questions I had for them. Also, as soon as I arrived at CTCA, they started me on a regimen of vitamins that I continue to take to this day. I don’t know if it was the vitamins or my prayers, but I never lost the hair on my head even with all the chemotherapy. Each time they did tests, it showed that the tumors had shrunk.

After five months, my platelets were too low to continue with the original treatment, so we went to plan B. I then started on a regimen of oral chemo, and within months, the tumor could not be seen at all on the scans. I have been off chemo since November 2002.

At present, I take Prilosec once a day and the vitamins that were recommended to me by Cancer Treatment Centers of America (CTCA). I enjoy spending my time working full time, riding my horses, camping, golfing, traveling, and being with my friends and family. Through the excellent care that I received at CTCA and the constant love, support and prayers from my family and friends, I have stayed positive and set goals for myself. I have talked to numerous patients and many of them say, “I wish I would have found CTCA right away.”

So many hospitals treat you like a number, but at CTCA they treat you like family. I was very fortunate to have found CTCA so soon after my diagnosis. I, like most people, wanted to be treated close to home, but I truly believe if I had, I would not be here to share my story. I continue to count my blessings every day and have recently taken on the opportunity of becoming South Dakota’s Team Hope Leader for an organization called the Pancreatic Cancer Action Network. I hope others that have been diagnosed with this disease and are not satisfied with what they have been told will call Cancer Treatment Centers of America. Remember there is always hope and as the song goes by Lee Ann Womack, “you have a choice to sit it out or dance”...“I Hope You Dance.”

April 28, 2008

Colon Cancer Survivors

Linda Fairchild's father had died from colon cancer a month before she herself was diagnosed with the disease in 1995. Linda followed the advice of her doctors and had surgery and chemotherapy. The first round of chemotherapy never made her lose her hair or have any severe side effects, although she did have some nausea.

About three years later, Linda had blood tests which came back abnormal, signaling the return of the colon cancer. She was given the option of having colostomy surgery, but refused it. She had another course of chemotherapy, which went much like the first course had.

In the summer of 2001, a tumor was found in Linda’s bladder. She had the colostomy surgery this time, with more chemotherapy. Linda also had radiation therapy, since the doctors couldn't remove the tumor in her bladder.

Three months after finishing these treatments, on Christmas Eve of 2001, Linda was told that the cancer had spread to her liver.

Linda said, "I started to receive mega-doses of chemotherapy. With this, I lost my hair, was very weak, disoriented and I couldn't eat, so I was severely malnourished. I diminished to 89 pounds, and many of my friends saw me in a losing battle." She also had severe diarrhea that her doctor claimed was from the chemotherapy.

Linda's friend Susan saw an advertisement for Cancer Treatment Centers of America (CTCA) and sent for a brochure. The nearest center, CTCA at Midwestern Regional Medical Center (Midwestern) in Zion, Illinois, was about three hours away. At first, Linda was reluctant to try anything new.

"I was too caught up in my illness at the time to really see how bad things were," Linda said. "Susan encouraged me to go to CTCA to see what they could offer me."

"I finally agreed to go to CTCA. When I told my oncologist this, he was first against it. But then, he said I should go because he couldn't do anything more for me. He never led me to believe this before."

"I was now handed a note saying he believed I would never work again and I had a limited life span. This came down like a rock on my head."

"I was so grateful at this point to have set up my appointment at CTCA, but I was scared," Linda said.

Linda was admitted to CTCA in April 2002, fed intravenously and treated for a parasitic infection that was the real cause of her diarrhea. She was also given fractionated doses of chemotherapy (four different drugs) over five days, in an intra-arterial procedure that delivered chemotherapy directly to the liver.

"After the five days of treatment, I was a little nauseated, tired and out of sorts, but I had a better quality of life for the next three weeks between treatments." Her weight was 100 pounds (up from 89 pounds) by the end of the three weeks.

By the end of her second series of treatments, the tumor was no longer visible on scans and her blood tests were near normal. She continued to receive nutrition intravenously for the next three months, until her weight returned to normal.

"I was determined to beat cancer. I also took comfort in speaking with the ministry at Midwestern. Today I still take various vitamins that I get through CTCA, do a lot of walking, keep an optimistic attitude, and appreciate the gift of life everyday."

Linda returned to work in November 2002. Her friend Susan says that Linda "looks great!" They both volunteer with CTCA, helping encourage other people with cancer.

"The local doctor who did my surgeries was amazed after seeing me a year later," Linda said. "He could not believe how healthy I was."

Linda's advice for us? "You can't be afraid to live with a serious illness. If you do, then dying becomes easy. Living is so much harder, but if you take a chance on fighting to live and believe in yourself, then the possibilities are endless."

Survivors of liver cancer stories

Fay Polson

Toward the end of 1996, I was looking forward to retirement after working for 22 years. I had been to the doctor several times about the pressure I felt in my abdomen. Then a raised place came up over my liver, and the doctor told me I needed a CT scan. The scan revealed a large tumor. He wanted to do a biopsy and I agreed to have one the next day. When they put the mirror in the incision they found that the tumor had grown onto my liver and had ruptured it. After telling me I only had a few months to live, unless we got this liver cancer under control, they sent me with my files across the street to a local hospital.

After looking at my scan, the doctor sat down and had a short conversation with us. My husband, Bob, and daughter, Sheryl, were with me. The doctor said he thought we could do direct chemo to the liver and try to shrink the tumor. But he said I only had a 50/50 chance. I was scared and didn’t know what to do. Because of his heart, our daughter’s husband had gone to Cancer Treatment Centers of America (CTCA) to use the radiation pellet implant to treat his prostate cancer. They were so pleased with CTCA and the service they received, Sheryl said we should go out to the center for a second opinion. The call was made and we got in almost immediately. By this time, my abdomen was so large I had to wear a maternity top.

From the day I walked into Cancer Treatment Centers of America in Tulsa, I knew that it was where I wanted to be. Everyone was so very friendly and warm. And, we did not have to sit in the waiting room for hours!

I saw Dr. Hans Nevinny. I cannot tell you how pleased we were with him. He hugged me and he hugged my husband and talked with us forever explaining what kind of treatment I would have. Then I saw Dr. Jimmie Crow, who was one of the surgeons at that time. He told us he wanted to save just one-fourth of the liver since the liver regenerates itself. If you could only know what a blessing I had just received! Until this point, I thought I was going to be dying in about three months, leaving my family, small grandchildren and all my wonderful friends. Words cannot explain the feeling. I had just been granted some more years.

On February 14, 1997, I had my first surgery. The tumor weighed 3 ½ pounds. Since my husband had wanted to see the tumor, Dr. Crow decided to carry it out in a bucket into the waiting room. After Bob looked at it, all the rest of the family wanted to see it too. I had a long six weeks trying to recover from this first surgery, as the tumor had zapped all of my minerals, from my body, and the nutritionist said I was severely malnourished. She gave me several things that I had to take every day, besides drinking Ensure. And I saw her every time I came in to see the doctor. She would always look at my charts and see how much I had improved. And if I needed other things, I would take them too. Also after my surgery, someone who came to see me at home must have had a stomach virus because I became very ill and had to be hospitalized again to take care of this. I had a long time recovering from this surgery.

In May of 1997, I took my first chemo treatment. My body was in good shape by then and I did not have any trouble with the chemo. I had radiation treatments along with the chemotherapy. It was not a chore for me to come out every day for chemo and radiation. There were so many wonderful people to talk and visit with, especially two men who were so much fun that everyone wanted to be in the room they were in. We did a lot of laughing every day.

In exactly one year, another tumor appeared in my liver. Once again there was surgery and all went well again. I only had to stay a week this time. And one of the wonderful things about CTCA is that they let Bob stay with me, every night, even in ICU. The people are just so wonderful at CTCA.

In the latter part of 2000, I had yet another tumor in my liver. This time they did four different ablations to try to destroy it, followed by two alcohol injections and two heat treatments. When the CT scans showed I still had the tumor, I once again faced surgery. Dr. Crow said that there were two tumors, one on top of the other. The injection treatments had destroyed the top tumor, but not the bottom one. The surgery was successful and it was my last one. My follow-up visits with my oncologist have all been with good results.

I just cannot explain how well I did with the wonderful help of the doctors and staff at Cancer Treatment Centers of America (CTCA). Along the way, Bob and I have met many people and tried to visit them at CTCA as often as we could. They are always so glad to see a person that has a successful cancer story. What a marvelous blessing we have received! If I had not come to CTCA, I know I would not be alive today. Thanks to their outstanding care, I am cancer free.

Survivors by Lung Cancer

John Kleinfeldt has reason to celebrate. Anyone who follows the statistics on cancer survival would have given up on him a long time ago. In fact, some did. But Kleinfeldt is alive today. Alive and well.

Kleinfeldt’s journey with cancer began with a regular check up with his doctor. He was 58 years old. Blood tests revealed he was anemic. When medication did not help and Kleinfeldt began losing weight, his medical doctor referred him to a gastroenterologist. The gastroenterologist referred him to a rheumatologist since he had arthritis in his knees. During his examination the rheumatologist noticed clubbing in Kleinfeldt’s hands and took an X-ray of his knees. The specialist had a suspicion it was lung cancer but could not be certain without performing a chest X-ray.

A referral to a radiologist and a chest X-ray later, Kleinfeldt and his wife, Eileen, heard that John has a mass in the upper left lobe of his lung. It was large, measuring 4.2 centimeters by 3.3 centimeters.

The next referral was to an oncologist, who recommended chemotherapy. The Kleinfeldts opted for a second opinion, which returned an opinion for a surgical intervention. After a third opinion concurred with the second, Kleinfeldt underwent lung cancer surgery in New York City in August of 1997 to remove the tumor and part of his lung.

Four months after his surgery, in December, Kleinfeldt began experiencing dizzy spells. An MRI revealed the cancer had metastasized to his brain, detecting three lesions and a tremendous amount of brain swelling. He was admitted to the hospital immediately.

Kleinfeldt underwent 15 radiation treatments at a treatment center in Long Island. Given the poor prognosis during those radiation treatments, Eileen began researching other treatment centers which might give Kleinfeldt more options and therefore a better chance at longer survival. She found a hospital in Zion, Illinois that appeared to offer treatments in addition to the standard protocols and told John, “this is where we are going.”

John told his doctor they had found Cancer Treatment Centers of America (CTCA) and requested his opinion of their treatment facilities. The doctor was reluctant to give an answer because he had never heard of CTCA. That inclined John not to seek treatment at CTCA until his doctor supplied another opinion.

“John, listen to Eileen and go to CTCA. See what they have to say. You have nothing to lose. I can’t do anything more for you,” he said. The Kleinfeldts did get on a plane to Chicago, something Eileen is thankful for to this day.

“That was the best decision we ever made and it has forever changed our lives,” Eileen said.

Lymphoma Survivors

My name is Randy Merriken and I've been a victor over non-Hodgkin's lymphoma for many years. My experience with Cancer Treatment Centers of America (CTCA) at Southwestern Regional Medical Center (Southwestern) began in July of 1996, when I saw my doctor (Dr. Brunk) for the first time. My struggle against cancer began several years earlier, though.

When I first noticed the "knot" in my abdomen in the summer of 1993, I wondered if there might be something serious going on, but I didn't see a doctor about it. I didn't want to be a "hypochondriac". I work in a hospital laboratory and since I'm around disease all the time I try not to worry about every bump or bruise I might see. Finally, about a year and a half after I first noticed the knot, I went to see him for a minor thing and then I used the "Oh, by the way, while I'm here·" line. He checked me out and sent me to a surgeon who ordered a CT of my abdomen to diagnose me. Three days after my CT I had a biopsy to confirm the lymphoma diagnosis.

In 1995, I went through a 5 month course of traditional chemotherapy in my hometown of Charleston, WV. My CT's looked good, but my doctors told me that this type of cancer is "easily controlled, but rarely cured". The average life expectancy for the advanced lymphoma, which I was fighting, was 3-5 years. The standard protocol is to treat it, then "watch and wait" until you have to treat it again. This involves stronger and stronger drugs until nothing else is available. (I didn't like the sound of that!)

A little over a year after I finished my chemotherapy I felt like the tumor was growing again and my CT scan confirmed my suspicions. My oncologist told me that if he were the patient he wouldn't necessarily get treatment again just yet. I wanted to be more aggressive than that so I went looking for a second opinion. I was given some information about the importance of nutrition at Southwestern and it sounded encouraging, so I called the toll free number. The folks at CTCA did all the legwork for me. They called my insurance company, then called me back and explained the plan. I made an appointment to see my doctor for an evaluation in July of 1996.

God is the great orchestrator of my healing, and I began asking Him to give my doctor wisdom for my treatment, even before my first appointment. My prayers (and those hundreds of others) were answered wonderfully! At CTCA, I found a host of caring people. The nutrition aspect of my treatment in incomparable, including an improved diet and an immune-stimulating supplement package. The Psychoneuroimmunology (PNI) or "Mind Body Connections" program, is an important part of my care. There are encouraging people everywhere - housekeeping, pastoral care, patient relations, guest room services, and on and on!

My doctor used a more aggressive treatment plan for me which involves a maintenance dose of oral medication to keep the lymphoma under control. He's had patients like me on this program for 10 years. I expect to keep getting good reports. I don't know what the future holds, but my Father does and that's all I need to know! God is good and I'm glad CTCA was part of His plan for me.

Prostate Cancer Survivors

My urologist called me at 10 p.m. on a November evening in 1997 to inform me that the biopsy of my prostate showed one area of cancer. He told me what my options were. I could have it removed, have radiation therapy or do nothing. He recommended that I have my prostate removed within two weeks. A second opinion confirmed the recommendation.

I came across a description of the "permanent seed treatment" in my research. At the same time, my wife saw an ad on TV describing the prostate cancer treatment given at Cancer Treatment Centers of America (CTCA) at Southwestern Regional Medical Center (Southwestern). She called the 800-number and spoke with Sharon, who gave her some basic information and also "overnighted" some information to us. After reading the material, I called CTCA to set up an appointment for a consultation. Several days later my wife and I were at Southwestern, talking with Dr. Flynn, who explained what the treatment consisted of. I had no doubt that the HDR brachytherapy treatment was the course I was going to take.

At the time of diagnosis, my PSA was 8, my Gleason was 6, and my age was 60. I had the brachytherapy treatment in March and April of 1998. I had no negative reactions from the treatment. I went right to work when I got home. I missed no days of work following the treatment.

We have never met a group of people nicer or more caring and professional than those at CTCA. We thank God every day for helping us find them. I hate to think what my condition would be if we hadn’t found them.

My health and lifestyle are normal now. I look forward to my checkups at Southwestern. The visits will give me the opportunity to see all the friends I made there, as well as to speak to others who are being treated or are contemplating treatment.

January 2003

It’s been many years since I had the HDR brachy treatment. At my last checkup, my PSA was 0.11!!! I thank God daily for helping me to make contact with CTCA in November 1997, and for the treatment I received there, and for the GREAT people that staff the hospital.

The treatment was painless for me and I did not experience any negative side effects during or following it. When I returned home, I went back to work immediately; I do outside work. I also do some running and simply refrained from that for a couple of weeks following the treatment. I have since then ran many marathons.

During my checkups at CTCA, I have spoken with a lot of patients who had been treated or were being treated. Time after time, I have been told how happy they were to have found CTCA because of the treatment and personal care they had received.

I constantly tell people about CTCA and the treatment that is provided for all types of cancer. If I were to have any type of cancer, CTCA is where I'd want to be treated. To me, it’s home away from home.

April 28, 2008

It’s been 10 years since I had the HDR brachytherapy for my prostate cancer. I now go once a year for a checkup. I have one scheduled in May at CTCA in Tulsa. A year ago, my PSA reading was .10.

In the 10 years since my treatment, I have not had any negative effects, interference with my work or any loss of work time.

I still run several times a week, a minimum of five miles a day, or 15 to 20 miles on weekends when I’m training for a marathon. I am now 70 and shudder to think of what my situation would be had I not had the HDR treatment. I have run 18 marathons since my treatment, and will run another one in May. I only mention this to indicate the positive outcome of my treatment, which hopefully will encourage others to look into the possibility of considering CTCA for treatment.

Ovarian Cancer Survivors

Speaking as a cancer survivor, Lori Warchol’s image is splashed across television screens across the nation. The De Pere, WI resident is an advocate for taking control of cancer and one’s own treatment as opposed to letting cancer take control.

That is not to say Warchol was always so self-assured.

At age 40, she went in for her annual gynecologic exam, except, she had actually skipped a year for her annual checkup. A program supervisor for Family Services, a private non-profit human service agency in Green Bay, Warchol leads a busy life and regular doctor appointments are something that can typically get pushed out of the way, especially when a person is feeling healthy. Her doctor noticed some changes in the exam results and ordered more tests. And though she had exhibited no outward symptoms except being a little more tired than usual, the news was not good.

“Those tests revealed a mass in my abdomen. They knew I needed surgery to remove the mass” Warchol said, recalling her emotion, “It could have been a number of things, but I didn’t want to believe it could be cancer.”

The mass did turn out to be endometriosis, which is benign, but during surgery, doctors noticed abnormalities with her ovaries and uterus. They performed a complete hysterectomy, then sent cells off for examination and, to be certain, for a second opinion. “The second opinion revealed the cells were not benign. They were cancerous. My life changed dramatically in two weeks,” Warchol said.

She was referred to a local oncologist. Numb from the diagnosis, she went to the appointment. Up until now, her treatment had been as she expected, but the there were nuances in her oncologist appointment that Warchol characterized as “things starting to go downhill.”

Within minutes, he told her the details of the diagnosis. The form of ovarian cancer was not necessarily aggressive but the statistics for outcome were also not very optimistic. Warchol was stunned.

“He did not give me a lot of hope. It was a very cold presentation that did not take into account what I was going through,” Warchol recalled. “He then referred me to a nurse. She told me the side effects to chemotherapy as though my treatment was already a done deal. The entire visit was very technical and lacked optimism and support.”

Even though Warchol had hoped for a little more compassion as well as options, possibly something including a holistic approach, she agreed to chemotherapy as prescribed because she was “scared, terrified” and did not think she had any more options. She was not offered any other choice.

Her first treatment was high dose of chemotherapy delivered over a three-hour period. She was tired and very sick for five days with awful body aches and nausea. She could not go to work. She had five more treatments to look forward to on top of her dissatisfaction with the oncologist.

“He was not able to answer questions about diet, nutrition and how I could become an active participant,” Warchol said, noting she had been reading about how proper nutrition could play a significant role in preventing and battling cancer.

After her oncologist told her it didn’t matter what she ate, she was determined to take control of the course of her treatment. A colleague at work gave her a brochure on a cancer treatment facility she had obtained while researching treatment options for another friend. That person decided to stay in the immediate Green Bay area for treatment, so the colleague still had the brochure.

The brochure, distributed by Cancer Treatment Centers of America at Midwestern Regional Medical Center in Zion, Ill., offered a number of answers to Warchol’s questions, yet she was suspicious because the brochure entailed a treatment practice that sounded too good when compared to her own experience with the healthcare system. She took a chance and made a toll free telephone call.

She spoke to an oncology information specialist who verified her insurance, listed the ways the hospital would help her travel to Zion, and other things Warchol said she did not have the knowledge nor the energy to do herself.

She received an information packet in the mail the next day but that was not the most startling thing. That night, she received a call from Dr. Sybilann Williams, a gynecologic oncologist from CTCA who spent a half hour on the phone asking questions, then answering others. Three days later, Warchol was in her car making the three-hour drive south to Zion. When she arrived, her reticence changed almost immediately. “Because of the people there, my suspicion just melted away. With the layout and design, it does not look or feel like a hospital. It was a compassionate place to be. I was treated with respect,” Warchol said, adding that Dr. Williams spent two hours with her on that initial consult.

The entire experience gave her hope she had not experienced to that point. But though it went well with all the specialists that day, chemotherapy was still on the horizon. That, too, was different at CTCA. The same, high dose of chemotherapy was delivered in fractionated doses over several days and Warchol felt healthier because of the nutrition and supplement support she received. She did have minor side effects but not the wracking body aches and nausea she experienced before.

In fact, she was now able to go to work between chemotherapy treatments. She finished her total of five chemotherapy treatments at CTCA in May of 1998. Every six months since, she has received a clean bill of health. Warchol said she looks forward to coming back each time because of the connection she has with the people who work at the Zion hospital. She has become an avid spokeswoman for seeking out all of one’s options and not giving up hope. This includes her desire to be featured in a television advertisement where she talks of options and hope.

“It is important for everyone to know, no matter how scared or devastated they are, there are a number of options out there. I experienced a combination of medical expertise and good customer service that is hard to come by. This has been the best healthcare experience of my life,” Warchol said.