Kidney cancer

The kidneys 

Most people have two kidneys. They sit at the back of the body, one on each side, just underneath the ribcage. They filter the blood to remove waste products, which they convert into urine. Urine is carried from each kidney, through a tube called a ureter to the bladder, where it is stored.

When you are ready to pass urine, it leaves the bladder through a tube called the urethra. The urethra opens immediately in front of the vagina in women and at the tip of the penis in men.

What is a kidney tumor?

A kidney tumor is an abnormal growth within the kidney. The terms "mass," "lesion" and "tumor" are often used interchangeably. Tumors may be benign (non-cancerous) or malignant (cancerous). The most common kidney lesion is a fluid-filled area called a cyst. Simple cysts are benign and have a typical appearance on imaging studies. They do not progress to cancer and usually require no follow-up or treatment. Solid kidney tumors can be benign, but are cancerous more than 80 percent of the time.
For more information you can see this video below

The following are also types of kidney cancers:

• Squamous cell carcinoma
• Juxtaglomerular cell tumor (reninoma)
• Angiomyolipoma
• Renal oncocytoma
• Bellini duct carcinoma
• Clear-cell sarcoma of the kidney
• Mesoblastic nephroma
• Wilms' tumor (usually diagnosed in children under 5)
• Mixed epithelial stromal tumor

What are the risk factors for kidney cancer?

Doctors don't know the causes of kidney cancer. But certain factors appear to increase the risk of getting kidney cancer. For example, kidney cancer occurs most often in people older than age 40. These are some other risk factors for kidney cancer:

• Smoking . If you smoke cigarettes, your risk for kidney cancer is twice that of nonsmokers. Smoking cigars may also increase your risk.
• Being male. Men are about twice as likely as women to get kidney cancer.
• Being obese. Extra weight may cause changes to hormones that increase your risk.
• Using certain pain medications for a long time. This includes over-the-counter drugs in addition to prescription drugs.
• Having advanced kidney disease or being on long-term dialysis, a treatment for people with kidneys that have stopped working.
• Having certain genetic conditions, such as von Hippel-Lindau (VHL) disease or inherited papillary renal cell carcinoma.
• Having a family history of kidney cancer. The risk is especially high in siblings.
• Being exposed to certain chemicals, such as asbestos, cadmium, benzene, organic solvents, or certain herbicides
• Having high blood pressure. Doctors don't know whether high blood pressure or medication used to treat it is the source of the increased risk.
• Being black. The risk in blacks is slightly higher than in whites. No one knows why.
• Having lymphoma. For an unknown reason, there is an increased risk of kidney cancer in patients with lymphoma.

Having these risk factors does not mean you will get kidney cancer. And it's also true that you can have none of them and still get the disease.

Symptoms

Unfortunately, kidney cancer does not have early symptoms but you should see your doctor if you notice the following:³

• Blood in your urine
• Lump in your abdomen
• Unexplained weight loss
• Pain in your side
• Loss of appetite

If cancer spreads (metastasizes) beyond the kidney, symptoms depend on the organ involved. Shortness of breath or coughing up blood may occur when cancer is in the lung. Bone pain or fractures may occur when cancer is in the bone. When cancer is in the brain, you may have neurologic symptoms.
In some cases, kidney cancer causes related conditions called paraneoplastic syndromes. These syndromes occur in about 20 percent of kidney cancer patients and can occur in any stage, including cancers confined to the kidney. Symptoms from paraneoplastic syndromes include weight loss, loss of appetite, fever, sweats and high blood pressure. In many cases, the paraneoplastic syndrome improves or disappears after the cancer is removed.

Diagnosis

If a patient has symptoms that suggest kidney cancer, the doctor may perform one or more of the following procedures:

• Physical exam: The doctor checks general signs of health and tests for fever and high blood pressure. The doctor also feels the abdomen and side for tumors.
• Urine tests: Urine is checked for blood and other signs of disease.
• Blood tests: The lab checks the blood to see how well the kidneys are working. The lab may check the level of several substances, such as creatinine. A high level of creatinine may mean the kidneys are not doing their job.
• Intravenous pyelogram (IVP): The doctor injects dye into a vein in the arm. The dye travels through the body and collects in the kidneys. The dye makes them show up on x-rays. A series of x-rays then tracks the dye as it moves through the kidneys to the ureters and bladder. The x-rays can show a kidney tumor or other problems.
• CT scan (CAT scan): An x-ray machine linked to a computer takes a series of detailed pictures of the kidneys. The patient may receive an injection of dye so the kidneys show up clearly in the pictures. A CT scan can show a kidney tumor.
• Ultrasound test: The ultrasound device uses sound waves that people cannot hear. The waves bounce off the kidneys, and a computer uses the echoes to create a picture called a sonogram. A solid tumor or cyst shows up on a sonogram.
• Biopsy: In some cases, the doctor may do a biopsy. A biopsy is the removal of tissue to look for cancer cells. The doctor inserts a thin needle through the skin into the kidney to remove a small amount of tissue. The doctor may use ultrasound or x-rays to guide the needle. A pathologist uses a microscope to look for cancer cells in the tissue.
• Surgery: In most cases, based on the results of the CT scan, ultrasound, and x-rays, the doctor has enough information to recommend surgery to remove part or all of the kidney. A pathologist makes the final diagnosis by examining the tissue under a microscope

Treatment  for kidney cancer

Surgery
 

Surgery is the initial treatment for the majority of kidney cancers. Surgical procedures used to treat kidney cancer include:

• Removing the affected kidney (nephrectomy). Radical nephrectomy involves the removal of the kidney, a border of healthy tissue and the adjacent lymph nodes. The adrenal gland also may be removed. Nephrectomy can be an open operation, meaning the surgeon makes one large incision to access your kidney. Or nephrectomy can be done laparoscopically, using several small incisions to insert a video camera and tiny surgical tools. The surgeon watches a video monitor to perform the nephrectomy.
• Removing the tumor from the kidney (nephron-sparing surgery). During this procedure, also called partial nephrectomy, the surgeon removes the tumor and a small margin of healthy tissue that surrounds it, rather than removing the entire kidney. Nephron-sparing surgery can be an open procedure, or it may be performed laparoscopically. Nephron-sparing surgery may be an option if you have a small kidney cancer or if you only have one kidney. When nephron-sparing surgery is possible, it's generally preferred over radical nephrectomy since retaining as much kidney tissue as possible may reduce your risk of later complications, such as kidney disease and the need for dialysis.

The type of surgery your doctor recommends will be based on your cancer and its stage, as well as your health. Surgery carries a risk of bleeding and infection.

Radiation Therapy (also called radiotherapy)

Radiation therapy uses high-energy x-rays to kill cancer cells, and is also sometimes used to relieve pain when kidney cancer has spread to the bone.

Biological Therapy (also called immunotherapy)

Biological therapy is a treatment that uses the body's own immune system to fight cancer. It uses materials made by the body or in the laboratory to restore the body's natural defenses against the disease.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be taken by pill, or injected by a needle into a vein or muscle.

Hormone Therapy

Hormone therapy uses hormones to stop cancer cells from growing. This type of therapy is used in a small number of patients with advanced kidney cancer.

Arterial Embolization

Arterial embolization is a procedure in which small pieces of a special gelatin sponge, or other material, are injected through a catheter to clog the main renal blood vessel. This procedure shrinks the tumor by depriving it of the oxygen-carrying blood and other substances it needs to grow.

thyroid cancer

The thyroid gland 

The thyroid is a small gland in the front of the neck just below the voice box (larynx).

It is made up of two parts, or lobes. It's one of a network of glands throughout the body that make up the endocrine system. This system is responsible for producing the body’s hormones that help to control and influence various functions.  

The thyroid is sometimes known as the ‘activity’ gland because it produces the two main hormones, thyroxine (T4) and triiodothyronine (T3), which are needed to keep the body functioning at its normal rate. In order to produce the thyroid hormones, the thyroid gland needs a regular supply of iodine (which is found in fish, seafood and dairy products). If the levels of T3 and T4 in the blood fall, the hypothalamus (a part of the brain) sends out thyroid-releasing hormone (TRH) into the blood. As the level of TRH in the blood rises, the pituitary gland releases thyroid-stimulating hormone (TSH) which stimulates the thyroid to produce more thyroid hormones.

If the thyroid gland doesn’t produce enough hormones, you will feel tired and lethargic and put on weight easily. This is called hypothyroidism, or myxoedema. If the thyroid gland produces too many hormones you will lose weight, have an increased appetite, feel shaky and anxious, or have palpitations. This is known as hyperthyroidism, or thyrotoxicosis.

What is thyroid cancer?

Thyroid cancer is a disease that you get when abnormal cells begin to grow in your thyroid gland .The thyroid gland is shaped like a butterfly and is located in the front of your neck. It makes hormones that regulate the way your body uses energy and that help your body work normally.
Thyroid cancer is an uncommon type of cancer. Most people who have it do very well, because the cancer is usually found early and the treatments work well. After it is treated, thyroid cancer may come back, sometimes many years after treatment.

Types of thyroid cancer

The type of thyroid cancer determines treatment and prognosis. Types of thyroid cancer include:

• Papillary thyroid cancer. The papillary type of thyroid cancer is the most common, making up about 80 percent of all thyroid cancer diagnoses.
• Follicular thyroid cancer. Follicular thyroid cancer also includes Hurthle cell cancer.
• Medullary thyroid cancer. Medullary thyroid cancer may be associated with inherited genetic syndromes that include tumors in other glands. However, most medullary thyroid cancers are sporadic, meaning they aren't associated with inherited genetic syndromes.
• Anaplastic thyroid cancer. The anaplastic type of thyroid cancer is very rare, aggressive and very difficult to treat.
• Thyroid lymphoma. Thyroid lymphoma begins in the immune system cells in the thyroid. Thyroid lymphoma is very rare.

Thyroid Cancer Risk Factors

Although the causes of thyroid cancer are not well understood, there are 2 main factors which are known to put an individual at higher risk of developing the disease:

1. a family history of thyroid cancer and
2. exposure to radiation.

Family History:

As with many types of cancer, a family history of thyroid cancer is a known risk factor. A family history of thyroid cancer carries the biggest risk for patients with first degree relatives (mother, father, sister, brother), second degree relatives (grandmother, grandfather, grandson, granddaughter), and/or multiple family members with thyroid cancer. About 5% of patients who develop papillary thyroid cancer and 20-25% of patients who develop medullary thyroid cancer have a relative who also had thyroid cancer.

Radiation Exposure:

In the 1960's it was discovered that exposure of the head and neck areas to radiation during treatment of benign diseases increases the risk of developing thyroid cancer. In addition to radiation treatment, exposure to radiation as a result of nuclear weapons or nuclear plant accidents, such as that experienced by the survivors of Hiroshima, Nagasaki and Chernobyl, also increases the risk for developing thyroid cancer.

Treatment of thyroid cancer

Surgery

Almost all cases of thyroid cancer are treated with surgery. Many are also treated with additional methods.
The surgery will most likely be one of the following:

• Total thyroidectomy. The entire thyroid is removed.
• Near-total thyroidectomy. Most of the thyroid is removed.
• Lobectomy. Only the side of the thyroid where the cancer is located is removed. This type of surgery may be used in papillary cancers smaller than 1 centimeter (about ½ inch) that have not spread.

Radiation

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or shrink tumors. Thyroid cancer may be treated with:

• Radioactive iodine. The patient drinks a liquid that contains radioactive iodine, which collects in thyroid tissue and kills cancer cells.
• External beam radiation. Radiation comes from outside the body.

The type of radiation used depends on the type and stage of your cancer. External beam radiation is most effective for thyroid cancers that do not absorb iodine, including anaplastic thyroid cancer. It is also used if any type of thyroid cancer remains after surgery or if cancer has spread to the bones.

Hormone therapy

Thyroid hormone therapy uses hormones to halt the growth of cancer cells. In papillary or follicular thyroid cancer, hormone treatment may be used to lower the level of thyroid stimulating hormone, which increases the chance of recurrence. In other thyroid cancers, thyroid hormone may be used to maintain normal levels of thyroid hormone in the body.
Hormone therapy is given as a pill. Taking thyroid hormone at the proper dose usually does not cause side effects. If the dose is too high, side effects may include heart palpitations, nervousness, insomnia, and osteoporosis (thinning of the bones).

Chemotherapy

Chemotherapy often is used in combination with external beam radiation therapy to treat anaplastic thyroid cancer. It is usually not particularly effective in other types of thyroid cancer.
Chemotherapy uses drugs to stop the growth of cancer cells by killing the cells or stopping them from dividing. The drugs can be given by mouth or injected into a vein or muscle. Usually, chemotherapy is given to a patient through a vein during an outpatient visit.

Bladder Cancer

Bladder Cancer Overview

The bladder is a hollow organ in the lower abdomen (pelvis). It collects and stores urine produced by the kidneys.

• As it fills with urine, the muscular wall of the bladder stretches and the bladder gets larger.
• When the bladder full of urine, the bladder wall contracts, although adults have voluntary control over the timing of this contraction. At the same time, a urinary control muscle (sphincter) in the urethra relaxes. The urine is then expelled from the bladder.
• The urine flows through a narrow tube called the urethra and leaves the body. This process is called urination, or micturation.

Cancer occurs when normal cells undergo a transformation whereby they grow and multiply without normal controls.

There are  different types of cells that form the bladder, the cells lining the inside of the bladder wall are most likely to develop cancer. Any of three different cell types can become cancerous. The resulting cancers are named after the cell types.

·       -  Urothelial carcinoma transitional carcinoma(tcc bladder): This is by far the most common type of bladder cancer in the United States. The so-called transitional cells are normal cells that form the innermost lining of the bladder wall. In transitional cell carcinoma, these normal lining cells undergo changes that lead to the uncontrolled cell growth characteristic of cancer.

·      -   Squamous cell carcinoma. These cancers originate from the thin, flat cells that typically form as a result of bladder inflammation or irritation that has taken place for many months or years.

·       -  adenocarcinoma. These cancers form from cells that make up glands. Glands are specialized structures that produce and release fluids such as mucus.

Bladder cancer causes and risk factors

Some of the possible causes of bladder cancer, or risk factors for bladder cancer developing include:

1.      Age, It’s unusual for anyone under the age of 40 to get bladder cancer. It becomes more common as people get older.

2.      Infection, Repeated (chronic) urinary infections and untreated bladder stones have been linked with a less common type of bladder cancer called squamous cell cancer. People who are paralysed have more bladder infections and also a higher risk of getting this type of bladder cancer.

3.      Smoker

4.      Gender,man has more chance to get bladder cancer than women,

5.      Exposure to chemical at work.

What are the symptoms of bladder cancer?

The following are the most common symptoms of bladder cancer found in patient. However, each individual may experience symptoms differently. Symptoms may include:

• visible blood in the urine
• hematuria - the presence of microscopic red blood cells (RBCs) in the urine.
• painful urination
• urgency - frequently feeling the need to urinate without results.
• frequent urination
• pelvic or flank pain

The symptoms of bladder cancer may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

Test and exams to diagnose bladder cancer

when we consult to physician ussualy they will request from the patient to do some test to diagnose the bladder cancer.its may include:

·         Ultrasound abdomen and pelvis

·         CT Scan

·         Urine cytology

·         Bone scan

·         Cystoscopy

·         Urinalysis and culture

·         Biopsy

Treatment of bladder cancer

Treatment depends on the position and size of the cancer in your bladder and how far it has spread. Your doctor will discuss your treatment options with you.

Transurethral resection of bladder tumour (TURBT)

This is a procedure used to remove any unusual growths or tumours on the bladder wall. Using a rigid cystoscope a special wire loop is passed into your bladder. An electric current is passed down the wire loop and used to cut or burn off the growth or tumour and a border of healthy tissue around it. For more information, see transurethral resection of bladder tumour, TURBT.

Bladder treatment with mitomycin C or Bacille Calmette-Guérin (BCG)

Mitomycin C is a chemotherapy medicine used to destroy cancer cells. BCG is an immunotherapy that contains a weak form of the bacterium Mycobacterium bovis, which is also used to vaccinate against tuberculosis (TB). BCG works by encouraging the immune system to attack cancer cells. Mitomycin C or BCG treatment is usually given after bladder surgery, sometime it may be used alone to treat bladder cancer. For more information, see bladder treatment with mitomycin C or Bacille Calmette-Guérin (BCG).

Surgery (complete or radical cystectomy)

Removing your bladder and surrounding tissues is the main treatment for muscle-invasive bladder cancer. The operation is called a complete or radical cystectomy. It is usually followed by radiotherapy