Brain Cancer - Symptoms- treatment- prevention - Early detection can cure

 There are cancers ofthe brain. Understandably, because of fear of disease that affects our brain and the fear about cancer, people don't like to hear the phrase "cancer of the brain." So we speak in the medical profession of gliomas and astrocytomas and the lay person talks about brain tumor. There are many types of growths that affect the brain, everything from circumscribed, completely benign tumors to the dreaded cancerous glioma. 

Once a space-occupying lesion in the brain is diagnosed, the doctor sees the out- look in terms of the information pro- vided by special x-rays and radiation scan tests that determine location and size of the tumor. A repeat of these observations provides information about the rate of growth of the mass. A malignant growth usually grows faster than a benign one. In most cases, there must be operation-and there is that moment of prayer when the surgeon reaches the growth and learns whether it is benign or cancerous.

If cancerous, the situation is more ominous than in other organs where the surgeon usually can excise the cancer and surrounding suspicious tissue. There are limitations in the brain because death or massive paralysis might be the result of too extensive surgery. Striking advances have been made in the treatment of some cancers for which there was once very little hope. For choriocarcinoma of the uterus, for example, treatment with methotrexate and actinomycin D now is producing long-term remission in nearly 75 percent of patients; and many children with tumor, a cancer of the kidney, are responding to actinomycin D. These results provide hope that increasingly effective chemical agents will be found for other cancers.

RADICAL SURGERY FOR SECONDARY PREVENTION

 There is some division of opinion among surgeons about how far to go in removing widespread cancer. Most surgeons try to get the primary growth and adjacent lymph nodes. A school of more radical surgeons believes that even important organs should be sacrificed if permanent cure may be possible with extensive surgery. For example, if cancer of the uterus has invaded the adjacent urinary bladder, more conservative surgeons would feel that the spreading cancer has already invaded other body areas and only palliation by radiation and chemical treatment is feasible. 

A radical surgeon, however, might hope that the cancer had invaded only organs in the pelvic area and might remove the uterus and bladder, and implant the urethras (which ordinarily connect bladder and kidney) into the colon to permit urine to drain into the fecal stream. Or suppose a cancer of the colon has been found to have spread to the liver. On the chance that there has been no spread beyond this, a radical surgeon might remove thecancer in the colon and then operate on the liver to remove all cancerous nodules there that he can see. 

Obviously, the rate of cure of widespread cancers by surgery is not high, but radical surgeons reason that even one life in a dozen saved is worth the gamble and effort. When a patient has to decide about radical surgery, he should discuss the problem openly with his family doctor, who can be objective and weigh the pros and cons. 

Cancer - Causes- symptoms- treatment -Tips to Prevent it

 Chemicals can cause cancer, and workers handling them should learn the safety rules as a means of primary prevention. Historically, it is interesting that one of the first chemically induced cancers to be noticed by doctors was in chimney sweeps whose contact with the tarry material in the chimneys led to cancers of the scrotum. 

Chromate chemicals today can cause lung cancer; aniline dyes can cause bladder cancer; asbestos can lead to cancers of the outer lining of the lungs or the intestinal cavity. Some 500 chemicals have been found to cause cancers in experimental animals. One of these, which were widely used as an artificial sweetener, cyclamate, was restricted after animal experiments produced cancers and led to fear that humans using it in large quantities over long periods might develop cancer. 

An additional reason for prevention of chronic liverdisease (page 611) is the tendency of this disease to allow cancer to be superimposed. Patients with ulcerative colitis need careful scrutiny because of their higher risk of developing cancer of the diseased colon. Secondary Prevention Once cancer is found, much can be done to prevent it from becoming a fatal illness. As we have indicated, cancer can be a curable disease. When the doctor discovers a lump in a breast or sees a suspicious sore on a lip, he must make a definitive diagnosis.

Usually this is possible only through removal of part or all of the suspicious area-biopsy- so a pathologist can examine it microscopically as well as grossly. If the diagnosis is cancer, then the physician considers the outlook for the patient in terms of localization versus metastasis or spread. If there has been spreading, the outlook is much less hopeful than if the cancer is still confined to the area of origin. For example, a breastcancer which has not spread to lymph nodes in the arm- pit offers a 70 percent or better chance for cure. 

If there has been a single metastasis, the chance for cure may drop to 50 percent. If there have been several metastases, the likelihood of living five years may drop to about 25 percent. Similarly, for example, a kidney cancer that has spread to a bone has a much more ominous outlook than one that is still confined to the kidney.

With metastasis, treatment usually depends upon radiation and chemicals, often less likely to provide permanent cure than when a surgeon can remove an entire intact growth at its primary site. Thus, early detection is the key to effective secondary prevention in cancer. Cancer in early stages rarely makes its presence known by such general symptoms as fever or loss of weight. It does, however, often provide local signals such as a painless lump in the breast or bleeding in stomach or rectum. 

Cardinal signs of cancer are lumps or sores that do not heal; bleeding from any part of the body when there is no obvious explanation for the bleeding; chronic hoarseness; chronic cough; unexplained stomach or intestinal symptoms such as constipation, diarrhea, nausea, vomiting, "indigestion"; unexplained pain; jaundice; impaired vision; convulsions; possibly headache.