Colon cancer facts

Colorectal cancer is a malignant tumor arising from the inner wall of the large intestine.
Colorectal cancer is the third leading cause of cancer in males and fourth in females in the U.S.
Risk factors for colorectal cancer include heredity, colon polyps, and long-standing ulcerative colitis.
Most colorectal cancers develop from polyps. Removal of colon polyps can prevent colorectal cancer.
Colon polyps and early cancer can have no symptoms. Therefore regular screening is important.
Diagnosis of colorectal cancer can be made by barium enema or by colonoscopy with biopsy confirmation of cancer tissue.
Treatment of colorectal cancer depends on the location, size, and extent of cancer spread, as well as the health of the patient.
Surgery is the most common treatment for colorectal cancer.
Chemotherapy can extend life and improve quality of life for those living with colorectal cancer.

What is cancer?

Every day within our bodies, a massive process of destruction and repair occurs. The human body is comprised of about fifteen trillion cells, and every day billions of cells wear out or are destroyed. In most cases, each time a cell is destroyed the body makes a new cell to replace it, trying to make a cell that is a perfect copy of the cell that was destroyed because the replacement cell must be capable of performing the same function as the destroyed cell. During the complex process of replacing cells, many errors occur. Despite remarkably elegant systems in place to prevent errors , the body still makes tens of thousands of mistakes daily while replacing cells either because of random errors or because there are outside pressures placed on the replacement process that promote errors. Most of these mistakes are corrected by additional elegant systems or the mistake leads to the death of the newly made cell, and another normal new cell is produced. Sometimes a mistake is made, however, and is not corrected. Many of the uncorrected mistakes have little effect on health, but if the mistake allows the newly made cell to divide independent of the checks and balances that control normal cell growth, that cell can begin to multiply in an uncontrolled manner. When this happens a tumor (essentially a mass of abnormal cells) can develop.

Tumors fall into two categories; there are benign tumors and malignant (cancerous) tumors. So what is the difference? The answer is that a benign tumor grows only in the tissue from which it arises. Benign tumors sometimes can grow quite large or rapidly and cause severe symptoms, even death, although most do not. For example, a fibroid tumor in a woman's uterus can cause bleeding or pain, but it will never travel outside the uterus and grow as a new tumor elsewhere. Fibroids, like all benign tumors, lack the capacity to shed cells into the blood and lymphatic system, so they are unable to travel to other places in the body and grow. A cancer, on the other hand, can shed cells that can float like dandelion seeds in the wind through the blood or lymphatic system, landing in tissues distant from the primary tumor and growing into new tumors in these distant tissues. This process of spreading to distant tissues, called metastasis, is the defining characteristic of a cancerous tumor.

Cancer often is referred to as a single entity, but in fact, it is a group of more than 100 different diseases, much like infectious diseases. Cancers are named by the tissues from which the first tumor arises. Hence, a lung cancer that travels to the liver is not a liver cancer but is described as lung cancer metastatic to the liver, and a breast cancer that spreads to the brain is not described as a brain tumor but rather as breast cancer metastatic to the brain. Each cancer is a different disease with different treatment options and varying prognoses (likely outcomes). In fact, each individual with cancer has a unique disease, and the relative success or lack thereof of treatment among patients with the same diagnosis may be very different. As a result, it is important to treat each person with a diagnosis of cancer as an individual regardless of the type of cancer.

What is cancer of the colon and rectum?

Picture of colon (colorectal) cancer.
The colon and the rectum are the final portions of the tube that extends from the mouth to the anus. Food enters the mouth where it is chewed and then swallowed. It then travels through the esophagus and into the stomach. In the stomach, the food is ground into smaller particles and then enters the small intestine in a carefully controlled manner. In the small intestine, final digestion of food and absorption of the nutrients contained in the food occurs. The food that is not digested and absorbed enters the large intestine or colon and finally the rectum. The large intestine is about six feet long and acts primarily as a storage facility for waste; however, additional water, salts, and some vitamins are further removed. In addition, some of the undigested food, for example, fiber, is digested by colonic bacteria and some of the products of digestion are absorbed from the colon and into the body. (It is estimated that 10% of the energy derived from food comes from these products of bacterial digestion in the colon.) The remaining undigested food, dying cells from the lining of the intestines, and large numbers of bacteria are stored in the colon and then periodically passed into the rectum. Their arrival into the rectum initiates a bowel movement that empties the colonic contents from the body as stool.

Most of the large intestine rests inside a cavity in the abdomen called the peritoneal cavity. Parts of the colon are able to move quite freely within the peritoneal cavity as the undigested food is passing through it. As the colon heads towards the rectum, it becomes fixed to the tissues behind the peritoneal cavity, an area called the retroperitoneum. The end portion of the large intestine, the part that resides in the retroperitoneum, is the rectum. Unlike much of the rest of the colon, the rectum is fixed in place by the tissues that surround it. Because of its location, treatment for rectal cancer often is different than treatment for cancer of the rest of the colon, as we'll explain later.

Picture of colon cross section.
Although the large intestine is a tube, it is structurally a complicated tube, more like a steel belted radial tire than a garden hose. The tube is comprised of four layers. The first is an inner layer of cells that line the cavity through which the undigested food travels, called the mucosa. The mucosa is attached to a thin second layer, the submucosa, that is attached itself to a layer of muscle, the muscularis. The entire tube is surrounded by fibrous (scar-like) tissue called the serosa. The most common cancers of the large intestine (the type called adenocarcinoma) arise from the mucosa, the inner layer of cells. These cells are exposed to toxins from food and bacteria as well as mechanical wear and tear and are constantly dying off and being replaced. Mistakes (usually a series of mistakes involving genes within the replacement cells) lead to abnormal cells and uncontrolled proliferation of the abnormal cells that give rise to cancer.

What are the causes of colon cancer?

Doctors are certain that colorectal cancer is not contagious (a person cannot catch the disease from a cancer patient). Some people are more likely to develop colorectal cancer than others. Factors that increase a person's risk of colorectal cancer include high fat intake, a family history of colorectal cancer and polyps, the presence of polyps in the large intestine, and inflammatory bowel diseases, primarily chronic ulcerative colitis.

Diet and colorectal cancer

Diets high in fat are believed to predispose people to colorectal cancer. In countries with high colorectal cancer rates, the fat intake by the population is much higher than in countries with low cancer rates. It is believed that the digestion of fat that occurs in the small intestine and the colon leads to the formation of cancer-causing chemicals (carcinogens). Diets high in vegetables and high-fiber foods such as whole-grain breads and cereals contain less fat that produces these carcinogens and may counter the effects of the carcinogens. Both effects would help reduce the risk of cancer.

Colon polyps and colorectal cancer

Doctors believe that most colorectal cancers develop in colorectal polyps. Therefore, removing benign (but precancerous) colorectal polyps can prevent colorectal cancer. Precancerous colorectal polyps develop when chromosomal damage occurs in cells of the inner lining of the colon. The damage produces abnormal cells, but the cells have not yet developed the ability to spread, the hallmark of cancer. Instead, the growing tissue remains localized within the polyp. When chromosomal damage increases further within the polyp, cell growth becomes uncontrolled, and the cells begin to spread, that is, they become cancer. Thus, colon polyps which are initially benign acquire additional chromosome damage to become cancerous.

Ulcerative colitis and colorectal cancer

Chronic ulcerative colitis causes inflammation of the inner lining of the colon. For further information, please read the Ulcerative Colitis article. Colon cancer is a recognized complication of chronic ulcerative colitis. The risk for cancer begins to increase after 8 to 10 years of colitis. The risk of developing colon cancer in a patient with ulcerative colitis also is related to the location and the extent of his or her disease.

Current estimates of the cumulative incidence of colon cancer associated with ulcerative colitis are 2.5% at 10 years, 7.6% at 30 years, and 10.8% at 50 years. Patients at higher risk of cancer are those with a family history of colon cancer, a long duration of colitis, extensive colon involvement with colitis, and those with an associated liver disease, sclerosing cholangitis.

Since the cancers associated with ulcerative colitis have a more favorable outcome when caught at an earlier stage, yearly examinations of the colon often are recommended after 8 years of known extensive disease. During these examinations, samples of tissue (biopsies) are taken to search for precancerous changes in the cells lining the colon. When precancerous changes are found, removal of the colon may be necessary to prevent colon cancer.

Genetics and colorectal cancer

A person's genetic background is an important factor in colon cancer risk. Among first-degree relatives of colon cancer patients, the lifetime risk of developing colon cancer is 18% (a threefold increase over the general population in the United States).

Even though a family history of colon cancer is an important risk factor, a majority (80%) of colon cancers occur sporadically in patients with no family history of colon cancer. Approximately 20% of cancers are associated with a family history of colon cancer. Hereditary colon cancer syndromes are disorders where affected family members have inherited cancer-causing genetic defects from one or both parents. In only 5% of colon cancers due to hereditary, however, have the exact chromosomal abnormalities been identified.

Chromosomes contain genetic information, and chromosomal damage causes genetic defects that lead to the formation of colon polyps and later colon cancer. In sporadic polyps and cancers (polyps and cancers that develop in the absence of family history), the chromosome damages are acquired (develop in a cell during adult life). The damaged chromosomes can only be found in the polyps and the cancers that develop from that cell. But in hereditary colon cancer syndromes, the chromosomal defects are inherited at birth and are present in every cell in the body. Patients who have inherited the hereditary colon cancer syndrome genes are at risk of developing colon polyps, usually at young ages, and are at very high risk of developing colon cancer early in life; they also are at risk of developing cancers in other organs.

Familial adenomatous polyposis (FAP) is one hereditary colorectal cancer syndrome where the affected family members will develop countless numbers (hundreds, sometimes thousands) of colon polyps starting during their teens. Unless the condition is detected and treated early (treatment involves removal of the colon), a person affected by FAP is almost sure to develop colon cancer from these polyps. Cancers almost certainly develop by the time a person is in their 40s. These patients are also at risk of developing other cancers such as cancers in the thyroid gland, stomach, and the ampulla (part of the bile duct that drains into the small intestine from the liver) as well as benign tumors called desmoid tumors. FAP arises from a mutation in a specific gene called the APC gene. The specific mutation can be identified in most people with appropriate testing, and such testing is recommended for individuals diagnosed with FAP as well as their family members.

Attenuated familial adenomatous polyposis (AFAP) is a milder version of FAP. Affected members develop fewer than 100 colon polyps. Nevertheless, they are still at very high risk of developing colon cancers at a young age. They are also at risk of having gastric polyps and duodenal polyps.

Hereditary nonpolyposis colon cancer (also known as Lynch Syndrome or HNPCC) is a hereditary colorectal cancer syndrome where affected family members can develop colon polyps and cancers, usually in the right colon, in their 30s to 40s. Patients with HNPCC are also at risk of developing uterine cancer, stomach cancer, ovarian cancer, and cancers of the ureters (the tubes that connect the kidneys to the bladder), and the bile ducts. Ironically, it appears that while colon cancer occurs more frequently in patients with HNPCC, these cancers may be more easily cured than "sporadic" colon cancers. The specific genetic abnormalities associated with HNPCC have been identified, and patients and family members can be tested to determine if HNPCC is present and if family members carry the abnormality and are likely to develop cancer.

MYH polyposis syndrome is a recently discovered hereditary colorectal cancer syndrome. Affected members typically develop 10 to 100 polyps occurring at around 40 years of age and are at high risk of developing colon cancer. Here, too, the genetic abnormality has been identified.

As time goes by, it is likely that additional hereditary syndromes leading to colon cancer will be identified. Nevertheless, it is important to remember that the overwhelming majority of colorectal cancers do not have a single, identifiable chromosomal abnormality that can be looked for in relatives in order to identify individuals at risk for colorectal cancer.

Cancers of the colon and rectum (colorectal cancer) start when the process of the normal replacement of lining cells goes awry. Mistakes in mucosal cell division occur frequently. For reasons that are poorly understood, sometimes mistakes occur that escape our editing systems. When this occurs, these cells begin to divide independently of the normal checks and balances that control growth. As these abnormal cells grow and divide, they can lead to growths within the colon called polyps. Polyps vary in type, but many are precancerous tumors that grow slowly over the course of years and do not spread. As polyps grow, additional genetic mutations further destabilize the cells and can make the cells more bizarre. When these precancerous tumors change direction (growing through the tube rather than into the middle of it) and invade other layers of the large intestine (such as the submucosa or muscular layer), the precancerous polyp has become cancerous. In most cases this process is slow, taking at least 8 to 10 years to develop from those early aberrant cells to a frank cancer.

Once a colorectal cancer forms, it begins to grow in two ways. First, the cancer can grow locally and extend through the wall of the intestine and invade adjacent structures, making the mass (called the primary tumor) more of a problem and harder to remove. Local extension can cause additional symptoms such as pain or fullness, or cause blockages of the colon or nearby structures. Second, as the cancer grows it begins the process of metastasis, shedding thousands of cells a day into the blood and lymphatic system that can cause cancers to form in distant locations. Colorectal cancers most commonly spread first to local lymph nodes before traveling to distant organs. Once local lymph nodes are involved, spread to the liver, the abdominal cavity, and the lung are the next most common destinations of metastatic spread.

What are the symptoms of colon cancer?

Symptoms of colorectal cancer are numerous and nonspecific. They include fatigue, weakness, shortness of breath, change in bowel habits, narrow stools, diarrhea or constipation, red or dark blood in stool, weight loss, abdominal pain, cramps, or bloating. Other conditions such as irritable bowel syndrome (spastic colon), ulcerative colitis, Crohn's disease, diverticulosis, and peptic ulcer disease can have symptoms that mimic colorectal cancer. For more information on these conditions, please read the following articles: Irritable Bowel Syndrome, Ulcerative Colitis, Crohn's Disease, Diverticulosis, and Peptic Ulcer Disease.

Colorectal cancer can be present for several years before symptoms develop. Symptoms vary according to where in the large intestine the tumor is located. The right colon is spacious, and cancers of the right colon can grow to large sizes before they cause any abdominal symptoms. Typically, right-sided cancers cause iron deficiency anemia due to the slow loss of blood over a long period of time. Iron deficiency anemia causes fatigue, weakness, and shortness of breath. The left colon is narrower than the right colon. Therefore, cancers of the left colon are more likely to cause partial or complete bowel obstruction. Cancers causing partial bowel obstruction can cause symptoms of constipation, narrowed stool, diarrhea, abdominal pains, cramps, and bloating. Bright red blood in the stool may also indicate a growth near the end of the left colon or rectum.

How can colon cancer be prevented?

The most effective prevention for colorectal cancer is early detection and removal of precancerous colorectal polyps before they turn cancerous. Even in cases where cancer has already developed, early detection still significantly improves the chances of a cure by surgically removing the cancer before the disease spreads to other organs. Multiple world health organizations have suggested general screening guidelines. For more specific recommendations, please contact the American Cancer Society at

Digital rectal examination and stool occult blood testing

It is recommended that all individuals over the age of 40 have yearly digital examinations of the rectum and their stool tested for hidden or "occult" blood. During digital examination of the rectum, the doctor inserts a gloved finger into the rectum to feel for abnormal growths. Stool samples can be obtained to test for occult blood (see below). The prostate gland can be examined at the same time for evidence of prostate cancer.

An important screening test for colorectal cancers and polyps is the stool occult blood test. Tumors of the colon and rectum tend to bleed slowly into the stool. The small amount of blood mixed into the stool usually is not visible to the naked eye. The commonly used stool occult blood tests rely on chemical color conversions to detect microscopic amounts of blood. These tests are both convenient and inexpensive. A small amount of stool is smeared on a special card for occult blood testing. Usually, three consecutive stool cards are collected. A person who tests positive for stool occult blood has a 30% to 45% chance of having a colon polyp and a 3% to 5% chance of having a colon cancer. Colon cancers found under these circumstances tend to be small and not to have spread and have a better long-term prognosis.

It is important to remember that having stool tested positive for occult blood does not necessarily mean a person has colon cancer. Many other conditions can cause occult blood in the stool. However, patients with a positive stool occult blood test should undergo further evaluations involving barium enema X-rays, colonoscopies, and other tests to exclude colon cancer and to explain the source of the bleeding. It is also important to realize that stool which has tested negative for occult blood does not mean that colorectal cancer or polyps do not exist. Even under ideal testing conditions, at least 20% of colon cancers can be missed by stool occult blood screening. Many patients with colon polyps do not have positive stool occult blood. In patients suspected of having colon tumors and in those at higher risk for developing colorectal polyps and cancer, screening flexible sigmoidoscopies or colonoscopies are performed even if the stool occult blood tests are negative.

Flexible sigmoidoscopy and colonoscopy

Beginning at age 50, a flexible sigmoidoscopy screening test is recommended every 3 to 5 years. Flexible sigmoidoscopy is an exam of the rectum and the lower colon using a viewing tube (a short version of colonoscopy). Recent studies have shown that the use of screening flexible sigmoidoscopy can reduce mortality from colon cancer. This is a result of the detection of polyps or early cancers in people with no symptoms. If a polyp or cancer is found, a complete colonoscopy is recommended. The majority of colon polyps can be completely removed at the time of colonoscopy without surgery. Recommendations now are that screening colonoscopies instead of screening flexible sigmoidoscopies should be done for healthy individuals starting at ages 50 to 55. Please read the Colon Cancer Screening article.

Patients with a high risk of developing colorectal cancer may undergo screening colonoscopies starting at earlier ages than 50. For example, patients with family history of colon cancer are recommended to start screening colonoscopies at an age 10 years before the earliest colon cancer diagnosed in a first-degree relative or 5 years earlier than the earliest precancerous colon polyp discovered in a first-degree relative. Patients with hereditary colon cancer syndromes such as FAP, AFAP, HNPCC, and MYH are recommended to begin colonoscopies early. The recommendations differ depending on the genetic defect. For example, in FAP colonoscopies may begin during teenage years to look for the development of colon polyps. Patients with a prior history of polyps or colon cancer may also undergo colonoscopies to exclude recurrence. Patients with a long history (greater than 10 years) of chronic ulcerative colitis have an increased risk of colon cancer, and should have regular colonoscopies to look for precancerous changes in the colon lining.

Genetic counseling and testing

Blood tests are now available to test for FAP, AFAP, MYH, and HNPCC hereditary colon cancer syndromes. Families with multiple members having colon cancers, multiple colon polyps, cancers at young ages, and other cancers such as cancers of the ureters, uterus, duodenum, and more, should be referred for genetic counseling, followed possibly by genetic testing. Genetic testing without prior counseling is discouraged because of the extensive family education that is involved and the complicated nature of interpreting the test results.

The advantages of genetic counseling followed by genetic testing include: (1) identifying family members at high risk of developing colon cancer to begin colonoscopies early; (2) identifying high-risk members so that screening may begin to prevent other cancers such as ultrasound tests for uterine cancer, urine examinations for ureter cancer, and upper endoscopies for stomach and duodenal cancers; and (3) alleviating concern for members who test negative for the hereditary genetic defects.

Diet and colon cancer to prevent colon cancer

People can change their eating habits by reducing fat intake and increasing fiber (roughage) in their diet. Major sources of fat are meat, eggs, dairy products, salad dressings, and oils used in cooking. Fiber is the insoluble, nondigestible part of plant material present in fruits, vegetables, and whole-grain breads and cereals. It is postulated that high fiber in the diet leads to the creation of bulky stools which can rid the intestines of potential carcinogens. In addition, fiber leads to the more rapid transit of fecal material through the intestine, thus allowing less time for a potential carcinogen to react with the intestinal lining.

Ovarian cancer facts

Most ovarian growths in women under age 30 are benign, fluid-filled cysts.
There are several types of ovarian cancer.
The exact causes of ovarian cancer are unknown.
Risk factors that increase the chance of developing ovarian cancer include a family history of cancer, being over 55 years of age, and never being pregnant.
The ovarian cancer symptoms and signs can be vague but may include abdominal swelling, pressure, or pain, frequent urination or urinary urgency, back pain, leg pain, unusual vaginal bleeding, and feeling full quickly.
There are no routine screening tests for ovarian cancer.
A physical examination (including pelvic exam), ultrasound, X-rays, the CA 125 blood test, and biopsy of the ovary may be needed to detect and diagnose ovarian cancer and determine staging.
The treatment, prognosis, and survival rate for ovarian cancer depend on the stage of the disease and the age and health of the woman.

What are the ovaries?

The ovaries are part of a woman's reproductive system. They are in the pelvis. Each ovary is about the size of an almond.

The ovaries make the female hormones -- estrogen and progesterone. They also release eggs. An egg travels from an ovary through a fallopian tube to the womb (uterus).

When a woman goes through her "change of life" (menopause), her ovaries stop releasing eggs and make far lower levels of hormones.

What is ovarian cancer?

Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.

Normally, cells grow and divide to form new cells as the body needs them. When cells grow old, they die, and new cells take their place.

Sometimes, this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.

Tumors can be benign or malignant:

Benign tumors are not cancer:

Benign tumors are rarely life-threatening.
Generally, benign tumors can be removed. They usually do not grow back.
Benign tumors do not invade the tissues around them.
Cells from benign tumors do not spread to other parts of the body.
Malignant tumors are cancer:

Malignant tumors are generally more serious than benign tumors. They may be life-threatening.
Malignant tumors often can be removed. But sometimes they grow back.
Malignant tumors can invade and damage nearby tissues and organs.
Cells from malignant tumors can spread to other parts of the body. Cancer cells spread by breaking away from the original (primary) tumor and entering the lymphatic system or bloodstream. The cells invade other organs and form new tumors that damage these organs. The spread of cancer is called metastasis.
Benign and malignant cysts

An ovarian cyst may be found on the surface of an ovary or inside it. A cyst contains fluid. Sometimes it contains solid tissue too. Most ovarian cysts are benign (not cancer).

Most ovarian cysts go away with time. Sometimes, a doctor will find a cyst that does not go away or that gets larger. The doctor may order tests to make sure that the cyst is not cancer.

Ovarian cancer can invade, shed, or spread to other organs:

Invade: A malignant ovarian tumor can grow and invade organs next to the ovaries, such as the fallopian tubes and uterus.
Shed: Cancer cells can shed (break off) from the main ovarian tumor. Shedding into the abdomen may lead to new tumors forming on the surface of nearby organs and tissues. The doctor may call these seeds or implants.
Spread: Cancer cells can spread through the lymphatic system to lymph nodes in the pelvis, abdomen, and chest. Cancer cells may also spread through the bloodstream to organs such as the liver and lungs.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original tumor. For example, if ovarian cancer spreads to the liver, the cancer cells in the liver are actually ovarian cancer cells. The disease is metastatic ovarian cancer, not liver cancer. For that reason, it is treated as ovarian cancer, not liver cancer. Doctors call the new tumor "distant" or metastatic disease.

What are risk factors for ovarian cancer?

Doctors cannot always explain why one woman develops ovarian cancer and another does not. However, we do know that women with certain risk factors may be more likely than others to develop ovarian cancer. A risk factor is something that may increase the chance of developing a disease.

Studies have found the following risk factors for ovarian cancer:

Family history of cancer: Women who have a mother, daughter, or sister with ovarian cancer have an increased risk of the disease. Also, women with a family history of cancer of the breast, uterus, colon, or rectum may also have an increased risk of ovarian cancer. If several women in a family have ovarian or breast cancer, especially at a young age, this is considered a strong family history. If you have a strong family history of ovarian or breast cancer, you may wish to talk to a genetic counselor. The counselor may suggest genetic testing for you and the women in your family. Genetic tests can sometimes show the presence of specific gene changes that increase the risk of ovarian cancer.
Personal history of cancer: Women who have had cancer of the breast, uterus, colon, or rectum have a higher risk of ovarian cancer.
Age over 55: Most women are over age 55 when diagnosed with ovarian cancer.
Never pregnant: Older women who have never been pregnant have an increased risk of ovarian cancer.
Menopausal hormone therapy: Some studies have suggested that women who take estrogen by itself (estrogen without progesterone) for 10 or more years may have an increased risk of ovarian cancer.
Scientists have also studied whether taking certain fertility drugs, using talcum powder, or being obese are risk factors. It is not clear whether these are risk factors, but if they are, they are not strong risk factors.

Having a risk factor does not mean that a woman will get ovarian cancer. Most women who have risk factors do not get ovarian cancer. On the other hand, women who do get the disease often have no known risk factors, except for growing older. Women who think they may be at risk of ovarian cancer should talk with their doctor.

Ovarian cancer symptoms

Early ovarian cancer may not cause obvious symptoms. But, as the cancer grows, symptoms may include:

Pressure or pain in the abdomen, pelvis, back, or legs
A swollen or bloated abdomen
Nausea, indigestion, gas, constipation, or diarrhea
Feeling very tired all the time
Less common symptoms include:

Shortness of breath
Feeling the need to urinate often
Unusual vaginal bleeding (heavy periods, or bleeding after menopause)
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.

How is ovarian cancer diagnosed?

If you have a symptom that suggests ovarian cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor may ask about your personal and family medical history.

You may have one or more of the following tests. Your doctor can explain more about each test:

Physical exam: Your doctor checks general signs of health. Your doctor may press on your abdomen to check for tumors or an abnormal buildup of fluid (ascites). A sample of fluid can be taken to look for ovarian cancer cells.
Pelvic exam: Your doctor feels the ovaries and nearby organs for lumps or other changes in their shape or size. A Pap test is part of a normal pelvic exam, but it is not used to collect ovarian cells. The Pap test detects cervical cancer. The Pap test is not used to diagnose ovarian cancer.
Blood tests: Your doctor may order blood tests. The lab may check the level of several substances, including CA-125. CA-125 is a substance found on the surface of ovarian cancer cells and on some normal tissues. A high CA-125 level could be a sign of cancer or other conditions. The CA-125 test is not used alone to diagnose ovarian cancer. This test is approved by the Food and Drug Administration for monitoring a woman's response to ovarian cancer treatment and for detecting its return after treatment.
Ultrasound: The ultrasound device uses sound waves that people cannot hear. The device aims sound waves at organs inside the pelvis. The waves bounce off the organs. A computer creates a picture from the echoes. The picture may show an ovarian tumor. For a better view of the ovaries, the device may be inserted into the vagina (transvaginal ultrasound).
Biopsy: A biopsy is the removal of tissue or fluid to look for cancer cells. Based on the results of the blood tests and ultrasound, your doctor may suggest surgery (a laparotomy) to remove tissue and fluid from the pelvis and abdomen. Surgery is usually needed to diagnose ovarian cancer. To learn more about surgery, see the "Treatment" section.
Although most women have a laparotomy for diagnosis, some women have a procedure known as laparoscopy. The doctor inserts a thin, lighted tube (a laparoscope) through a small incision in the abdomen. Laparoscopy may be used to remove a small, benign cyst or an early ovarian cancer. It may also be used to learn whether cancer has spread.

A pathologist uses a microscope to look for cancer cells in the tissue or fluid. If ovarian cancer cells are found, the pathologist describes the grade of the cells. Grades 1, 2, and 3 describe how abnormal the cancer cells look. Grade 1 cancer cells are not as likely as to grow and spread as grade 3 cells.

The Deadliest Skin Cancer, Melanoma

Melanoma is a cancer that develops in melanocytes, the pigment cells present in the skin. It can be more serious than the other forms of skin cancer because it may spread to other parts of the body (metastasize) and cause serious illness and death. About 50,000 new cases of melanoma are diagnosed in the United States every year.Because most melanomas occur on the skin where they can be seen, patients themselves are often the first to detect many melanomas. Early detection and diagnosis are crucial. Caught early, most melanomas can be cured with relatively minor surgery.

This is the deadliest form of skin cancer that develops in the melanocytes which are pigment cells present in the skin. Melanoma develops when unrepaired DNA damage caused by the sun's ultraviolet rays or tanning beds triggers a genetic defect or mutation. This mutation causes the skin cells to multiply rapidly forming malignant tumors. Melanoma can also form in the colored part of the eye and very rarely internal organs like the intestines.

Melanoma occurs when there are changes in pigment producing cells of the body called melanocytes. Melanocytes produce melanin which is responsible for skin and hair color. These changes disrupt the orderly manner in which skin cells form (new skin cells push older skin to the skin surface which die and fall off) and make the skin cells grow rapidly and out-of-order. The disorderly skin cell formation is what eventually develop into a mass of cancerous tissues. Melanocytes produce melanin which is responsible for skin and hair color. Melanoma often begins as a mole but it may also come in the form of a skin discoloration (red, pink, blue, purple or white).
Stages of melanoma
Melanoma has 5 stages. Staging is based on thickness of the lesion, depth of penetration and how far it has spread.
Stage 0 - This type of melanoma is confined to the epidermis. It has not yet reached the dermis
Stage I - This has two subclasses. It is characterized by the thickness of the tumor, presence and number of mitosis and status of any ulceration
Stage II - This has 3 subclasses. It is characterized by the tumor thickness and the status of ulceration. There is usually no distance or lymph node metastasis at this stage.
Stage III - This stage has 3 subclasses and its characterized by lymph node metastasis. There is no distant metastasis at this stage.
Stage IV - This has no subclasses. It is characterized by the location of distance met
Treatment of melanomas depend on the stage of the cancer, your age and other medical condition. Usually early detection requires surgery to remove the cancer and surrounding tissue. The depth of the cancer is taken into consideration when removing the surrounding tissues. If the cancer has spread to the lymph nodes, they will be taken out. Surgery is normally the only type of treatment required for early melanomas.
For advanced cases, the solution here is to shrink the tumor and make the patients as comfortable as possible. These may include;
Chemotherapy - These drugs can be given intravenously, in the form of a pill or where necessary both ways. Chemotherapy kills the cancer cells.
Radiation - These use high energy beams to relieve pain and discomfort caused by cancer that has spread.
Biological therapy - Medications like interferon or interleukin are used to boost your immune system to fight the disease.
Surgery - This is also done when the cancer has spread to relieve pain and discomfort


Dermatologists and Skin Cancer Treatment Options

Patients know that when dermatologists mentions skin cancer, it is time to to sit up and pay attention. Even if they receive reassurances that everything is okay and the issue can be addressed right away, it makes sense to take action before things are able to progress. The first step is diagnosing the issue and beginning the prescribed treatment as soon as possible.

When dermatologists suspect basal cell and squamous cell carcinomas, one of the first options is to have it removed. Then a curette can be used to scrape away remnants. This scraping tool removes not only the cancerous cells but also some of the healthy skin that surrounds it. The goal is obvious to take more than necessary instead of not taking enough and needing to go back and revisit the issue. For smaller areas, the work can be done in the office and a local anesthetic is sufficient.
Dermatologists can also choose to freeze the cancer cells with liquid nitrogen. While the technical term is cryosurgery, it is a fairly simple procedure. Once the area has thawed out, the dead tissue comes off easily. This procedure can also be done in the medical office and handled in just one appointment. It may be necessary to come back in for a follow up to recheck the area.
Other Surgical Procedures
Sometimes skin cancer reoccurs in the same area despite all of the effort to remove it. When that happens, it may be time to take more serious action and set up and appointment for something like a Mohs surgery. Instead of just scraping out the entire area, dermatologists can pull off each layer of skin and take a closer look to ensure that there are no abnormal cells left. There is no need to take out any healthy skin, making it a very precise operation.
When patients hear about chemotherapy, they have a very specific image in their minds. Today's treatment for skin cancer often involves creams or lotions that can be applied to the area. This will only be effective on a specific area. If the cancer spreads, a more aggressive form of chemotherapy may be necessary and dermatologists often have to refer their patients to other specialists for help.
Photodynamic Therapy (PDT)
A popular alternative to other treatments is photodynamic therapy. It can treat a large amount of skin all at the same time. With a mix of lasers and medication, the skin cancer cells are destroyed. While patients feel confident that they have a clean bill of health once the treatment is complete, the skin remains sensitive to light and it requires that individuals limit their direct sunlight for at least six weeks.


Can Tattoo Inks Cause Skin Cancer?

It seems today most people obtaining tattoos are more concerned about the quality of the tattoo and the effect of aging altering the tattoo, than any potential long term health risks. The health dangers associated with being injected by hundreds of needles into the dermis or the inner layer of the skin are widely publicised and most tattoo artists take these issues very seriously. We have all heard about Aids and Hep C, but are you aware of the current debate on the possible skin cancer risks associated with tattoo inks?

Recent years have seen an increase in stories associated with the potential of getting skin cancer from tattoo inks. Limited studies taken to date have not confirmed a direct link between cancer and tattoo inks..
Phthalates and other chemical ingredients used in tattoo inks have raised questions about the long term risks on our health such as skin cancer.It has been reported that some forms of phthalates are believed to have the potential to disrupt testosterone or mimic estrogen. Phthalate exposure has been identified to possible sperm defects and altered thyroid hormones. The phthalates in tattoo inks are believed to be cleared from the body within hours unlike many other forms of phthalate exposure. A study reported that Phthalates applied to the skin in a lotion were absorbed and metabolised and the same thing is likely to happen with the phthalates in tattoo inks. It would be well advised for pregnant and nursing women to avoid any exposure to phthalates.
Injecting tattoo inks, containing exogenous pigments, into the dermis creates a unique situation, due to the large amount of metallic salts and organic dyes remain in the skin for a lifetime. The potential carcinogenic risks of tattoo inks remain debatable. Several studies have identified the presence of potential carcinogenic or procarcinogenic products in tattoo inks.One chemical commonly used in black tattoo ink called benzo(a)pyrene is known to be a potent carcinogen that causes skin cancer in animal tests. As tattooing injects inks such asbenzo(a)pyrene directly into the dermis damaging the skin. You could conclude it may contribute to skin cancer.
Scientists and health professionals continue to debate the possible link between tattoo inks and cancer. In the last forty years there have only been 50 documented cases of squamous cell carcinoma, malignant skin melanoma or basal cell carcinoma with possible connections to tattoos, compared to the millions of tattoos obtained. Epidemiological studies on the effects of tattoo ink could be taken, although they would not be easy. A large number of tattooed people would have to be monitored over a long period of time to see whether they developed problems such as skin cancer near their tattoos. The low number of reported skin cancers arising in tattoos could be considered coincidental.
Further in depth studies will need to be carried out to give more conclusive evidence on the effects of tattoo ink and the cancer risks associated. The FDA is growing more concerned about the ingredients in tattoo ink. In the early 2000's, the FDA received a large number of complaints associated with giving and receiving tattoos. Since then the FDA has commenced more research into the chemical components of tattoo inks. The FDA is investigating how the body breaks down the tattoo ink as it fades over time. Is the body absorbing the ink or is it fading from sun exposure? A common pigment in yellow tattoo inks, Pigment Yellow 74, is believed to be a risk of being broken down by the body.
When skin cells containing tattoo inks are killed by sunlight or laser light, the tattoo inks break down and could possibly spread throughout the body. It is believed that tattoo inks could spread into lymph nodes whether this has unknown health concerns or not is still unknown. Our lymph nodes filtering out disease-causing organisms any interference in that process could have devastating effects on our health.
It is recommended not to have a tattoo placed too close to a mole. Changes occurring in a mole such as asymmetry, border, color, size, shape, texture are all warning signs of a possible melanoma or another skin cancer. Ensure all moles are left completely visible to prevent possible delays in detecting any changes. When a melanoma is discovered early it is usually curable where as more advanced melanomas are far harder to cure. A tattoo covering a mole could delay detection and be extremely dangerous even life threatening. If you get a tattoo, make sure it is placed a good distance from any mole. This is especially important for people who have multiple moles or dysplastic nevus (atypical mole) syndrome, due to the increased risk of developing melanoma, potentially within one of their moles.
It's imperative to be extremely diligent in caring for our skin correctly after a tattoo and monitor any changes that may occur to the skin. Our skin is the largest organ of the body and has many important functions. It protective us against injury and disease, regulates our temperature and maintains our bodies hydration. There are three layers to our skin the first layers is the epidermis the outer layer of the skin. The second layer is the dermis or the inner layer and the third layer is the subcutaneous fat layer.
Cancer is a disease of the body's cells. Normally the body's cells grow and divide in an orderly fashion. Some cells may grow and divide abnormally growing into a lump, a tumour. Tumours can be non-cancerous (benign) or cancerous (malignant). Benign tumours do not spread to other parts of the body. Cancer cells in a malignant tumour have the ability to spread to over areas in the body, if left untreated. These cells can destroy surrounding tissue and break away from the original cancer, affecting other organs in the body. These cells can then form another tumour referred to as a secondary cancer.
Skin cancer begins in the basal layer of the epidermis. There are three main types of skin cancer basal cell carcinoma; squamous cell carcinoma and melanoma. Melanomas start in the pigment cells while basal and squamous cell carcinomas develop from the epidermal cells. Basal cell carcinomas are the most common but least dangerous type of skin cancer. They grow slowly but if left untreated, a deep ulcer can occur. Fortunately they very rarely spread to other parts of the body. Basal cell carcinomas are most commonly found on the face, neck and upper trunk. They appear as a lump or scaly area and are pale, pearly or red in colour. Squamous cell carcinomas are less common but more dangerous. They typically grow over a period of weeks to months. These cancers may spread to other parts of the body if not treated immediately. Squamous cell carcinomas appear on areas of skin most often exposed to the sun. They have scaling, red areas which may bleed easily and ulcerate, looking like an unhealing sore. The major cause of these skin cancers is sun exposure for years. Melanoma is the rarest but most dangerous skin cancer. It is often a fast growing cancer which if left untreated can spread quickly to other parts of the body to form secondary cancers. Melanomas can appear anywhere on the body. The first sign of a melanoma is usually a change in a freckle or mole, or the appearance of a new spot. Changes in size, shape or colour are normally seen over a period of several weeks to months. Melanoma typically appears from adolescence onwards, most commonly seen between 30 and 50 years of age.
Any sign of a crusty, non-healing sore, a small lump which is red, pale or pearly in colour, or a new spot, freckle or mole changing in colour, thickness or shape over a period of several weeks to months. Any spots that range from dark brown to black, red or blue-black should be checked by a doctor immediately. A very high per cent of basal and squamous cell carcinomas that are found and treated early are cured.
If you have any concerns regarding the health of your skin or tattoo seek professional medical advice immediately, it's better to be safe than sorry.


Types, Symptoms and Treatment of Skin Cancer

Skin cancer is one of the most common cancers that affects individuals throughout the world. Like all other types of cancer, it is better to diagnose this condition early. This is because early diagnosis and treatment could mean the difference between life and death. Unfortunately, most people do not know the types or symptoms of this type of cancer and they always realize that they have the disease when it is too late.

There are three main types of skin cancer based on the layer of the skin that the cancer affects. The first type is Basal cell carcinoma or BCC which attacks the basal cells of the epidermis. The second type is the Squamous cell carcinoma or SCC which affects the epidermal layer of the skin. The third and most dangerous type is the melanoma which affects the melanocytes present in the lower part of the epidermal layer.
The symptoms of cancer also vary depending on the type of cancer. Sometimes, the individual may notice a scaly patch on their skin which is itchy or very uncomfortable. Such patches are usually more common in areas of the skin that are exposed to sunlight most of the time. These patches may sometimes begin to bleed or develop into an ulcer. Such a symptom should never be ignored as this could be the early stages of SCC cancer development. Anyone who notices this on their skin should quickly visit a hospital in order to ensure that the ulcer is treated before cancer develops.
A symptom of BCC cancer is the development of lumps and bumps on the skin which become infected. These bumps may form crusts that begin to bleed and this could be a sign of cancer development. The patient should not hesitate to visit a doctor as soon as they notice these symptoms so that they can begin treatment immediately.
Melanoma is the severest form of skin cancer and it can prove to be deadly. One of the earliest symptoms of this cancer is the development of a mole on the skin. These moles may be brownish or red in color. An individual who already had a mole on their skin may notice that the asymmetry, border, color or even the diameter of the mole has changed. The area around may become itchy or painful and this should be a cause for concern. If there is redness, itchiness or tenderness around skin markings, the individual should visit a practitioner in order to rule out the onset of cancer.
Treatment of cancer also depends on the type of skin cancer that the patient is suffering from. SCC and BCC are less severe and they are not likely to spread to other organs in the body. Therefore, the individual can be able to receive localized treatment that will help them to get rid of the cancer cells. However, melanoma is quite severe and the treatment is more systematic. This is because melanoma is very dangerous and there is usually a chance that the cancer will spread to other internal cells and organs in the body. However, for all types of cancer, the patient who is able to get to a doctor during the early stages will have a better chance of treatment. Therefore, individuals should take note of the symptoms so that they can stop the development of cancer cells before they take over their skin.
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Skin Cancer: Warning Signs, Prevention and Self-Examination

Skin cancer comes in three forms, but the two most common - which correspond to 90% of all cases - are the Basal Carcionoma and the Squamous. The third form of skin cancer is known and Malignant Melanoma and, as its own name suggests, this type of skin cancer is the most dangerous beyond them all. It can disseminate threw the whole body, leading to death.

Luckily, the chances of cure in all cases are of practically 100% if the disease is detected in time for adequate treatment. Therefore it is extremely important to avoid the contraction of skin cancer and beware for warning signs and symptoms. This is why you should include in your routine three fundamental habits:
1. Regular use of sunscreen, both in physical and chemical forms;
2. Take care for exaggerated sun exposure and artificial tanning procedures;
3. Self-examination for skin cancer symptoms and immediate consult with your dermatologist in case of any alteration on moles, signs and any skin spots you may have;
Over-exposing your body to UV radiation not only damages your skin, but may also harm your eyes, lower your organism's defenses and cause premature aging. It is important to note that nobody is free of the possibility to develop skin cancer or other diseases due to excessive sun exposure. However, the risks are higher for those who fit into at least one of the following features:
• Light-skinned people;
• Family history of skin cancer or previous personal experiences;
• Chronic sun exposure;
• History of severe sunburns during infancy and/or adolescence;
• People who have a great number of freckles and other skin signs.
Warning Signs
Skin cancer may be detected early because of the symptoms shown on the skin. By self-examining yourself, beware for the following signs:
• New wounds or alterations such as: growth of the wound and a "pearl" aspect. They might be semi-transparency, brown, red, pink our multicolored.
• Alterations in skin signs, such as: change of color and/or texture and alterations on its borders, leaving them with and irregular shape, and growth.
• Itchiness and signs that bleed, heal and, after a while, reappear;
• Rough skin areas;
• Redness and swelling of a sign;
• New signs appearing after the age of 21.
Remember your ABCD:
• A - Asymmetry: If you trace a straight line right at the middle of a benignant sign, their half's will be practically equal; in a malignant sign, it won't.
• B - Border: a benignant sign has regular shapes and forms. The malignant signs are irregular in their shapes, forms and textures.
• C - Color: the benignant signs are normally brown and uniform; malignant signs may have a brown-and-black coloration and sometimes may be red, white and even blue.
• D - Diameter: a malignant sign is normally bigger than a pencil's diameter.
How to self-examine your skin for skin cancer
One in every five American men develop skin cancer, hence the importance of the self-examination. Combined with an annual consult with your dermatologist, the self-exam for skin cancer made every trimester is the best method to detect the first alterations. Look for signs and any other alterations in your skin. You'll have to do this in a bright room, with the use of a handy mirror and a chair. Follow the instructions below:
1. Examine your head and face, scalp and palpate the lymph nodes of your neck.
2. Examine your hands, including fingernails. Don't forget your elbows and arms.
3. Examine your thorax and back. Women should also examine the area below the breasts.
4. Facing backwards to a bigger mirror use your handy mirror to inspection the back of your neck, buttocks, arms, back, thighs and legs.
5. Seated, examine your legs and feet, including fingernails. Use your handy mirror to examine the genitals.
Follow the instructions below and prevent skin cancer:
• Limit your time of sun exposure and avoid the sun between 10h and 15h;
• Use hats and appropriate clothes;
• Use sunscreen on a regular basis with protection above 15 UPS. When exposed daily to sunlight, reapply every two hours;
• Avoid artificial tanning;
• Keep your kids out of the sun. Sunscreen may be used in children above six months old.