Cancer overview

Cancer overview

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Cancer is the name given to any illness caused by the abnormal growth of cells in your body. Someone is diagnosed with cancer in the Nigeria every two minutes. There are around 293,000 new cases diagnosed in Nigeria each year and more than 200 types of cancer. Breast, lung, bowel and prostate cancer are the most common of the illness, together accounting for over half of new cancers each year. Cancer symptoms vary widely based on the type of cancer but typical treatment includes chemotherapy, radiation and surgery. If you''re considering complementary cancer treatments, discuss this with your doctor as they may interact with other cancer treatments.

Cancer Health Centre

Understanding cancer - symptoms

What are the symptoms of cancer?

In its early stages, cancer usually has no symptoms, but eventually a malignant tumour will grow large enough to be detected. As it continues to grow, it may press on nerves and produce pain, penetrate blood vessels and cause bleeding, or interfere with the function of a body organ or system.

The seven warning signs of cancer

To remember the seven early warning signs of cancer, think of the word
CAUTION:
Change in bowel or bladder habits.
A sore that does not heal.
Unusual bleeding or discharge.
Thickening or lump in the breast, testicles, or elsewhere.
Indigestion or difficulty swallowing.
Obvious change in the size, colour, shape, or thickness of a wart, mole, or mouth sore.


Nagging cough or hoarseness.


The following symptoms may also signal the presence of some form of cancer:

  • Persistent headaches
  • Unexplained loss of weight or appetite
  • Chronic pain in bones
  • Persistent fatigue, nausea, or vomiting
  • Persistent low-grade fever, either constant or intermittent
  • Repeated instances of infection


Seek advice from your APLIE health pharmacist about any worries you have concerning cancer & if:


You develop symptoms that may signal cancer, that are not clearly linked to another cause, and persist for more than two weeks. You should arrange to have a medical examination. If the cause of your symptoms is cancer, early diagnosis and treatment will offer a better chance of being cured.
Types of Cancer:


Types of cancers

Common treatments

1) Breast cancer health centre

Breast cancer overview

Breast cancer is the most common type of cancer among women. About 45,000 cases are diagnosed every year. Often, there are no symptoms of breast cancer, but signs of breast cancer can include a breast lump or an abnormal mammogram. Breast cancer stages range from early, curable breast cancer to metastatic breast cancer, with a variety of breast cancer treatments. In addition, around 300 men in the UK are diagnosed with breast cancer every year, and male breast cancer must be taken seriously.

Overview & facts

Is what you know about breast cancer based on facts or fear? End worry by learning about breast cancer causes, risk factors, symptoms, and prevention.

What is breast cancer?

Breast cancer facts : this is a link to below info

Read a detailed description of breast cancer.

Understanding breast cancer - the basics

What is breast cancer?

Before discussing breast cancer, it''s important to be familiar with the anatomy of the breast. The normal breast consists of milk-producing glands that are connected to the surface of the skin at the nipple by narrow ducts. The glands and ducts are supported by connective tissue made up of fat and fibrous material. Blood vessels, nerves, and channels to the lymph nodes make up most of the rest of the breast tissue. The breast, all the things just mentioned, sit under the skin but on top of the chest muscles.

As in all forms of cancer, the abnormal tissue that makes up breast cancer is the patient''s own cells that have multiplied uncontrollably. Those cells may also travel to locations in the body where they are not normally needed, which means the cancer is malignant.

Breast cancer develops in the breast tissue, primarily in the milk ducts (ductal carcinoma) or glands (lobular carcinoma). The cancer is still called and treated as breast cancer even if it is first discovered after travelling to other areas of the body such as the lungs, liver, or bones. In those cases, the cancer is referred to as metastatic or advanced breast cancer.

Breast cancer usually begins with the formation of a small, confined tumour (lump) and then spreads through channels to the lymph nodes or through the blood stream to other organs. The tumour may also grow and invade tissue around the breast, such as the skin or chest wall. Different types of breast cancer grow and spread at different rates, some take years to spread beyond the breast while other move quickly.

Some lumps are benign (not cancerous). The only safe way to distinguish between a benign lump and cancer is to have the tissue examined by a doctor.

Men can get breast cancer too, but they account for just 1% of all cases. Among women, breast cancer is the most common cancer and the second leading cause of cancer deaths behind lung cancer. It affects about one in every nine women. Most women with breast cancer are over the age of 50. Fortunately, breast cancer is very treatable if detected early. Localised tumours can usually be treated successfully before the cancer spreads. Overall, in England and Wales, 80 out of every 100 people diagnosed with breast cancer live for at least 5 years after diagnosis. About 72 out of every 100 people live for at least 10 years. The figures for Scotland are very similar. Experts usually consider a five year survival to be a cure although late recurrences do occur.

Once the cancer begins to spread, getting rid of it completely is more difficult, although treatment can often control the disease for years. Around 90% of women diagnosed with stage one breast cancer survive beyond five years. This drops to around 10% diagnosed with stage four breast cancer.

Learn about the healthy, normal breast and breast anatomy in this brief article.

Breast cancer: The normal breast

Each breast has 15 to 20 sections, or lobes, that surround the nipple like spokes on a wheel. Inside these lobes are smaller lobes, called lobules. At the end of each lobule are tiny "bulbs" that produce milk. These structures are linked together by small tubes called ducts, which carry milk to the nipples.

The nipple is in the centre of a darker area of skin called the areola. The areola contains small glands, called Montgomery glands, which lubricate the nipple during breastfeeding. Fat fills the spaces between the lobes and ducts. There are no muscles in the breasts, but the pectoral or chest muscles lie under each breast and cover the ribs.

Each breast also contains blood vessels, as well as vessels that carry a fluid called lymph. Lymph travels throughout the body through a network called the lymphatic system, carrying cells that help the body fight infections. The lymph vessels lead to the lymph nodes (small, bean-shaped glands).

One group of lymph nodes is located in the armpits, above the collarbone and in the chest. If breast cancer has reached these nodes, it may mean that cancer cells have spread to other parts of the body via the lymphatic system. Lymph nodes are also found in many other parts of the body.

Breast development and function depend on the hormones oestrogen and progesterone, which are produced in the ovaries. Oestrogen elongates the ducts and causes them to create side branches. Progesterone increases the number and size of the lobules in order to prepare the breast for nourishing a baby.

After ovulation, progesterone makes the breast cells grow and blood vessels enlarge and fill with blood. At this time, the breasts often become engorged with fluid and may be tender and swollen.

Causes

It’s often hard to say exactly what causes a person’s cancer. But some factors are associated with breast cancer. Read more about them here.

BMJ Group Medical Reference

Introduction

Many women who get breast cancer say it changes their life. Most women cope better with their illness and have a better quality of life if they learn about their breast cancer and are involved in making decisions about their treatment.

We''ve brought together the best research about breast cancer and weighed up the evidence about how to treat it. You can use our information to talk to your doctor and decide which treatments are best for you.

It can be devastating to be told that you have breast cancer. The condition is so common that you may already know at least one woman who has it. But you can still feel frightened and alone when you''re the one who has been diagnosed with breast cancer.

Getting breast cancer will undoubtedly change your life. We know from women with breast cancer that, although you''ll feel shocked, you''ll probably want to learn about your condition. Many women with breast cancer also say that, once the shock fades, they often appreciate life more and feel more positive and optimistic.

Key points for women with breast cancer

  • More women live with breast cancer than die from it.
  • Breast cancer is the most common cancer among women.
  • Each generation of women has a better chance of surviving breast cancer than their mothers'' generation.
  • Different women will have different treatments, depending on what type of breast cancer they have and how they feel about the treatments.
  • Early breast cancer can usually be cured.
  • There are two main types of treatments for breast cancer. Treatment that just affects your breast, such as surgery and radiotherapy, and whole-body treatment, such as chemotherapy and hormone treatment.
  • Breast-conserving surgery (which removes only some of your breast) often works just as well as a mastectomy (which removes all of your breast).

Your breasts

To understand how breast cancer starts and how it is treated, it helps to know about your breasts.

In women, the breast is designed to make milk for babies. Milk is made in parts of your breast called lobules. Milk drains into the nipple through thin tubes, called ducts.

  • The space between the lobules and milk ducts is filled with supporting tissue (called connective tissue).
  • A layer of fat surrounds the connective tissue and lies between the milk-producing parts of the breast and the skin.
  • This layer of fat contains blood vessels (which carry oxygen and food to the cells of the breast) and lymph vessels (which carry a fluid, known as lymph, back into the bloodstream). To read more, see What are lymph vessels?
  • The part of the breast that is most likely to get a disease is the part that includes the lobule and the last drain duct (known as the terminal duct lobular unit).

Are you at risk?

Doctors don’t always know why breast cancer starts, but some risk factors stand out. Read an overview. The below info are only seen when the above blue highlighted heading is clicked.

Breast cancer is the most common type of cancer among women. Around one in nine women are affected by breats cancer in their lifetime. Approximately 46,000 cases are diagnosed every year, most often in women who are over 50 years old.

What are the risk factors of breast cancer?

A risk factor is anything that increases a person''s chance of getting a disease. Different cancers have different risk factors.

But having a cancer risk factor, or even several of them, does not necessarily mean that a person will get cancer. Some women with one or more breast cancer risk factors never develop it, while most women with breast cancer have no apparent risk factors.

Significantly higher risk

A woman with a history of cancer in one breast has a much greater chance of developing a new breast cancer, unrelated to the first one, in the other breast or in another part of the same breast. This is different from a recurrence of the previous breast cancer.

Moderately higher risk

  • Getting older. Your risk for breast cancer increases as you age. About 75% of women diagnosed with breast cancer each year are over age 50, and about 90% of breast cancer deaths are in women aged 50 or older.
  • Direct family history. Having a mother, sister or daughter (first degree relative) who has breast cancer puts you at higher risk for the disease. The risk is even greater if your relative developed breast cancer before menopause and had cancer in both breasts. Having one first degree relative with breast cancer approximately doubles a woman''s risk. Having a male blood relative with breast cancer will also increase a woman''s risk of the disease.
  • Genetics. Carriers of alterations in either of two familial breast cancer genes called BRCA1 or BRCA2 are at higher risk. Women with an inherited alteration in either of these genes have up to an 65% chance of developing breast cancer by the age of 70. There are rarer genes, such as TP53 and PTEN which can also increase risk of breast cancer.
  • Breast lesions. A previous breast biopsy result of atypical hyperplasia increases a woman''s breast cancer risk by two to four times.
  • Slightly higher risk
  • Distant family history. This refers to breast cancer in more distant relatives such as aunts, grandmothers and cousins.
  • Previous abnormal breast biopsy. Women with earlier biopsies showing any of the following have a slight increased risk: fibroadenomas with complex features, hyperplasia without atypia, sclerosing adenosis, and solitary papilloma.
  • Age at childbirth. Having your first child after age 30 or never having children puts you at higher risk.
  • Early menstruation. Your risk increases if your periods began before the age of 11.
  • Late menopause. If you begin the menopause after age 55, your risk increases.
  • Weight. Being overweight (especially in the waist), with excess calories and fat intake, increases your risk, especially after menopause.
  • Excessive radiation. This is especially true for women who were given radiation for postpartum mastitis, received prolonged fluoroscopic X-rays for tuberculosis or who were exposed to a large amount of radiation before age 30, usually as treatment for cancers such as lymphoma.
  • Other cancer in the family. A family history of cancer of the ovaries, cervix, uterus or colon increases your risk.
  • Heritage. Women born in North America and northern Europe are at increased risk.
  • Alcohol. Use of alcohol is linked to increased risk of developing breast cancer. Alcohol is also known to increase the risk of developing cancers of the mouth, throat, and oesophagus.
  • Race. White women are at a slightly higher risk of developing breast cancer than are African, Asian and Hispanic women.
  • Hormone Replacement Therapy(HRT). Long term use of combined oestrogen and progesterone increases the risk of breast cancer. The risk returns to the same as that of a woman who has never used HRT five years after a woman stops using HRT.
  • Combined Oral Contraceptive Pill. Cancer Research UK says there seems to be a small increase in risk while you are taking the pill, but this goes back to a normal level of risk 10 years after you''ve stopped taking it. However the pill seems to reduce the risk of some other cancers, including ovarian cancer.

    Low risk
  • Pregnancy before age 18.
  • Early onset of menopause.
  • Surgical removal of the ovaries before age 37.

Factors not related to breast cancer

  • Fibrocystic breast changes.
  • Multiple pregnancies.
  • Coffee or caffeine intake.
  • Antiperspirants.
  • Underwire bras.

Scientists are still investigating whether breastfeeding, smoking, high fat diets, lack of exercise and environmental pollution increase breast cancer risk.

Learn more about the genetic risk factors for breast cancer.

The below info are only seen when the above blue highlighted heading is clicked

Breast cancer: Your genes

Women with a family history of breast cancer account for five per cent to ten per cent of all women with the disease. Having a first-degree relative (mother, sister or daughter) with breast cancer poses the greatest risk to other female members of the family -- doubling the risk compared to that of the general population.

Several characteristics may suggest that a woman has a breast cancer gene:

  • Diagnosis of breast cancer before the age of 50.
  • Several family members diagnosed with breast and/or ovarian cancer.
  • Diagnosis of bilateral breast cancer (cancer in both breasts).
  • If there are men in the family who have had breast cancer.

What are the "breast cancer genes?"

Each of us is born with two copies of about 100,000 different genes contained in each cell. Genes are tiny segments of DNA that control how cells function, such as telling them when to divide and grow. One copy of each gene comes from your mother; the other is from your father.

A gene can develop an abnormality that changes the way the cell works. Abnormalities in two genes - BRCA1 and BRCA2 - have been found in some women with breast cancer. Over 200 mutations of these genes exist. Specific mutations in these genes are associated with an increased breast cancer risk.

An estimated 1 in 800 women carries the BRCA1 gene abnormality (the number of carriers of BRCA2 abnormality remains unknown). Women with inherited changes in either of these genes have 50 to 80% chance of developing breast cancer in their lifetime.

The risk of developing a second breast cancer among individuals carrying the BRCA1 gene abnormality is 65%. Bilateral breast cancer (cancer in both breasts) is also common in women who carry the mutated form of this gene.

Although less is known about the BRCA2 gene, scientists do know that mutations in the gene are associated with a similar risk of developing breast cancer among carriers. Alterations in the BRCA2 gene may also account for a small percentage of male breast cancer.

Mutations in both the BRCA1 and BRCA2 genes can be inherited from either parent. Therefore, the father''s family history of breast cancer is also important. Men or women who carry one of these gene mutations have a 50/50 chance of passing it on to each of their children.

Usually, these BRCA genes help to prevent cancer by creating proteins that keep cells from growing abnormally. But, if a changed or mutated BRCA1 or BRCA2 is inherited, you may be more susceptible to developing cancer during your lifetime. In addition, women with an altered BRCA gene usually have an increased risk of developing breast cancer at a younger age (before menopause). However, it''s important to note that not all women who carry these genes will develop cancer.

Hormone replacement therapy (HRT) has been linked to a higher risk of breast cancer. Get the facts on hormone replacement therapy and breast cancer.

The below info are only seen when the above blue highlighted heading is clicked

Breast cancer: Horomone replacement therapy and cancer risk

Hormone replacement therapy (HRT) is used to relieve menopause symptoms, especially hot flushes. A woman on hormone therapy usually takes both oestrogen and progestogen (typically a synthetic form of progesterone). Women who have had a hysterectomy can take oestrogen alone. Oestrogen relieves hot flushes and prevents osteoporosis, but oestrogen can increase your risk of developing uterine cancer. Progestogen is added in women with a uterus to prevent this.

Many studies have looked at the association between hormone therapy and breast cancer. The best evidence for the benefits and risks of hormone replacement therapy come from the US Women''s Health Initiative (WHI), a large study involving more than 16,000 healthy women. The results published in July 2002 showed that the risks of combined HRT of oestrogen plus progestogen outweigh the benefits. These risks include an increase in breast cancer, heart disease, stroke and blood clots.

Not only does combined HRT increase the risk of developing breast cancer, but it also increases the chances that the cancer will be discovered at a more advanced stage. This is due to its influence in reducing the effectiveness of mammography.

If a woman no longer has a uterus, oestrogen alone can be given for symptoms of menopause. This probably does not increase the risk of developing breast cancer much, if at all. In March 2004 it was concluded from the WHI study that those taking only oestrogen had no increased risk of breast cancer or heart disease, however oestrogen does appear to increase one''s risk of stroke.

If a woman is faced with menopause and hot flushes, she and her doctor should discuss the risks and benefits and decide if treatment should included hormone therapy or not.

Do the benefits of hormone therapy outweigh the risk?

Hormone therapy is an effective treatment for relieving hot flushes from menopause. However the known link between hormone therapy and increased breast cancer risk has discouraged many women and their doctors from choosing or recommending this treatment.

The type of hormone therapy (oestrogen only or combination of oestrogen and progestogen), as well as the woman''s individual characteristics, risk factors and severity of menopause symptoms, should be considered when weighing the risks and benefits of HRT. The decision to use hormone therapy after menopause should be made by a woman and her doctor after weighing all of the potential risks (including heart disease, breast cancer, stroke and blood clots) and benefits (relief of menopause symptoms and prevention of osteoporosis).

The known association between HRT and breast cancer has prevented many breast specialists from recommending it for breast cancer survivors. Unfortunately many women experience menopause symptoms after breast cancer treatment. Some forms of chemotherapy can also cause early menopause in premenopausal women.

In the past doctors had offered HRT after breast cancer treatment because there weren''t clear-cut studies to show that it did any harm. However in 2004 a US study (the HABITS study) was stopped early after it was shown that cancer survivors on HRT were more likely to develop a new or recurrent breast cancer. Doctors now feel it may be too risky to treat breast cancer survivors with HRT.

Prevention

Breast cancer preventionDoctors can’t make any promises, but some habits, like exercise and a healthy diet, may cut your risk of breast cancer. Speak to your APLIE health pharmacist.

about breast cancer prevention.

The below info are only seen when the above blue highlighted heading is clicked

Understanding breast cancer - prevention

How can I prevent breast cancer?

Doctors still are not certain how you can stop breast cancer from happening in the first place.

Regular aerobic exercise may offer some protection against a woman''s risk of developing breast cancer. Studies have suggested that women who exercise can reduce their risk of breast cancer by around a third, even though other factors probably play a role. Exercise also can help women with breast cancer better tolerate the side effects of radiotherapy or chemotherapy and can help promote a faster recovery after surgery.

Nutrition and diet to prevent breast cancer

Diet plays a very small but measurable role in breast cancer prevention. Dietary fats may increase your risk of developing breast cancer, and fruit, vegetables and grains may help to reduce the risk. It''s a good idea to make whole milk dairy products, meat and foods fried at high temperatures only occasional treats rather than staples. You can liven up your menus by sampling different kinds of fresh fruit and vegetables and basing new dishes on whole grains and legumes. This way, you''re bound to get plenty of fibre, along with vitamins and minerals thought to protect against breast cancer, specifically vitamins A, C, D, and E and calcium, selenium, and iodine. Some doctors recommend that breast cancer patients take antioxidant supplements.

Being overweight or obese may increase a woman’s risk of breast cancer so achieving a healthy weight is advised.

The risk of breast cancer increases with the amount of alcohol consumed so women are advised to keep within safe recommended amounts.

It''s important to keep in mind that dietary measures are insufficient to overcome other risk factors for breast cancer. Women who adhere to a healthy diet should still take other preventive measures such as having regular mammograms.

Early detection, catching the disease, and treating it early in its development when it is most treatable remains proper strategy for better cancer outcome. The following is a common approach, but ask your doctor exactly what you should do to help prevent breast cancer or find it early:

• Be “breast aware”. The five points of this APLIE health’s plan are:

1. Know what is normal for you
2. Look and feel
3. Know what changes to look for
4. Report any changes without delay
5. Attend breast screening if you are aged 50 or over

  • All women between the age of 50 and 70 years should be routinely invited for a mammogram every three years. Those over the age of 70 can still have a mammogram but need to request this. Women over 40 years of age at high-risk of breast cancer or who have a family history of breast cancer should seek breast screening mammogram and on annual basis. Those at high-risk who are under 40 years of age should go for an MRI scan screening instead of a mammogram because breast tissue at this age is often too dense to get a clear mammogram.
  • Build your diet around fruit, vegetables, grains, and fish.
  • If you use contraception, ask your pharmacist about the pros and cons of contraceptive pills.
  • If you are near or in menopause, ask your doctor if you should use hormone replacement therapy to treat menopause symptoms. Studies suggest that hormone replacement can increase the risk of breast cancer. You and your doctor can make this decision based on your risk of breast cancer.

Preventive mastectomy is an operation to remove breasts to avoid breast cancer in high-risk women. Learn about it here

The below info are only seen when the above blue highlighted heading is clicked

Breast cancer: Preventive mastectomy

In hopes of avoiding future disease, some women at very high risk of developing breast cancer elect to have both breasts surgically removed, a procedure called bilateral prophylactic mastectomy. The surgery aims to remove all breast tissue that potentially could develop breast cancer. Preventive breast cancer surgery also may be considered if a woman has already had breast cancer and is therefore at increased risk for developing the disease again in either breast.

Is prophylactic mastectomy effective?

A recent study suggests that prophylactic mastectomy may reduce the risk of breast cancer by as much as 90%. However, results vary widely. In some studies, women had prophylactic mastectomies for a variety of reasons, such as pain, fibrocystic breast disease, dense breast tissue, cancer phobia or a family history of breast cancer. Some women still developed breast cancer even though they had their breast tissue removed. But in most studies, patients did not develop breast cancer after prophylactic mastectomy. However, many of these patients would not have been considered high-risk for developing cancer.

Some experts have argued that even for high-risk women, prophylactic mastectomy is inappropriate because not all breast tissue can be removed during a surgical procedure. To understand why, we need to know what comprises breast tissue and where cancer originates.

Where does cancer form?

Breast cancers may develop in the glandular tissue of the breast, specifically in the milk ducts and the milk lobules. These ducts and lobules are located in all parts of the breast tissue, including tissue just under the skin. The breast tissue extends from the collarbone to the lower rib margin, and from the middle of the chest, around the side and under the arm.

In a mastectomy, it is necessary to remove tissue from just beneath the skin down to the chest wall and around the borders of the chest. However, even with very thorough and delicate surgical techniques, it is impossible to remove every milk duct and lobule, given the extent of the breast tissue and the location of these glands just beneath the skin.

Who should have a prophylactic mastectomy?

Does this mean that every patient should consider breast cancer prevention surgery? The answer is clearly no. The decision to proceed with prophylactic mastectomy is an individual decision. Such factors as an estimation of individual breast cancer risk, the ability to monitor the patient for early breast cancer and, most importantly, the patient''s concerns and feelings need to be considered in making this decision.

The prophylactic mastectomy should be available for women with:

  • Mutated BRCA genes.
  • Previous cancer in one breast and a high risk of recurrence.
  • A strong family history of breast cancer.

Prophylactic mastectomy should only be considered after you''ve received the appropriate genetic and psychological counselling to discuss the psychosocial impacts of the procedure.

1)Symptoms & types

Breast lumps aren’t the only possible sign of breast cancer, and most breast lumps aren’t cancer. Read about the signs, symptoms, and types of breast cancer.

Symptoms

What are the symptoms of breast cancer?

In its early stages, breast cancer usually has no symptoms. As a tumour develops, you may note the following signs:

  • A lump in the breast or underarm that persists after your menstrual cycle; often the first apparent symptom of breast cancer, breast lumps are painless, although some may cause a prickly sensation. Lumps are usually visible on a mammogram long before they can be seen or felt.
  • Swelling in the armpit.
  • Although lumps are usually painless, pain or tenderness in the breast can be a sign of breast cancer.
  • A noticeable flattening or indentation on the breast, which may indicate a tumour that cannot be seen or felt.
  • Any change in the size, contour, texture, or temperature of the breast; a reddish, pitted surface like the skin of an orange could be a sign of advanced breast cancer.
  • A change in the nipple, such as an indrawn or dimpled look, itching or burning sensation, or ulceration; scaling of the nipple is symptomatic of Paget''s disease, a localised cancer.
  • Unusual discharge from the nipple that may be clear, bloody, or another colour. It''s usually caused by benign conditions but could be due to cancer in some cases.
  • A marble-like area under the skin.
  • An area that is distinctly different from any other area on either breast.

Contact your APLIE health pharmacist is need advice about breast cancer and if yor are sure of

  • One or both breasts develop an abnormal lump or persistent pain, or look or feel abnormal. The cause often is something other than cancer but should be identified.
  • You have swollen lymph glands in your armpits. Any such swelling could be associated with cancer.

Types

Breast cancer recurrence (return) is possible after treatment, and it doesn’t always come back to the breast. This detailed article is all about breast cancer recurrence.

Breast cancer is generally seen in women after the menopause. But it can strike much earlier. Learn about breast cancer in young women Speak to your APLIE health pharmacist.

Breast cancer in pregnancy is very rare. But it can happen. Learn how breast cancer in pregnancy is treated from APLIE health pharmacist .

The vast majority of breast cancer patients are women. But men can get breast cancer too. Speak to your APLIE health pharmacist, we will put your mind at rest

Inflammatory breast cancer is a rare type of breast cancer in which the breast appears swollen and inflamed. It doesn’t always involve a lump. Learn more about inflammatory breast cancer from your APLIE health pharmacist.

Complications

Breast cancer treatments are powerful medicines and can have side effects. Find out more about common breast cancer treatment side effects from your APLIE health pharmacist

Lymphoedema is abnormal fluid build-up, usually in the arms or legs, and it needs prompt treatment. Want to learn about lymphoedema and breast cancer? Speak to your APLIE health pharmacist

Breast cancer treatments may affect young women’s ability to have children. Learn how that issue can be addressed from your APLIE health pharmacist

2)Diagnosis & tests

Early detection can be important in treating breast cancer. Learn about breast cancer tests and diagnosis. If you are due for a mammogram, make your appointment now.

Diagnosis

The earlier breast cancer is detected, the better it may be for the patient’s long-term health. Get a brief overview of the tests that can help detect breast cancer from your APLIE health pharmacist

Tests

Do you do regular breast self-examinations? While some cancers are too tiny to feel, and most lumps aren’t cancer, self-examinations are a proactive way to help take care of yourself. Learn how from your APLIE health pharmacist

A clinical breast examination is a breast examination performed by a health care professional. It’s often part of a woman’s check-up. Find out what to expect from breast screening Speak to your APLIE health pharmacist.

A mammogram is a special type of X-ray taken to look for abnormal growths or changes in breast tissue. It’s a key tool in breast cancer detection, though no test is perfect. Learn more here from us.

Doctors sometimes use ultrasound images to check whether a breast lump is a cyst (a fluid-filled sac that is not cancer) or a solid mass. learn more from us.

When doctors perform a biopsy, they remove cells from a suspicious lump to see if it’s cancer. We will help you understand breast biopsies.

In a sentinel node biopsy, doctors check lymph nodes under the arm to see if cancer has spread into the lymphatic system. Learn what’s involved in a sentinel node biopsy from your APLIE health pharmacist

3)Treatment & care

There are many breast cancer survivors, and modern medicine is a big reason for that success. Want to learn about breast cancer treatment and care? Speak to your APLIE health pharmacist

Treatment

What are the treatments for breast cancer?

Breast cancer treatments have come a long way in the past few generations. Get a general overview of treatment options for today’s breast cancer patients. Speak to your APLIE health pharmacist

Our pharmacist will provides you with in-depth information on breast cancer chemotherapy.

Radiotherapy (radiation) therapy is another way to help reduce the chance of cancer’s return.

Hormone therapy may help curb the growth, spread, or recurrence of some types of breast cancer.

Monoclonal antibodies are a type of biological therapy medicine for breast cancer. Want to find out more about it? Speak to your APLIE health pharmacist .

After breast cancer treatment, follow-up care is important. Ask your APLIE health pharmacist

If breast cancer returns, it doesn’t always come back to the breast, and its location may help doctors decide on the best treatment. Learn more about treating recurrent breast cancer. Speak to your APLIE health pharmacist

Most doctors don’t recommend relying only on alternative medicine for breast cancer. But some complementary therapies, including meditation and acupuncture, may be worth discussing with your doctor to enhance, but not replace, conventional care. For help with choice Speak to your APLIE health pharmacist

Care

New breast cancer patients may have a lot of questions about their care. Here’s a general list to start with before choosing treatment.

4)Living & managing

Coping with breast cancer can be draining and stressful. To get facts and tips on managing and living with breast cancer during treatment and beyond, Speak to your APLIE health pharmacist

Living and coping

Do you have a friend or relative with breast cancer? Speak to your APLIE health pharmacist for tips on how to support them.

Breast cancer clothing: bras, scarves, accessories, and more

Find advice on bras, scarves, comfortable tops and even breast cancer awareness bracelets and ribbons from your APLIE health pharmacist

Finished your breast cancer treatment? Learn how to deal with anxiety about whether the cancer may come back from Speak to your APLIE health pharmacist

Who should opt to have breast reconstruction surgery? How is the surgery performed? How long does it take to recover? Answers to these questions and more? Speak to your APLIE health pharmacist

5)Finding help

If you are looking for more information about breast cancer, care and treatment, we can help. You don''t have to do it alone. Use these resources to get more help, support, and advice on living with breast cancer.

Organisations

If you are looking for more information about breast cancer, care and treatment, we can help. You don''t have to do it alone. Use these resources to get more help, support, and advice on living with breast cancer.

2) Lung cancer health centre

Lung cancer overview

Lung cancer is the second most common type of cancer in the UK. Lung cancer and smoking often, but not always, go hand in hand. There usually are no signs or early symptoms of lung cancer. As lung cancer stages advance, lung cancer symptoms may include coughing, weight loss, shortness of breath and bloody sputum. Treatment for lung cancer depends on the stage of the disease but can include surgery, chemotherapy and/or radiotherapy.

Overview & facts

Confused about lung cancer? Or just looking for some quick facts? These links take you to essential information on lung cancer, its causes and its risk factors.

What is lung cancer?

BMJ Group Medical Reference

Introduction

If you''re diagnosed with lung cancer, you''ll need to make some important decisions about your treatment.

We''ve brought together the best research about lung cancer and weighed up the evidence about how to treat it. You can use our information to talk to your doctor and decide which treatments are best for you.

It can be devastating to find out that you or someone close to you has lung cancer. It''s a serious illness. It means some of the cells in your lungs have started to grow out of control, invading and destroying other cells. In the weeks and months to follow, you will probably have many different emotions, including anxiety about what lies ahead.

Almost before you have had time to take in what the doctors have told you, you will be offered a range of tests and treatments that aim to get rid of your cancer or relieve your symptoms, or both. The treatments you''re offered will depend on the type of lung cancer you have, how large it is, and whether it has spread. A lot will also depend on how you feel about your illnes, how you would like it to be treated and what you can afford.

We hope our information will answer your questions about lung cancer. It may also help you talk to your doctor about the best treatments for you.

Some people want to know more about their cancer than others. Some will choose to have treatments that may help them live longer but which could have unpleasant, sometimes harmful, side effects. Other people prefer to enjoy as much of life as they can.[1]

There''s no right or wrong way for you to deal with your cancer. The most important thing is for you to feel comfortable with the decisions you make. It''s also essential that your medical team and those who care about you listen to what you say and respect your wishes.

Key points for people with lung cancer

  • Lung cancer is the second most common type of cancer in men and the third most common in women (not counting skin cancer). It''s the leading cause of death from cancer.
  • By the time most people are diagnosed, their lung cancer has spread outside their lungs.
  • You will be offered a range of treatments that aim to get rid of the cancer and improve your symptoms.
  • Most treatments have side effects. You need to weigh these against the benefits.
  • Cigarette smoking is the most common cause of lung cancer. The best way to prevent lung cancer is not to smoke.

Your lungs and what they do

You have two lungs. They sit in your chest, inside your rib cage, one on each side of your heart. They are covered by a layer of moist tissue called the pleura.

Just diagnosed with lung cancer? Get more info from your APLIE health pharmacist

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Causes

Lung cancer risk factors

To learn about the common causes of lung cancer Speak to your APLIE health pharmacist

Lung cancer guide

Symptoms & types

Here''s where you''ll find a guide to the different types and different stages of lung cancer. You''ll also find articles on lung cancer signs and symptoms.

Symptoms

There are many different lung cancer symptoms. Find out more from your APLIE health pharmacist

BMJ Group Medical Reference

The most common symptoms of lung cancer are coughing and breathing problems. But you also get other illnesses that affect your lungs, such as colds, flu, asthma, and bronchitis.

Although your symptoms may start off seeming like a cold or flu, if you have lung cancer they won''t get better. They won''t be cured by remedies you can buy at a pharmacy or get from your doctor. You may also get much more worrying symptoms, such as coughing up blood.

You shouldn''t ignore minor symptoms like coughing and breathlessness, especially if they go on longer than you would usually expect with a cold or chest infection. And remember: people who''ve never smoked can get lung cancer too. So it''s important to get these symptoms checked out, even if you''re a life-long non-smoker.

If you have lung cancer, you may get symptoms that are caused by the cancer in your lung. And if the cancer has spread, you may get symptoms caused by its effects on your chest or other parts of your body. Many people get both types of symptoms, although usually they get symptoms in the lung first.[16]

Symptoms from the cancer in your lung

  • Coughing: If you have lung cancer, you may get a cough that doesn''t go away and gets worse over time. This happens when the cancer stops you getting enough air into your lungs.
  • Shortness of breath or wheezing: This may be due to a cold or flu. Or it may happen if you are getting more exercise than you''re used to. But it may be a symptom of lung cancer. Again, the cancer is preventing you from getting enough air into your lungs.
  • Coughing up blood: This could be just a few spots on a tissue. Or there could be larger amounts. It may be caused by the tumour damaging your lung tissue. If you cough up blood you should see a doctor straight away.
  • Airway infections: Repeated chest infections, such as bronchitis and pneumonia, can happen when a tumour starts to block your airways. Fluid in your lungs becomes trapped and infected.
  • Fever: Lung cancer can cause a rise in body temperature.

Symptoms from cancer spreading into the lining of your lung

  • Pain in the chest: You may also get this with other conditions, such as indigestion or angina (chest pain caused by narrowing of blood vessels near your heart). But with lung cancer, the pain doesn''t go away.

Symptoms from cancer spreading to other parts of your chest

  • Hoarseness when you speak: A tumour in your left lung could spread into the middle of your chest. When this happens, the nerve that goes to your voice box may be damaged. This can cause hoarseness.
  • Swallowing problems: This can happen if a tumour grows near the tube that carries food from your mouth to your stomach (oesophagus).

Types

These are the most common lung cancers. Speak to your APLIE health pharmacist about this.

Cancers are diseases in which normal cells transform so that they grow and multiply without normal controls. In many types of cancer, this results in the growth of one or more large masses, or tumours, of these transformed cells. This can happen in almost any part of the body. When it happens in the lungs, the disease is called lung cancer.

Lung cancer is one of the most common types of cancer; this is because the lungs are exposed to the external environment more than most other organs are. In many cases, cancer-causing substances (carcinogens) in the air are inhaled and cause cell damage that later becomes cancer. The most common cause of lung cancer, without a doubt, is smoking.

Two main types of lung cancer exist: small cell lung cancer and non-small-cell lung cancer. Non-small-cell lung cancer is a catchall term for all lung cancers that are not small-cell type. They are grouped together because the treatment is the same for all non-small-cell types. Together, non-small-cell lung cancers, or NSCLCs, make up about 80% of all lung cancers. Each type is named after the types of cells that were transformed to become cancer. The following are the 3 most common types of NSCLC in the United Kingdom.

  • Squamous cell carcinoma - 35%
  • Adenocarcinoma/bronchoalveolar - 27%
  • Large-cell carcinoma - 10%

Like all cancers, lung cancer is most easily and successfully treated if it is caught early. An early-stage cancer is less likely to have grown to a large size or to have spread to other parts of the body (metastasised). Large or metastasised cancers are much more difficult to treat.

Non-small-cell lung cancer causes

  • Tobacco smoking
  • Tobacco smoking is the cause of lung cancer in as many as 90% of cases.
  • A person who smokes is 13.3 times more likely to develop lung cancer than a person who has never smoked. The risk also varies with the number of cigarettes smoked per day; people who smoke more than 20 cigarettes a day have a much greater risk of developing lung cancer than do those who smoke fewer than 20 cigarettes a day.
  • Once a person stops smoking, the risk of lung cancer will gradually decrease, but never quite returns to the same level as that of a person who has never smoked.
  • Not all people who smoke develop lung cancer, and not all people with lung cancer smoke. Clearly, other factors, including genetic predisposition and exposure to other harmful agents, also play a role.
  • Passive smoking (secondhand smoke)
  • As many as 15% of lung cancer cases involving nonsmokers may be caused by secondhand smoke.
  • The British Medical Association has recognised passive smoking as a potential cause of cancer.
  • Asbestos
  • Asbestos exposure has been linked to lung cancer, particularly a type of lung cancer called mesothelioma, and other lung diseases.
  • The silicate type of asbestos fibre is an important carcinogen.
  • Asbestos exposure increases the risk of lung cancer by as much as 5 times.
  • People who both smoke and have been exposed to asbestos are at an especially high risk of developing lung cancer.

For further information, speak to your APLIE health pharmacist about this.

Treatment, and prognosis, depends on the stage of a lung cancer. Get the basics from us.

What is the prognosis (outcome) of lung cancer?

The prognosis of lung cancer refers to the chance of recovery and is dependent upon the location and size of the tumour, the presence of symptoms, the type of lung cancer, and the overall health status of the patient.

Small cell lung cancer (SCLC) has the most aggressive growth of all lung cancers, with a median survival time of only 2 - 4 months after diagnosis when untreated. (That is, by 2 - 4 months, half of all patients have died.) However, SCLC is also the type of lung cancer most responsive to radiotherapy and chemotherapy. Because SCLC spreads rapidly and is usually disseminated at the time of diagnosis, treatments such as surgical removal or localised radiotherapy are less effective in treating this tumour type. However, when chemotherapy is used alone or in combination with other methods, survival time can be prolonged four- to fivefold. Of all patients with SCLC, only 5-10% are alive 5 years after diagnosis. Most of those who survive have limited stage (LS) SCLC.

In non-small cell lung cancer (NSCLC), results of standard treatment are generally poor in all but the most localised cancers, which can be surgically removed. However, in Stage I cancers that can be completely removed, the 5-year survival rate can approach 75%. Radiotherapy can produce a cure in a small minority of patients with NSCLC and relief of symptoms in most patients. In advanced-stage disease, chemotherapy offers modest improvements in survival time, although overall survival rates are poor.

Survival rates for lung cancer are generally lower than those for most cancers, with an overall 5-year survival rate for lung cancer of about 15% compared to 63% for colon cancer, 88% for breast cancer, and 99% for prostate cancer

Diagnosis & tests

How is lung cancer diagnosed? What tests will doctors have to perform? Get that vital information from your APLIE health pharmacist

Diagnosis

To find out more about how lung cancer is diagnosed, speak to your APLIE health pharmacist

Tests

Learn here about having a chest X-ray, CT scan and other tests for diagnosing lung cancer. Find out what to expect from your APLIE health pharmacist

Lung cancer guide

Treatment & care

Start with the links to basic information on lung cancer treatment and care. Then move on to the more detailed information. Take your time, there''s a lot to learn.

Treatment

Find out the options from your APLIE health pharmacist on how lung cancer is treated, including radiotherapy (radiation) and chemotherapy.

Surgery is the preferred treatment for many people with lung cancer. Learn more about the different types of surgery from your APLIE health pharmacist.

What is palliative care? What’s the goal? Find out here.

Care

Eating healthily and getting adequate nutrition is more important than ever when you’re being treated for cancer. Find out more.

Ovarian cancer health centre

Ovarian cancer overview

Overian cancer are common in women. Ovarian cancer occurs when a cancerous tumour forms in a woman’s ovary. In most cases, there are no known causes. Symptoms are often vague, but common ovarian cancer symptoms include ongoing pain or cramps in the stomach or back, increased abdominal girth, and nausea and bloating. Depending on the cancer stage, ovarian cancer treatment includes surgery and chemotherapy and occasionally radiotherapy.

Overview & facts

To learn more about ovarian cancer’s causes, risk factors and prevention. Speak to your APLIE health pharmacy team

Understanding ovarian cancer - the basics

Each side of the uterus are the two ovaries, each about the size of an almond, which produce eggs and female hormones. Ovarian cancer can occur at any age, even in childhood, but is most common after menopause. About 6,800 new cases of ovarian cancer are diagnosed in the UK each year.

During her childbearing years, a woman''s ovaries deliver eggs to the uterus through the fallopian tubes. The ovaries are susceptible to several types of growths, which are often benign cysts but are sometimes cancerous. The cancer typically has no obvious symptoms until it is well advanced. Early growths can sometimes be detected during a routine pelvic examination.

If ovarian cancer could be readily diagnosed in its earliest stages, more women would be cured. However like many cancers, it usually has spread by the time it is diagnosed. The importance of early diagnosis is clear: about 90% of women live five years or longer if ovarian cancer is detected early; the rate for all cases is only about 40%. Unfortunately, only 25% of ovarian cancers are found at an early stage.

What causes ovarian cancer?

Most women with ovarian cancer have no family history of the disease, yet a woman is more likely to get the disease if her mother or sister has had ovarian, breast, or uterine cancer; the more relatives affected, the greater the risk. Women who have had few or no children, who delay childbearing until their thirties, or who have trouble conceiving are also at greater risk for ovarian cancer. A link between the number of periods in a women’s life and the risk of ovarian cancer exists as well.

Some studies have also reported that long-time use of the fertility drug clomiphene citrate, especially if no pregnancy took place, may increase the risk of borderline ovarian tumours. This finding is not clear since infertility itself is a risk to ovarian cancer. Those who have several children, who breastfeed, or who use the contraceptive pill are at reduced risk. The difference may be linked to less frequent ovulation.

Most ovarian cancers occur after menopause, with half presenting over the age of 65.

A study in the US found that the risk of death from ovarian cancer was higher in overweight women. Evidence suggests that the more saturated fat a woman eats, the greater her chance of ovarian cancer. Many high-fat foods contain oestrogen and all stimulate natural oestrogen production. Because most ovarian cancers grow more rapidly in the presence of oestrogen, some experts believe that abnormally elevated oestrogen in a woman''s body promotes the onset of ovarian cancer. Exposure to asbestos is also believed to be a factor in some cases. This was a concern when some of the talcum powders used years ago contained asbestos.

Using post-menopausal hormones for more than 10 years may also slightly increase ovarian cancer risks, but these risks need to be discussed with your doctor and your personal circumstances taken into consideration.

Further Reading:

What is ovarian cancer?

Ovarian cancer starts in the ovaries and can spread to other parts of the body. Read a short overview of ovarian cancer.

Frequently asked questions about ovarian cancer.

Frequently asked questions about ovarian cancer

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We can help answer your questions. Just speak to your APLIE health pharmacist

Prevention

Doctors haven''t found a way to prevent ovarian cancer, but they have found that certain factors make ovarian cancer less likely.

Symptoms

Early ovarian cancer often does not show any obvious signs, but here are 12 symptoms that may occur in the later stages.

Understanding ovarian cancer - symptoms

What are the symptoms of ovarian cancer?

Ovarian cancer is difficult to diagnose because symptoms often do not occur until late in the disease. Symptoms do not occur until the tumour has grown large enough to apply pressure to other organs in the abdomen, or until the cancer has spread to remote organs. The symptoms are non-specific, meaning they could be due to many different conditions. Cancer is not usually the first thing considered in a woman having symptoms.

What are the symptoms of ovarian cancer?

Although ovarian cancer rarely produces symptoms in its earliest stages, eventual warning signs may include:

Persistent pelvic and abdominal pain

Increased abdominal size/persistent bloating (not bloating that comes and goes)

Difficulty eating, feeling full up quickly, or feeling nauseous

Sometimes urinary symptoms, change in bowel habit, extreme fatigue, abnormal vaginal bleeding, or back pain may occur.

Symptoms associated with advanced ovarian cancer include severe nausea, vomiting, pain and weight loss.

Seek medical advice about ovarian cancer if:

You have unexplained abdominal pain or vaginal bleeding, particularly if these symptoms accompany the more general symptoms listed above.

Do not allow such symptoms to continue undiagnosed for more than two weeks.

Types

The type of cell where the abnormal growth originated determines the type of ovarian tumour.

Types of ovarian cancer cells

Ovarian cancer occurs when a tumour forms in one or both of a woman''s ovaries,
The type of cell where the abnormal growth originated determines the type of ovarian tumour.

  • Epithelial tumours: These tumours arise from a layer of cells that surrounds the outside of the ovary called the germinal epithelium. About 70%-80% of all ovarian cancers are epithelial. These are most common in women who have been through the menopause (between 45-70 years).
  • Stromal tumours: Stromal tumours develop from connective-tissue cells that help form the structure of the ovary and produce hormones. Usually, only one ovary is involved. These account for 5%-10% of ovarian cancers. These tumours typically occur in women between the ages of 40 and 60 years.
  • Germ cell tumours: Tumours that arise from germ cells (cells that produce the egg) account for about 15% of all ovarian cancers. These tumours develop most often in young women (including teenage girls). Although 90% of women with this type of cancer are successfully treated, many become permanently infertile.
  • Metastatic tumours: Only 5% of ovarian cancers have spread from other sites. The most common sites from which they spread are the colon (52%), breast (17%), stomach (10%) and pancreas (5%).
  • Within these main classes are many subtypes of tumours.
    Non-cancerous (benign) ovarian masses include abscesses, cysts, endometriosis-related masses, ectopic pregnancies and others.
  • Of markedly enlarged ovarian masses (>4cm) found in women who are still menstruating (have not been through the menopause), about 20% are cancerous.
  • Of markedly enlarged masses found in women who have been through the menopause, about 45%-50% are cancerous.

Diagnosis & tests

Currently, ovarian cancer isn’t often found in its early stages, due to few symptoms and no reliable screening tests. Learn about ovarian cancer diagnosis and tests.

Diagnosis and tests

Find out about the examinations and tests that doctors use to diagnose ovarian cancer.

Ovarian cancer examinations and tests

Many examinations and tests are used to determine if a woman has ovarian cancer.

Physical examination

Every woman should have regular cervical screening tests (smear tests) because although the smear test is designed to check for pre-cancerous changes that can become cervical cancer, there have been some rare cases in which abnormal ovarian cells were identified with this test. Because ovaries are normally small and deep within the pelvis, pelvic examinations may not be very effective in detecting early ovarian cancer. Masses large enough to be felt may represent advanced disease. More often, they are harmless growths or other non-cancerous conditions.

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Imaging

Ultrasound: If a mass is present, the doctor may recommend an ultrasound examination to find out what kind of mass it is.

  • Ultrasound imaging can detect small masses and can distinguish whether a mass is solid or fluid filled (cystic).
  • A solid mass or complex mass (having both cystic and solid components) may be cancerous.
  • Incorporating Doppler technology to identify certain patterns associated with tumours seems to improve the usefulness of ultrasound screenings.
  • If the ultrasound shows a solid or complex mass, the next step is to obtain a sample of the mass to see whether it is a cancerous tumour.
  • CT (computed tomography) scanning: If ultrasound reveals a solid or complex mass, a CT scan of the pelvis may be done.
  • A CT scan is a type of X-ray that shows much greater detail in three dimensions.
  • A CT scan provides more information about the size and extent of the tumour. It can also show whether the tumour has spread to other organs in the pelvis.
  • Laboratory tests
  • The doctor can also arrange laboratory tests to gather information about the woman''s medical condition and to detect substances released into the blood by ovarian cancers (tumour markers).
  • The doctor may request a pregnancy test if there is any chance the woman could be pregnant. Ovarian masses during pregnancy may be associated with ectopic pregnancies (pregnancy outside the womb) or may be normal structures that produce other hormones important in gestation.
  • The woman''s blood will probably be checked for tumour markers. Doctors suspicious that ovarian cancer is present usually conduct the CA-125 test.
  • The level of the most widely studied tumour marker, CA-125, is elevated in more than 80% of women with advanced ovarian cancer and in about 50% of women with early ovarian cancer.
  • The level of this marker value can be affected by a number of factors, including age, menstrual status and conditions such as endometriosis, pregnancy, liver disease and congestive heart failure.
  • Cancers of the breast, pancreas, colon and lung also secrete the CA-125 marker.
  • Because this marker can be influenced by so many factors that have nothing to do with ovarian cancer, this marker is not generally used for routine screening of women who have no symptoms.
  • Doctors may recommend genetic screening for women with a strong family history of ovarian or breast cancer at a specialist genetic screening centre.
  • Ovarian cancer is diagnosed by taking a sample of the tumour (biopsy). Find out about the biopsy process and how doctors determine the stages of ovarian cancer

Living & managing

If you or a loved one has ovarian cancer, you may want to read these tips and personal stories about living with and managing the disease and its treatment speak to your APLIE health pharmacist.

Living and coping

10 important questions to ask your Doctors about ovarian cancer

If you’re someone with ovarian cancer, you may want to ask your doctor these 10 questions about your condition and treatment

Ten questions to ask your doctor about ovarian cancer

1.How far has my cancer spread?

2.Do I have to have both of my ovaries removed? If so, will I have hot flushes?

3.How confident are you that all of the cancer has been removed?

4.Which chemotherapy drugs do you recommend? Do I have any other options?

5.How long will I have to undergo chemotherapy?

6.What side effects should I look for? Are there ways to minimise these side effects?

7.Will I need any additional surgery?

8.Should I be tested for the BRCA-1 mutation? What should I do if the test is positive?

9.What signs should I look for that might indicate the cancer has come back?

10.How often should I come in for follow-up visits?

Finding help

If you have ovarian cancer, don’t hesitate to reach out for help if you need it. These message boards and web sites may help you find support and information.

Finding help

Looking for more information on ovarian cancer? Speak to your APLIE health pharmacist.

Ovarian cancer: Finding help

If you still have questions, or need support for coping with ovarian cancer, search for advice from our selection of organisations.


WebMD Medical Reference

  • If you are living with cancer, it presents many new challenges for you and for your family and friends.
  • You will probably have many worries about how the cancer will affect you and your ability to live a normal life, that is, to care for your family and home, to hold down your job, and to continue the friendships and activities you enjoy.
  • Many people feel anxious and depressed. Some people feel angry and resentful; others feel helpless and defeated.
  • For most people with cancer, talking about their feelings and concerns helps.
  • Your friends and family members can be very supportive. They may be hesitant to offer support until they see how you are coping. Do not wait for them to bring it up. If you want to talk about your concerns, let them know.
  • Some people do not want to “burden” their loved ones, or they prefer talking about their concerns with a more neutral professional. A social worker, counsellor or member of the clergy can be helpful if you want to discuss your feelings and concerns about having cancer. Your GP, gynaecologist or oncologist should be able to recommend someone.
  • Talking to other people who have cancer has profoundly helped many people. Support groups of people with cancer may be available through the hospital, clinic or medical centre where you are receiving your treatment. A number of organisations can offer more advice or put you in touch with local groups.
  • If you still have questions, or need support for coping with ovarian cancer, search for advice from our selection of organisations.

The Eve Appeal

The Eve Appeal raises funds for research into ovarian cancer, the most fatal of all the gynaecological cancers in the UK. Search the site for information about signs and risk factors of the disease.

Ovarian Cancer Action

Ovarian Cancer Action campaigns to improve survival rates for women with ovarian cancer. You can find out more about the symptoms of the disease and read a quarterly newsletter about the latest research into beating ovarian cancer.

Macmillan Cancer Support

This charity exists to help improve the lives of people living with cancer, their families and carers. macmillan.org.uk

Royal College of Obstetricians and Gynaecologists

A professional body with the aim of setting the standards for women’s health. The Royal College of Obstetricians and Gynaecologists'' website contains useful information for patients, including a section with frequently asked questions, an explanation of medical terms and links to podcasts.

The Royal College of Radiologists

The Royal College of Radiologists is the professional body for radiologists.

British Association for Cancer Research (BACR)

The British Association for Cancer Research has promoted cancer research for almost 50 years. It gives educational and training opportunities for those involved in cancer care.

British Association for Surgical Oncology

Prostate cancer health centre

Prostate cancer overview

Cancer Research UK says the number of men diagnosed with prostate cancer is on the increase, a large number of men are now finding out they have the disease each year. Prostate cancer occurs when cells in the prostate gland grow out of control. There are often no early prostate cancer symptoms, but some men have urinary symptoms and discomfort. Prostate cancer treatment options are surgery, chemotherapy, hormonal therapy, and/or radiotherapy. In some instances, doctors recommend "watchful waiting."

Overview & facts

Prostate cancer is common among older men. Genetics and age play a role in its development, but what other risks are involved?

Causes

Understanding prostate cancer - the basics

What is prostate cancer?

The prostate is a gland in the male reproductive system that produces the majority of fluid that makes up semen, the thick fluid that carries sperm. The walnut-sized gland is located beneath a man''s bladder and surrounds the upper part of the urethra, the tube that carries urine from the bladder. Prostate function is regulated by testosterone, a male sex hormone produced mainly in the testicles.

Prostate cancer is a major health concern for men. Although the disease is rare before age 50, experts believe that most elderly men have at least traces of it.

The PSA screening test

Prostate-specific antigen (PSA) is a substance produced by the prostate gland. Elevated PSA levels may indicate prostate cancer or a non-cancerous condition such as prostatitis or an enlarged prostate.

Just as important as the PSA number is the trend of that number (whether it is going up, how quickly, and over what period of time). It is important to understand that the PSA test is not perfect. Most men with elevated PSA levels have non-cancerous prostate enlargement, which is a normal part of ageing. Conversely, low levels of PSA in the bloodstream do not rule out the possibility of prostate cancer. However, most cases of early prostate cancer are found by a PSA blood test.

More new cases are diagnosed each year and it has shown to be the most common cancer among men. For reasons not fully understood, black men have the highest frequency of prostate cancer in the world and the highest death rate from the disease. Asian men are the least likely to get it.

Prostate cancer cells do not follow normal patterns. Instead, they grow uncontrollably and spread to other tissues. Prostate cancer is typically a very slow growing tumour, often causing no symptoms until advanced stages. Most men with prostate cancer die of other causes - many without ever realising that they have the disease. But once prostate cancer begins to grow more rapidly or spreads outside the prostate, it is dangerous. This aggressive type of prostate cancer can occur at any age. Although the disease tends to progress slowly, it is generally fatal if it spreads beyond the prostate gland itself.

Prostate cancer in its early stages (confined to the prostate gland) can be cured. Around 70% of newly diagnosed cases now survive beyond five years. In the 1970s, it was just 37%.

Cancer that has spread beyond the prostate to distant tissues (such as the bones, lymph nodes and lungs) is not curable, but it often can be controlled for many years. Because of the many advances in available treatments, the majority of men whose prostate cancer becomes widespread can expect to live five years or longer.

Diet and genetics may be factors in prostate cancer development, but they are not the only ones. Find out what the research shows.

Are you at risk?

Are you at risk of prostate cancer?

Age, race, diet, family history, even a sedentary lifestyle, may all play a part in contributing to your prostate cancer risks. Learn how from your APLIE health pharmacist.

Prevention

Is there a connection between a high-fat diet and prostate cancer? Find out what the evidence suggests and learn a few easy ways you can make your diet a healthier one. Speak to your APLIE health pharmacist.

Preventing prostate cancer

To date there is no evidence that prostate cancer can be prevented. However you may be able to lower your risk of developing the disease.

A low-fat diet consisting mainly of vegetables, fruits and grains such as rice may help to reduce your risk for prostate cancer. You may also want to limit high-fat foods from animal sources. Eat five or more servings of fruits and vegetables each day. Other healthy foods include bread, cereals, pasta and beans.

Substances in foods called antioxidants, which are found especially in fruits, vegetables and beans, help prevent damage to the DNA in the body''s cells. This damage has been linked to disease including cancer.

Lycopenes, in particular, are antioxidants that have been linked to a lower risk of prostate cancer. They are present in foods such as tomatoes (raw or cooked), spinach, artichoke hearts, beans, berries (especially blueberries), pink grapefruit, red oranges and watermelons.

Some clinical trials are looking at the benefits of various “chemoprevention” protocols designed to lower the risk of prostate cancer. So far, it''s too soon to know if there are any new ways to prevent prostate cancer, although there have been some promising results from drugs in clinical trials.

Studies of men taking the drug finasteride have shown they were about 25% less likely to develop prostate cancer than those taking a placebo. Finasteride is currently used to treat benign prostatic hyperplasia (BPH) or male pattern baldness. The findings from the Prostate Cancer Prevention Trial also suggested that finasteride was associated with an increased risk of sexual side effects and of prostate cancers with a tendency to be more aggressive (higher-grade), though later research has not confirmed this. As things stand it is not clear whether it is beneficial to take finasteride as a means of preventing prostate cancer.

Using vitamin supplements may affect your risk of prostate cancer. Some studies show that taking vitamin E may lower the risk of prostate cancer, while others show no impact on cancer risk. Taking selenium may also lower your risk. The SELECT trial is a large trial studying whether taking vitamin E and selenium supplements could prevent prostate cancer. It found that taking vitamin E and/or selenium for an average of 5.5 years did not prevent prostate cancer, but the researchers are continuing to monitor those men who took part in the trial.

Before taking any supplements it is advisable first to talk to your doctor.

Screening guidelines

Not all medical institutions and advocacy groups agree on whether or when men should be screened (routinely tested) for prostate cancer. As is the case with most other types of cancer, early detection often means more treatment options are available and less extensive treatment is required. However screening may result in needless anxiety and unnecessary treatment in some cases.

PSA testing is available with APLIE health group on request through Our Health’s Prostate Cancer Risk Management Programme. However as yet, a routine population screening using the PSA test has not been introduced in the Nigeria. Men may wish to consider asking for a PSA test once they reach 50 years old, or 40 years old for black men and those with a family history of prostate cancer, who are at higher risk.

Many doctors agree the prostate-specific antigen (PSA) blood test remains an important diagnostic tool. Find out why.

Save your prostate: get a PSA test

What is a PSA test anyway, and do you really need to get one?

Like his favourite car, a man’s body needs regular check-ups - and that includes a screening for prostate cancer, otherwise known as a PSA test. The risk of prostate cancer goes up every year after the age of 50 and that''s why men need to take steps in preventing it, or making sure it''s detected early.

The prostate-specific antigen (PSA) test is the best way to detect prostate cancer in its early stages. It''s typically done along with a rectal examination, because most malignant prostate tumours start nearest the rectum. With these two examinations, prostate cancer can be detected when it''s most treatable.

PSA tests and prostate cancer risk factors

Though all men should get a PSA test after the age of 50, some may need one sooner, if they have certain prostate cancer risk factors, which include:

  • Family history: having a father or brother with prostate cancer more than doubles your risk, according to Cancer Research UK. Men who have multiple family members affected have an even higher risk so screening should start at age 40
  • Ethnicity: West African men and African-Caribbean men have a 60% higher rate of prostate cancer, compared to white men, so they should also begin screening at age 40
  • ·Diet: a high-fat diet seems to contribute to prostate cancer so switching to a diet high in the antioxidant lycopene may lower your risk so get plenty of tomatoes, pink grapefruit, and watermelon, which contain high levels of lycopene
  • Sedentary lifestyle: getting regular exercise and keeping weight under control seems to reduce the risk for prostate cancer, especially for aggressive cancer. One survey of almost 70,000 American men found those who lost at least five kilos (11.02 pounds) over a 10-year period were about 40% less likely to develop aggressive prostate cancers, compared to men who had little weight change
  • Age: this is the biggest factor. After the age of 50, prostate cancer risk rises significantly. About two-thirds of all prostate cancers occur in men aged 65 and older

Symptoms & types

Do you know the symptoms of prostate cancer? Learn about prostate cancer symptoms, the significance of an enlarged prostate and more.

Symptoms

Are there early warning signs of prostate cancer? What other prostate problems are there? Find out here.

Prostate cancer: Symptoms of prostate cancer

Symptoms of prostate disease

The three most common types of prostate disease are:

  • Benign prostatic hyperplasia
  • Prostatitis
  • Prostate cancer

Although these diseases have different causes, they have similar symptoms. This is why it''s important to report any urinary symptoms promptly to your doctor. He or she will often refer you to an urologist (a doctor who specialises in diseases of the urinary tract and the male reproductive system) if you have symptoms of any of the following diseases.

Benign prostatic hyperplasia

Often called BPH, benign prostatic hyperplasia is a non-cancerous enlargement of the prostate gland. It is very common but rarely causes symptoms before age 40. Nearly half of men over age 65 and over 80% of men older than 80 have BPH.

Symptoms of BPH include:

  • Difficulty urinating
  • An urge to urinate even when the bladder is empty
  • Frequent urination, especially at night
  • A weak or intermittent stream of urine and a sense of incomplete emptying when urinating

Prostatitis

Prostatitis is an inflammation of the prostate. This can be caused by a bacterial infection. Men of all ages can get prostatitis, and it can occur in any size prostate (enlarged or not).

  • Symptoms of prostatitis include:
  • Difficulty urinating
  • Frequent urination, especially at night
  • Pain or burning during urination
  • Chills and a high temperature along with urinating problems

Prostate cancer

Prostate cancer, in its early stages, may not cause any symptoms. But as it progresses, symptoms often appear.

Symptoms of prostate cancer include:

  • A need to urinate frequently, especially at night
  • Difficulty starting urination
  • Inability to urinate
  • Weak or interrupted flow of urine (dribbling)
  • Painful or burning urination
  • Painful ejaculation
  • Blood in urine or semen
  • Frequent pain or stiffness in the back, hips, or upper thighs

Types

Staging prostate cancer occurs after diagnosis, when tests are done to discover the size and location of the cancer. Find out more about staging.

Stages of prostate cancer

As with other forms of cancer, the prognosis for prostate cancer depends on how far the cancer has spread at the time it’s diagnosed. Doctors describe this spread using a system of classification called staging.

Prostate cancer stages can be complex and difficult to understand. Below are the different stages and what they mean to you.

Prostate cancer stages: growth and spread

Prostate cancer grows locally within the prostate gland, often for many years. Eventually the cancer extends beyond the prostate. Prostate cancer can spread outside the prostate gland in three ways:

  • By growing into neighbouring tissues (invasion)
  • By spreading through the lymph system of lymph nodes and lymph vessels
  • By travelling to distant tissues through the blood (metastasis)

Prostate cancer stages describe the precise extent of prostate cancer’s spread.

Tests to identify prostate cancer stage

After a prostate cancer diagnosis, tests are done to detect how the cancer has spread, if it has, outside the prostate. Not all men need every test. It depends on the characteristics of a man’s prostate cancer, as seen in a biopsy. Tests to help determine the stage of prostate cancer include:

  • Digital rectal examination (using a gloved finger)
  • Prostate-specific antigen (PSA, a blood test)
  • Transrectal ultrasound
  • MRI (magnetic resonance imaging) of the prostate using a rectal probe
  • CT (computerised tomography) scan of the abdomen and pelvis, looking for prostate cancer metastasis to other organs
  • MRI of the skeleton, or a nuclear-medicine bone scan, to look for metastasis to the bones
  • Surgery to examine the lymph nodes in the pelvis for any prostate cancer spread

The TNM system of prostate cancer stages

As they do with most cancers, doctors use the TNM system of prostate cancer stages. The stages are described in terms of three different aspects of tumour growth and spread: tumour, nodes and metastasis:

  • T - for tumour - Describes how large the main area of prostate cancer is.
  • N- for nodes - Describes whether the prostate cancer has spread to any lymph nodes, and to what extent.
  • M - for metastasis - Means the distant spread of prostate cancer, for example to the bones or liver.

There are other ways of classifying prostate cancer such as the Gleason grading system. Sometimes the TNM system, the Gleason score and results from a DRE and PSA tests are combined to describe the stage of prostate cancer as a simple number:

Prostate cancer stage I

In stage I, prostate cancer is found in only the prostate. Stage I prostate cancer is microscopic: it cannot be felt in a digital rectal examination (DRE) and it isn’t seen on imaging of the prostate gland.

Prostate cancer stage II

In stage II, the tumour has grown inside the prostate but hasn’t extended beyond it.

Prostate cancer stage III

Stage III prostate cancer has spread outside the prostate, but only marginally. Prostate cancer in stage III may involve nearby tissues such as the seminal vesicles.

Prostate cancer stage IV

In stage IV, the cancer has spread (metastasised) outside the prostate to other tissues. Stage IV prostate cancer commonly involves the lymph nodes, bones, liver or lungs.

Accurately identifying the prostate cancer stage is extremely important. It helps to determine the optimal treatment, as well as the prognosis for the disease. For this reason it’s worth going through extensive testing to get the correct prostate cancer stage.

Grading refers to a cancer''s appearance and indicates how quickly it''s growing. Grading takes place after a biopsy (removal and examination of tissue), using the Gleason score. Learn more about the Gleason score and cancer grading here.

Complications

Prostate cancer treatments may lead to erectile dysfunction. Learn what to expect and how to treat impotence if it occurs. Speak to your APLIE health pharmacist.

Prostate cancer: Erectile dysfunction

Erectile dysfunction, also called impotence, is the inability to develop or sustain an erection satisfactory for sexual intercourse.

Although prostate cancer is not a cause of erectile dysfunction, treatments for the disease can cause the problem. These include:

  • Surgery to remove the entire prostate gland
  • Radiotherapy, whether by external beam or radioactive seed implants
  • High Intensity Focussed Ultrasound (HIFU)
  • Cryosurgery (freezing cancerous tissue)
  • Hormone therapy

All current treatments for prostate cancer can cause erectile dysfunction, although some treatments may lead to impotence sooner than others.

When can erectile dysfunction occur after treatment?

  • Surgery. Some degree of erectile dysfunction occurs straight after surgery to remove the prostate, regardless of whether this surgery includes trying to spare the nerve that controls erections.
  • The severity of the erectile dysfunction depends on the type of surgery used, the stage of the cancer and the skill of the surgeon.
  • If the nerve-sparing technique is used, the patient may recover from erectile dysfunction within a year of surgery. Recovery of erectile function after non-nerve-sparing surgery is unlikely but possible.
  • One study shows erectile dysfunction rates of 66% for nerve-sparing prostatectomy versus 75% for non-nerve sparing surgery one year after the procedure. The use of vacuum devices or drugs such as sildenafil once the body has healed from the surgery may improve the quality of erections and speed the return of normal sexual function (see below).
  • If an erection can be achieved after surgery, the ability to reach orgasm is maintained but these are “dry” orgasms in which little (if any) ejaculate comes out. With most men this results in infertility. Although that is often not a concern, since most men are over 50 years old at the time of diagnosis, you can talk to your doctor about “banking” sperm before the procedure.
  • Radiotherapy. The onset of erectile dysfunction following radiotherapy is gradual and usually begins about six months after the treatment.
  • Loss of erectile function is the most common long-term complication of radiotherapy. But it occurs less frequently when more sophisticated treatments such as radioactive seed implants (brachytherapy), intensity-modulated radiotherapy (IMRT) and 3-D conformal radiotherapy are used.
  • Hormone therapy. When hormone therapy is used, erectile dysfunction may occur approximately two to four weeks after the start of therapy. This is accompanied by a reduced desire for sex.

How is erectile dysfunction treated?

The current options for erectile dysfunction in men who have received treatment for prostate cancer include:

Injections of medicine into the penis before intercourse (called intracavernous or intracavernosal injection therapy)

Use of a vacuum constriction device to draw blood into the penis, causing an erection

Medicine taken as a suppository that is inserted into the penis prior to intercourse (intraurethral suppositories)

Penile implants

Prostate cancer treatments can sometimes cause urinary incontinence, but there are new techniques that can reduce your chances of this side effect. Find out more from your APLIE health pharmacists.

Prostate cancer: urinary incontinence

Urinary incontinence, or the loss of ability to control urination, is common in men who have had surgery or radiation for prostate cancer. You should prepare for this possibility and understand that, for a while at least, urinary incontinence may complicate your life.

There are different types of urinary incontinence and differing degrees of severity. Some men dribble urine whereas others will experience a total leakage. Loss of urine with a cough, sneeze or laugh is called stress incontinence and is the most common type of urine leakage men experience after prostate surgery. On the other hand, the need to frequently urinate with episodes of leakage is the type seen most often after radiation treatment. Doctors continue to improve treatments for prostate cancer to reduce the chance of having incontinence after surgery or radiation.

Why do prostate cancer treatments cause urinary incontinence?

It helps to know a bit about how the bladder holds urine. When urine is emptied into the bladder from the kidneys, it is stored inside the bladder until you have the urge to urinate. The bladder is a hollow, muscular, balloon-shaped organ. Urine flows out of the bladder, and leaves the body through a tube called the urethra. Urination happens when the muscles in the wall of the bladder contract, forcing urine out of the bladder. At the same time, muscles that surround the urethra relax and allow the flow of urine. The prostate gland surrounds the urethra. Because an enlarged prostate gland can obstruct the urethra, a man with an enlarged prostate can have urinary retention or other problems with urination.

Removing the prostate through surgery or destroying it through radiation (either with an external beam or with radioactive seed implants) disrupts the way the bladder holds urine and can result in urine leakage. Radiation can decrease the capacity of the bladder and cause spasms that force urine out. Surgery can, at times, damage the nerves that help control bladder function.

What are some new techniques that reduce the chance of becoming incontinent?

When removing the prostate, surgeons try to save as much as they can of the area around the bladder and the sphincter muscles around the urethra, thus limiting damage to the sphincter. Doctors have also fine-tuned the process of placing radioactive seed implants, using sophisticated computer projections that allow the seeds to destroy the prostate while limiting damage to the bladder.

Still, at this point, any man who is undergoing radiation or surgery to treat prostate cancer should expect to develop some problems with urinary control. With newer techniques, some men will have only temporary problems controlling their urine, and many will regain full control of their bladder in time.

What can be done to treat urinary incontinence after prostate cancer treatment?

Treatments include:

Pelvic floor treatments. Many doctors prefer to start with behavioural techniques that train men to control their ability to hold in their urine. A popular set of exercises, called Kegel exercises, strengthens the muscles you squeeze when trying to stop urinating mid-stream. These exercises can be combined with other programmes that help you train these muscles even better.

  • Supportive care. This treatment includes behaviour modification, such as drinking less fluid, avoiding caffeine, alcohol, or spices, and not drinking at bedtime. People are encouraged to urinate regularly and not wait until the last moment possible before doing so. In some people, losing weight may result in improved urinary control. Supportive care also involves changing any medications that may interfere with bladder control.
  • Medication. A variety of medications can increase bladder capacity and decrease frequency of urination. In the near future, newer medications will become available to help stop some other forms of urinary leakage.
  • Neuromuscular electrical stimulation. This treatment is used to retrain and strengthen weak urinary muscles and improve bladder control. With this treatment, a probe is inserted into the anus and a current is passed through the probe at a level below the pain threshold, causing a contraction. The patient is instructed to squeeze the muscles when the current is on. After the contraction, the current is switched off.
  • Surgery, injections, and devices. A number of techniques may improve bladder function.
  • Artificial sphincter. This patient-controlled device is made of three parts: a pump, a pressure-regulating balloon, and a cuff that encircles the urethra and prevents urine from leaking. The use of the artificial sphincter can cure or greatly improve more than 70 to 80% of patients.
  • Bulbourethal sling. For some types of leakage, a sling can be used. A sling is a device used to suspend and compress the urethra. It is made from synthetic material or from the patient''s own tissue and is used to create the urethral compression necessary to achieve bladder control.
  • Other surgery. A specialist can also perform an operation that has helped some men. It involves placing rubber rings around the tip of the bladder to help hold urine.

.

Fatigue isn''t the same as tiredness. Learn the differences, what causes cancer-related fatigue and how you can combat the problem.

Prostate cancer: Dealing with fatigue

Fatigue is often confused with tiredness. Tiredness happens to everyone. It''s a feeling you expect after certain activities or at the end of the day. Usually you know why you are tired and a good night''s sleep solves the problem.

Fatigue is a daily lack of energy. It is an unusual or excessive whole-body tiredness relieved by sleep. It can last for only a short time (a month or less) or hang around for longer (one to six months or more). Fatigue can prevent you from functioning normally and gets in the way of things you enjoy or need to do.

Cancer-related fatigue is one of the most common side effects of cancer and its treatment. It is not predictable by tumour type, treatment or stage of illness. Usually it comes on suddenly, is not due to activity or exertion and is not relieved by rest or sleep. Fatigue is often described as "paralysing". It may continue even after treatment is completed.

What causes cancer-related fatigue?

The exact reason for cancer-related fatigue is unknown. It may be related to the disease itself or to its treatment.

The following cancer treatments are commonly associated with fatigue:

  • Chemotherapy. Any chemotherapy product may cause fatigue, but it may be a more common side effect of drugs such as vincristine and cisplatin. Patients often notice fatigue after several weeks of chemotherapy, but this varies from person to person. Some patients feel fatigue for a few days, while others say the problem persists throughout the course of treatment and even after it is completed.
  • Radiotherapy. Radiotherapy can cause fatigue that increases over time. This can occur regardless of where the treatment site is. Fatigue usually lasts for three to four weeks after treatment ends but can continue for three months to a year from that point.
  • Combination therapy. More than one cancer treatment at the same time or one after the other increase the chances of developing fatigue.

What other factors contribute to fatigue?

  • Several other factors can contribute to fatigue including:
  • Tumour cells compete for nutrients, often at the expense of normal cell growth.
  • Nutritional deficiency resulting from the sideeeffects of treatments (such as nausea, vomiting, mouth ulcers, taste changes, heartburn or diarrhoea) can also cause fatigue.
  • Cancer treatments, specifically chemotherapy, can reduce blood counts. This can lead to anaemia, which occurs when the blood cannot adequately transport oxygen through the body. When tissues don''t get enough oxygen, the result can be fatigue.
  • Medicines used to treat side effects such as nausea, pain, depression, anxiety and seizures can also cause fatigue.
  • Research shows that chronic, severe pain increases fatigue.
  • Stress can make feelings of fatigue worse. Stress can come from dealing with the disease and the “unknowns”, as well as worrying about daily tasks or trying to meet others'' needs.
  • Fatigue may occur when you try to maintain your normal daily routines and activities during treatment. Modifying your schedule and activities can help to conserve energy.
  • Depression and fatigue often go hand in hand. It may not be clear which started first. One way to sort this out is trying to understand your depressed feelings and how they affect your life. If you are depressed all the time, were depressed before your cancer diagnosis or are preoccupied with feeling worthless and useless, you may need treatment for depression.(continued)

What can I do to combat fatigue?

The best way to combat fatigue is to treat any underlying medical cause. Unfortunately often the exact cause is often unknown or there may be multiple causes.

Some treatments may help to improve fatigue caused by an underactive thyroid gland or anaemia. Other causes of fatigue must be managed individually. You can use the following to help combat fatigue:

  • Assessment. Evaluate your energy levels. Think of your personal energy stores as a “bank”. Deposits and withdrawals have to be made over the course of a day or a week to balance the amount of energy you store and the amount you need each day. Keep a diary for a week to identify the time of day when you are either most fatigued or have the most energy. Note what you think may be contributing factors. Be alert to your personal warning signs of fatigue. These may include tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy/lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness and increased irritability, nervousness, anxiety or impatience.
  • Energy conservation. You can conserve your energy in several ways. Here are some suggestions:

Plan ahead and organise your work.

Change the way you store things to reduce the need to move about or stretch.

Delegate tasks when needed.

Combine activities and simplify details.

Schedule rest.

Balance periods of rest and work.

Rest before you become fatigued. Frequent, short rests are more beneficial than one long nap.

Pace yourself.

A moderate pace is better than rushing through activities.

Reduce sudden or prolonged strain on your body.

Alternate sitting and standing.

Practise proper body mechanics.

When sitting use a chair with good back support. Sit up with your back straight and your shoulders back.

Adjust the level of your work to avoid bending over.

When bending to lift something, bend your knees and use your leg muscles to lift, not your back. Do not bend forward at the waist with your knees straight.

Carry several small loads instead of one large one, or use a trolley.

Limit work that involves reaching over your head.

Use long-handled tools.

Store items lower.

Delegate activities whenever possible.

Limit work that increases muscle tension.

Breathe evenly; do not hold your breath.

Wear comfortable clothes to allow for free and easy breathing.

Identify the effects of your environment.

Avoid temperature extremes.

Eliminate smoke or harmful fumes.

Avoid long hot showers or baths.

Prioritise your activities.

Decide which activities are important to you and which can be delegated.

Use your energy on important tasks.

Other ways to combat fatigue include:

Maintain healthy nutrition

Get moderate exercise on a regular basis

Learn to manage stress

continued)

When should I call my doctor?

Although cancer-related fatigue is a common, and often expected, side effect of cancer and its treatment, feel free to mention any concerns to your healthcare providers. Fatigue may be a clue to an underlying medical problem. There may be treatments to help control some of the causes of fatigue.

A healthcare professional can make suggestions more specific to your situation that would help in combating your fatigue. Make sure you let your doctor or nurse know if you have:

  • Increased shortness of breath after minimal exertion.
  • Uncontrolled pain.
  • Inability to control side effects from treatments such as nausea, vomiting, diarrhoea or loss of appetite.
  • Uncontrollable anxiety or nervousness.
  • Ongoing depression.

APLIE health group can help you make sense of your Diagnosis & Tests

Several tests are used to diagnose prostate cancer. Learn about these tests, what you can do after diagnosis, and more.

Diagnosis

Two initial tests are commonly used to look for prostate cancer in the absence of symptoms. Learn what those tests are and how well they work.

Tests

Learn more about the tests a doctor may perform to diagnose prostate cancer, and the basics on the treatments available.

A digital rectal examination is an early, simple test to screen for prostate cancer. It can catch the disease early, when it''s most treatable. Learn who should get one and what to expect.

When the results of this blood test are high, it may indicate cancer. Find out how the test is done and what the results can mean.

After an abnormal digital rectal examination or a high PSA your GP may suggest a closer look. Find out what to expect from a prostate cancer biopsy or ultrasound and how to prepare for them.

Cystoscopy, also called a cystourethroscopy or a bladder scope, examines the urethra and bladder. Used to diagnose disease, find out how this test works and what to expect.

Treatment & care

Prostate cancer treatments vary: From newer techniques like cryotherapy, to surgery, hormone therapy and more. Learn about prostate cancer treatment, and care, here.

Treatment

Treatment for prostate cancer may include everything from "watchful waiting" to removal of the entire prostate gland. Get a brief overview of your treatment from your APLIE health team

Learn about the types that are available.

Hormone treatment means removing, blocking or adding hormones to fight prostate cancer. Learn more about prostate cancer and hormones here.

Chemotherapy may be used to treat advanced prostate cancer. Learn what to expect and the possible side effects.

Cryotherapy involves freezing areas of the prostate. However its long-term effectiveness is unknown. Learn when this therapy is used, and what its advantages are.

If you''re thinking about alternative therapy for prostate cancer, get the facts, from types of therapy available to talking with your APLIE health team about your choices.

Care

Prostate cancer management: self-care at home

A simple list of things you can do after prostate cancer treatment to help speed your recovery. Find out more from your APLIE health team.

Living & managing

From coping with cancer-related fatigue to eating healthily and getting a boost from exercise, here are helpful tips on living with and managing prostate cancer.

Living and coping

Taking action early helps you understand and deal with the many effects of your prostate cancer. Here are tips to get you started.

Coping with prostate cancer

Facing a prostate cancer diagnosis can be overwhelming. Your stress levels may rise. You may worry about finances. You may be asking yourself difficult questions such as whether to write a living will. However with education and supportive care you can deal with the many issues and emotions confronting you. The most important step you can take is to seek help as soon as you feel you are having trouble coping. Taking action early will enable you to understand and deal with the many effects of your chronic illness.

  • Some tips to get you started:
  • Do not hesitate to ask yourAPLIE health pharmacist, nurse or other healthcare provider to repeat any instructions you don''t understand. Your medical team should always be willing to answer your questions and address your concerns
  • Make use of resources and support services offered by your hospital and in the community. Learning more about your disease will help you to feel more at ease with your treatment
  • Ask your family and friends to help you sort through the information you receive
  • There are many sources of support available for patients and their families from your APLIE health team.
  • They can help to alleviate any concerns you and your family may have about your practical, financial or personal situation. They can provide you with education, counselling on lifestyle changes and referrals to community or national agencies and support groups.
  • Individual counselling. Sometimes people have problems that are better addressed in a one-to-one setting. With individual counselling, you may be better able to express sensitive or private feelings you have about your illness and its impact on your life APLIE health team are here for you.
  • Mental healthcare providers are also available to draw up a treatment plan that meets your specific needs. Strategies can be designed to help you regain a sense of control over your life and improve your quality of life. At times, if you are experiencing depression, medicines other than those to treat the physical illness may be prescribed. Ask APLIE health team for support
  • Support groups. Support groups are a very useful sharing experience. They provide an environment in which you can learn new ways of dealing with your illness. Sometimes other people who have been through similar experiences can explain things in a different way from your healthcare providers. You may also want to share approaches to the illness you have discovered with others. You will gain strength in knowing that you are not facing hardships alone APLIE health team can organise this support.
  • However remember that others may share information or experiences that do not apply to you. Never replace your doctor''s advice with that of another patient.

Cancer organisations

If you are looking for more information about cancer, care and treatment, we can help. You don''t have to do it alone. Use these resources to get more help, support, and advice on living with cancer

Why would prostate cancer come back after treatment? How is a recurrence detected? Get the answers to these questions and more your APLIE health team.

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