One more for September - Thyroid Cancer

September was busy for those of us who make an effort to educate people about cancer awareness. We've already covered childhood cancers, gynecological cancers, and blood cancers... finally we are sharing some information about Thyroid cancer.

According to the American Cancer Society, the incidence rate for thyroid cancer has been increasing sharply since the mid-1990s, and it is the fastest-growing cancer in both men and women. Three out of four cases of thyroid cancer occur in women. This means that 36,015 of the 48,020 estimated diagnoses in 2011 will be in our sisters, mothers, daughters, and girlfriends. If you aren't concerned for yourself, we hope you'll read and share the following information for their sake.

The most common symptom of thyroid cancer is a lump in the neck. This is why your doctor always feels your neck when you pay them your annual visit. Lymph nodes in your neck and your thyroid gland are good indicators when something is amiss that hasn't yet been detected through other physical signs. Other symptoms include:

• tight or full feeling in the neck
• difficulty breathing or swallowing
• hoarseness and pain in the throat
• neck that does not go away

Although most lumps in the thyroid gland are not cancerous, individuals who detect an abnormality should pay a visit to their doctor as soon as possible to rule out the possibility of cancer.

There are a few risk factors associated with thyroid cancer, the most common of which include being female, a family history of thyroid cancer, history of goiter or other non-malignant thyroid condition, and radiation exposure related to medical treatment during childhood.

Our resource room at Highlands Oncology Group in Rogers stocks a great deal of materials about different types of cancer. Stop by, or contact one of our social workers to request more information.

Gynecological Cancers

September is National Gynecological Cancers Awareness Month. We aren't going to list all the symptoms and treatment options for the six types of cancer listed, but there are links provided that will provide more information. There are a number of cancers that fall under the description of "gynecological":

• Cervical - an estimated 12,710 new cases will be diagnosed in 2011. Virtually all cases of cervical cancer (over 99%) are caused by some strain of the Human Papillomavirus (HPV). The virus also causes some cancers of the vulva, vagina and penis. A vaccine is recommended for females between the ages of 9 and 26 which prevents the most common of the strains of HPV, which account for over 70% of the newly diagnosed cases of cervical cancer. 
• Endometrial (Uterine Corpus) - The National Cancer Institute predicts 46,470 new cases will be diagnosed in 2011, with 8,120 women dying from the disease. It is the most common cancer of the female reproductive system, accounting for approximately 6 percent of all cancers in women in the United States.
• Fallopian Tube - Primary carcinoma of the fallopian tube is one of the rarest gynecological cancers. Only about 1,500 to 2,000 cases have ever been reported in the United States. Secondary cancers due to metastasis from the ovaries, endometrium, gastrointestinal tract or breast are more common.
• Gestational Trophoblastic Disease - Gestational trophoblastic disease (GTD) is a set of diseases that arise from cells related to pregnancy that become cancerous. Hydatidiform moles occur in about 1 pregnancy out of 1,000 in the United States and Europe. Choriocarcinoma, a malignant form of gestational trophoblastic disease (GTD), is even less common, affecting approximately 1 pregnancy out of 40,000 in the United States.
• Ovarian - An estimated 21,990 new cases of ovarian cancer will be diagnosed in the U.S. this year. It will account for about 3% of all cancers among women. The good news is that we have seen a 9% decline in the incidence of ovarian cancer since 1992. Ovarian cancer causes more deaths than any other gynecological cancer. For this reason, ongoing research studies and awareness education are still vital.
• Vulvar -Although this type of cancer is rare, the symptoms can be confused with those of sexually transmitted diseases such as herpes. It's important to communicate with your gynecologist if you are concerned about any of the symptoms listed for vulvar cancer since it may take a while for outward signs to develop.

As with all cancers, one of the best things an individual can do to manage their health is to have a good relationship with a physician. Scheduling annual exams, routine screenings according to medical guidelines, and quick attention to anything out of the ordinary are indispensable habits to develop when hoping to catch  problems early and prevent them from becoming a more serious threat to one's health.

In addition to the screenings recommended, family history could indicate a need for closer attention being paid to certain potential issues. Many kinds of cancer have a genetic component, and may necessitate screenings earlier than the recommended age. Family history of illness should be discussed with your physician.

When the Patient is a Child

It's estimated that just over 11,000 children between infancy and age 14 will be diagnosed with cancer in 2011. Overall, cancer is rare in children (total cancer diagnoses predicted for this year is over 1.5 million), but incidence rates have been increasing slightly by 0.6% every year since 1975.

The good news is that while new cases are increasing, the mortality rate has been cut in half (53%) in that same time-period. This can be attributed to improvements in treatment and the high number of young patients who are participating in clinical trials.

But there is still reason for awareness and diligence in caring for our children's health. Though the mortality rate for childhood cancers is relatively small, only 1,300 children are expected to lose their battles with cancer compared to over 570,000 adults - it is still listed as the second-leading cause of death in children, surpassed only by accidents. One-third of the estimated deaths will be in children who are diagnosed with leukemia. 

Early symptoms of cancer in children are usually non-specific. Children should be receiving regular medical checkups to help parents and doctors become familiar with what is "normal" for their health. Any unusual symptoms that persist can be investigated. If there is a suspicion of cancer, it's vital that it is caught early, avoiding a potentially health-threatening delay in diagnosis.

Some symptoms can include:

• An unusual mass or swelling in any part of the body;
• unexplained paleness and/or loss of energy;
• Sudden tendency to bruise;
• Persistent, localized pain;
• Prolonged, unexplained fever or illness;
• Frequent headaches, often with vomiting;
• Sudden eye or vision changes; and
• Excessive, rapid weight loss.

Major categories of childhood cancer and their respective symptoms can be found on the Ped-Onc Resource Center. As with any cancer, the best defense is a good offense. Know your children and their habits and health histories well, and visit with a doctor if you have concerns about their health.

If you need further information about specific cancers or would like to visit with a social worker about our patient support services, contact us at 479-361-5847. Most children in Northwest Arkansas who are diagnosed with cancer will travel out of our area for treatment. We can assist with travel expenses and help make arrangements in some cases. We can also help connect you with other agencies that can be of assistance. Don't hesitate to contact us if you have questions for our staff.

Cancers of the Blood

Two different cancers are frequently lumped together when we're talking about "blood cancers". Leukemia and Lymphoma develop differently, and have different lists of symptoms, but both involve the blood.

The American Cancer Society estimates that 44,600 new cases of leukemia will be diagnosed in 2011. It's a cancer of the bone marrow and blood, and there are four groups based on cell type: acute lymphocytic (ALL), chronic lymphocytic (CLL), acute myeloid (AML), and chronic myeloid (CML). Three-quarters of children and adolescents diagnosed with leukemia have ALL. Although we tend to hear a lot about children with leukemia, 90% of leukemia cases are actually diagnosed in adults 20 years of age or older. For them, the most common diagnoses are AML and CLL.

Symptoms of leukemia include:

• fatigue
• paleness
• weight loss
• repeated infections
• fever
• bruising easily
• nosebleeds or other hemorrhages

In acute leukemia, these symptoms may show up suddenly, while chronic leukemia may progress more slowly and show very few symptoms. It's often diagnosed with a routine blood test.

There are several risk factors known to cause higher incidences of leukemia. Medical radiation, such as that used in cancer treatment, and even some chemotherapy, have been linked to the disease. Genetic abnormalities such as those that cause Down syndrome have been found to increase risk as well. Some recent studies have suggested a link between leukemia and obesity. Family history remains one of the most significant risk factors for CLL, while cigarette smoking and exposure to certain chemicals such as benzene (found in gasoline and cigarette smoke) are risk factors for AML.

It is estimated that 75,190 new cases of lymphoma will be diagnosed this year. It's a cancer of the lymphocytes, or white blood cells. There are two types of lymphoma - Hodgkin (also called Hodgkin's Disease) and Non-Hodgkin. Non-Hodgkin (NHL) is the most common, with 66,630 predicted cases in 2011. Within NHL, there are a wide variety of subtypes.

Symptoms of lymphoma include:

• swollen lymph nodes
• itching
• night sweats
• fatigue
• unexplained weight loss
• intermittent fever

The risk of developing NHL increases with age, as does the risk of most cancers. The risk of developing Hodgkin, on the other hand, is highest in adolescents and young adults. The cause of lymphoma is unknown in most cases, although a few factors associated with altered immune function have been identified. People who receive organ transplants are at greater risk due to the required immune suppressing medications they have to take to prevent rejection of their transplant. Also, people with HIV and human T-cell leukemia virus type I have a higher risk factor. As with many other cancers, a family history of lymphoma carries a slightly higher risk, as do occupational and environmental exposures to certain chemicals.

Be aware of your risk, and discuss any unusual physical symptoms with your doctor. Since these cancers affect children, be sure to listen to any complaints your children share and don't hesitate to have them evaluated if you are concerned.

If you are currently fighting leukemia or lymphoma, or are a survivor or caregiver, you may be interested in a support group that meets at our office the 2nd Tuesday of each month from 5:30-6:30 p.m. For more information, contact Meredith Kinsey, BSW at 361-5847.