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Minggu, 04 Januari 2015


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A patient receives chemotherapy treatment for breast cancer at the Antoine-Lacassagne Cancer Center in Nice July 26, 2012. REUTERS/Eric Gaillard

Women's bodies are always changing. Sometimes changes that seem normal can be signs of cancer, though.
The key is to pay attention to your body so you can notice when something's different, says Robyn Andersen, PhD, of the Fred Hutchinson Cancer Research Center in Seattle. "New symptoms indicate something has changed in your body, and you want to know what that means."
So, what should you watch for?
1. Breast changes
Most breast lumps aren't cancer, but your doctor should always check them. Let her know about these changes, too:
  • Skin dimpling or puckering
  • Nipples that turn inward
  • Nipple discharge
  • Redness or scaling of your nipple or breast skin
To look for the cause of your symptoms, your doctor will do a physical exam and ask you questions about your medical history. You may also have tests like a mammogram or a biopsy, when doctors remove a tiny piece of tissue for testing.
"Women are natural bloaters," says Marleen Meyers, MD, an oncologist at NYU Langone Medical Center. "It's OK to wait a week or two to see if it goes away."
If your symptoms don't get better with time, or if they happen with weight loss or bleeding, see a doctor. Constant bloating can sometimes mean ovarian cancer. You'll have a pelvic exam as well as blood tests, and sometimes an ultrasound, to look for the cause of the problem, Andersen says. 
3. Between-Period Bleeding
If you’re still getting periods, tell your doctor if you’re spotting between them. Bleeding that’s not a part of your usual monthly cycle can have many causes, but your doctor will want to rule out endometrial cancer(cancer of the lining of your uterus). 
Bleeding after menopause is never normal and should be checked right away.
4: Skin Changes
A change in the size, shape, or color of a mole or other spot is a common sign of skin cancer. See your doctor for a thorough exam and perhaps a biopsy. This is one time you don't want to wait, Meyers says.
5. Blood in Your Pee or Stool
Talk to your doctor if you're bleeding from a part of your body that normally doesn't, especially if the bleeding lasts more than a day or two, Meyers says.
Bloody stool is often from hemorrhoids, but it can also be a symptom of colon cancer. Bloody urine is usually the first sign of cancer of the bladder or kidneys, says Herbert Lepor, MD, a urologist at NYU's Langone.
6. Changes in Lymph Nodes
Lymph nodes are small, bean-shaped glands around the body. Most changes in them come from common infections. But some cancers, including leukemia and lymphoma, can also cause lymph nodes to swell.
It's a good idea to see your doctor if you have a lump or swelling anywhere in your body that lasts a month or more, Meyers says.
7. Trouble Swallowing
Occasional trouble swallowing is nothing to worry about. But when it happens often, especially with vomiting or weight loss, your doctor may want to check you for throat or stomach cancer. 
He'll look into your symptoms with a throat exam and a barium X-ray. During a barium test, you drink a special liquid that makes your throat stand out on the X-ray.
8Weight Loss Without Trying
Most women wish extra pounds would magically melt away. But losing 10 pounds or more without a change in your diet or exercisehabits could signal a problem.
Most unintended weight loss is not cancer, Meyers says. "It's often caused by stress or your thyroid, but it can be a sign of pancreatic cancer," she says. Stomach and lung cancers are also possible. 
Your doctor may ask for a lot of tests to look for a problem, including blood tests and imaging tests, like a CT scan.
9. Heartburn
Too much food, alcohol, or stress (or all three) can cause seriousheartburn. Meyers suggests that you change your diet for a week or two to see if your symptoms get better. 
If that doesn't help, talk to your doctor. Heartburn that doesn't go away or gets worse could mean cancer of the stomach, throat, or ovaries.
10. Mouth Changes
If you smoke, watch for white or bright-red patches inside your mouth or on your lips. Both can signal oral cancer. Ask your doctor or dentist about tests and treatment.
11. Fever
A fever that doesn’t go away and can't be explained could mean leukemia or another blood cancer. Your doctor should get the details of your medical history and give you a physical exam to check for the cause.
12. Fatigue
A lot of women are tired because they lead hectic lives. But extreme tiredness that won’t go away isn’t normal.
Talk to your doctor if your fatigue never gets better or if you have other symptoms, like blood in your stool. Your doctor will ask for your complete medical history and give you blood tests. 
13. Cough
Most coughs go away on their own in 3 to 4 weeks. Don't ignore one that lasts longer than that, especially if you smoke or are short of breath. If you cough up blood, go to the doctor. A cough is the most common symptom of lung cancer.
14. Pain
Cancer doesn’t cause most aches. But ongoing pain can signal bone, brain, or other cancers. Ask your doctor about any unexplained aches that last a month or longer.
15. Belly Pain and Depression
It’s rare, but belly pain plus depression can be a sign of pancreatic cancer. Should you worry? Not unless pancreatic cancer runs in your family, Meyers says. "Then you need a prompt [exam]."

For some women with breast cancer, changes in brain activity while multitasking could explain “chemo brain” – reduced mental functioning that many experience after chemotherapy, Belgian researchers say.
“Cognitive complaints of people increase with chemotherapy and we are trying to find out why,” said Sabine Deprez, who led the new study. “Difficulty multitasking is one of the biggest complaints.”
Past research has documented changes in mental performance following chemotherapy – and in some cases, in cancer patients before chemotherapy, suggesting disease-related processes may also play a role, according to Deprez’s team.
Other studies have used imaging to show differences in brain activity between cancer patients who had chemotherapy and healthy people not being treated for cancer, the researchers write in the Journal of Clinical Oncology.
To compare women with themselves before and after chemo, as well as with other women, Deprez and her colleagues at the University Hospital Gasthuisberg of the Katholieke Universiteit Leuven, used functional Magnetic Resonance Imaging (fMRI).
The imaging technique indirectly assesses brain activity by signaling changes in blood and oxygen delivered to various regions of the brain.
Eighteen women with breast cancer scheduled to receive chemotherapy performed a multitasking exercise in an MRI machine before starting treatment and four to six months after treatment ended.
Two comparison groups - one of women with breast cancer not scheduled to receive chemotherapy and another of healthy women - also performed the tasks.
“The special thing about how we did the design was that before we did it we adjusted the difficulty for each patient, and the performance of everyone was between 70 and 80 percent,” Deprez said.
That meant patients’ performance on the test, which included indicating if two sounds were the same frequency and if two moving circles with lines through them were at the same orientation or not, while remembering two symbols presented earlier, did not change over time. This allowed the researchers to measure changes in brain activity levels during the task, not in the women’s ability to complete the task, Deprez said.
Neither of the two comparison groups seemed to change in terms of the parts of the brain activated by the tasks or their level of activation, while in the chemotherapy group brain activation significantly decreased, the authors report.
Meanwhile, patients in the chemotherapy group also complained of “foggy thinking” more than those in the other groups. Before the chemotherapy started, all the participants had about the same amount of cognitive complaints.
“The important thing that we found was a relation with subjective cognitive complaint,” Deprez told Reuters Health.
The decreased brain activation seen with fMRI may help explain why many chemotherapy patients complain of chemo brain.
“It feels like they have to do more effort to get the same result after chemo,” Deprez said.
That could be because chemotherapy causes structural changes in the brain, but experts still don’t know, she said.
Functional MRI is very useful for research, but for the cognitive effects of cancer treatment it can only be used to draw conclusions about people in general, not individual patients, Brenna C. McDonald told Reuters Health in an email.
McDonald, of the Radiology and Imaging Sciences department at Indiana University School of Medicine in Indianapolis, has investigated this topic but was not part of the new study.
“There is a more limited literature suggesting that other cancer treatments, like antiestrogen therapies, may be related to some cognitive symptoms, but this effect, if present, appears to be smaller than the effects noted after chemotherapy,” McDonald said. “Generally, however, the most significant effects have been shown with regard to chemotherapy.”
Patients who are older at diagnosis seem to be at greater risk for foggy thinking problems from chemotherapy, she added.
“As we advance our understanding of which patients are at greatest risk, hopefully we will be able to personalize medical treatment to minimize cognitive risks while still effectively treating the cancer,” McDonald said.
“Being aware of the possibility of cognitive effects of treatment is important in the same way it is important to know about other possible treatment-related side effects,” she said.
Doctors can scale back treatment for certain cancer patients, based on evidence that some drugs can be used less frequently, according to new information that is clearing the way for physicians to limit the risks of care.
Several studies backing up this "less-is-more" strategy, which can also lower the cost of care, were presented on Friday at the American Society of Clinical Oncology meeting in Chicago.
Patients with breast cancer that has spread to the bone, for instance, are often treated with monthly intravenous infusions of a class of drugs known as bisphosphonates, such as zoledronic acid, that protect against fractures and other bone problems. Zoledronic acid is sold by Novartis AG under the brand name Zometa.
Researchers at MD Anderson Cancer Center in Houston found that women with breast cancer and bone metastasis can, after the first year of monthly bisphosphonate treatment, safely scale back to receiving the drug every three months. The change could lower the risk of kidney problems as well as a rare, but serious side effect in which parts of the jawbones weaken and die.
"We found that less frequent treatment may reduce the risk of serious side effects, with added benefits in reduced patient inconvenience and cost," lead study author Dr. Gabriel Hortobagyi said in a statement.
A separate study funded by the National Institutes of Health found that certain patients with head and neck cancer linked to the human papillomavirus can safely receive lower-dose radiation therapy without compromising their chances of survival.
This approach would spare many patients from debilitating, often lifelong side effects of radiation treatment, such as trouble swallowing, loss of taste and thyroid problems - but more long-term follow up of patients is needed, said lead study author Dr. Anthony Cmelak, a professor of radiation oncology at the Vanderbilt-Ingram Cancer Center in Nashville, Tennessee.
Another federally funded study showed that it is safe to stop the use of cholesterol-lowering drugs known as statins in cancer patients with a life expectancy of less than a year. It estimated that the move would save around $603 million in the United States. Commonly used statins include atorvastatin, sold by Pfizer under the brand name Lipitor.
The study found that discontinuing statins, which are used to reduce the risk of heart attack and stroke, did not shorten survival, but did reduce incidence of cancer symptoms, including pain, depression, nausea and tiredness.
"We now have evidence that discontinuing certain medications is safe, specifically, in the case of the widely prescribed statin drugs, and can improve quality of life for patients," Dr Patricia Ganz, a Los Angeles hematologist and American Society of Clinical Oncology expert, said in a statement. 

Sumber : Internet

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