Global Banknote Market Report Essay

As the technological environment is swiftly undergoing evolution, companies operating in the healthcare/science/pharmaceutical/therapeutic industry are now scaling new heights. Also, the respective sector’s growth is boosted by the rising number of health related issues emanating from the changing lifestyle and incessantly evolving surroundings. To address the rising demand for better healthcare options and the unmet needs within the some of the underlying segments, related companies are coming up with novel and improved therapies especially in the field of cancer treatment wherein the radiation therapy is gaining quick acceptance.

Radiation therapy (RT) deploys ionized radiation and limits the proliferation of malignant cells by impairing their DNA. Radiation therapy involves the application of various types of radiations including photons, electron beams, proton beams and neutron beams. Also, the treatment regimes are classified as external radiation therapy, internal radiation therapy or brachytherapy and systemic radioisotope therapy.

This report elicits the global radiation therapy market with focus on key regional markets like North America, EMEA, Asia Pacific and Latin America.

Also, industry developments like development of LINACs, rapid Arc therapy and proton therapy; growth drivers including rising cancer cases, increasing use of alcohol and tobacco, expanding obese population and ageing population, rising healthcare expenditure and increasing GNI; and challenges like fatal cancer types, risks associated with treatment procedure and side effects, increasing treatment costs and price pressure among others are discussed in detail. Furthermore, the competitive scenario of the global radiation therapy market, along with the profiles of top 4 industry players viz. Varian, Elekta, Siemens, and Accuray are being included in the report.

By combining SPSS Inc.’s data integration and analysis capabilities with our relevant findings, we have predicted the future growth of the industry. We employed various significant variables that have an impact on this industry and created regression models with SPSS Base to determine the future direction of the industry. Before deploying the regression model, the relationship between several independent or predictor variables and the dependent variable was analyzed using standard SPSS output, including charts, tables, and tests.

Skin cancer Essay

How many of you have every laid out in the sun on purpose just to get a tan?  Or better yet how many of you believe you look prettier or more handsome tan?  According to the American Cancer Society more than 1 million people are diagnosed with skin cancer each year and the numbers seem to be increasing day to day. And believe it or not skin cancer is the most common of all cancers.  Today I am going to inform you about skin cancer and how you can protect yourself from it.

To begin, our skin is the largest organ of the body and it covers our internal organs and protects them from injury.  The skin also serves as a barrier between germs and our internal organs.  Our skin regulates body temperature and helps the body get rid of excess waste.  Certain cells in our skin also communicate with the brain and allow us the feel temperature, touch, and pain sensations.

Some may ask, what exactly is skin cancer and why is it such a big deal now?  Well there are two basic types of skin cancer; Nonmelanoma (which is also called basal or squamous cell) skin cancer and then there is melanoma skin cancer.

Most skin cancers are classified under nonmelanoma, meaning that the cells are located at the base of the outer, layer of the skin.  Basically, the skin that covers the surface of the body, not the deep tissues.  Nonmelanoma skin cancer usually develops on sun-exposed areas of the body, places like: the face, ears, necks, lips, and the backs of hands.  Depending on the type they can be fast or slow growing but rarely spreads to other parts of the body.  There is a cure for nonmelanoma skin cancer is detected and treated early.

On the other hand, you have melanoma skin cancer.  Which is the more dangerous of the two; however it is also the least common.  Melanoma skin cancer tends to spread very quickly to other body parts.  However, it is almost always curable if it is detected in the early stages.  But the killer part is a lot of people do not realize that they may have melanoma skin cancer until the later stages, after it has already started affecting other organs.  Once it has reached that stage, it is virtually incurable.  People diagnosed with melanoma skin cancer that has already spread to other body parts are given on average a five year survival rate.

So what puts you at risk for skin cancer?  Some high risk factors include:

· Unprotected and/or excessive exposure to Ultraviolet(uv) radiation

· Fair complexions( people with red hair, most likely)

· Occupational exposures (i.e. Construction workers, arsenic compounders, baseball players)

· Family history of skin cancer

· Multiple or atypical moles

· Severe sunburns as a child

So how can you detect skin cancer? Some signs of skin cancer in the early stages may include but are not limited:

· any change on the skin, especially in the size or color of a mole or other darkly pigmented growth or spot, or a new growth

· scaliness, oozing, bleeding, or change in the appearance of a bump or nodule

· the spread of pigmentation beyond its border such as dark coloring that spreads past the edge of a mole or mark

· a change in sensation, itchiness, tenderness, or pain in a mole

Ovarian Cancer Research Paper Essay


Ovarian cancer is one of the most common types of cancer among women. It is considered to be one of the most common types of cancer of the female reproductive system. According to McGuire and Markman (2003), “despite advances in treatment over the last 40 years, ovarian cancer is the second most commonly diagnosed gynaecological malignancy, and causes more deaths than any other cancer of the reproductive system” (p. 4). Despite the fact that ovarian cancer occurs less frequently than uterine cancer, it is more aggressive and can occur at any age.

In addition, it does not manifest itself in the first stages, and in most cases are diagnosed only in the later ones. All the malignant ovarian tumors are subdivided into epithelial, germ or stromal cell types (cancer). These cancers have the highest incidence among all other tumors. (Jordan, S., Green, A., & Webb, P. 2006 p.109-116).

Signs and symptoms of ovarian cancer

“Ovarian cancer has often been called the “silent killer” because symptoms are not thought to develop until advanced stages when chance of cure is poor” (Goff, Mandel, Melancon, & Muntz, 2004, p.

2705). That is why the symptoms of ovarian cancer are not specific and can be disguised as other more common diseases, such as diseases of the digestive system or urinary system. The reason for the lack of clearly defined symptoms is that ovarian cancer develops in the abdominal cavity and does not cause discomfort for the patient. The main sign of the presence of most disease is a constant presence of symptoms or their worsening. For example, ovarian cancer symptoms are distinguished by their immutability of the manifestations: they progress gradually. (Goff, B. A., Mandel, L. S., Melancon, C. H., Muntz, H. G., 2004 p. 2705-2712). The main symptoms of ovarian cancer may include the following:

1. Feeling of overeating, swelling or bloating;
2. Urgent need to urinate;
3. Pain or discomfort in the pelvic area.
4. Constant indigestion or nausea;
5. Sudden, unexplained changes of stools, which include diarrhea or constipation;
6. Frequent urination;
7. Appetite loss;
8. Rapid weight loss or rapid weight gain;
9. Increased waist circumference, which can be seen by the fact that the clothing suddenly became small; 10. Pain during intercourse;
11. Permanent weakness;
12. Pain in the lumbar area, abdominal pain. The growing tumor extends through the fallopian tubes, causing the lower abdominal pain on the affected side. The large tumors can compress the large intestine that is manifested in bloating or constipation. (Goff, B. A., Mandel, L. S., Melancon, C. H., Muntz, H. G., 2004, p. 2705-2712). In addition, ovarian cancer is characterized by metastases at the “gate” of the liver that leads to the development of ascites – an accumulation of fluid in the abdominal cavity due to the compression of the hepatic portal vein. (Goff, B. A., Mandel, L. S., Melancon, C. H., Muntz, H. G., 2004, p. 2705-2712). The later stages (3 and 4) of ovarian cancer are characterized by more severe symptoms, such as intoxication and anemia. The doctors usually can diagnose ovarian cancer for three months after the first symptoms. However, sometimes it is necessary to wait for six months or even more in order to put the final diagnosis. (Goff, B. A., Mandel, L. S., Melancon, C. H., Muntz, H. G., 2004, p. 2705-2712).

Causes of ovarian cancer

Currently, the etiological factors of malignant ovarian tumors are not significantly determined. However, some researches have advanced several hypotheses about the etiology of epithelial ovarian tumors (Modugno et al., 2003, p. 439- 446). The first one being that ovarian cancer usually occurs when a tumor develops in one or both of a woman’s ovaries. (Modugno et al., 2003, p. 439- 446). Another hypothesis is based on the concept of “incessant ovulation” (early menarche, late menopause, a small number of pregnancies, the shortening of lactation).

Remember, the constant ovulations cause serious damage to epithelial inclusions in the ovarian cortex. The following hypothesis shows that ovarian cancer, most often, is caused by the glandular epithelial cells, which produce hormones. Therefore, a violation of hormonal regulation leads to the changes of malignant epithelial cells. Ovarian cancer often develops in the presence of chronic inflammation, benign tumors or ovarian cysts. (Jordan, S., Green, A., & Webb, P., 2006, p. 109-116).

Risk factors

It is difficult enough to determine the risk factors for ovarian cancer. However, it is believed that the healthy women, who have relatives diagnosed with breast cancer, ovarian cancer or uterine cancer, are at risk of those diseases. Supporting this point of view, Cannistra (2004) states that “a strong family history of ovarian or breast cancer is the most important risk factor” for women. Too often ovarian cancer develops after menopause. However, the risk is increased only after 60 years. In turn, Cannistra (2004) supports this information and adds that “the median age of patients with ovarian cancer is 60 years, and the average lifetime risk for women is about 1 in 70”. (p. 2519-2522)

Despite the fact that most ovarian cancers are diagnosed in postmenopausal women, the disease can also occur in women who are in the premenopausal period. Women, who have been pregnant at least once, are less likely to have ovarian cancer. The use of birth control pills also reduces this probability. (Kuper, H., Cramer, D. W., & Titus-Ernstoff, L., 2002., p. 455-463). The appearance of cysts is a normal process that occurs during ovulation in women who are premenopausal. However, cysts formed in the postmenopausal period have a great chance to cause cancer. Women are at increased risk if they are having trouble conceiving. Environment factors also affect the incidence of ovarian cancer. (Kuper, H., Cramer, D. W., & Titus-Ernstoff, L., 2002., p. 455-463).

Ovarian cancer can be primary, secondary and metastatic. The malignant tumors, which primarily affect the ovary, are known as primary cancer. Secondary ovarian cancer (cystadenocarcinoma) occurs due to the benign or borderline tumors. Metastatic ovarian cancer (Krukenberg tumor) is a spreading of the primary tumor, which is often located in the gastro-intestinal tract, stomach, breast, thyroid or uterus. (Rossing, M. A., Tang, M. C., Flagg, E. W., Weiss, L. K., Wicklund, K. G., & Weiss, N. S.,2006, p. 713-720).

Ovarian cancer staging

It is possible to trace the following ovarian cancer stages, such as:
Stage 1 — limited to one or both ovaries;
• 1A) cone ovary is affected, no ascites;
• 1B) both ovaries are affected, no ascites;
• 1C) appearance of the tumor on the surface of the ovary (s), ascites.

Stage 2 — disease spreads in the small pelvis;
• 2A) affection of the uterus or fallopian tubes;
• 2B) affection of other tissues of the small pelvis;
• 2C) tumor on the surface of the ovary (s), ascites.
Stage 3 — affection of the peritoneum, metastases in the liver and other organs within the abdomen, affection of groin lymph nodes;
• 3A) — microscopic peritoneal metastasis beyond the pelvis;
• 3B) — metastasis less than 2 cm in size;

• 3C) — metastases more than 2 cm in diameter, involving retroperitoneal and inguinal lymph nodes. Stage 4 — distant metastases. (Rossing, M. A., Tang, M. C., Flagg, E. W., Weiss, L. K., Wicklund, K. G., & Weiss, N. S., 2006., p. 713-720). Thus, these are the basic ovarian cancer stages, which help to find out how widespread ovarian cancer is. Classification of ovarian tumors

1) Surface epithelial-stromal tumors – the largest group of benign epithelial ovarian tumors are cystadenoma. 2) Sex cord-stromal tumors with a minimum number of elements have the structure of sex cord-tech fibroids and may contain small nests or tubules of sex cord-type cells. 3) Germ cell tumors are teratomas, which in most cases are benign. . (Rossing, M. A., Tang, M. C., Flagg, E. W., Weiss, L. K., Wicklund, K. G., & Weiss, N. S., 2006., p. 713-720). Ovarian cancer treatment

Ovarian cancer can be suspected by a gynecologist during a standard pelvic examination. However, “much of the problem is that ovarian cancer is often detected too late. Not everyone has symptoms, and the classic ones—bloating, pelvic pain, difficulty eating and urinary frequency, are easily confused with other maladies” (Johannes, 2010, para. 6). That is why the doctor should regularly check the pelvis and conduct the palpation of the uterus, vagina, tubes, ovaries, bladder, and rectum. In addition, it is essential to use a pelvic organ ultrasound, magnetic resonance imaging (MRI), radionuclide studies (scintigraphy), intestinal endoscopy, as well as a laparoscopic examination of the pelvis with a biopsy. (Zhang, M., Xie, X., Lee, A. H., & Binns, C. W., 2004, p. 83-89). Remember that ovarian cancer does not have any obvious symptoms in the early stages. Therefore, the annual gynecological examination and ultrasonography of the groin area are very important. Main treatment usually involves surgery, chemotherapy, and sometimes radiotherapy.

Depending on the extent of tumor spread, surgery can be performed in various capacities. The obtained material must be sent for further examination. If the tumor significantly extends, the doctor should conduct the courses of chemotherapy, and then perform surgery. Mainly, surgery is performed in a radical way: the uterus with the tubes, pelvic tissue with lymph nodes, and omentum in the form of an apron are removed completely. Gland contains lymph nodes, which are often affected by metastases. Ovarian cancer has the ability to affect a healthy ovary through the cross metastases. (Rossing, M. A., Tang, M. C., Flagg, E. W., Weiss, L. K., Wicklund, K. G., & Weiss, N. S., 2006., p. 713-720). Therefore, it is very important to remove both ovaries in order to preserve the life of the patient. Taking into consideration the aggressive nature of the disease, chemotherapy is considered to be a required component of ovarian cancer treatment.

The standard chemotherapy protocol consists of two major drugs, such as Carboplatin and Taxol. (Kiani, F., Knutsen, S., Singh, P., Ursin, G., & Fraser, G., 2006, p. 137-146). Medication duration, dosage and additional drugs are determined individually: in accordance with the type of tumor, the degree of spreading and other indicators. It is possible to conduct the additional courses of chemotherapy after surgery. Ovarian cancer treatment has its specific nature. It is connected with the fact that the tumor in the ovary cannot be seen. Therefore, in cases when the doctor does not operate the patient, the only way to be sure that the tumor is gone completely is use a high-dose chemotherapy. The main features of chemotherapy for ovarian cancer

Chemotherapy is performed in almost all the stages of the disease.

Sometimes it is used to fight against the tumor, sometimes to contain the tumor and prevent it’s spreading, sometimes in order to delay the total defeat of the body. In any case, chemotherapy for ovarian cancer is proved as an effective fighting method. Chemotherapy does serious damage to the body, but its main advantage is that the drugs work in the body, and thus blocks the development of the last stage of cancer, as well as the spreading to adjacent organs. Chemotherapy for ovarian cancer has a greater chance of success than radiotherapy, because it comes to the heart of the problem.

The most important thing is that chemotherapy can get rid of cancer cells, which have already started to progress, but have not yet appeared in the specific symptoms. In other words, it can nip with the problem in the bud. Thus, if the use of chemotherapy for ovarian cancer is offered, do not refuse to do it. This is one of the few chances that could save your life, and give a reason to hope for the restoration of a normal life and future. In some cases, in addition to chemotherapy, the doctor can prescribe radiotherapy in order to kill the cancer cells. However, it is not commonly used and does not play an important role in the treatment of ovarian cancer. How to prevent the development of ovarian cancer?

Every woman should know her vulnerabilities – “loopholes” through which cancer can penetrate into the body. Loophole 1: Late arrival to the gynecologist

The annual preventive gynecological examination is required for all the women. Women, who have ovarian cancer, address to the doctor too late. This is due to the irregular visits to the gynecologist, because of this the initial stages of the disease go unnoticed. At first, cancer progresses usually without any of the characteristic symptoms. Subsequently, women can suffer from uterine bleeding, that doesn’t usually coincide with the period of menstruation and often ignore the abnormality. (Grilli, R., Apolone, G., Marsoni, S., Nicolucci, A., Zola, P., & Liberati, A., 1991, p.50-63). Women need to understand that the existence of such a symptom is a serious cause for concern, because any vaginal bleeding aside from the normal monthly menstruation may indicate a malfunction in the body. Another characteristic which women often ignore is lower abdominal pain. These pains can be short or long, weak, or strong.

However, it is not desirable to immediately take analgesics to numb the unpleasant feelings. In such a case, it will be more reasonable to see a gynecologist. In addition, it is important to conduct an ultrasound of the uterus and ovaries. Usually a pelvic examination and ultrasound can detect ovarian cancer at the early stages. (Titus-Ernstoff, L., Rees, J. R., Terry, K. L., & Cramer, D. W., 2010, p. 201-207). The growth of ovarian tumors may be accompanied by low-grade temperature, shivering, and weakness. If you do not have an infectious disease and severe pain, but constant weakness and nausea, it is essential to consult with a gynecologist. (Titus-Ernstoff, L., Rees, J. R., Terry, K. L., & Cramer, D. W., 2010, p. 201-207).

Loophole 2: Changes in hormonal balance

Many women going through menopause also experience profound changes in the level of sex hormones. “An excess of female hormones can lead to ovarian tumors and other serious gynecological diseases” (Jordan, S. J., Purdie, D. M., Green, A. C., & Webb, P. M., 2004, p.359-365). The patients, who have had surgery on the uterus and ovaries, are also at increased risk. In addition to various infectious complications, they can also have a hormonal disorder. One of the reasons for ovarian cancer is an excess of sex hormone called gonadotropin, which leads to the development of other hormone-dependent tumors. (Jordan, S. J., Purdie, D. M., Green, A. C., & Webb, P. M., 2004, p.359-365).

Therefore, women with hormonal malfunctions should be evaluated by a gynecologist with special attention. Loophole 3: Change of sexual partners and childlessness Sexual promiscuity often leads to frequent abortions. Every abortion is a serious hormonal disruption of the whole female body. The consequences of abortion are infertility, chronic diseases of the uterus and other reproductive organs. Sexual promiscuity can also lead to various infectious diseases of the genital organs. Some of these diseases often increase the risk of ovarian cancer. Nulliparous women suffer from ovarian cancer more often than those who have children. (King, M., Marks, J. H., Mandell, J. B., 2003, p. 643-646).

Loophole 4: Unhealthy lifestyles

It is known that women, who smoke or drink alcohol, are much more susceptible to ovarian cancer. Cigarette smoking and alcohol consumption weaken their health and therefore they have a higher risk of cancer. “In recent years, it is possible to trace the appearance of different cosmetics and dietary supplements. They contain the hormonal stimulants, which are very harmful for the female body” (Kiani, F., Knutsen, S., Singh, P., Ursin, G., & Fraser, G., 2006, p.137-146). It is necessary to carefully use such stimulants. Before taking these pills, it is essential to consult your primary care physician or gynecologist. Women, who have menopause, should eat a balanced diet full of vitamins and other nutrients (Kiani, F., Knutsen, S., Singh, P., Ursin, G., & Fraser, G., 2006, p.137-146). Furthermore, personal hygiene is vital to good health. Remember that any chronic diseases, especially concerning the sexual organs, weaken the immune system and increases the risk of tumor development.

However, if diagnosed as having ovarian cancer don’t give up. Remember that timely access to a physician is the key to success. Tumors can be detected by the usual examination and then refined with the help of the ultrasound and analysis. If the disease is detected in an early stage, treatment will be more effective. In such a case, the doctor has the ability to combine surgical and medical treatment, without affecting the uterus and ovaries. Such patients can even get pregnant and give birth to a healthy baby. The later stages of ovarian cancer are characterized by more severe symptoms and can even lead to the complete removal of the ovaries, uterus and other organs affected by the tumor. Unfortunately, the survival rate of these patients is very low, and they often have relapse (McGuire, W.P., & Markman, M. (2003).


Taking the above-mentioned information into consideration, it is possible to draw a conclusion that ovarian cancer is often called the “silent killer” because clinically the first manifestations are associated with the spread of the tumor outside the ovary, and sometimes beyond the pelvis. Ovarian cancer can be divided into the following forms, such as primary, secondary, and metastatic. The most common symptoms for ovarian cancer are pain in the abdomen and lower back, accompanied with abdominal distention and ascites. However, these symptoms are typical for a number of benign ovarian tumors. Surgical treatment of ovarian cancer is considered to be the fundamental. The prevention of ovarian cancer is possible through the regular preventive examinations.


Cannistra, S.A. (2004). Cancer of the ovary. N. Engl. J. Med., 351 (24), 2519-29. doi: 10.1056/NEJMra041842 Goff, B. A., Mandel, L. S., Melancon, C. H., Muntz, H. G. (2004). Frequency of Symptoms of Ovarian Cancer in Women Presenting to Primary Care Clinics. American Medical Association, 291 (22), 2705-2712. Grilli, R., Apolone, G., Marsoni, S., Nicolucci, A., Zola, P., & Liberati, A. (1991). The Impact of Patient Management Guidelines on the Care of Breast, Colorectal, and Ovarian Cancer Patients in Italy. Medical Care, 29 (1), 50-63. Johannes, L. (2010, March 9). Test to Help Determine If Ovarian Masses Are Cancer. The Wall Street Journal. Retrieved from Jordan, S., Green, A., & Webb, P. (2006). Benign Epithelial Ovarian Tumours: Cancer Precursors or Markers for Ovarian Cancer Risk? Cancer Causes & Control, 17 (5), 623-632. Jordan, S. J., Purdie, D. M., Green, A. C., & Webb, P. M. (2004). Coffee, Tea and Caffeine and Risk of Epithelial Ovarian Cancer. Cancer Causes & Control, 15 (4), 359-365. Jordan, S. J., Siskind, V., Green, A. C., Whiteman, D. C., & Webb, P. M. (2010). Breastfeeding and Risk of Epithelial Ovarian Cancer. Cancer Causes & Control, 21 (1), 109-116. Kiani, F., Knutsen, S., Singh, P., Ursin, G., & Fraser, G. (2006). Dietary Risk Factors for Ovarian Cancer: The Adventist Health Study (United States). Cancer Causes & Control, 17 (2), 137-146. King, M., Marks, J. H., Mandell, J. B. (2003). Breast and Ovarian Cancer Risks Due to Inherited Mutations in BRCA1 and BRCA2. The New York Breast Cancer Study Group Science, New Series, 302 (5645), 643-646. Kuper, H., Cramer, D. W., & Titus-Ernstoff, L. (2002). Risk of Ovarian Cancer in the United States in Relation to Anthropometric Measures: Does the Association Depend on Menopausal Status? Cancer Causes & Control, 13 (5), 455-463. McGuire, W.P., & Markman, M. (2003). Primary ovarian cancer chemotherapy: current standards of care. Br. J. Cancer, 89 (3), 3-8. doi:10.1038/sj.bjc.6601494. Modugno, F., Moslehi, R., Ness, R. B., Nelson, D. B., Bell, S., Kant, J. A., Wheeler, J. E., Fishman, D., Karlan, B., Risch, J., Cramer, D. W., Dube, M., & Narod, S. A. (2003). Reproductive factors and ovarian cancer risk in Jewish BRCA1 and BRCA2 mutation carriers (United States). Cancer Cause and Control, 14, 439-446. Rossing, M. A., Tang, M. C., Flagg, E. W., Weiss, L. K., Wicklund,

Culberson County, Texas: the Unreported County in Regards to Cancer Occurrence Essay

According to the American Cancer Society and the National Cancer Institute’s cancer registries, cancer is the second leading cause of death in the state of Texas. However, in many rural communities where cancer treatment facilities are not located, the cancer incidence statistics are suppressed to prevent duplication of counts from the reporting county where the patient is treated. An overview of the cancer incidence and trends of the top ten cancers for the United States and all sites combined for the rural area of Culberson County, Texas was performed for the years 2000 through 2009.

Data for the study was obtained based on reports from the International Classification of Diseases (ICD-9) and medical records from Culberson County Hospital and the Van Horn Rural Health Clinic in Culberson County, Texas. A total of 429 actual new cancers were identified over the ten year period. This is an average of 42. 9 official new cases each year for a rural population of only 2431. After adjusting these numbers to make comparable at a “per 100,000” population, the cancer incidence rate for this target area was found to be three times the national and state average.

With medical advancements in cancer treatment and the aging of the population, the cancer incidence will likely continue to rise for years or even decades to come. Accurately accounting for rural areas will provide information on the impact of cancer on the health care system, document the need for increased research, and further the progress in supporting cancer control knowledge across all segments of the population. In the state of Texas, cancer is the second leading cause of death (Wilkerson and Smith, 1995).

The incidence of various cancers in Culberson County (population 2,431), which has it’s primarily residence as the town of Van Horn, Texas (population of 2,013), is largely unknown (www. city-data. com). Most patients who present to Culberson County Hospital and the Van Horn Rural Health Clinic are referred to other facilities, and as such do not get counted for this county. The possibility of developing cancer can have an effect not only on individuals but also on the medical management of patients undergoing routine clinical care as well.

In an attempt to better quantify the numbers of cancer incidence in the county, the records of Culberson County Hospital and the Van Horn Rural Health Clinic were examined over a ten year period of 2000 through 2009 to investigate the rate of cancer incidence in Culberson County. This preliminary study was prompted due to a strong recent opinion among various Culberson County Hospital providers in Van Horn, Texas. There is the perception that local healthcare providers are seeing many more patients with cancer symptoms than previously (Friday, A. Md. , Pers. Comm. ).

As Culberson County Hospital is a frontier hospital, it does not have the staff or resources to treat a range of specialty conditions, and thus refers patients to El Paso, Midland, Odessa, Lubbock, Dallas, Houston and elsewhere. The patients being referred to oncologists outside of Culberson County for official diagnosis are not reported in their county of residence but in the county of treatment. This is due to the method of reporting by the referred oncologist.

In an effort to prevent duplication of state statistics and inflate occurrence percentages, reports from the home provider are omitted (Carrillo, J. , Pers. Comm. ). However, this still potentially results in artificial increases in counties with cancer treatment facilities, and subsequent decreases in areas that don’t. As a result, there is little data to validate these notions. The number of cancer cases, especially in rural areas, has an effect on the demand placed on the local health care system.

The key to survival for cancer is prevention and early detection, which is influenced by the type of cancer prevalent in an area, the extent of the disease, and treatment options. Quality tracking of cancer cases provides vital information to communities to assist in early detection. Hence, this study was undertaken to investigate the hypothesis of a potential increasing trend in the number of cancer incidences in comparison to statistics based on the Texas Bureau of Vital Statistics (http://www. cancer-rates. info/tx/), National Cancer Institute (http://seer. ancer. gov) and Texas Department of Health (http://www. dshs. state. tx. us/).

The Surveillance, Epidemiology, and End Results (SEER) program has a complete source of population-based data in the U. S. that includes stage of cancer at the time of diagnosis and follow-up of all patients for survival data (Howe et al. , 2006). Although records are amassed from health care providers, hospitals, laboratories, nursing homes and treatment facilities, only those in the registry’s defined geographic area are documented (Howe et al. , 2006).

By 1975, SEER was reporting data each November to the National Cancer Institute (NCI) (Howe et al. , 2006). The most recent reports for cancer trends are based on the diagnosis years of 1975–2007. Furthermore, each state registry collects data on patient demographics and primary cancer site, which is also submitted to NCI for U. S. statistics. Despite that cancer registries continuously update their databases, the acceptance of various records, and the disallowance of other records that would cause duplication of statistics, creates many reporting delays (Howe et al. , 2006).

It is the hope of this study that such reporting delays, in addition to the confusion with patient county demographics, can be discussed. Methods –Prior to initiating any medical record review, HIPAA (Health Insurance Portability and Accountability Act (HIPAA of 1996) disclosure forms were signed. Maintaining confidentiality of medical information is mandated by law and patient privacy was held at highest priority during this study. HIPAA regulations were assessed and conducted this study in compliance with proper protocol for research data gathering (Anzaldua and Sanchez, 2002).

Review of records in preparation for research – Under the “preparatory to research” provision, covered entities may use or disclose PHI to researchers to aid in study recruitment. The covered entity may allow a researcher, either within or outside the covered entity, to identify, but not contact, potential study participants under the “preparatory to research” provision. However, before permitting this activity, a covered entity must receive proper representation that (1) the use or disclosure is sought solely to review PHI for activities preparatory to research, and (2) that the PHI sought is necessary for the research purposes.

A researcher may contact potential study participants without an Authorization from the individual, if the researcher is a workforce member of a covered entity or a business associate of the covered entity (Gates, 2003). Data collection began with reviewing monthly International Classification of Diseases (ICD-9-CM) reports from Culberson Hospital which is reported to the Texas Department of Health – Cancer Registry. The information for these reports is gathered from local provider referrals, biopsies, and lab reports for each month. Excluded from the research were death certificates.

Due to privacy issues and HIPAA regulations, all medical records were retained at Culberson Hospital. For each patient record, a dedicated coding system for disease identification is indicated. The principal manual for classifying diseases used by healthcare providers is the International Classification of Diseases (ICD), published by the World Health Organization. Various cancers are coded according to the International Classification of Diseases, 9th edition (ICD-9) (Buck, 2004) or the more specialized International Classification of Diseases for Oncology, 3rd edition (ICD-O-3) (Percy et al. 2000).

The ICD-9 reports were used for this study due to their dominate usage as a diagnostic classification based on the multilevel arrangement of site, morphology, behavior, and grading of neoplasms that system categorizes malignant neoplasms for all types of tumors. ICD is used principally in cancer registries for coding the site (topography) and the histology (morphology) of neoplasms, usually obtained from a pathology report (Muir and Percy, 1991). A neoplasm is an abnormal new growth of cells or tissue that will continue to grow if not treated and become a tumor (McKean, 2005).

The major advantage of using the ICD for research purposes is that the ICD-9 is globally accepted and has been published by the World Health Organization (WHO) since its 6th revision in 1946 (Jemal et al. , 2007). Additionally, ICD is used by all WHO Member States for most health statistics (Jemal et al. , 2007). The ninth revision, in which codes are valid from October 1, 2009 through September 30, 2010, is the current edition in use at the time of this study. Most classifications assign numerical codes so that recurring information can be expressed, stored and retrieved easily.

The ICD-9 uses codes ranging from 140. 0 to 796. 76 for diagnosis and V10. 0 through V87. 41 for code explanation. This information conveys three levels of description: malignancy, organ affected, and histological type. ICD-O-3 codes add a separate one-digit code for histologic grading (differentiation) (Hannah and Ball, 2003). Neoplasms can be categorized in many ways and involves allocation into classes according to the ICD system. The two most important factors for proper classification of neoplasms for clinician and cancer registry are the location of the tumor in the body and the morphology, (i. . , the form of the tumor under microscopic examination) (dos Santos Silva, 1999). This indicates its behavior (malignant, benign, in situ, and uncertain).

Cancer registries attempt to classify each neoplasm according to its topography, morphology and behavior, as well as recording particulars of the host (Muir and Percy, 1999). The statistics presented, with the exception of mortality, were obtained from review of records from both Culberson Hospital and Van Horn Rural Health Clinic, as these records are managed separately.

Over sixteen-hundred different codes were pulled from the ICD-9 reports, for which each patient’s medical record was retrospectively searched to verify a referral to an oncologist, and/or reported an abnormal screening. A binder was created for each year for quick reference as needed and maintained solely at Culberson Hospital. Based on the local physician’s referral, follow up with respective oncologists was conducted for confirmation of diagnosis and official diagnostic record that would link the patient back to Culberson County. All patients’ records were verified as being Culberson County residents prior to diagnosis follow up.

Once all ten years were reviewed, a patient list was compiled and sent to each referred oncologist for confirmation with the provider code. Additionally, personal contact was made with Texas Oncology in El Paso, Texas, for verifying the accuracy of confirmed cancer treatments. In retrieving data, it was necessary to convert some descriptions and codes in order to group into broader classifications for certain sites, and each specific diagnostic code had to be matched with a more general cancer site in order to make local statistics comparable to state and national statistics (Doll and Peto, 1981).

Another issue that arouse during this study was carefully identifying any codes that had been changed over the years with the revisions of the ICD. Data was converted from a detailed to a more generalized version, but the impact of this change of content was very difficult to assess. In converting from one revision to another, many terms listed were only in the alphabetical index. As different editions are sometimes indexed differently from one another, this created additional complications.

These changes made it more challenging to compare data over long periods of time (Hayat et al. , 2007). A final spreadsheet was created categorizing each diagnosis for each year reviewed. Each worksheet was compared from previous years to insure only primary cancers and initial secondary cancers were counted. Duplications were highlighted and eliminated manually from counts. This spreadsheet was analyzed statistically using Microsoft Excel (Redmond, USA) and generated corresponding tables and graphs of the outcomes (dos Santos Silva, 1999; Zar, 2010).

The incidence rates presented in this study are expressed as the number of new primary cancers per year as well as for second or multiple cancers occurring among survivors previously diagnosed with cancer. To accurately compare to state and national statistics, the results for each site and year were multiplied by 41. 13 in order to modify the actual population of 2431 to a target population that could be expressed in the statistical rate of “per 100,000” people. Data analyzed was approximately 98% complete for all cancer sites combined, as some cancer sites, such as melanoma, were less complete in the records.

We recognize that some residents of Culberson return to their home provider for annual checkups and serious illness, and there are possible cancer patients not originally seen by a Culberson County provider that would not be accounted for. Therefore, the results of this study are to be considered conservative. While it is understood that these results will not be complete, it is believed that the above methodologies will produce the most accurate data for cancer occurrence in Culberson County to date.

Results –This study presents the cancer occurrence of new cases among residents of Culberson County from 2000 through 2009. Examination of over 48,000 documents over the ten year period yielded a total of 429 new cancers in Culberson County, Texas. This is an average of 42. 9 new cases each year. The actual number of new cancer cases for each cancer sites are shown in Table 1. When rates are adjusted to the state and national population for comparisons, these results report cancer rates approximately three times the state and national average (Figure 1) (Anzaldua and Sanchez, 2002).

Included in these cancer totals were 255 men (59%) and 174 women (41%), with ages ranging from 3-101. The ten most commonly diagnosed cancers in the United States and Texas were used for comparisons with statistics in Culberson County (Anzaldua and Sanchez, 2002). These top ten sites include prostate, breast, lung and bronchus, colon and rectum, corpus and uterus and non-specific, urinary bladder, non-Hodgkin lymphoma, melanomas of the skin, kidney and renal pelvis, and cancer of the ovary (Figure 2) (www. cdc. gov).

These ten sites accounted for 59% of total cancers in men in Culberson County and 41% of total cancers in women (Anzaldua and Sanchez, 2002). Within these 429 patients, an average of 9. 2 cases per year (41%) of all cancer sites were diagnosed as melanoma, and prostate cancer was the leading type of cancer diagnosed in men at an average of 4. 1 cases per year (18%) (Figure 3).

Melanoma occurrence separated by gender resulted in 62% occurrence in males, while 38% of females developed this cancer with the median age for both being 63. years of age (Anzaldua and Sanchez, 2002). Cancers of the lung and bronchus and cancers of the uterine were tied for the third most commonly diagnosed cancers in Culberson County. These four cancers together (melanoma, prostate, lung and bronchus, and uterine) accounted for 79% of all cancers reported among Culberson County residents during 2000 through 2009. Of additional interest, breast cancer accounted for 9% of all cases reported, with a total of 21 cases over the ten years within the study area.

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Cancer Informative Speech Essay

Cancer is a big issue all around the world. It can affect the young and old, active and inactive, and slim and overweight. There are no guarantees for anyone. Even though everyone may be at risk, there are ways to protect yourself and lower your risk. By protecting yourself from cancer, you can avoid smoking and avoid exposure to other’s people smoke. You don’t want to overeat, drink too much alcohol, or eat too many fatty foods. Also, exercise should be in your daily routine.

Cancer cells develop from out-of-control growth of abnormal cells. Cells become cancer cells from damage DNA. In most cases, cancer cells will then form a tumor.

The cancer cells do spread throughout the body, by which they’re replacing normal tissue. As the cancer is spreading, the cancer will be named by where it started. Signs and symptoms of cancer can be very noticeable. Some of the symptoms you may recognize and should get checked out by your doctor are: lump anywhere on your body, changes on your skin to and existing mole, a cough that lasts for more than three weeks, change in bowel habit that lasts more than six weeks, any abnormal bleeding from urine, unexplained weight loss, and coughing up blood.

There are a lot of different cancers and they all can be treated in different ways.

There are options you can choose from, such as chemotherapy, radiation, medications, or surgery. The options may very how far along your cancer is and how much your cancer has spread throughout your body. Cancer is never 100% curable. If the cancer is treated early, then it’s more likely to be curable and more chances to the person’s survival. It does depend on what type of cancer the person has, what stage it is in, and how well they respond to the treatment. If you are diagnosed with cancer, it is very rare that it’s not going to come back within the next five years.

The leading type of cancer for women is breast cancer. The other most common types of cancer are lung cancer, colorectal cancer, and cancer of the uterus. The leading type of cancer for men is prostate cancer. Then the other common cancers are lung cancer, colorectal cancer, and also “race-dependent” cancer. If you are a white male this type of cancer is bladder cancer. If you are a black male is cancer of the mouth and throat. Then for Asian/Pacific Island males it is stomach cancer. Also the leading type of cancer for children is leukemia. There is also brain tumors, and lymphoma.

Textual Analysis of Thank You for Smoking Essay

In the movie “Thank you for smoking”, big companies are seen as having no social responsibility with its consumers and the people that are affected by their products when they clearly know the negative effects and impacts that their products have in society. The big companies in the movie are the ones that belong to the tobacco industry and concentrate in the cigarette business. These companies are shown as not caring for the damage that tobacco does and that regardless of the effects of cigarettes on people, because they still want to sell their product in order to earn a profit.

These companies fund an association called The Academy of Tobacco Studies, whose main purpose is to research the connection that may exist between cigarettes and lung cancer.

In the association a very important employee named Nick Naylor, who is the main character of the movie, holds two very important roles, that of chief spokesman and vice-president. Nick Naylor has the hard job of representing the interests of tobacco companies in a society that finds tobacco despicable.

In other words, he tries to persuade people that the tobacco companies and cigarettes are not bad for people, when globally it is known that tobacco kills. It is known that tobacco kills because it is the primary producer of lung cancer. Throughout the whole movie many clear evidences on how these tobacco companies have no social responsibility can be seen.

In the movie a very important quote said by Nick Naylor is one that said; “ We can put the sex back in the cigarettes.” That quote came out when the board of the academy for tobacco studies was in session due to the threat posted by the Vermont Senator Ortolan Finisterre, an important critic against cigarettes usage in the United States. The threat against all of the tobacco companies was a year after the announcement every package of cigarettes must contain a picture of skull and crossbones with a message in containing the word POISON on all cigarette packages. The threat alarmed the entire Academy and so it was proposed by Naylor to try to put back cigarettes into movies and to send the message that smoking is cool and sexy. Nick later in the movie was sent to Los with the purpose of proposing to a very important media manager to a deal to make cigarettes appear in a new film.

On that same trip to California, another clear evidence on why companies on the film have no Social Responsibility is, the whole dilemma with the Marlboro Man. The Marlboro Man was the head figure used in advertisement by the Marlboro Company. He is shown in the movie with lung cancer, originated because he fell on the vice of smoking due to the advertisement that he made, that had as target to sell cigarettes. Nick Naylor, while in California, was sent with a suitcase full of money to the Marlboro Man’s ranch. When he first arrived he wasn’t well greeted, instead he was pointed with a rifle. He instantly assumed that Nick’s appearance at his home could be a bribe in order for him not to talk publicly about his conditions. But Nick, with the intentions he had convinced the Marlboro Man that he could enter his ranch so they could talk. While inside the ranch, even the Marlboro Man’s wife told Nick that how could he dare to come to their home.

When they both, Nick and Marlboro Man settled in the living room to talk, the Marlboro Man told Nick the whole story about how the company treated him when he was diagnosed with lung cancer. The Marlboro Man told Nick that when he was diagnosed with lung cancer, he went to the annual stockholders convention, where he stated that the company should cut back on advertising. The response he got from Nick’s boss at the convention when he said that was; “ We are certainly sorry to hear about your medical problem, however not knowing more about your medical history we cant come in any further”. The Marlboro Man told Nick that this was as if he had never worked for them, that they treated him like he never did an advertisement, promotion, and marketing for their deadly product.

This whole dilemma about the Marlboro Man has a lot to do with the lack of social responsibility in the companies’ side. For example in the evidence shown before about the Marlboro Man, it can be clearly showed that they didn’t care about their own people. Not caring about the people that make your company work and ditching them in the way The Marlboro Man was, only makes you look like a person who is only looking for their own interests throughout life, which from my point of view is wrong. Having self-interest in life is wrong, because things are just going to be done in a way that you only want to be benefited as is the case of the companies in the film, whose only goal and purpose is to make a profit from selling cigarettes without caring who is going to die, either it is a costumer, an employee or even a family member. In the course of the movie it can also be seen as how important and high ranked figures in the tobacco companies behave with the decisions taken.

B.R., who is not only Nick’s Boss but also the president of the academy, in the beginning of the movie, before Nick said the quote about sex and cigarettes, B.R.: “We don’t sell tic-tacs for Christ’s sake, we sell cigarettes; and they’re cool, available, and addictive. The job is almost done for us.” In these quote it can be seen from the point of view of the company that what they want is to make a profit, and that regardless of what they’ll have to do to keep the company profitable they will do it. In other words the quote says that cigarettes cause an addiction and that are always available, and that the only thing that is not done for them is that people believe that cigarettes are cancerous and harmful and in effect would stop buying their deadly product. So with barriers like the POISON tag that the Vermont Senator wants to implement, the quantity of cigarettes sold will decrease, so the company will start to profit less. It can be seen in the film that the companies know accurately what they are selling and know the harm they are doing to their customers.

In conclusion, most companies all around the world don’t care about the effects of what their products do, how they treat their employees, etc, because what they only care about is making a profit and earning money. Companies lack on their social responsibility in the film, they don’t care whom and how their products affect. It can be seen very clearly that the tobacco companies don’t care that thousands of people die ever year because of cigarettes, they only care about themselves, so they can produce and keep on selling cigarettes to people. People need to care more about their “neighbors”, which means that people need to be more aware of the fellow people around themselves and to care about them. From my point of view, I
think that it is intended in the movie to put the companies in this way so people can realize how the world is today, people are just thinking about themselves all day and caring for the others less and less everyday.

Thyroid Cancer Essay

  1. Introduction

            Cancer of the thyroid is less prevalent than other forms of cancer; however, it accounts 90% of endocrine malignancies. According to the American Cancer Society (2002), about 20, 700 new cases of thyroid cancer are diagnosed each year. Women account for 15, 800 of the new cases and men 4, 900. About 800 women and 500 men die annually from this malignancy. There are several types of cancer of the thyroid gland.

            External radiation of the head, neck, or chest in infancy and childhood increases the risk of thyroid carcinoma.

Between 1940 and 1960, radiation therapy was occasionally used to shrink enlarged tonsillar and adenoid tissue, to treat acne, or to reduce an enlarged thymus. For people exposed to external radiation in childhood, there appears to be an increased incidence of thyroid cancer 5 to 40 years after irradiation. Consequently, people who underwent such treatment should consult a physician, request an isotope thyroid scan as part of the evaluation, follow recommended treatment of abnormalities of the gland, and continue with annual checkups (Tierney, 2001).

  1. Discussion
  2. Assessment and Diagnostic Findings

            Lesions that are single, hard, and fixed on palpation or associated with cervical lymphadwnopathy suggest malignancy.

Thyroid function tests may be helpful in evaluating thyroid nodules and masses; however, their results are rarely conclusive. Needle biopsy of the thyroid gland is used as an outpatient procedure to make a diagnosis of thyroid cancer, to differentiate cancerous thyroid nodules from noncancerous nodules, and to stage the cancer if detected.

The procedure is safe and usually requires only a local anesthetic. Patients who undergo who undergo the procedure are followed closely, however, because cancerous tissues may be missed during the procedure (Tierney, 2001).  A second type of aspiration or biopsy uses a large-bore needle rather than the fine needle used in standard biopsy; it may be used when the results of the standard biopsy are inclusive, or with rapidly growing tumors. Additional diagnostic studies include ultrasound, MRI, CT scans, thyroid scans, radioactive iodine uptake studies, and thyroid suppression tests.

  1. Medical Management

            The treatment of choice for thyroid carcinoma is surgical removal. Total or near-total thyroidectomy is performed when possible. Modified neck dissection or more extensive radical neck dissection is performed if there is lymph node involvement.

  • Surgical management

Efforts are made to spare parathyroid tissue to reduce the risk for postoperative hypocalcemia and tetany. After surgery, ablation procedures are carried out with radioactive iodine to eradicate residual thyroid tissue if the tumor is radiosensitive. Radioactive iodine also maximizes the chance discovering thyroid metastasis at a later date if the total-body scans are carried out.

After surgery, thyroid hormone is administered in suppressive doses to lower the levels of TSH to a euthyroid state (Thyroid Carcinoma Guidelines, 2001). If remaining thyroid tissue is inadequate to produce sufficient thyroid hormone, thyroxine is required permanently.

Several routes are available for administering radiation to the thyroid or tissues of the neck, including oral administration of radioactive iodine and external administration of radiation therapy. The patient who receives external sources of radiation therapy is at risk for mucositis, dryness of the mouth, dysphagia, and redness of the skin, anorexia, and fatigue. Chemotherapy is infrequently used to treat thyroid cancer.

Patients whose thyroid cancer is detected early and who are appropriately treated usually do very well. Patients who have had papillary cancer, the most common and least aggressive tumor, have a 10-year survival rate greater than 90%. Long-term survival is also common in follicular cancer, a more aggressive form of thyroid cancer (Tierney, 2001). Continued thyroid hormone therapy and periodic follow-up and diagnostic testing, however, are important to ensure the patient’s well-being (Thyroid Carcinoma Guidelines, 2001).

Postoperatively, the patient is instructed to take exogenous thyroid hormone to prevent hypothyroidism. Later follow-up includes clinical assessment for recurrence of nodules or masses in the neck and signs of hoarseness, dysphagia, or dyspnea. Total-body scans are performed 2 to 4 months after surgery to detect residual thyroid tissue or metastatic disease. Thyroid hormones are stopped for about 6 weeks before the tests. Care must be taken to avoid iodine-containing foods and contrast agents. A repeat scan is done 1 year after the initial surgery. If measurements are stable, a final scan is obtained in 3 to 5 years.

            FT4 TSH, serum calcium, and phosphorus levels are monitored to determine whether the thyroid hormone supplementation is adequate and to note whether calcium balance is maintained.

            Although local and systematic reactions to radiation may occur and may include neutropenia or thrombocytopenia, these complications are rare when radioactive iodine is used. Patients who undergo surgery that is combined with radioiodine have a higher survival rate than those undergoing surgery alone. Patient teaching emphasizes the importance of taking prescribed medications and following recommendations for following-up monitoring. The patient who is undergoing radiation therapy is also instructed in how to assess and manage side effects of treatment Thyroid Carcinoma Guidelines, 2001).

            Partial or complete thyroidectomy may be carried out as primary treatment of thyroid carcinoma, hyperthyroidism, or hyper-parathyroidism. The type and extent of the surgery depend on the diagnosis, goal of surgery, and prognosis. Thyroidectomy may be treatment of choice for patients with symptomatic hyperthyroidism is given appropriate medications to return the thyroid hormone levels and metabolic rate to normal and to reduce the risk for thyroid storm and hemorrhage during the postoperative period. Medications that may prolong clotting (eg, aspirin) are stopped several weeks before surgery to minimize the risk for postoperative bleeding.

  1. Nursing Management

            Important preoperative goals are to gain patient’s confidence and reduce anxiety. Often, the patient’s home life has become tense because of his or her restlessness, irritability, and nervousness secondary to hyperthyroidism. Efforts are necessary to protect the patient from such tension and stress to avoid precipitating thyroid storm. If the patient reports increased stress when with family or friends, suggestions are made to limit contact with them. Quiet and relaxing forms of recreation or occupational therapy may be helpful (American Cancer Society (2002).

  • Teaching Patient’s Health-Care

            The patient may be discharged the evening of surgery or within 1 0r 2 days. Therefore, the patient and family need to be acknowledgeable about the signs and symptoms of the complications that may occur and those that should be reported. Strategies are suggested for managing postoperative pain at home and for increasing humidification. The nurse explains to the patient and family the need for rest, relaxation and nutrition. The patient is permitted to resume his or her former activities and responsibilities completely once recovered from surgery (Tierney, 2001).

III. Conclusion

            In conclusion, if indicated, a referral to home care is made. The home care nurse assesses the patient’s recovery from surgery. The nurse also assesses the surgical incision and reinforces instruction about limiting activities that put strain on the incision and sutures. Family responsibilities and factors relating to the home environment that produce emotional tension have often been implicated as precipitating causes of thyrotoxicosis.


  1. American Cancer Society (2002). Cancer Facts and Figures. Atlanta: American Cancer Society.
  2. Tierney, L.M. (2001). Current and Medical Diagnosis and Treatment. New York: Lange Medical Books/McGraw-Hill.
  3. Thyroid Carcinoma Task Force (2001). AACE/AAES Medical and Surgical guidelines for clinical practice: Management of thyroid carcinoma. Endocrine Practice, 345 (7), 202-220.

Breast Cancer Essay

In regard to its origin, dynamics and consequences breast cancer can be considered to be the second leading cause of cancer death among US and European women (Smith-Bindman et al, 2003).  Every year over 200,000 women are diagnosed with breast cancer, and though statistical data remains constant, the issue gets significant psychological and public resonance (Jemal et al, 2004).

The overall lifetime risk for American women constitutes 1:8, which essentially means that out of eight females born today, one will receive a breast cancer diagnosis during her lifetime (Ogden, 2004).

  Mortality rates are highest among older African American women (American Cancer Society, 2001).  Simultaneously, statistics reveals that diseased woman’s life expectancy decreases by nineteen years.

Although medical scientists and practitioners debate on the methods regarding disease treatment and how to diminish the number of breast cancer cases, many public health analysts indicate about an education exigency of young people.  Despite the fact that the younger generations are not aware of the importance of detecting breast cancer early, with the help of teens getting involved and teaching others about breast cancer, more lives will be saved.

The educational program developed for young people to prevent, forecast and diminish consequences of breast cancer involves several important aspects.  Primarily, audience should know the essence of the disease, in particular its nature, various risk factors associated with it and methods of its prevention.  Younger generation should be informed about how breast cancer or its first signs could be detected, what constitutes post-diagnosis procedure and treatments of the disease.

  However, from the critical point of view, the main objective of such programs is to prevent the appearance of the disease and decrease to the minimum lethal consequences.  This primary concern and emphasis are stipulated with the conditions under which if breast cancer is detected on its early stages, patients have from 78% to 92% survival rate (Ogden, 2004:10).

Breast cancer is considered to be a group of undifferentiated cells reproducing under extremely rapid rate in the area of the breast in women.  The earliest changes usually appear in the epithelial cells of the terminal end buds of the breast milk system, where new cancer cells form tumors.  If cancer cell are active, the tumor increases at significant rate and may result in metastasis.

Being a complex process in which cells are separated from their initial tumors and supplied trough blood and lymph systems to other organs, metastasis spreads the cancer throughout the body.  According to generally accepted medical practice, if size of a lump does not exceed one centimeter, it is indicated as benign (Hart, 1999), however, in every case adequate medical consultation should be provided.

Medical specialists distinguish risk factors for breast cancer that individual can change and those that cannot be affected (Barton, 2005).  Constant risk factors are considered to be being a woman, getting older, having a family history as well as previous breast cancer history, having radiation therapy to the chest area, being Caucasian, getting periods young, usually before 12 years old, having late menopause, never having children and having genetic mutation that increases individual’s risk.

There were several studies conducted regarding genetic mutation for breast cancer, and it was disclosed that 3%-10% of breast cancers are related to changes in either gene BRCA1 or the gene BRCA2 (Ogden, 2004).  Simultaneously, younger audience should be taught that along with so called uncontrolled risk factors, there are several factors that can be affected by individual’s behavior.

Thus, taking hormone replacement therapy, birth control pills, not breastfeeding, moderate and heavy alcohol drinking, being overweight and not exercising can actually being qualified as risk factors for breast cancer, though not as much important as gender, age and family history (Barton, 2005:28).

However, factors mentioned above can be controlled by every woman in order to reduce chances of developing a breast malignancy.  From the practical point of view, cancer risk factors are based on probabilities, therefore proper screening and early detection remain to be the most adequate methods in reducing the mortality associated with breast cancer.

     During the education process, the main thing that should be emphasized is that the effectiveness of treatment is directly related to the stage on which a breast cancer is detected (Barton, 2005; Ogden, 2004).  The common medical practice indicates that regular mammography screening allows decreasing the mortality of breast cancer by 30% (Hart, 1999:144), which means that every woman should get a yearly mammogram starting from age 40 or even earlier.

     During the mammography screening, the x-ray picture sometimes detects various substances in the breast, essence, character and nature of which is not recognizable and thus, it may provoke unnecessary worrying of both patient and health professional (Barton , 2005).  Young woman are recommended to have a compulsory clinical breast exam done by a health professional.  In addition, during clinical breast exam everywoman has an opportunity to learn how to conduct self-examination for lumps and shape of the breast.

One should not underestimate the value of clinical breast exams or self-examination because 15% of tumors are felt but cannot be detected by regular mammographic screening (Fletcher et al, 2003:1674).  Although a lump in the breast is the most common way women discover a breast cancer, younger women should understand that any changes in a breast require further medical consultation and investigation.  Among the clinical tests that are conducted in modern oncological clinics, some women are a chance to know if they have a chance of getting the disease by simply tracing back cases of breast cancer throughout  the history of relatives.

Contemporary oncologists consider the following signs to be those that require immediate attention from health specialist:

  • Thickening or density in the breast or underarm;
  • Ulcerated or inverted nipple;
  • Puckered or dimple skin;
  • Redness or swelling of the breast;
  • A lump near the breast, including the underarm, collarbone and neck (Ogden, 2004:20-22).

If these abnormalities have been detected, and it should be specifically emphasized during the education program, individual should get immediate consultation (physical exam) from a health professional, get a mammogram and possibly an ultrasound, and visit a breast surgeon for examination if needed.  Contemporary medicine possesses various treatment techniques for breast cancer, in particular, radiotherapy, toxic chemotherapy combinations, hormonal treatments and prophylactic mastectomies are used to treat early lesions. 20-year follow-up data from the NSABP B-06 trial (Mirshahidi, 2004:25) have confirmed that radiation therapy clearly decreases the rate of locoregional recurrence in patients who undergo lumpectomy.

Usually, radiation treatment is given after, rather than before, chemotherapy (Mirshahidi, 2005:24). Newer radiation techniques include partial breast irradiation, partial breast irradiation and brachytherapy, and interstitial brachytherapy. These techniques are under investigation and, at this point, may be used in the context of a clinical trial (Giap, 2004).

Another effective treatment of the disease, adjuvant treatment, is defined as the use of systemic therapy for microscopic metastatic disease after surgical resection of the primary tumor. Chemotherapy and antiestrogen therapy are the two major forms of adjuvant treatment, and patients may be given one or both. A meta-analysis conducted by the Early Breast Cancer Trialists’ Collaborative Group (Mirshahidi, 2004: 25) showed the benefit of adjuvant therapy in premenopausal and postmenopausal women and in women with node-negative and node-positive disease.

Breast cancer can affect almost every individual, however there are certain risk factors according to which one woman has more chances for breast cancer diagnosis.  From the statistical point of view, the lifetime risk of any woman getting the disease is about 1:8, however the lifetime risk of dying from breast cancer is lower than 1:28 (Ogden, 2004).

General education about the disease, possible risk factors and various screening and detection methods allow women to notice the disease or its signs before giving it a chance to spread.  Simultaneously, education and enhanced awareness of younger generation regarding a breast cancer reveals new opportunities in preventing the disease, its consequences and diminishing lethal cases.


American Cancer Society. (2001). Cancer facts and figures, 2001 (Publication No. 5008.96).     Atlanta: American Cancer Society

Hamid R. Mirshahidi, MD Jame Abraham, MD. (2004). Managing early breast   cancer. Postgraduate Medicine. Minneapolis: Oct. 116(4), 23-27

Joy Ogden (2004). Understanding Breast Cancer, Wiley, 2004

Diane Hart. (1999). Diagnosis and treatment of breast cancer. Plastic Surgical Nursing. Pitman:             Fall.19(3): 137-145

Wylie Burke (2005). “Taking Family History Seriously”, Annals of Internal Medicine.   Philadelphia: 143(5):388-390

Huan B Giap (2004). “Accelerated breast brachytherapy: an effective and convenient alternative           for selected patients with early-stage breast cancer.” Women’s Oncology Review. Boca       Raton: 4(4):251-261

Mary B. Barton, MD (2005) “Breast cancer screening.” Postgraduate Medicine. Minneapolis:    Aug 118(2): 27-35

Fletcher S.W, Elmore J.G. (2003). “Clinical practice. Mammographic screening for breast         cancer.” New England Journal of Medicine; 348(17):1672-80

Smith-Bindman R., Chu P.W, Miglioretti D.L., et al. (2003). “Comparison of screening mammography in the United States and the United Kingdom.” JAMA; 290(16):2129-37

Jemal A, Clegg LX, Ward E, et al.( 2004). Annual report to the nation on the status of cancer,   1975-2001, with a special feature regarding survival. Cancer; 101(1):3-27


Endometrial Cance Essay

This cancer mainly has the supported information of how it happens, where it happens in the body, how can it be treated, and who to turn to when one needs help. Endometrial cancer is found in the endometrium, which is the lining of the uterus. The endometrium is found in a woman’s pelvic area and is where a fetus grows until birth. Endometrial cancer occurs when cells of the endometrium begin to grow and multiply without the control mechanisms that normally limit their growth.

As the cells grow, they form a tumor. (“Endometrial Cancer – PubMed Health. , 2012) The exact cause of endometrial cancer is unknown, but there are many risk factors that lead to what causes it to grow rapidly, killing off thousands of women each year. Endometrial cancer is usually found in women in between the ages of 50 and 60. Women, who are obese, fifty pounds over their ideal weight, are ten times greater at risk than women that are not obese.

Body fat produces estrogen and the higher level of estrogen are believed to increase the risk of cancer. This is believed because women with excess fat have higher levels of estrogen.

Women that have not been pregnant are at three times higher risk. Women who have their periods before the age of twelve are at an increased risk because early puberty increases the number of years that the endometrium is exposed to higher levels of estrogens. (“Endometrial Cancer – PubMed Health. “, 2012). A woman who goes through menopause after the age of fifty-two, which is called late menopause, actually increases the number of years that the endometrium is exposed to estrogen. To all cancers there are symptoms that may be long term or short term.

In endometrial cancer, the most common symptoms are abnormal bleeding from the vagina. (Cervical Cancer, 2013). Abnormal bleeding happens during menopause, which makes it harder to determine if something is wrong. During menopause, the menstrual period should become shorter, and the frequency should become farther apart. If there were to be any uncommon bleeding, it should be reported to a physician. Pelvic pain, swelling or lumps in the pelvic area, and weight loss are symptoms that are less common and would indicate advanced cancer.

The staging system that is used for endometrial cancer was developed by the international Federation of Gynecology and Obstetrics. Staging is used to classify the cancer based on how extent the disease is. In endometrial cancer, staging is mostly based on how far the main tumor has spread. There are four stages as follows: Stage I: The tumor is limited to the upper part of the uterus and has not spread to the surrounding lymph nodes or other organs. Stage IA: Tumor limited to the endometrium or less than one half of the myometrium.

Stage IB: Invasion equal to or more than one half the myometrium (middle layer of the uterine wall) Stage II: Invasion of the cervical stroma but does not extend beyond the uterus (strong supportive connective tissues of the cervix) Stage IIIA: Invasion of the serosa (outermost layer of the myometrium) and/or the adnexa (the ovaries or fallopian tubes) Stage IIIB: Invasion of the vagina and/or parametrical involvement Stage IIIC1: Cancer has spread to the pelvic lymph nodes but not to distant organs Stage IIIC2: Cancer has spread to the par aortic lymph nodes with or without positive pelvic lymph nodes but not too distant organs Stage IV: The cancer has spread to the inside of the bladder or the rectum and/or to the inguinal lymph nodes and/or to the bones or distant organs outside the pelvis, such as the lungs. Stage IVA: Tumor invasion of the bladder, the bowel mucosa, or both Stage IVB: Metastasis to distant organs, including intra-abdominal metastasis, and/or inguinal lymph nodes (“Endometrial Cancer – PubMed Health. “, 2012). There are treatments for endometrial cancer, but it depends on the stage of the cancer. There is an initial surgery that has to be done, which involves removing the entire uterus and cervix, fallopian tubes, and ovaries. After this surgery is done staging is determined.

After the staging is determined, only then will there be a treatment by a physician. Surgery is the main form of treatment for endometrial cancer, but there are other options. There is radiation therapy, but this is used for stages two, three, and four. It is given to kill any cancer cells remaining in the body. Chemotherapy is another option and drugs are used to kill cancer cells. The advantage of this option is that the chemicals can attack cancer cells anywhere in the body. The disadvantage of this option is that the side effects include nausea, hair loss, fatigue, anemia, infections, and damage to organs like the kidneys. This therapy is mainly used for advanced endometrial cancer. (“Endometrial Cancer – PubMed Health. , 2012). The last option would be hormone therapy, which uses hormones to fight cancer cells. This is only used in advanced and metastatic endometrial cancer. If endometrial cancer is determined, there should be foods in the individual’s diet to avoid. Many women with this condition can improve their symptoms by just controlling their diet. When this diet is created, the main goal is to eliminate foods that increase stimulated estrogen, prostaglandins. There are ten foods to avoid following an endometriosis diet. The first food to avoid is sugar. Sugar can produce an acidic environment within the body, which produces more pain of endometriosis.

Wheat should be avoided because it contains phytic acid, which aggravates symptoms. Soy products contain phytic acid and irritate the digestive system and reduce mineral absorption. Caffeine increase estrogen levels and estrogen triggers endometriosis flare ups. When you consume more than two cups of coffee a day, estrogen levels are caused to rise. Alcohol should be avoided because vitamin B from the liver is being destroyed. The liver is needed to clear out the excess estrogen to control the cancer. Dairy products, mostly milk and cheese, should be avoided because they aggravate the symptoms also. Red meat contains growth hormones that include estrogen, so this should also be avoided.

Saturated fats and oils are high in fatty acids that stimulate production of hormone levels. Foods like butter, margarine, lard, organ meats, and fried foods are high in saturated fats and oils. Another group of food that should be avoided is refined carbohydrates. This includes white bread, pasta, flour, pastry, cakes, etc. These should be avoided because most of their natural nutrients are removed, which leads to increase endometriosis symptoms. The last groups of food that should be avoided are additives and preservatives. This includes processed, frozen, and pre-packaged foods. (Nutrition Facts, 2012) There are not many alternatives for this type of cancer.

This is said because there is strictly surgery that has to be done before anything else can happen. This surgery then leads to the treatment for the individual that has the cancer. (“Endometrial Cancer – PubMed Health. “, 2012) In every cancer, you have a statically breakdown of how many people have survived or died from a certain type of cancer. My statically breakdown is involved mostly with women, because no man can get the cancer. Endometrial cancer is usually diagnosed at an early stage. “The one year survival rate is about 92%. The five year survival rate for this cancer that has not spread is 95%. If the cancer has spread to distant organs, the five year survival rate drops to 23%.

Survival rates for African American women are 10% lower than that of white females for every stage” (ncbi. nlm. nih. gov). In conclusion, most women who have endometrial cancer are cured. There are many women who die from the emotional part of obtaining the cancer. Many women would feel anxious and depressed. There are many support and counseling groups that are concerned with the individual’s feelings. Friends and family members should be very supportive and the individual that has obtained the cancer should not be hesitant to bring the topic up to close friends or family. It is amazing how many people are helped through their cancer by just talking out the worries or concerns they may have.

My opinion about endometrial cancer is that it should not be taken as a joke. This is something serious that affects 200,000 women each year from their day to day life. I never knew this cancer existed until I conducted research for an original cancer. This cancer is something that will affect many people in the future if prevention actions are not taken. References “Endometrial Cancer – PubMed Health. ” Web. 07 Jan. 2012. <http://www. ncbi. nlm. nih. gov/pubmedhealth/pmh0001908/>. “Endometrial Cancer Staging – EMedicineHealth: Symptoms, Prognosis, Treatment and Risk Factors by. ” Endometrial Cancer. Web. 07 Jan. 2012. <http://www. emedicinehealth. com/endometrial_cancer/article_em. htm>. Endometrial Cancer Treatment after Surgery. ” UpToDate Inc. Web. 07 Jan. 2012. <http://www. uptodate. com/contents/patient-information-endometrial-cancer-treatment-after-surgery>. “Endometriosis Diet – Foods to Avoid | Relieve Endometriosis. ” Endometriosis Explained | Relieve Endometriosis. Web. 07 Jan. 2012. <http://relieveendometriosis. com/foods-to-avoid-on-an-endometriosis-diet/>. ·, Media Flow. “Endometriosis. ” Alternative Surgery. Web. 07 Jan. 2012. <http://www. alternativesurgery. com/education/endometriosis/>. “Self Nutrition Data” Know what you eat. Web. 21 March. 2012. <http://nutritiondata. self. com/>