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PETITIONED PUBLIC HEALTH ASSESSMENT

NEWTOWN COMMUNITY
GAINESVILLE, HALL COUNTY, GEORGIA


APPENDIX H: NEWTON CANCER STATISTICS AND INFORMATION FOR RESIDENTS

How do Newtown cancers compare to U.S. cancers?

What are the most common cancers in the nation?

In 1996, the American Cancer Society expected to see a diagnosis of 136,480 new cancers in blacksin the United States. The most commonly diagnosed cancer in black males in the United States isprostate cancer (34,000/yr), followed by lung cancer (11,600), and cancer of the colon and rectum(6,800). The most common cancers in black women in the United States is breast cancer (16,000),followed by lung cancer (8,800) and colon-rectal cancers (7,700).

What are the most common cancers in Newtown?

Additional cancer information was obtained by ATSDR from the Northeast Georgia Medical Centercancer registry for cancers diagnosed from 1980 to present. No new cancers of the buccal cavity andpharynx have been diagnosed since the 1990 state epidemiologic study was conducted. The mostfrequently occurring cancers in this community were prostate cancers, colorectal cancers, breastcancer, and cervical cancer. These cancers are very common in the United States, and many are verycommon in aging populations. The common cancers in Newtown follow frequency trends in theUnited States. Newtown cancers are cancers common in an older population. The wide range ofdifferent types of cancer in this community makes it difficult for ATSDR to conclude anyassociation between contaminants from any source, and the incidence or mortality of cancer inNewtown. When environmental contamination is present and is adversely effecting a population onecancer or a few related cancers would be expected to be markedly more prevalent than other cancers.In this case, there are no highly elevated rates of any one or two particular cancers, only a widevariation of a number of cancers that were not frequently diagnosed.

Cancer Age Groups-Number of Cases per Age Group, Newtown 1980-19961
Cancer Type Age less than 30 years old 30-39 years old 40-49 years old 50-59 years old 60-69 years old 70-79 years old 80+ years old
Prostate         2 2 2
Colon/Rectal     1 1 1   2
Breast     2 1 1    
Cervical 1   3        
Bladder     1 1   1  
Leukemia/blood         2 1  
Esophagus       1 1    
Pancreas           2  
Lung2         1 1  
Pharynx       1      
Oral         1    
Kidney           1  
Liver           1  
Uterine         1    
Testicular   1          
Age Group Totals 1 1 7 5 10 9 4
1 Cancers reported between the years 1980-1996 were collected from Northeast Georgia Regional Medical Center. Patients could have sought treatment in other cities and their cases been missed.
2 This lung cancer was diagnosed on a neighboring street, not in the ten street Newtown Community.

 

Year of Diagnosis by Cancer Type, Number of Residents-Newtown 1980-1996*

Cancer Type Diagnosed 1980-1983 Diagnosed 1984-1987 Diagnosed 1988-1991 Diagnosed
1992-1996
Prostate Cancer   1 4 1
Colon/Rectal 2   1 2
Breast   2   2
Cervix 1 1   2
Bladder   1 2  
Leukemia/blood 1 1 1  
Esophagus 1 1    
Pancreas   1 1  
Lung*     2  
Pharynx 1      
Oral   1    
Kidney       1
Liver     1  
Uterine     1  
Testicular   1    
Year Totals 6 10 12 8

Newtown Cancer Profiles

The following information was made possible with excerpts from fact sheets distributed by the American Cancer Society and the NationalCancer Institute. The cancers listed are the types of cancers diagnosed in Newtown between 1980 and 1996. Hopefully, this information will helpresidents understand each type of cancer, its symptoms, and risk factors, a little better.

What is Cancer?
Cancer is a group of many related diseases. All forms of cancer involve out-of-control growth and spread of abnormal cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person's life, normal cells divide more rapidly until the person becomes an adult. After that, normal cells of most tissues divide only to replace worn-out or dying cells and to repair injuries.

Cancer cells, however, continue to grow and divide, and can spread to other parts of the body. These cells accumulate and form tumors (lumps) thatmay compress, invade, and destroy normal tissue. If cells break away from such a tumor, they can travel through the bloodstream, or the lymph system(part of the body that fights off infection) to other areas of the body. There, they may settle and form "colony" tumors. In their new location, the cancercells continue growing. The spread of a tumor to a new site is called metastasis. When cancer spreads, though, it is still named after the part of thebody where it started. For example, if prostate cancer spreads to the bones, it is still prostate cancer, and if breast cancer spreads to the lungs it is stillcalled breast cancer.

Leukemia, a form of cancer, does not usually form a tumor. Instead, these cancer cells involve the blood and blood-forming organs (bone marrow,lymphatic system, and spleen), and circulate through other tissues where they can accumulate. It is important to realize that not all tumors arecancerous. Benign (noncancerous) tumors do not metastasize and, with very rare exceptions, are not life-threatening.

How is cancer detected?
Cancer is often detected after a patient notices changes in their normal body functions, pain, or discomfort. A doctor does tests (called screening) because a patient is having symptoms or because it is routine to screen for some conditions. An example of a routine screening for cancer is a Pap smear, at a woman's annual gynecologic exam. Screening may involve a physical exam, lab tests, and/or procedures to look at internal organs, either directly or indirectly. During a physical exam, the doctor looks for anything unusual and feels for any lumps or growths. Examples of lab tests include blood and urine tests, the Pap test (microscopic examination of cells collected from the cervix), and the fecal occult blood test (to check for hidden blood in stool). Internal organs can be seen directly through a thin lighted tube (such as a sigmoidoscope, which lets the doctor see the rectum and the lower part of the colon) or indirectly with x-ray images (such as mammograms to check the breasts).

Doctors consider many factors before recommending a screening test. They weigh factors related to the individual, the test, and the cancer that the test is intended to detect. For example, doctors take into account the person's age, medical history and general health, family history, and lifestyle. These factors greatly influence a person's health and well-being. In addition, they assess the accuracy and the risks of the screening test and any followup tests that may be necessary. Doctors also consider the effectiveness and side effects of the treatment that will be needed if cancer is found. People may want to discuss any concerns or questions they have with their doctors, so they can weigh the pros and cons and make an informed decision about whether to have a screening test.

What are the symptoms of cancer?
A symptom is an indication of disease, illness, injury, or that something is not right in the body. Symptoms are felt or noticed by a patient, but not easily observed by anyone else. For example chills, weakness, achiness, shortness of breath, and a cough are symptoms that might indicate pneumonia. A sign is also an indication of illness, injury, or that something is not right in the body. But, signs are defined as observations made by a physician, nurse or other health care professional. Fever, rapid breathing rate, abnormal breathing sounds heard through a stethoscope are signs that may indicate pneumonia.

The presence of one symptom or sign may not provide enough information to suggest a cause. Forexample a rash in a child could be a symptom of a number of things including poison ivy, ageneralized infection like rubella, an infection limited to the skin, or a food allergy. But, if the rashis associated with a high fever, chills, achiness and a sore throat, then all of the symptoms togetherprovide a better picture of the illness. In many cases, a patient's signs and symptoms do not provideenough clues to determine the cause of an illness, and medical tests such as x-rays, blood tests, or abiopsy may be needed.

Although some generalized symptoms and signs such as unexplained weight loss, fever, fatigue, orlumps may be due to several types of cancer, they are often caused by other types of diseases. Othersigns and symptoms are relatively specific to a particular type of cancer. It is important to see yourdoctor so they can correctly determine if your symptoms are an indication of cancer orsomething less serious.

How is cancer treated?
Treatment choices for the person with cancer depend on the stage of the tumor, that is, if it has spread and how far. Treatment options may include surgery, radiation, chemotherapy, hormone therapy, and immunotherapy:

  • Surgery is the oldest form of treatment for cancer. Before the discovery of anesthesia andantisepsis (methods such as sterilization of instruments to prevent infection), surgery wasperformed with great discomfort and risk to the patient. Today surgery offers the greatest chance for cure for many types of cancer. About 60% of people with cancer will have some type of surgery, or operation.

  • Radiation therapy uses high-energy particles or waves, such as x-rays or gamma rays, to destroy or damage cancer cells.

  • Chemotherapy is the use of medicines (drugs) to treat cancer. Systemic chemotherapy usesanticancer drugs that are usually given into a vein or by mouth. These drugs enter thebloodstream and reach all areas of the body, making this treatment potentially useful for cancer that has spread.

  • Hormone Therapy is treatment with hormones, drugs that interfere with hormone production or hormone action, or surgical removal of hormone-producing glands to kill cancer cells or slow their growth.

  • Immunotherapy is the use of treatments that promote or support the body's immune system response to a disease such as cancer.

  • Alternative and Complementary Therapies
    Unproven therapy is any therapy that has not been scientifically tested and approved. Useof an unproven therapy instead of standard therapy is called alternative therapy. Somealternative therapies have dangerous or even life-threatening side effects. For others, themain danger is that a patient may lose the opportunity to benefit from standard therapy.Complementary therapy, on the other hand, refers to therapies used in addition to standardtherapy. Some complementary therapies may help relieve certain symptoms of cancer,relieve side effects of standard cancer therapy, or improve a patient's sense of well-being.The American Cancer Society recommends that patients considering use of any alternativeor complementary therapy discuss this with their health care team.

What are risk factors for cancer and how can cancer be prevented?
A risk factor is anything that increases a person's chance of developing a disease such as cancer. Different cancers have different risk factors. For example, smoking is a risk factor for cancers of the lungs, mouth, throat, larynx, bladder, and several other organs. It is important to remember, however, that these factors increase a person's risk but do not always "cause" the disease. Many people with one or more risk factors never develop cancer, while others with this disease have no known risk factors. It is important, however, to know about risk factors so that appropriate action can be taken, such as changing a health behavior or being monitored closely for a potential cancer.

All cancers caused by cigarette smoking and heavy use of alcohol could be prevented completely.The ACS estimates that in 2000 about 171,000 cancer deaths are expected to be caused by tobaccouse, and about 19,000 cancer deaths may be related to excessive alcohol use, frequently incombination with tobacco use. Many cancers that are related to dietary factors could also be prevented. Scientific evidence suggests that up to one-third of the 552,200 cancer deaths expected tooccur in the US in 2000 are related to nutrition and other lifestyle factors and could also beprevented. Certain cancers are related to viral infections-for example, hepatitis B virus (HBV),human papillomavirus (HPV), human immunodeficiency virus (HIV), human T-cellleukemia/lymphoma virus-I (HTLV-I), and others-and could be prevented through behavioralchanges. In addition, many of the 1.3 million skin cancers that are expected to be diagnosed in 2000could have been prevented by protection from the sun's rays.

Regular screening examinations by a health care professional can result in the detection of cancers ofthe breast, colon, rectum, cervix, prostate, testis, oral cavity, and skin at earlier stages, whentreatment is more likely to be successful. Self examinations for cancers of the breast and skin mayalso result in detection of tumors at earlier stages. The screening-accessible cancers listed aboveaccount for about half of all new cancer cases. The 5-year relative survival rate for these cancers isabout 80%. If all Americans participated in regular cancer screenings, this rate could increase to95%.

Cancer Diagnosed in Newtown
(note: cancers are in alphabetical order)

Bladder Cancer

Where is the bladder located and what does it do?
The bladder is a hollow organ in the lower abdomen. It stores urine, the waste that is produced when the kidneys filter the blood.

How common is bladder cancer?
Each year, nearly 55,000 people in the United States learn that they have bladder cancer.

What are the symptoms of bladder cancer?
Some common symptoms of bladder cancer include: blood in the urine (slightly rusty to deep red in color), pain during urination, and frequent urination, or feeling the need to urinate without results. When symptoms occur, they are not sure signs of bladder cancer. They may also be caused by infections, benign tumors, bladder stones, or other problems. A screening should be done by a doctor to make a diagnosis.

Who is most at risk for bladder cancer?
Researchers have found that white people in the United States get bladder cancer twice as often as African-Americans, and men are affected about three times as often as women. People with family members who have bladder cancer may be more likely to get the disease as well. Most bladder cancers occur after the age of 55, but the disease can also develop in younger people. Smoking cigarettes can increase risk of developing bladder cancer two to three times that of a nonsmoker. Also, occupational hazards have been associated with developing bladder cancer. Increased risk is seen in people in the rubber, chemical, and leather industries, as well as in hairdressers, machinists, metal workers, printers, painters, textile workers, and truck drivers (NCI).

Breast Cancer

How common is breast cancer?
Beyond skin cancer, breast cancer is the most common cancer among women, accounting for nearly one of every three cancers diagnosed in the United States. Last year, 215,000 new cases of breast cancer were diagnosed.

What are the risk factors for breast cancer?
Breast cancer has a number of risk factors including: age, race, gender (male breast cancer is rare), a family or personal history of breast cancer, use of birth control pills, use of estrogen replacement hormones, alcohol, and diet. Breast cancer is most common in older women, with 84 percent of breast cancer deaths occurring in women 50 years of age and older. Generally, breast cancer is more common in white women, however, black women under age 50 have higher incidence rates of breast cancer than white women under age 50. There is also evidence that suggests women who breastfeed their babies have a lower risk of breast cancer than women who do not.

What should I do to detect breast cancer early?
Following the American Cancer Society's guidelines for the early detection of breast cancer improves the chances that breast cancer can be diagnosed at an early stage and treated successfully.

  • Women aged 40 and older should have a screening mammogram every year.
  • Between the ages of 20 and 39, women should have a clinical breast examination by a health professional every 3 years. After age 40, women should have a breast exam by a health professional every year.
  • Women aged 20 or older should perform breast self-examination (BSE) every month. By doing the exam regularly, you get to know how your breasts normally feel and you can more readily detect any change. If a change occurs, such as development of a lump or swelling in the breast or underarm area, skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk, you should see your health care provider as soon as possible for evaluation. However, remember that most of the time, these breast changes are not cancer.

Cervical Cancer

What is the cervix?
The cervix is the lower part of the womb (uterus). The uterus has two parts. The upper part, called the body of the uterus, is where the baby grows. The cervix, in the lower part, connects the body of the uterus to the vagina, or birth canal. Cervical cancer begins in the lining of the cervix.

How common is cervical cancer?
Cervical cancer is diagnosed in approximately 12,800 women annually, and approximately 4,600 women will die from it this year.

What are the symptoms of cervical cancer?
It is important to remember that cervical precancers and early cancers usually show no symptoms or signs. A woman usually develops symptoms when the cancer has become invasive. An unusual discharge from the vagina (separate from your normal monthly menstrual period) can be a sign of cervical cancer. Such discharges may include blood spots or light bleeding and may occur in between or following your periods. Bleeding following intercourse is a common symptom. Pain during intercourse may also indicate cervical cancer. However, all of these signs and symptoms can be caused by conditions other than cervical cancer. For example, an infection can cause pain or bleeding.

What are the risk factors for cervical cancer?
The most important risk factor for cervical cancer is infection with the Human Papilloma Virus (HPV), which often manifests itself as genital warts. It is transmitted from one person to another during sex. Black women have a death rate from cervical cancer over twice the national average. Unprotected sex makes infection more likely. HIV (the virus that causes AIDS) infection also makes a woman more likely to develop cervical cancer, as well as smoking, and diet. Regular Pap tests during a woman's annual exam can result in early detection and increase chances of surviving the cancer. Primary prevention of this disease is use of condoms, monogamous sexual relationships, and smoking cessation. Beyond smoking cigarettes, no other chemical risks have been identified.

Colon and Rectal Cancers

Where do colon and rectal cancers develop?
Colon and rectal cancer develop in the digestive tract, which is also the gastrointestinal, or GI, tract. The colon is the first part of the large bowel, or large intestine and is connected to the small intestine. The first part of the large bowel, called the colon continues to absorb water and mineral nutrients from the food matter and serves as a storage place for waste matter. The waste matter left after this process goes into the rectum, the final 6 inches or so of the large bowel. From there it passes out of the body through the anus. The digestive system processes food for energy and rids the body of solid waste matter (fecal matter or stool).

How common are colon and rectal cancers (also called colorectal cancer)?
Among men and women, colorectal cancer is the third most common cancer diagnosed in Americans. About 93,800 new cases of colon cancer (43,400 men and 50,400 women) and 36,400 new cases of rectal cancer (20,200 men and 16,200 women) will be diagnosed in 2000. Colon cancer is expected to be responsible for about 47,700 deaths(23,100 men and 24,600 women) during 2000. About 8,600 people(4,700 men and 3,900 women) will die from rectal cancer during 2000.

What are the symptoms people with colorectal cancers have?
Common signs and symptoms of colorectal cancer include:

  • A change in bowel habits
  • Diarrhea, constipation, or feeling that the bowel does not empty completely
  • Blood (either bright red or very dark) in the stool
  • Stools that are narrower than usual
  • General abdominal discomfort (frequent gas pains, bloating, fullness, and/or cramps)
  • Weight loss with no known reason
  • Constant tiredness
  • Vomiting

What are the risk factors for colorectal cancer?
Certain things can put a person at higher risk for developing colorectal cancers, such as: a family history of colon or rectal cancers, having had colon or rectal cancer before, a history of intestinal polyps (small growths), history of inflammatory bowel syndrome, aging (90% of colorectal cancers are in people over 50 years old), high fat diets, physical inactivity, and obesity. Some of these risk factors can be controlled and others are genetic (hereditary, or passed down in families) and cannot. However, early detection can greatly increase the chances that a person diagnosed with colorectal cancer will survive the disease (ACS).

Esophageal Cancer

What does the esophagus do?
Esophageal cancer starts in the muscular tube that connects the throat to the stomach, the esophagus. This tube allows food to enter the stomach for digestion. The esophagus is about 10-13 inches long. At its smallest point, it is a little less than one inch wide.

How common is esophageal cancer?
Approximately 12,300 people are diagnosed annually with esophageal cancer.

What are the symptoms of esophageal cancer?
Trouble swallowing (dispahgia) is the most common symptom of cancer of the esophagus. It means that you feel as if food is lodged in the chest. Other symptoms include: pain swallowing or pain, weight loss, in the chest that feels like heartburn, hoarseness, hiccups, pneumonia, and high calcium levels are usually signs of more advanced cancer.

Who is at greatest risk, or is most likely to get esophageal cancer?
Esophageal cancer is three times more common in men than women, and three times more common among African American than whites. It is also more common in the elderly. Other risk factors also include drinking and smoking.

Kidney Cancer

What are kidneys and what do they do?
The kidneys are two reddish-brown, bean-shaped organs located just above the waist, one on each side of the spine. They are part of the urinary system. Their main function is to filter blood and produce urine to rid the body of waste. As blood flows through the kidneys, they remove waste products and unneeded water (NCI).

How common is kidney cancer?
The American Cancer Society predicts that there will be about 31,200 new cases of kidney cancer in the year 2000 in this country. About 11,900 people, adults and children, will die from this disease (ACS).

What are the symptoms of kidney cancer?
If the disease is found early, the chances of surviving kidney cancer are very good. Noticing early symptoms often helps in early diagnosis. Blood in the urine is the most common sign of renal cell cancer. Blood in the urine can also be caused by a bladder infection or some other non-cancerous kidney disease. Signs and symptoms of renal cell cancer include: blood in the urine, low back pain (not from an injury), mass or lump in the belly, tiredness, weight loss (rapid, and without a known reason), fever (not from a cold, the flu, or other infection), swelling of ankles and legs, and high blood pressure.

What increases the risk of someone developing kidney cancer?
Risk factors for kidney cancer include:

  • Smoking: smoking doubles the risk of getting kidney cancer.
  • Overuse of certain painkillers: pain killers containing phenacetin were once popular non-prescription medications, but they have not been available in the United States for over 20 years.
  • Asbestos: some studies show a link between exposure to asbestos in the workplace and kidney cancer.
  • Cadmium: there may be a link between cadmium exposure and kidney cancer. Also, cadmium may increase the cancer-causing effect of smoking. Workers can be exposed to cadmium in the air from working with products such as batteries, paints, or welding materials.
  • Gene changes (mutations): Genes are made up of DNA and are the basic units of heredity. They are the reason we resemble our parents. Changes or mutations in certain genes can increase the risk of developing kidney tumors. Some of these changes are inherited (people with a family history of renal cell cancer have an increased risk) and some can be caused by later damage, for example, by cigarette smoke.
  • von Hippel-Lindau syndrome: this disease, caused by an inherited gene mutation (change), increases the chances of renal cell cancer and other types of cancer.
  • Tuberous sclerosis: patients who have this disease often have cysts in the kidneys, liver, and pancreas and are more likely to get renal cell cancer.
  • Diet and weight: some studies show a link between being overweight, a diet high in fat, and renal cell cancer.
  • Long-term dialysis: people who have been on dialysis for a long time may develop cysts in their kidneys that can give rise to renal cell cancer.
  • Age: RCC is rare in children and young adults; it is found mostly in adults between the ages of 50-70 years.
  • Gender: men are twice as likely to get renal cell cancer as are women.

Chronic Lymphoproliferative and Myeloproliferative Disorders

What is leukemia and how does it effect the body?
Bone marrow is the soft, spongy, inner part of bones. All of the different types of blood cells are made in the bone marrow. In babies, bone marrow is found in almost all the bones of the body. But by the teen-age years, it is found mostly in the flat bones such as those of the skull, shoulder blades, ribs, pelvis, and back bones. Bone marrow is made up of blood-forming cells, fat cells, and tissues that aid the growth of blood cells. Early (primitive) blood cells are called stem cells. These stem cells grow (mature) in an orderly process to produce red blood cells, white blood cells, and platelets. Red blood cells carry oxygen from the lungs to all other tissues of the body. They also carry away carbon dioxide, a waste product of cell activity. A shortage of red blood cells (anemia) causes weakness, shortness of breath, and tiredness.

White blood cells (leukocytes) help defend the body against germs--viruses and bacteria. There arequite a few types (and sub-types) of white blood cells. Each has a special role to play in protectingthe body against infection. The three main types of white blood cells are granulocytes, monocytes,and lymphocytes. The suffix--cyte means cell. Platelets are actually pieces that break off fromcertain bone marrow cells. They are called platelets because they look a little bit like plates whenseen under the microscope. Platelets help prevent bleeding by plugging up areas of blood vesselsdamaged by cuts or bruises.

The lymphatic system consists of lymph vessels, lymph nodes, and lymph fluid. Lymph vessels arelike veins except that they carry a clear fluid, lymph, instead of blood. Lymph is composed of excessfluid from tissues, waste products, and immune system cells. Lymph nodes (sometimes called lymphglands) are pea-sized organs found along the lymph vessels. Lymph nodes collect immune systemcells. The nodes get bigger when they fight infection. Swollen lymph nodes are not usually serious,especially in children but rarely they can be a sign of leukemia when the cancer has spread outsidethe bone marrow.

There are four major types of leukemia: acute versus chronic and lymphocytic versus myelogenous.Acute means rapidly growing. Although the cells grow rapidly, they are not able to mature properly.Chronic refers to a condition where the cells look mature but they are not completely normal. Thecells live too long and cause a build-up of certain kinds of white blood cells. Lymphocytic andmyelogenous (or myeloid) refer to the two different cell types from which leukemias start.Lymphocytic leukemias develop from lymphocytes in the bone marrow. Myelogenous leukemiadevelops from either of two types of white blood cells: granulocytes or monocytes.

Leukemia is cancer of the white blood cells. This cancer starts in the bone marrow but can thenspread to the blood, lymph nodes, the spleen, liver, central nervous system and other organs. In orderto understand the different types of leukemia, it is helpful to have some basic knowledge of the bloodand lymph systems. Following is an explanation of some of the parts of these systems.

How common is leukemia?
The American Cancer Society predicts that, in the year 2000, there will be about 30,800 new cases of all types of leukemia in this country. Of these, about 12, 500 will be chronic leukemia: 8,100 chronic lymphocytic leukemia (CLL) and 4,400 chronic myelogenous leukemia (CML). The remaining cases are of other chronic types. Chronic leukemia affects mostly older adults. Only about 2% of chronic leukemia patients are children.

What are the symptoms of leukemia?
At least one-fifth of people with chronic leukemia have no symptoms at the time their cancer is diagnosed. Their cancer is diagnosed by blood tests performed during an evaluation some unrelated health problem or during a routine checkup. Even when symptoms are present, they are often vague and nonspecific. Most symptoms of chronic leukemia, such as weakness, fatigue, reduced exercise tolerance, weight loss, fever, bone pain, and pain or a sense of "fullness" in the abdomen (especially after eating a small meal) can also occur with other cancers as well as many noncancerous conditions. Many of the signs and symptoms of chronic leukemia occur because the leukemic cells replace the bone marrow's normal blood-producing cells. As a result, people do not have enough properly functioning red blood cells, white blood cells, and blood platelets.

Other symptoms include:

  • Anemia, a shortage of red blood cells, causes excessive tiredness, a "pale" color to the skin, and in more serious cases, shortness of breath.

  • Not having enough normal white blood cells increases the risk of infections. Although leukemia is a cancer of white blood cells and patients with leukemia may have very high white blood cell counts, the leukemic cells do not protect against infection the way normal white blood cells do.

  • Thrombocytopenia (not having enough of the blood platelets needed for plugging holes indamaged blood vessels) can lead to excessive bruising, bleeding, frequent or severenosebleeds, and bleeding gums.

  • Leukemia cells may spread to other organs and can cause symptoms there. For example,spreading to the brain may cause headaches, weakness, seizures, vomiting, difficulty inmaintaining balance, or blurred vision.

  • Some patients have bone pain or joint pain caused by leukemic cells spreading from the marrow cavity to the surface of the bone or into the joint.

  • Leukemia often causes enlargement of the liver and spleen, organs located on the upper rightand upper left side of the abdomen, respectively. Enlargement of these organs may benoticed as a fullness, or even swelling, of the belly. These organs are usually covered by the lower ribs but when they are abnormally large, they can be felt by a doctor.

  • Leukemia may spread to lymph nodes. If the affected nodes are close to the surface of thebody (for example, lymph nodes on the sides of the neck, in the groin, the underarm areas,and above the collarbone), the patient or health care provider may notice the swelling.Swelling of lymph nodes inside the chest or abdomen may also occur, but can be detectedonly by imaging tests.

What are the risk factors for developing leukemia?
There are some factors in the environment that are linked to chronic leukemia. For example, high-dose radiation exposure (such as from an atomic blast or nuclear reactor accident) increases the risk of CML but not CLL. Long-term contact with herbicides or pesticides among farmers can increase their risk of CLL. There is some concern about very high-voltage power lines as a risk factor for leukemia. The NCI has several large studies going on now to look into this question. So far, the studies show either no increased risk or a very slightly increased risk. Clearly, most cases of leukemia are not related to power lines. The only known inherited risk factor for chronic leukemia is having first-degree relatives (parents, siblings, or children) who have had CLL. Most people who develop leukemia, however, do not have any of the above risk factors. The cause of their leukemia remains unknown at this time. Because the cause is not known, there is no way to prevent most cases of leukemia. The exception is smoking, which has been shown to increase the risk of leukemia.

Liver Cancer

Where is the liver and what does it do?
Liver cancer begins in the liver, the largest organ in the body. The liver weighs about three pounds. It is found under the right lung. The liver has two sections, called lobes. Each is divided into segments. It is one of the most important organs and has a number of vital tasks, such as storing and changing vitamins and nutrients so they can be used by the body, creating the agents responsible for allowing blood to clot, and controlling the level of blood glucose in the body.

How common is liver cancer and who is at highest risk?
In this country, liver cancer is found more often in men than in women. The American Cancer Society predicts that there will be about 15,300 new cases of liver cancer in the year 2000 in this country. About 13,800 people will die of the disease. Liver cancer is fairly rare in the United States and Europe. However, in the United States, rates in the black populations and Hispanic populations are roughly twice as high as the rates in whites. Liver cancer is very common in Asian countries and the highest rate of liver cancer in the United States is found in Vietnamese males and other Asian Americans.

What are the symptoms of liver cancer?
There are signs and symptoms of liver cancer in later stages. These could include weight loss, lack of appetite, pain in the stomach area and sudden jaundice (yellow-green color of skin and eyes). These problems can also be caused by many illnesses other than cancer. Physicians can perform the appropriate tests to determine whether the symptoms are cancer, or a less serious condition.

What are the risk factors of developing liver cancer?
Having certain diseases can increase a person's risk of getting liver cancer. These include infection with the hepatitis B or hepatitis C virus. Cirrhosis of the liver (formation of scar tissue in the liver) is another risk factor for liver cancer. Cirrhosis can be caused by alcohol abuse or by a disorder that causes iron to build up in the liver. Exposure to certain chemicals can also increase the risk of liver cancer. These include:

  • Aflatoxin: This substance is made by a fungus found in tropical and subtropical regions. It often infects wheat, peanuts, soybeans, corn, and rice in those areas.
  • Vinyl chloride and thorium dioxide: These chemicals are used far less often today or are strictly controlled.
  • Anabolic steroids: These are male hormones. They are sometimes given for medical reasons, but some athletes also take them to increase their strength.
  • Arsenic : In some parts of the world, drinking water contains traces of arsenic. This can increase the risk of liver cancer.
  • Tobacco: Some studies suggest a link between tobacco use and liver cancer. Others do not.
  • Birth control pills: Most of the studies linking birth control pills to liver cancer involved types of pills no longer in use. We do not know whether current birth control pills increase liver cancer risk.

Lung Cancer

How common is lung cancer?
Lung cancer is the leading cause of cancer death for both men and women. During the year 2000 there will be about 164,100 new cases of lung cancer in this country. About 156,900 people will die of lung cancer: about 89,300 men and 67,600 women. More people die of lung cancer than of colon, breast, and prostate cancers combined. Lung cancer is fairly rare in people under the age of 40. The average age of people found to have lung cancer is 60.

What are the symptoms of lung cancer?
Symptoms of lung cancer include:

  • A cough that does not go away
  • Chest pain, often made worse by deep breathing
  • Hoarseness
  • Weight loss and loss of appetite
  • Bloody or rust-colored sputum (spit or phlegm)
  • Shortness of breath
  • Fever without a known reason
  • Recurring infections such as bronchitis and pneumonia
  • New onset of wheezing

When lung cancer spreads to distant organs, it may cause:

  • Bone pain
  • Weakness or numbness of the arms or legs, dizziness
  • Yellow coloring of the skin and eyes (jaundice)
  • Masses near the surface of the body, caused by cancer spreading to the skin or to lymph nodes in the neck or above the collarbone

What are the risk factors for lung cancer?
Smoking is by far the leading risk factor for lung cancer. More than 8 out of 10 lung cancers are thought to result from smoking. Nonsmokers who breathe the smoke of others also increase their risk of lung cancer. Non-smoking spouses of smokers, for example, have a 30% greater risk of developing lung cancer than do spouses of nonsmokers. Workers exposed to tobacco smoke in the workplace are also more likely to get lung cancer. There are other risk factors for lung cancer besides smoking. People who work with asbestos have a higher risk of getting lung cancer. If they also smoke, the risk is greatly increased. Besides smoking and asbestos, there are a few other risk factors for lung cancer. These include certain cancer-causing agents in the workplace, radon gas, and lung scarring from some types of pneumonia. Also, people who have had lung cancer in the past have a higher chance of having it again and, as mentioned earlier, the risk of lung cancer increases with age. Some studies have shown that the lung cells of women who smoke may develop cancer more easily than those of men. While some people believe that air pollution is a major cause of lung cancer, the truth is that air pollution only slightly increases the risk. Smoking is by far the more important cause. Even so, some people who have never smoked or worked with asbestos still get lung cancer. Since we do not know why this happens, there is no sure way to prevent it.

Multiple Myeloma

How does multiple myeloma effect the immune system?
The immune system is composed of several types of cells that work together to fight off infections and other diseases. Lymphocytes (lymph cells) are the main cell type of the immune system. There are two types of lymphocytes: T-cells and B-cells. When B-cells respond to an infection, they mature and change into plasma cells. Plasma cells produce and release proteins called immunoglobins (antibodies) to attack and help kill disease-causing germs such as bacteria.

Multiple myeloma is a type of cancer formed by malignant plasma cells. Normal plasma cells are animportant part of the immune system. When plasma cells grow out of control they can produce atumor. These tumors can grow in several sites, particularly in the soft middle parts of bone calledthe bone marrow. When these tumors grow in multiple sites they are referred to as multiplemyeloma.

How common is multiple myeloma?
Approximately 13,000 people are diagnosed with multiple myeloma a year.

What are the symptoms of multiple myeloma?
Symptoms of multiple myeloma depend on how advanced the disease is. In the earliest stage of the disease, there may be no symptoms. When symptoms do occur, patients commonly have bone pain, often in the back or ribs. Patients also may have broken bones, weakness, fatigue, weight loss, or repeated infections. When the disease is advanced, symptoms may include nausea, vomiting, constipation, problems with urination, and weakness or numbness in the legs. These are not sure signs of multiple myeloma; they can be symptoms of other types of medical problems. A person should see a doctor if these symptoms occur.

What are the risk factors for multiple myeloma?
The following risk factors can make developing multiple myeloma more likely:

  • Aging: Age is the most significant multiple myeloma risk factor. Only 2% of cases are diagnosed in people younger than 40. The average age at diagnosis is about 70.
  • Race: Multiple myeloma is about twice as common among African Americans as whiteAmericans. The reason is not known.
  • Radiation exposure: Exposure to radioactivity has been suggested as a risk factor but accounts for a very small number of cases.
  • Family history: This cancer may seem to be more common in some families. This is quite rare, however, and most patients have no affected relatives.
  • Occupational exposure: Some studies have suggested that workers in certainpetroleum-related industries may be at a higher risk.
  • Other plasma cell diseases: About 20% of people with monoclonal gammopathy ofundetermined significance (MGUS) or extramedullary plasmacytoma will eventuallydevelop multiple myeloma.

Oral and Oropharyngeal Cancers

What are oral and oropharyngeal cancers?
Oral cancer is cancer that starts in the oral cavity (mouth). The oral cavity starts at the skin edge of the lips. It includes the lips, the buccal mucosa (inside lining of the lips and cheeks), the teeth, the gums, the front two-thirds of the tongue, the floor of the mouth below the tongue, the hard palate (bony roof of the mouth), and the retromolar trigone (area behind the wisdom teeth). Oropharyngeal cancer develops in the oropharynx (the part of the throat just behind the mouth). The oropharynx begins where the oral cavity stops. It includes the base of tongue (back third of the tongue), the soft palate, the tonsillar area (tonsils and tonsillar pillars), and the posterior pharyngeal wall (back wall of the throat).

How common are oral and oropharyngeal cancers?
The American Cancer Society estimates that there are 30,200 new cases of oral and oropharyngeal cancers diagnosed each year.

What are the symptoms of oral and oropharyngeal cancers?
Signs and symptoms of oral and oropharyngeal cancers include:

  • a sore in the mouth that does not heal (most common symptom)
  • a lump or thickening in the cheek
  • a white or red patch on the gums, tongue, tonsil, or lining of the mouth
  • a sore throat or a feeling that something is caught in the throat
  • difficulty chewing or swallowing
  • difficulty moving the jaw or tongue
  • numbness of the tongue or other area of the mouth
  • swelling of the jaw that causes dentures to fit poorly or
  • become uncomfortable
  • loosening of the teeth or pain around the teeth or jaw
  • voice changes
  • a lump or mass in the neck
  • weight loss

What are the greatest risk factors of oral and oropharyngeal cancers?
The greatest risk factors for these cancers are drinking and smoking. Approximately 90 percent of people with this type of cancer are smokers, and approximately 75 to 80 percent of those diagnosed are frequent drinkers. Being male is also a risk factor. Males are diagnosed twice as often as women for oral and oropharyngeal cancers.

Pancreatic Cancer

What is the pancreas and what does it do?
The pancreas is a gland found behind the stomach. It is shaped a little bit like a fish with a wide head, a tapering body, and a narrow pointed tail. It is about six inches long but less than 2 inches wide. The pancreas extends horizontally across the abdomen (ACS). The pancreas is like an organ with two separate glands. It produces pancreatic juice, or enzymes, that break down food in the small intestine so it can be digested and its nutrients absorbed by the body to help tissue repair itself and grow. Some cells in the pancreas are arranged in clusters called islets. Islets release two hormones, insulin and glucagon, that are important in controlling the amount of sugar in the blood. Insulin and glucagon are released from the islet cells directly into the bloodstream and not into the ducts of the pancreas.

How common is pancreatic cancer and who is at greatest risk for the disease?
The American Cancer Society estimates that 28,300 Americans (13,700 men and 14,600 women) will be diagnosed with cancer of the pancreas during 2000. An estimated 28,200 Americans (13,700 men and 14,500 women) will die of pancreatic cancer in 2000, making this type of cancer the fourth leading cause of cancer death in men and in women. Men have higher incidence and mortality rates for pancreatic cancer than women in each racial/ethnic group. Black men and women have incidence and mortality rates that are about 50% higher than the rates for whites. Pancreatic cancer is rare in the 30-54 years age group. In the 55-69 years age group, incidence rates in the black populations exceed those for whites by about 60%. This difference diminishes somewhat among persons aged 70 years and older.

What are the symptoms of pancreatic cancer?
Pancreatic cancer has been called a "silent" disease because it usually does not cause symptoms early on. The cancer may grow for some time before it causes pressure in the abdomen, pain, or other problems. When symptoms do appear, they may be so vague that they are ignored at first. For these reasons, pancreatic cancer is hard to find early. In many, the cancer has spread outside the pancreas by the time it is found. When symptoms appear, they depend on the location and size of the tumor. If the tumor blocks the common bile duct so that bile cannot pass into the intestines, the skin and whites of the eyes may become yellow, and the urine may become dark. This condition is called jaundice. As the cancer grows and spreads, pain often develops in the upper abdomen and sometimes spreads to the back. The pain may become worse after the person eats or lies down. Cancer of the pancreas can also cause nausea, loss of appetite, weight loss, and weakness. Islet cell cancer can cause the pancreas to make too much insulin or other hormones. When this happens, the person may feel weak or dizzy and may have chills, muscle spasms, or diarrhea. Cigarette smoking has been identified consistently as an important risk factor for cancer of the pancreas. Other risk factors which have been suggested, but not confirmed include coffee drinking, high fat diets, diabetes mellitus and some occupations.

Prostate Cancer

Where is the prostate and what does it do?
The prostate is about the size of a walnut. It is just below the bladder and in front of the rectum. The tube that carries urine (urethra) runs through the prostate.

How common is prostate cancer?
Prostate Cancer is the second leading cause of death in men, second only to lung cancer. Approximately 180,400 men will be diagnosed with prostate cancer this year. The chance of having prostate cancer increases rapidly after age 50. More than 80% of all prostate cancers are diagnosed in men over the age of 65.

What are the symptoms of prostate cancer?
Most cases of early prostate cancer cause no symptoms and are found by a PSA blood test and/or DRE. Some prostate cancers may be found because of symptoms such as slowing or weakening of the urinary stream or the need to urinate more often. These symptoms are not specific, and can also be caused by benign diseases of the prostate, such as nodular hyperplasia. Symptoms of advanced prostate cancer include hematuria (blood in the urine), impotence (difficulty having an erection), and pain in the pelvis, spine, hips, or ribs. These symptoms may also be present with other diseases.

What are the risk factors of prostate cancer?
The greatest risk factor for prostate cancer is age. The majority of prostate cancers are diagnosed in men over the age of 65. Prostate cancer is about twice as common among African-American men as it is among white American men. Results of most studies suggest that men who eat a lot of fat in their diet have a greater chance of developing prostate cancer. Other risk factors, such as lack of physical activity and family history also increase risk of developing prostate cancer.

Testicular Cancer

What are the testis and what is their role in body functioning?
The testicles (also called testes or gonads) are a pair of male sex glands. They produce and store sperm, and are also the body's main source of male hormones. These hormones control the development of the reproductive organs and male characteristics. The testicles are located under the penis in a sac-like pouch called the scrotum.

How common is testicular cancer (cancer of the testis)?
The American Cancer Society estimates that in the year 2000 about 6,900 new cases of testicular cancer will be diagnosed in the United States. An estimated 300 men will die of testicular cancer in the year 2000. Testicular cancer is one of the most curable forms of the disease. Studies show that the cure rate exceeds 90% in all stages combined. Although testicular cancer accounts for only 1 percent of all cancers in men, it is the most common form of cancer in young men between the ages of 15 and 40. Any man can get testicular cancer, but it is more common in white men than in black men.

What are the symptoms of testicular cancer?
Symptoms of testicular cancer are usually markedly obvious. In about 90% of cases, men have a painless or an uncomfortable lump on a testicle, or they may notice testicular enlargement or swelling. Men with testicular cancer often report a sensation of heaviness or aching in the lower abdomen or scrotum.

What are the risk factors of testicular cancer?
The main risk factors for testicular cancer include:

  • Age: Most men who develop testicular cancer are between the ages of 15 and 40.

  • Undescended testicle (cryptorchidism): Normally, the testicles descend into the scrotum before birth. Men who have had a testicle that did not move down into the scrotum are at greater risk for developing the disease.

  • Family history: A family history of testicular cancer increases the risk.

  • Occupational risks: A recent study, found that nonseminoma germ cell tumors occur morefrequently among men with certain occupations (miners, oil and gas workers, leatherworkers, food and beverage processing workers, janitors, and utility workers). It may be that exposure to certain chemicals contributes to development of the disease

  • Race and ethnicity: The risk of testicular cancer among white American men is about fivetimes that of African-American men and more than double that of Asian-American men. Therisk for Hispanics is intermediate between that of Asians and non-Hispanic whites. Thereason for this difference is not known. Testicular cancer risk has more than doubled among white Americans in the past 40 years but has remained the same for African-Americans.

  • Testicular injury, HIV infection, and cancer of the other testicle are all other risk factors for testicular cancer.

Uterine Cancer

Where is the uterus located?
The uterus is a hollow, pear-shaped organ. It is located in a woman's lower abdomen between the bladder and the rectum. Attached to either side of the top of the uterus are the fallopian tubes, which extend from the uterus to the ovaries.

How common is uterine cancer?
An estimated 36,100 new cases of cancer of the uterine corpus (body of the uterus), usually of the endometrium, will be diagnosed in the United States during 2000. It is estimated that about 6,500 women in the United States will die from cancer of the uterine corpus during 2000.

What are symptoms of uterine cancer?
Abnormal vaginal bleeding, especially after menopause, is the most common symptom of uterine cancer. Bleeding may start as a watery, blood-streaked flow that gradually contains more blood. Although uterine cancer usually occurs after menopause, it sometimes occurs around the time that menopause begins. Abnormal bleeding should not be considered simply part of menopause; it should always be checked by a doctor. A woman should see a doctor if she has any of the following symptoms:

  • Unusual vaginal bleeding or discharge
  • Difficult or painful urination
  • Pain during intercourse
  • Pain in the pelvic area

These symptoms can be caused by cancer or other less serious conditions.

What increases a woman's risk of developing uterine cancer?
Some factors increase the likelihood of developing uterine cancer, such as prior pelvic radiation therapy (used to treat other types of cancer), race (one type of uterine sarcoma, leiomyosarcoma, is more common among African Americans than among whites or Asians), age (uterine sarcomas tend to occur in middle aged and elderly women, although they may affect younger women as well), and Endometrial cancer risk factors. Factors that increase a woman's risk of developing endometrial cancer also increase her risk for developing carcinosarcoma, but not any of the other types of uterine sarcoma. These factors tend to be related to levels of the female hormones, estrogen and progesterone. Obesity, certain types of estrogen replacement therapy, treatment with tamoxifen (a hormonal drug used for breast cancer treatment and breast cancer risk reduction), infertility, diabetes, starting menstrual periods before age 12, and reaching menopause after age 52 all increase the amount of estrogen a woman's uterus is exposed to, increase the duration of that exposure, or alter the balance between estrogen and progesterone toward a relative excess of estrogen.

To receive more detailed cancer information, please contact:

The American Cancer Society:
Toll free: 1-800-ACS-2345
Internet address: www.cancer.org

National Cancer Institute
Cancer Information Service 1-800-4-CANCER
Internet address: www.nci.nih.gov

You may want more information for yourself, your family, and your health care provider. The following National Cancer Institute (NCI) services are available to help you.

Telephone Cancer Information Service (CIS)
Provides accurate, up-to-date information on cancer to patients and their families, health professionals, and the general public. Information specialists translate the latest scientific information into understandable language and respond in English, Spanish, or on TTY equipment.

Toll-free: 1-800-4-CANCER (1-800-422-6237)
TTY (for deaf and hard of hearing callers): 1-800-332-8615

Internet
These web sites may be useful:

NCI's primary Web site; contains information about the Institute and its programs.

cancerTrials™; NCI's comprehensive clinical trials information center for patients, healthprofessionals, and the public. Includes information on understanding trials, deciding whether toparticipate in trials, finding specific trials, plus research news and other resources.

http://cancernet.nci.nih.gov CancerNet™; contains material for health professionals, patients, andthe public, including information from PDQ® about cancer treatment, screening, prevention,supportive care, and clinical trials; and CANCERLIT®, a bibliographic database.

E-mail
CancerMail includes NCI information about cancer treatment, screening, prevention, and supportive care. To obtain a contents list, send e-mail to cancermail@icicc.nci.nih.gov with the word "help" in the body of the message.

Fax
CancerFax® includes NCI information about cancer treatment, screening, prevention, and supportive care. To obtain a contents list, dial 301-402-5874 from a fax machine hand set and follow the recorded instructions

Cancer Glossary

acute leukemia : Cancer of the blood-forming tissue (bone marrow) that progresses rapidly.

anemia (a-NEE-mee-a): A condition in which the number of red blood cells is below normal.

antibiotic (an-tih-by-AH-tik): A drug used to treat infections caused by bacteria and other microorganisms.

biological therapy (by-o-LAHJ-i-kul): Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also called immunotherapy or biological response modifier (BRM) therapy.

blasts : Immature blood cells.

blood-brain barrier : A network of blood vessels with closely spaced cells that makes it difficult for potentially toxic substances (such as anticancer drugs) to penetrate the blood vessel walls and enter the brain.

bone marrow : The soft, sponge-like tissue in the center of bones that produces white blood cells, red blood cells, and platelets.

bone marrow aspiration (as-per-AY-shun): The removal of a small sample of bone marrow (usually from the hip) through a needle for examination under a microscope.

bone marrow biopsy (BY-ahp-see): The removal of a sample of tissue from the bone marrow with a needle for examination under a microscope.

bone marrow transplantation (trans-plan-TAY-shun): A procedure to replace bone marrow destroyed by treatment with high doses of anticancer drugs or radiation. Transplantation may be autologous (the person's marrow saved before treatment), allogeneic (marrow donated by someone else), or syngeneic (marrow donated by an identical twin).

cancer : A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread through the bloodstream and lymphatic system to other parts of the body.

catheter (KATH-i-ter): A flexible tube used to deliver fluids into or withdraw fluids from the body.

central nervous system : CNS. The brain and spinal cord.

cerebrospinal fluid (seh-REE-bro-SPY-nal): CSF. The fluid flowing around the brain and spinalcord. Cerebrospinal fluid is produced in the ventricles in the brain.

chemotherapy (kee-mo-THER-a-pee): Treatment with anticancer drugs.

chronic leukemia (KRAHN-ik): Cancer of the blood-forming tissues that progresses slowly.

clinical trial : A research study that tests how well new medical treatments or other interventionswork in people. Each study is designed to test new methods of screening, prevention,diagnosis, or treatment of a disease.

colony-stimulating factors : Substances that stimulate the production of blood cells.Colony-stimulating factors include granulocyte colony-stimulating factors (also calledG-CSF and filgrastim), granulocyte-macrophage colony-stimulating factors (also calledGM-CSF and sargramostim), and promegapoietin.

digestive tract (dye-JES-tiv): The organs through which food passes when food is eaten. Theseorgans are the mouth, esophagus, stomach, small and large intestines, and rectum.

erythrocytes (eh-RITH-ro-sites): Cells that carry oxygen to all parts of the body. Also called red blood cells (RBCs).

fertility (fer-TIL-i-tee): The ability to produce children.

genetic : Inherited; having to do with information that is passed from parents to children through genes in sperm and egg cells.

graft-versus-host disease : GVHD. A reaction of donated bone marrow or peripheral stem cellsagainst a person's tissue.

hairy cell leukemia : A type of chronic leukemia in which the abnormal white blood cells appear to be covered with tiny hairs when viewed under a microscope.

hematologist (hee-ma-TOL-o-jist): A doctor who specializes in treating diseases of the blood.

immune system (im-YOON): The complex group of organs and cells that defends the body againstinfection or disease.

interferon (in-ter-FEER-on): A biological response modifier (a substance that stimulates the body's response to infection and disease). Interferons affect the division of cancer cells and slow tumor growth. There are several types of interferons, including interferon-alpha, interferon-beta, and interferon-gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases.

interleukins (in-ter-LOO-kins): Biological response modifiers (substances that can improvethe body's natural response to disease) that help the immune system fight infection andcancer. These substances are normally produced by the body. They are also made in thelaboratory for use in treating cancer and other diseases.

intrathecal chemotherapy (in-tra-THEE-kal KEE-mo-THER-a-pee): Anticancer drugs infused intothe thin space between the lining of the spinal cord and brain to treat or reduce the risk ofcancers in the brain and spinal cord.

intravenous (in-tra-VEE-nus): IV. Injected into a vein.

kidneys (KID-neez): A pair of organs in the abdomen that remove waste from the blood (as urine), produce erythropoietin, and are responsible for the long-term regulation of blood pressure.

leukemia (loo-KEE-mee-a): Cancer of blood-forming tissue.

leukocytes (LOO-ko-sites): Cells that help the body fight infections and other diseases. Also called white blood cells (WBCs).

liver : A large, glandular organ, located in the upper abdomen, that cleanses the blood and aids indigestion by secreting bile.

lumbar puncture : The insertion of a needle into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap.

lymph node : A rounded mass of lymphatic tissue that is surrounded by a capsule of connectivetissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vesselsand they contain many lymphocytes, which filter the lymphatic fluid (lymph).

lymphocytic (lim-fo-SIT-ik): Referring to lymphocytes, a type of white blood cell.

lymphoid (LIM-foyd): Referring to lymphocytes, a type of white blood cell. Also refers to tissue inwhich lymphocytes develop.

monoclonal antibodies (MAH-no-KLO-nul AN-tih-BAH-deez): Laboratory-produced substancesthat can locate and bind to cancer cells wherever they are in the body. Many monoclonalantibodies are used in cancer detection or therapy; each one recognizes a different protein oncertain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliverdrugs, toxins, or radioactive material directly to the tumor.

myelogenous (mye-eh-LAH-jen-us): Produced by or originating in the bone marrow.

myeloid (MYE-eh-loyd): Pertaining to, derived from, or manifesting certain features of the bone marrow. In some cases also pertains to certain types of non-lymphocyte white blood cells found in the bone marrow, including granulocyte, monocyte, and platelet lineages. Also called myelogenous.

Ommaya reservoir (o-MYE-a REZ-er-vwahr): A device surgically placed under the scalp and usedto deliver anticancer drugs to the fluid surrounding the brain and spinal cord.

oncologist (on-KOL-o-jist): A doctor who specializes in treating cancer.

pathologist (pa-THOL-o-jist): A doctor who identifies diseases by studying cells and tissues under amicroscope.

pediatric (pee-dee-AT-rik): Pertaining to children.

petechiae (peh-TEE-kee-a): Pinpoint, unraised, round red spots under the skin caused by bleeding.

plasma (PLAS-ma): The clear, yellowish, fluid part of the blood that carries the blood cells. Theproteins that form blood clots are in plasma.

platelets (PLAYT-lets): A type of blood cell that helps prevent bleeding by causing blood clots toform. Also called thrombocytes.

prognosis (prog-NO-sis): The likely outcome or course of a disease; the chance of recovery.

radiation therapy (ray-dee-AY-shun): The use of high-energy radiation from x-rays, neutrons, andother sources to kill cancer cells and shrink tumors. Radiation may come from a machineoutside the body (external-beam radiation therapy) or from material called radioisotopes.Radioisotopes produce radiation and are placed in or near a tumor or near cancer cells. Thistype of radiation treatment is called internal radiation therapy, implant radiation, orbrachytherapy. Systemic radiation therapy uses a radioactive substance, such as aradiolabeled monoclonal antibody, that circulates throughout the body. Also calledradiotherapy.

recur : To occur again. Recurrence is the return of cancer, at the same site as the original (primary)tumor or in another location, after it had disappeared.

red blood cells : RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes.

relapse : The return of signs and symptoms of cancer after a period of improvement.

remission : Disappearance of the signs and symptoms of cancer. When this happens, the disease issaid to be "in remission." A remission may be temporary or permanent.

risk factor : Anything that increases the chance of developing a disease.

seizures (SEE-zhurz): Convulsions; sudden, involuntary movements of the muscles.

spleen : An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters theblood, stores blood cells, and destroys old blood cells. The spleen is on the left side of theabdomen near the stomach.

splenectomy (splen-EK-toe-mee): An operation to remove the spleen.

supportive care : Treatment given to prevent, control, or relieve complications and side effects and toimprove the person's comfort and quality of life.

testicles (TES-tih-kuls): The two egg-shaped glands found inside the scrotum. They produce spermand male hormones.

thrombocytes (THROM-bo-sites): Blood cells that help prevent bleeding by causing blood clots toform. Also called platelets.

transfusion (trans-FYOO-zhun): The infusion of components of blood or whole blood into thebloodstream. The blood may be donated from another person or it may have been taken fromthe person earlier and stored until needed.

white blood cell : A type of cell in the immune system that help the body fight infection and disease.White blood cells include lymphocytes, granulocytes, macrophages, and others.

x-ray : High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer.



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