2012年5月31日 星期四

Hodgkin's Lymphoma and Brian's Story: A Highly Curable Cancer


BRIAN'S STORY

Brian was a 20-year old college basketball star who was in excellent condition and had no history of health problems. He grew up in a tough neighborhood with a single mother who raised him to be a fine young gentleman. He was awarded a basketball scholarship to state college, where he became the league leading scorer during his junior year. When his mother came to visit for a game late in the season, she noticed that Brian's neck appeared much larger on one side than the other. The next day, she convinced him to see the college physician who felt multiple enlarged lymph nodes in his right neck extending from the angle of the jaw down to just above his collarbone. The doctor ordered a CT scan of the neck and chest that confirmed multiple abnormal lymph nodes in the right side of the neck as well as the center of the chest. Brian was referred to a general surgeon who removed one of the larger lymph nodes in his neck during an outpatient surgery. This excisional biopsy revealed Hodgkin lymphoma.

Following his diagnosis, Brian was sent for a bone marrow biopsy which was negative. He also underwent a PET/CT scan that confirmed abnormal activity in the right neck and chest in multiple lymph nodes. Brian was referred to a medical oncologist who recommended treatment with ABVD chemotherapy. He received 4 cycles which he tolerated very well, with only moderate fatigue. A restaging PET/CT scan revealed no residual abnormal activity. He was seen by a radiation oncologist who recommended low dose involved field radiation therapy (IFRT) after chemotherapy which was delivered over 3 weeks. Other than a mild sore throat, Brian tolerated RT quite well. He was seen every 3-6 months by his medical and radiation oncologist for alternating follow-up visits. Brian has been free of disease for 7 years.

BASICS

Hodgkin's lymphoma (HL) is much less common than non-Hodgkin lymphoma (NHL), though it may be diagnosed in children as well as the elderly. If the disease is localized, then the 5-year survival is over 90%. Even patients with more advanced HL have a 5-year survival rate of 75-80%

RISKS & CAUSES

People who have history of a first degree relative diagnosed with HL are at a significantly increased risk of developing the disease themselves. In addition, patients who have Epstein-Barr virus (EBV) infection early in life appear to have an increased risk of HL later in life. There appears to be a correlation with patients of low socioeconomic status also.

SIGNS & SYMPTOMS

The vast majority of patients with HL will come to the doctor with the complaint of an enlarged lymph node or multiple lymph nodes that won't go away. Most frequently the node will arise in the neck, but may also be felt in other common lymph node areas including the axilla (under the arm) and the groin. Doctors should also ask questions regarding unexplained weight loss, fevers, or drenching night sweats, the "B symptoms" that are classic for lymphoma. Although they are only present in a subset of patients, B symptoms tend to predict for more advanced disease. Rarely, patients may present with diffuse itching or flushing of the skin when drinking alcohol as an initial sign of HL.

DIAGNOSIS

Like NHL, the preferred method of biopsy for HL is complete surgical removal of an enlarged lymph node (excisional biopsy) whenever feasible and safe. There are multiple subtypes of HL including: nodular sclerosing, mixed cellularity, lymphocyte rich and lymphocyte depleted. Yet another subtype, called nodular lymphocyte predominant HL, appears to be biologically different from the others, but also has an extremely high cure rate.

STAGING

Standard laboratory evaluation should include complete blood count, serum chemistries including kidney and liver function, blood levels of lactate dehydrogenase (LDH) and erythrocyte sedimentation rate (ESR), the latter two of which have been shown to predict for more advanced disease when elevated. As with NHL, the Ann Arbor staging system is used. This system is based on the number and sites of involvement in lymph nodes and other organs, as well as the presence or absence of B symptoms. Imaging should include CT of involved areas including neck, chest, abdomen and pelvis. Wherever available, PET/CT is extremely useful for staging, radiation therapy (RT) planning, and assessing response to treatment. Bone marrow biopsies are indicated for patients with advanced disease including those who present with B symptoms. Other factors that may negatively impact outcome include male sex, age older than 45, low serum hemoglobin, high white blood cell count, low albumin, and stage IV disease.

TREATMENT

Like NHL, HL is treated with a combination of chemotherapy drugs. In the case of HL, four drugs are utilized most commonly in the United States: adriamycin, bleomycin, vinblastine, and dacarbazine. The acronym for the combination is ABVD. Treatment of tens of thousands of patients over the past few decades with ABVD has shown consistently excellent results.

Patients with early stage HL generally receive 2-6 cycles of ABVD. Restaging imaging is obtained after 2-4 cycles to guide further treatment. PET restaging is predictive of outcome. The combination of ABVD followed by involved field radiation therapy (IFRT) yields an excellent chance for cure.

Common acute side effects of ABVD include fatigue, nausea (usually well-controlled with medication), mild anorexia, decreased blood counts, and hair loss. Uncommon but serious late side effects following treatment include heart damage from adriamycin, lung damage from bleomycin, and nerve damage from vinblastine. Chemotherapy does put patients at a slightly increased risk for development of future cancers, most commonly leukemia or NHL.

Since low doses and fairly small treatment areas are currently utilized for IFRT, side effects are much less than decades ago when the doses were higher and treatment areas were larger. Common acute side effects of IFRT include mild fatigue, possible partial alopecia (hair loss), and sore throat or difficulty swallowing, depending on the area treated. There is a risk of pneumonitis (inflammation of the lung) characterized by low-grade fever, dry cough, and shortness of breath with exertion, that occurs classically 1-3 months after RT. The 5-10% of patients who develop lung inflammation usually have resolution of their symptoms within 3-4 weeks after start of steroids. Long-term, despite the low doses and small RT fields, there remains a small risk of developing a radiation-induced cancer years after treatment. Patients should be encouraged to quit smoking prior to RT. Teenage girls and young women who require RT to the chest should begin annual mammogram (and usually breast MRI) screening within 7-10 years following treatment or at age 40, whichever comes first.

Advanced stage HL is treated most commonly with systemic chemotherapy alone, again predominantly ABVD in the U.S. Cure rates are about 70%. Patients may receive 6-8 cycles of ABVD, with restaging PET/CT performed after 4-6 cycles to assess response. The role of consolidative IFRT for these patients is controversial.




Dr. Maguire's home reference book for the public, "When Cancer Hits Home," has received excellent reviews from cancer survivors and experts alike: http://www.amazon.com/When-Cancer-Hits-Home-Prevention/dp/0615391117.

To learn more or read Dr. Maguire's blog, visit: http://patrickmaguiremd.com/





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Lymphoma - Medical and Alternative Treatments


Lywphomas are malignant tumors of the lymph system, the network of nodes and glands that produce infection fighting substances. In the United States, there are about 58,000 new cases each year. The most common general symptom is a painless enlargement of one or more lymph nodes in the neck, groin, or armpit. Additional indications of Hodgkin's disease include a chronic low grade fever and night sweats. Some people with non Hodgkin's lymphoma also develop skin rashes, enlarged tonsils, and abdominal swelling. Although the cause of most lymphomas is unknown, some are strongly linked to viruses. In Africa, Burkitt's lymphoma is associated with the Epstein Barr virus and chromosomal abnormalities. In recent years, the AIDS :HIV) virus has been linked to a type of non Hodgkin's lymphoma.

Diagnostic Studies And Procedures

A doctor who suspects lymphoma will carefully palpate, or feel, all lymph nodes that lie close to the surface of the body. Any suspicious areas will be biopsied, which may entail removal of several lymph nodes. If Hodgkin's disease seems probable, diagnostic procedures may include laparotomy, in which a viewing tube is inserted through a small incision near the navel, allowing a doctor to collect tissue samples from abdominal organs that lymphoma often attacks. Lymphangiography may also be done. In this procedure, a radiopaque dye is injected into the lymph system where it reveals abnormalities under X-ray examination. If non Hodgkin's lymphoma is diagnosed, bone marrow studies and CT scans can detect any spread.

Medical Treatments

Until recently, most lymphomas were invariably fatal. Today, many can be cured, especially when treated early. Hodgkin's disease, for example, often responds to radiation therapy alone. Or the patient may undergo a combination of radiation and chemotherapy and possibly surgery. Hodgkin's disease is now one of the most treatable forms of cancer; 77 percent of patients are still living five years after the diagnosis. For non Hodgkin's lymphoma, radiation therapy is often employed. Chemotherapy may also be used, particularly if the disease has spread. When remission has been achieved, a bone marrow transplant may be tried. This involves destroying the patient's bone marrow with drugs or radiation and replacing it with healthy marrow from a donor. Marrow may also be collected from the patient during a remission, treated to destroy any lingering cancer cells, and then frozen for use later should there be a relapse. Marrow transplants may cure lymphoma, but there is an increased risk of infection due to the use of immunosuppressive drugs that prevent rejection of the donor marrow. New approaches are also being developed to treat lymphoma patients after a relapse. These include the use of highly specific monoclonal antibodies that are directed against lymphoma cells, and improved methods for preserving and transplanting bone marrow.

Alternative Therapies

Acupuncture and Acupressure

These techniques are generally accepted by physicians as an adjunct to medical therapy to ease pain and stress.

Herbal Medicine

Teas or extracts of Siberian ginseng, sarsaparilla, and wild Oregon grape may help minimize the negative side effects of chemotherapy. Chinese herbalists may use ginseng, bupleurum, and the Longan herbal combination to treat manifestations of lymphoma, including anemia, fatigue, and an enlarged spleen. An herbal preparation called Golden Yellow powder is used to counteract skin inflammation caused by radiation therapy.

Hypnotherapy

Hypnosis and self hypnosis are employed to control pain and to impart a positive attitude, which many experts believe facilitates medical treatment. These methods, along with meditation, can also reduce stress.

Nutrition Therapy

Nutritionists recommend foods that may have an anticancer effect. High on the list are those that contain beta carotene, a precursor to the antioxidant vitamin A, which studies suggest may help the body fight off cancer. Foods high in beta carotene include yellow and dark green vegetables, such as carrots and broccoli. Although some nutritionists also advocate supplements of antioxidants, food sources are more effective.

Visualization

This fosters relaxation, which is thought to have a positive effect on the immune system. It may be combined with guided imagery, which involves imagining the body's immune system destroying the cancer cells.

Self Treatment

Self care is directed toward coping with the side effects of treatment. Fatigue is common, so it is important to schedule frequent rest periods.

Other Causes of Lymphoma Symptoms

Enlarged lymph nodes, fever, and other lymphoma symptoms also occur in leukemia, mononucleosis, and AIDS.




Read more on Lymphedema Check out for Lymphedema treatment and venous ulcers





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Fibroid Hype is Usually Overrated


Fibroids are benign tumors in the uterine wall. Being obsessed with the diagnosis of fibroids especially if they have grown is making a mountain out of a mole hill. For the record . . . fibroids practically never become malignant! Twenty five to thirty percent of all women over thirty years of age have fibroids. Fibroids can grow from age thirty to age forty but that does not mean they will become problematic; or that a hysterectomy should be performed. Once a woman has completed menopause reduction in the level of estrogen will usually cause fibroids to shrink.

There are cases where women experience Menorrhagia which is heavy period bleeding. Abnormally heavy bleeding can lead to iron deficiency anemia. This condition can be determined by a blood test or bone marrow biopsy.

Large fibroid tumors may press on the bladder creating discomfort on nearby organs. Kidneys can be affected and damaged due to this pressure. Any abdominal pain, constant need to void or rectal pressure should be reported to a physician immediately. Treatments for fibroids are listed below:

#1. Ibuprofen

#2. Oral contraceptives

#3. Myomectomy - medical procedure that removes fibroids but leaves the uterus intact

#4. Medication to shrink tumors

#5. Endometrial Ablation (for women who are done with childbearing only) low-voltage is placed on the lining of the uterus in order to block its growth

Unless fibroids are associated with a tremendous amount of bleeding or are making a woman's life unbearable, the newest studies have shown it's best to avoid a hysterectomy and keep our uterus intact.




Maria Beck is a licensed fitness instructor and an author who has published multiple articles on fitness, spirituality, life changes, and other subjects revolving around centered and healthy lifestyles. If you have any questions about this article please go to
http://www.bodysenseridgefield.com





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2012年5月30日 星期三

Web Based Electronic Medical Records & Medical Practice Management System


A web based Electronic Medical Records (EMR) & Medical practice Management system.

The software intended to be develop is an online web based Medical Practice Management system intended to computerize the clinic and provide a seam less integration of its various processes.

The application should facilitate input, storage, transfer and retrieval of medical information within a practice and enables interfacing with other data providers outside the practice.

The application aims to expedite record keeping processes and enable doctors to retrieve and input Patient Data, Medical Data, Analysis Reports etc., anywhere and anytime from a PC. Also the application should provide electronic capabilities for routine tasks related to clinical data( Such as Patient Registration, Search for Patient Transcription, imaging, Messaging and Prescription writing, Staging of Cancer, Suggestion of Relevant Regimens based upon Staging, as well as a wireless point-of-care solution for Doctors in the examination room.

EMR Workflow

Modules Overview:

1. Patient Registration and Appointment Scheduling

Patient will be registered with the system through a Nurse/ front office / doctor.

2. Patient Demographics

Capture all the patient preliminary details, such as

o Personal Information

o Correspondence details

o History of the Patient

o Social Background

o Insurance Details

o Family History

o Family Medical History

o Allergies and Operations

o Education details

3. Patient Chart

Patient chart includes complaints, diagnosis, vitals, prescribed tests, current medications, drug allergies, past surgeries and clinical reminders details will be displayed. Also patient name, sex, age, date of last visit and patient related menu will be displayed. A patient related menu option includes chart, subjective, plan, order, assessment, others, super bill and mark as seen.

4. Physical Examination

List of items for a New Physical Exam will be displayed and by default General details form will be displayed for capturing the details. New Physical Exam can be made for a patient includes general details, eyes, ears, etc details list will be displayed.

5. Review of System

If any Clinical Trials information available, the doctor refers to it including the drug information Charts, Lab Reports, Chemo Order generation, Clinical Trials Info.

Review all the previous hospitalization, reports before starting the treatment.

6. Diagnosis, Staging and Chemotherapy

The doctor uses the proposed software from the point where he diagnoses the patient and determines the cancer type. The software will be used from then onwards as under:

o ICD Code Master

o Diagnosis Process based on ICD

o Staging

o Stage Grouping

o Medicine for Chemotherapy

o Chemo Order Generation

o Flow Sheet for Chemo Cycle

Based on all the above inputs the doctor diagnoses the patient and understands the problem. This leads to determining the Cancer Stage.

In case there has been and Clinical Trials information the doctor refers to it including the drug information Charts, Lab Reports, Chemo Order generation, Clinical Trials Info. Based on all this information the doctor writes a prescription and doctor's note and enter the relevant details with the charge capture form.

In case the patient requires Chemotherapy the doctor schedules the next appointment for him with a nurse and the relevant procedures have to be followed.

7. E-Prescription

Displays all previous prescriptions (if exists) with date and edit links for a particular patient. If no prescription exists, i.e., the patient is a new patient doctor will create a new prescription.

8. Doctor Notes

Doctor can able to enter notes regarding patient, after physical testing and diagnosis. And a doctor/nurse can also view the list of all doctor notes created for a patient

9. Nurses Notes

List of regimens prescribed to a patient by the doctor will be displayed to a nurse to select regimen for capturing other details. Nurses can provide other treatment apart from regimen treatment by phone.

The nurse initiates the chemotherapy process and maintains a detail of medication and IV access for the patient. This process ends with Charge Capture based on ICD Codes and subsequent Scheduling for next appointment.

o Nurse will get the relevant patient chart.

o Views the Chemo Schedule and description.

o Updates the chemo order sheet and creates the nurses notes.

o Closes the 'chemo day' after the chemo has been completed.

o Views the nurse's report/notes.

o Closes the 'Chemo' after all the chemo days have been closed

10. Laboratory Management

This is used to capture tests information under special diagnosis. If tests are already prescribed for a patient by a doctor, then page will be displayed with existing data and can be captured other new tests otherwise new page will be displayed for input, new prescribed tests will be captured and shown back with captured data.

11. Others

o Demo Project Codes

o Other Scanned Documents

o Spell checker

o Audit Trail

o Phone Call board

12. Billing Management

The software shall not deal with the billing module and if required shall only have an integration with the existing Billing Management System

13. Reports

o Patient Registrations

o Patient Visits

o Diagnosis-Location

o Diagnosis-Cancer

o Doctor Visits

The above reports will be presented in a graphical representation (Bar and pie chart) for the respective data captured in the application.

Key Features:

1) Patient Registration & Appointment Scheduling

2) Patient Demographics

3) Patient Chart

4) Physical Examination

5) Review Of Systems

6) MRI

7) HPI

8) Diagnosis, Cancer Staging and Chemotherapy

9) E-Prescription

10) Doctor Notes

11) Nurses Notes

12) Laboratory Management

13) Others

14) Billing Management

15) Reports

16) Admin Module

1) Patient Registration & Appointment Scheduling:

Patient registration can be done in two ways:

1. Through Appointment Scheduling

2. Registration by visit.

Patient will be registered with the system through a Nurse/ front office / doctor. If a patient booked an appointment on a particular date, the front office will have a provision to track the patient physical arrival status.

2) Patient Demographics

Capture all the patient preliminary details, such as

The sub functionalities of this feature are as follows:

a. Personal details

b. Insurance Details

c. Social history details.

d. Medical history details.

e. Family history details.

f. Family medical history details.

g. Surgical history details.

h. Hospitalization details.

i. Correspondence details.

j. Chief complaint(s) details.

k. Drug allergies details.

l. Current medication(s) details.

m. Discontinued medication(s) details.

n. Vitals details will be captured and can update date wise.

o. Women Only - Women related information will be captured (like Number of

Pregnancies and Number of Children born etc). This is exclusively for women only.

p. HIPAA - A provision to upload HIPAA related docs.

Update existing details.

3) Patient Chart

Patient chart includes complaints, diagnosis, vitals, prescribed tests, current medications, drug allergies, past surgeries and clinical reminders details will be displayed. Also patient name, sex, age, date of last visit and patient related menu will be displayed. A patient related menu option includes chart, subjective, plan, order, assessment, others, super bill and mark as seen.

a. Display Patient Chart

b. Display, Add and Modify Complaints details

c. Display, Add and Modify Diagnosis details

d. Display, Add and Modify Vitals details

e. Display, Add and Modify Prescribed Tests details

f. Display, Add and Modify Current Medications details

g. Display, Add and Modify Drug Allergies details

h. Displaying different details of a patient as a report

i. Display, Add and Modify Past Surgeries details

j. Display, Add and Modify Clinical Reminders details

k. Display, Add and Modify Flow sheet details

l. Display, Add and Modify Template for referral note details

m. Display, Add and Modify Template for letter details

n. Display, Add and Modify Tumor Marker details

o. Display, Add and Modify PT/INR details

p. Display, Add and Modify Diagnostic test details

4) Physical Examination

List of items for a New Physical Exam will be displayed and by default General details form will be displayed for capturing the details. New Physical Exam can be made for a patient includes general details, eyes, ears, etc details list will be displayed. . Physical Exam Gen ID will be generated.

i. The sub functionalities of this feature are:

a. General details

b. Central Line details

c. Skin details

d. Head and Face details

e. Eyes details

f. Ears details

g. Nose and Nasopharynx details

h. Neck details

i. Lymph Nodes details

j. Musculoskeletal Details

k. Genitalia

l. Rectal

m. Breast

n. Cardiovascular details

o. Respiratory details

p. Abdomen details

q. Extremities details

r. Neurological details

ii. Display list of report(s) created for a particular patient date wise

iii. Display individual report.

iv. Update existing report details.

v. Delete existing report(s) details.

5) Review of System

i. Capture the following details

a. General details

b. Eyes details

c. Cardiovascular details

d. Genitourinary details

e. Musculoskeletal details

f. Skin details

g. Psychiatric details

h. Endocrine details

i. Respiratory details

j. Ear, Nose, Mouth and Throat details

k. Gastrointestinal details

l. Breasts details

m. Neurological details

n. Hematological/Lymphatic details

o. Chest Details

ii. Display list of report(s) created for a particular patient date wise

iii. Display individual report.

iv. Update existing report details.

iv. Delete existing report(s) details.

6) MRI Details

i. Capture MRI details

ii. Display list of report(s) created for a particular patient date wise

iii. Display individual report.

iv. Update existing report details.

iv. Delete existing report(s) details.

7) HPI

a. General HPI or HPI details and can view past HPI details date wise.

b. Lung Cancer HPI details.

c. Colon HPI details.

d. Breast HPI details.

8) Diagnosis, Cancer Staging and Chemotherapy

The doctor uses the proposed software from the point where he diagnoses the patient and determines the cancer type. The software will be used from then onwards as under:

o ICD Code Master

o Diagnosis Process based on ICD

o Staging

o Stage Grouping

o Medicine for Chemotherapy

o Chemo Order Generation

o Flow Sheet for Chemo Cycle

Based on all the above inputs the doctor diagnoses the patient and understands the problem. This leads to determining the Cancer Stage.

In case there has been any Clinical Trials information the doctor refers to it including the drug information Charts, Lab Reports, Chemo Order generation, Clinical Trials Info. Based on all this information the doctor writes a prescription and doctor's note and enter the relevant details with the charge capture form.

In case the patient requires Chemotherapy the doctor schedules the next appointment for him with a nurse and the relevant procedures have to be followed.

a. Doctors can view diagnosis report.

b. Doctors can create diagnosis by selecting ICD Code and Disease Name.

c. Capture ICD Code, histology details, histological grade and residual tumor

grade details.

d. Define the stage and capture stage details.

e. Doctors can see all the existing regimens.

f. Doctors can create blank regimen or related regimens with cancer type or

ICD Code and capture the details of regimen.

9) E-Prescription

Displays all previous prescriptions (if exists) with date and edit links for a particular patient. If no prescription exists, i.e., the doctor will create a new prescription.

a. Doctors can maintain common prescription list.

b. Doctors can maintain common drug(s) list.

c. Doctor can generate a new prescription or generate prescription with an

existing common prescription.

d. Doctor can update or delete an existing prescription(s) for a particular patient.

e. Doctor can have a preview, print and fax the entire prescription.

f. Doctor will have glance of chief complaints, cancer type, stage and current

medication(s) and discontinued medication(s) details at the time of giving a

new prescription or updating prescription.

g. Doctor will have a facility search for selecting the drug(s).

10) Doctor Notes

Doctor can able to enter notes regarding patient, after physical testing and diagnosis. And a doctor/nurse can also view the list of all doctor notes created for a patient

a. Doctors have a facility to view list of doctor notes as a report created for a

particular patient.

b. Doctors have a facility to view particular doctor note created for a particular

patient

c. Doctors can update exiting doctor note created for a particular patient.

d. Doctors can delete exiting doctor notes created for a particular patient.

e. Doctors can create new note on patient last visits containing the details of

HPI, history and plan.

f. Doctor can create a new note with an existing doctor note for a particular

patient.

g. Doctor can have facility to search referral doctors list and can add them to

doctor note.

h. Displaying different details of a patient as a report

i. Including different details of a patient in a particular doctor note

j. Modifying different details of a patient in a particular doctor note

k. Doctor's note can be print and fax.

11) Nurse Notes

List of regimens prescribed to a patient by the doctor will be displayed to a nurse, to select regimen for capturing other details. Nurses can provide other treatment apart from regimen treatment by phone.

The nurse initiates the chemotherapy process and maintains a detail of medication and IV access for the patient. This process ends with Charge Capture based on ICD Codes and subsequent Scheduling for next appointment.

1) Clicks on the Patient ID to get the patient chart relevant to the nurse.

2) Views the Chemo Schedule and description.

3) Updates the chemo order sheet and creates the nurses notes.

4) Closes the 'chemo day' after the chemo has been completed.

5) Views the nurse's report/notes.

Closes the 'Chemo' after all the chemo days have been closed

a. Nurse can view all the regimens prescribed by the doctor to a patient.

b. Nurse can select regimen to view treatment schedule for that particular

regimen to a patient.

c. Nurse can select a day in treatment schedule cycle and required data will be

captured for regimen.

d. Nurse can make a note under Non ChemoMedicine, Chemotherapy, Pump,

Phlebotomy, Antibiotic, Hydration, Hormone Injection, Antiemetics, Laboratory

and Paracentesis.

e. Nurse can close or open a day in a cycle for particular regimen.

f. Nurse can close or open a cycle or chemo cycle for particular regimen.

g. Nurses can provide non chemo other medicine at hospital or on phone.

h. Nurse can view cycle report to a particular regimen for a particular patient.

12) Laboratory Management

This is used to capture tests information under special diagnosis. If tests are already prescribed for a patient by a doctor, then page will be displayed with existing data and can be captured other new tests, otherwise new page will be displayed for input, new prescribed tests will be captured and shown back with captured data.

a. Doctors can order In-house or Out-House lab tests under Laboratory, Special

Diagnosis, CT scan, Radiology, Respiratory, Physiotherapy, Nuclear Meds,

Ultrasound and Miscellaneous Orders for a particular patient.

b. Doctors can cancel the tests which were ordered previously for a particular

patient.

c. Doctors can view pending, completed and seen tests for a particular patient.

d. Doctors or Lab Person can upload In-house or Out-house tests information

which were undergone present or past by the patient.

e. Clinical Reminders can be captured, modified and displayed.

f. Doctor or Lab person can view today's tests by patient name or test name.

13) Others:

a. Capture Patient Other Scanned documents & Modify or Edit Patient Other Scanned documents

b. Demo Project Codes - Here the diagnosis related data will be mapped with the Insurance according to the given gcodes

c. Capture, Modify and Display Patient Educational information on diseases

d. Capture, Modify and Display Patient Medication log

e. Capture, Modify and Display Pathology

f. Display Patient Diagnosis flow sheet according to the patient visits.

g. Capture, Modify and Display Bone marrow biopsy

h. Capture, Modify and Display Phlebotomy

i. Capture, Modify and Display Paracentesis

j. Phone Call board - Where the nurse/front office/doctor can attend and prescribe a suitable solution to a patient through phone call. All these details will be captured.

k. Mark as Seen - Doctor can mark the patient consultation status as seen for the day.

l. Spell Checker - Using this feature, the user can perform the spell check with the related forms.

m. Audi trail - Captures Doctor Visits on patient including IP address, visit time stamp and navigation information on patient records.

14) Billing Management

The system should provide the billing information, which needs to be integrated with the third party billing software.

Capture the following details

a. Primary focus of visit charges

b. Practice Guideline Adherence charges.

c. Current Disease State charges.

d. Office services charges.

e. Out patient initial consultation charges.

f. Prolonged services charges.

g. Miscellaneous charges.

h. Non-chemotherapy Injections charges.

i. Chemotherapy Injections charges.

j. Non-chemotherapy drugs charges.

k. Chemo Administration charges.

l. Chemotherapy drugs charges.

m. Laboratory services charges.

n. New Consultation charges.

o. Confirmatory Consultation charges.

p. Emergency Department Service charges.

q. Initial Hospital Care charges.

r. Initial Observation Care 8 hrs charges.

t. Subsequent Hospital Care charges.

u. Follow up Consultation charges.

v. Chemo drug charges will be automatically added to the super bill.

ii. Update existing details.

iii. Display super bill for all charges.

Note: The software shall not deal with the billing module and if required shall only have an integration with the existing Billing Management System. It will facilitate all the required inputs/information to the billing software.

15) Reports

a. Patient Registrations

b. Patient Visits

c. Diagnosis-Location

d. Diagnosis-Cancer

e. Doctor Visits

The above reports will be presented in a graphical representation (Bar and pie chart) for the respective data captured in the application.

16) Admin Control Panel

I. Office Admin details

1. Capture the following details

a. Appointment Type details.

Appointment type details include appointment type and description will be

captured.

b. Clinic details.

Clinic details include clinic name, street line1, street line2, city, state, zip, country,

work phone and other phone will be captured.

c. Pharmacy details.

Pharmacy details include pharmacy name, contact person, address1, address2, zip,

phone1, phone2, email, fax1, fax2, registration id, open time, close time and round

clock will be captured.

d. Holiday details.

Holiday details include holiday name, start date, end date, day, recursive and

creation date will be captured.

e. Employee category details.

Employee Category details include employee category name and remarks will be

captured.

f. Employee Master details.

Employee Master details include salutation, title, first name, middle name, last

name, date of birth, sex, ssn, marital status, photograph, address1, address2,

city, state, zip, email, home, work, other phone, cell, username, password, role,

superior and employee category will be captured.

g. Custom Scheduler details.

Custom Scheduler details include clinic name, start time, end time, default interval and custom interval will be captured.

h. Employee Leave/Vacation details.

Leave details include employee name, from date, to date, start time and end time will be captured.

i. Referral doctor details.

Referral Doctor Details include doctor name, hospital name, hospital phone, doctor phone and classification will be captured.

j. Doctor clinic details.

Doctor Clinic details include clinic name, employee name, from date time, to date time, recursive date, start date, from day time, to day time, recurrent day, end date and terminated will be captured.

2. Update existing details.

3. Delete the existing details

II. Diagnosis Management details

1. Capture the following details

a. Residual Tumor Grade details.

b. Histological details.

c. Histological Grade details.

d. ICD Code details.

e. ICD Histology details.

2. Update existing details.

3. Delete the existing details

III. Staging Treatment details

1. Capture the following details

a. Chemo drug code details.

b. Antiemetics details.

c. TNM details.

d. Regimen details.

e. Admin code details.

f. Drug code details.

2. Update existing details.

3. Delete the existing details

IV. Orders details

1. Capture the following details

a. MRI Part details.

b. Test details.

2. Update existing details.

3. Delete the existing details

V. Super Bill details

1. Capture the following details

a. Super Bill Header details.

b. Super Bill Data details.

2. Update existing details.

3. Delete the existing details

VI. Flow sheet details

1. Capture the following details

a. Flow sheet details.

2. Update existing details.

3. Delete the existing details

VII. Demo Project

1. Capture the following details

a. Section details.

b. Cancer Type details.

c. GCode details.

d. ICD & GCode mapping details.

2. Update existing details.

3. Delete the existing details

regards,

Dr Tom








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Stages and Procedures Regarding AIDS-related Lymphoma


AIDS-related lymphoma can be diagnosed by performing a serie of tests known as staging too. Much more, by doing these tests the patient can find out if cancer cells have spread within the body, affecting other organs as well. It is important to know that the tests may easily confirm the stage of the disease and in this way the physician can prescriebe the appropriate treatment. Moreover, AIDS-related lymphoma is usually diagnosed when the illness is already advanced.

To begin with, a first common procedure to find malignant tumor cells in the body is called PET scan (positron emission tomography scan). Firstly, this procedure involves the injection of radionuclide glucose into the vein in order to show in a picture made by the PET scanner where the glucose is being used in the body. So, by scanning the body, the malign tumor cells become brighter because they are more active and take up more sugar than other healthy cells.

Secondly, another well known procedure is CT scan also called computed tomography or computerisez axial tomography. CT scan is a procedure that makes a serie of pictures of the areas inside the body, showing a clear image of the organs and tissues. Moreover, a common procedure is Bone marrow biopsy which includes the removing of a small piece of bone marrow and bone from the hipbone or breatsbone in order to be examined under a microscope.

Furthermore, stages of AIDS-related lymphoma may include E which means that the cancer is found in an area or organ other than the lymph nodes or has spread to tissues beyond and S stands for spleen and means the cancer affected the spleen. In addition to this there are 4 stages which are used for AIDS-related that indicate the place where the cancer can be found, lymph nodes, organs other than the lymph nodes, near the diaphragm or spleen.

It is considered that people who suffer from Epstein-Barr virus or whose AIDS-related lymphona usually affects the bone marrow and in some cases may lead to complications, such as the spreading of cancer to the central nervous system.(CNS). Much more, CNS lymphoma which starts in other parts of the body is not considered primary as the CNS lymphoma that starts in the brain and spinal cord.




So, if you want to find out more about symptoms of lymphoma or even about lymphoma cancer please visit this link http://www.lymphoma-center.com/





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2012年5月29日 星期二

Acute Lymphocyctic Leukemia


Acute lymphocytic leukemia (ALL), a type of blood cancer, causes damage and possible death by crowding the normal blood cells in the bone marrow and will eventually spread to other organs. ALL is commonly found in children but also found in adults and if left untreated can be fatal. The risk of getting ALL goes up in people age 45 and will go up again as you grow older. There are over 5000 people expected to be diagnosed with ALL in year 2008.

Effects of ALL

There is short term and long term effects living with ALL and it will be emotionally, physically and financially straining them. While living with ALL, your abnormal blood cells crowd around other cells in the bone marrow. This prevents your body from producing red blood cells, white blood cells and platelets causing many problems in their future such as anemia, and more infection.

Other acute lymphocytic leukemia symptoms are:

* Swollen lymph nodes

* Dyspnea

* Bleed more easily

* Enlarged liver or spleen

Diagnosing ALL

There are many tests that doctors use to diagnose ALL and the tests they use will depend on other factors such as your age, the severity of the symptoms. The tests given are blood work, a bone marrow biopsy, cytogenetics, imaging tests and more.

Treatment

Chemotherapy is the primary treatment for this disease varying in length and number of drugs involved. Clinical trials are another often used option that allow doctors to continue to learn about and improve treatments for ALL.

If you are experiencing some or all of acute lymphocyctic leukemia symptoms then you need the right legal guidance. Please contact a medical attorney today. There are experienced and trustworthy people who can give you the legal support you deserve.




David Austin is an Attorney focused on complex injury cases. You can learn more about Acute Lymphocyctic Leukemia at his website. Burke-Eisner.com





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Pancytopenia - What is This Condition?


In a patient with pancytopenia, there is a shortage of certain kinds of blood cells. These include platelets, and red and white blood cells. In contrast, there are other conditions in which only one of these deficiencies is present. For instance, leukopenia is a low white blood cell count, while in anemia there is a reduction simply in red ones, and thrombocytopenia is a medical condition involving a lower count of platelets.

Different medical signs and symptoms can be present in a case of pancytopenia. Some are in the area of easy bleeding, including that under the skin, such as: bruising easily, nose bleeds, petechiae, and others. Some pancytopenic patients may have issues such as shortness of breath (also known as dyspnea), a rapid heart rate, and general weakness. Pallor, headaches, and frequent infections are also possibilities. Additionally, symptoms of the aforementioned conditions involving lowered counts of one particular type of blood cells -- such as anemia for red blood cells -- can also occur.

Pancytopenia can be caused by different issues. Some are infections or diseases, such as HIV (human immunodeficiency virus) and SLE (systemic lupus erythematosus). Medications and treatments can also cause this, for instance, it can occur in rare cases due to taking antibiotics or blood pressure medications, and is a possible side effect of having chemotherapy. Deficiencies in certain areas, like vitamin B12 and folate, can also lead to pancytopenia.

Undergoing a bone marrow biopsy is a common method of diagnosis to be used in order to detect whether pancytopenia is in fact the condition that a patient is in.




You can read more about pancytopenia such as additional symptoms and causes, and more. Head to Pancytopenia.net for further information.





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How Can non-Hodgkin's Lymphoma Be Detected?


Non-Hodgkin's lymphoma is a term that describes a group of over 30 subtypes of lymphoma, each of which grows and differentiates at a different rate and so responds differently to treatment. Even though the subtypes are all individual they exhibit very similar symptoms and so a list of common symptoms associated with lymphoma have been produced by doctors and researchers.

Primary Symptom

The primary symptom that suggests the presence of lymphoma is a painless swelling of the lymph glands. These can be found in a number of body areas however the main ones that can be felt with the hand are in the neck, just above the jaw line on either side of the throat, in the armpit area and in the groin. It may be that only one of these areas is affected and so lymphoma is often missed until the swelling grows and starts to become uncomfortable. Not every case of lymph gland swelling is caused by lymphoma and there are a number of other, less serious, conditions that can make the glands swell. Thus if you do experience any swelling you should not jump to the conclusion that you have cancer; it is much more likely to be due to a simple infection.

Other Symptoms

If non-Hodgkin's lymphoma is not detected early then there is the possibility that the cancerous cells will break away from the main site of growth and spread to secondary sites in the body. At this point the disease become systemic and obvious symptoms start to become apparent. These symptoms can include fever, night sweats, unexplained weight loss, abdominal distension and occasionally anemia. Anemia has its own set of symptoms including pale skin, tiredness, and chronic fatigue. Many of these symptoms are caused by the immune system response to the cancerous cells and they are often severe enough to cause the patient to consult a doctor.

Diagnosis

Once a doctor is consulted it is only a matter of time before a diagnosis of non-Hodgkin's lymphoma is made. A general physician will be able to diagnose possible lymphoma however the patient will be referred to a specialist so that a number of diagnostic tests can be carried out. Lymphoma can be confirmed using blood tests however more precise tests will then be needed in order to detect the exact type of lymphoma present, how fast it is growing and what stage it has reached. These additional tests will include CT and MRI scans of the main body areas i.e. the chest, abdomen and pelvis areas, x-rays and in severe cases a bone marrow biopsy.

Treatment

Once non-Hodgkin's lymphoma is detected and properly diagnosed then treatment will start soon after. The type of treatment that is recommended will depend on what stage the lymphoma has reached because some forms of treatment are useless against late stage cancer. In very advanced cases it may be that treatment is pointless and palliative care is all that can be offered. Thus it is important to consult a doctor as soon as possible if any of the symptoms mentioned above are felt, even if it is just to put the mind at ease.




For more information and resources on hodgkin's and non-hodgkin's lymphoma, other types of lymphoma, symptoms, causes of lymphoma [http://www.lymphomaresources.com/Causes-of-Lymphoma.html], treatment, medication, lymphoma research [http://www.lymphomaresources.com/Research.html], solutions and facts, visit Jeremy Parker's complete reference guide on lymphoma. Get your free copy of the "Lymphoma Information Guide" report at [http://www.LymphomaResources.com]





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2012年5月28日 星期一

Multiple Myeloma: What You Need To Know - Part 1


1. What is Multiple Myeloma?

Multiple myeloma is a relatively uncommon form of cancer which affects the plasma cells that are produced in the bone marrow - the soft tissue found inside some hollow bones. Normally plasma cells have the function of producing antibodies (immunoglobulin) as part of the body's immune system. However when plasma cells become cancerous they grow out of control producing tumors called plasmacytomas. These tumors usually develop in a bone, but may also occur in other tissues. A single plasma cell tumor is called an isolated (or solitary) plasmacytoma, whereas several plasma cell tumors are referred to as multiple myeloma.

2. What are the common symptoms?

There is a range of symptoms possible with multiple myeloma.


Anemia: a shortage of red blood cells causes sufferers to become pale, weak and fatigued.
Increased bleeding and bruising: due to low levels of platelets in the blood (thrombocytopenia).
Difficulty fighting infections: due to a shortage of normal white blood cells (leukopenia).
Weak and fragile bones: due to the myeloma cells sending signals to dissolve bone but not rebuild it.
Bone Pain: Any bone can be affected, but painful back, hips and skull are most common.
High Blood Calcium: due to dissolution of the bones. Related symptoms include extreme thirst, excessive urination, dehydration, constipation, loss of appetite, weakness, drowsiness and confusion. Extreme levels of calcium can lead to a coma.
Kidney Problems: due to high quantities of myeloma protein damaging the kidneys.
Nervous System Problems: due to physical collapse of affected vertebrae. Also myeloma proteins can be toxic to nerve calls, causing weakness and numbness.

3. What are the risk factors?

There are few risk factors that may affect someone's chance of getting multiple myeloma. However the following have been observed:


Age: Most sufferers are over 65 years while less than 1% of cases involve people under 35.
Gender: Men have a slightly greater chance of developing MM as women.
Race: MM is nearly twice as likely in black compared to white Americans.
Radiation Exposure: may slightly increase the risk.
Family History: A person with a parent or sibling with myeloma has a 4 times greater risk.
Workplace: Workers in petroleum related industries may have a higher risk.
Obesity: Overweight people have a slightly greater risk.
Plasma Cell Diseases: Many people with Solitary Plasmacytoma eventually develop multiple myeloma.

4. What causes this cancer?

Unfortunately, despite extensive research, the causes of multiple myeloma are still unknown.

5. How is it detected?

Multiple Myeloma causes few symptoms in the early stages and any occurring are often vague. Routine blood tests may show an abnormally high level of protein in the blood. If symptoms do suggest Multiple Myeloma then usually laboratory tests of blood and urine, bone x-rays and bone marrow biopsies are performed.


Blood Counts: Low levels of red cells, white cells and platelets.
Quantitative Immunoglobulins: Often one type of immunoglobulin is high while others are low.
Electrophoresis: Carried out on blood and urine to determine proportions of immunoglobulins.
Beta-2 microglobulin: Not harmful of itself, but high levels are indicative that the disease is advanced and the prognosis worse.
Bone Marrow Biopsy: A small amount of liquid bone marrow is withdrawn from the bone via a needle. The sample is examined with a microscope for the presence of myeloma cells.
Imaging Studies: Bone X-rays, CAT Scans, PET Scans and MRI's may all be carried out to locate and identify myeloma tumors throughout the body.

Diagnosis of Multiple Myeloma requires a combination of the patient's symptoms, doctor's physical examination and the results of blood tests and x-rays. The following observations are necessary for a positive diagnosis:


A plasma cell tumor identified via biopsy
OR
Plasma cells constituting over 10% of bone marrow cells

In addition any one of the following:


High levels of Myeloma protein in blood (> 3g/dL)
High levels of Myeloma protein in urine (> 1g/dL)
Holes in bones, caused by growth of tumors, detected on x-rays




By John Cusworth (Editor: "Healthy Wealth For Life")
Part 2 of this article will include information about the Stages of Multiple Myeloma as well as conventional and alternative treatments.
More information on Multiple Myeloma can be found at http://www.multiplemyelomasymptoms.net





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Myelodysplastic Syndrome Diagnosis


Myelodysplastic syndrome (MDS) is somewhat difficult to diagnose because it has symptoms that closely resemble the signs of aplastic anemia, leukemia, HIV infection, malfunctioning immune system, and rheumatoid arthritis. Oftentimes, MDS is misdiagnosed as one of these diseases. It is important to get a correct diagnosis of MDS at the earliest possible time because effective treatment cannot be given when disease is not properly diagnosed.

What are the Tests Used to Diagnose MDS?

Uncontrolled bleeding can be a sign of myelodysplastic syndrome but the doctors must be sure so certain clinical examinations must be performed first to diagnose MDS definitely. Getting a correct diagnosis is very important on finding the effective treatment for the patient. MDS patients can only be properly diagnosed after they have been thoroughly examined by expert hematologists or hemato-pathologists.

Common clinical tests include: complete blood cell count (CBC) and examination, bone marrow biopsy and aspiration, and close examinations of chromosomes.

CBC and Examination

The CBC test measures the amount of different types of blood cells (red, white, and platelets). The examination uses a smear, which is a glass slide spread with small amount of blood, observed under the microscope to see how these cells look. Patients with MDS are often characterized by having very few red blood cells. When abnormalities are noted, the next to examine is a sample of bone marrow cells.

Bone Marrow Biopsy and Aspiration

The bone marrow aspiration is the process of inserting a thin and hollow needle into the bone to suck out a small amount of liquid marrow. The marrow biopsy, usually done right after, is the process of removing a small piece of bone and marrow by pushing a large and twisted needle into the bone.

The size and shape of the cells will determine whether red blood cells contain iron particles or white blood cells contain granules. The bone marrow stem cells produce blasts, which will eventually mature into any of the three types of blood cells (red, white, and platelets). In MDS, these blasts do not mature properly so there may be a number of blasts in the marrow sample.

Other Tests

These other tests are performed in biopsied marrow tissue to determine specific features of the cells such as genetic abnormalities (chromosomal rearrangements) that are common in MDS.




David Austin is an Attorney focused on complex injury cases. You can learn more about Myelodysplastic Syndrome Diagnosis at his website: http://www.Burke-Eisner.com





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General Knowledge of A Cancer of Retina - Retinoblastoma


Retinoblastoma, abbreviated as Rb, is rapidly developing cancer which develops in the cells of retina, the light detecting tissue of the eye. It usually develops in young children, despite such an eye disease would come at any age. Although it is a kind of cancer, Rb has one of the best cure rates of all childhood cancers, with more than nine out of every ten sufferers surviving into adulthood. That is to say, it is treatable, but if not treated, retinoblastoma is fatal. Therefore to have a general knowledge of its symptoms and its diagnosis is necessary.

The most common and obvious sign of Rb is an abnormal appearance of the pupil. And other specific signs can be deterioration of vision, a red and irritated eye and faltering growth or delayed development. Some children with retinoblastoma can develop a squint, commonly referred to as cross eyed or wall eyed. A red, painful eye poor vision is possible as well.

Rb usually occur in one eye, but the other eyes would be affected. The two forms of the diseases include the genetic and the non-genetic. Children with genetic Rb usually have tumors in both eyes(bilateral), while those with the non-genetic Rb have tumor in only one eye(unilateral). Retinoblastom occurs when a cell of the growing retina develops a mutation in the RB gene, resulting in the cell to grow out of control and become cancerous. The copy of those mutated gene would increase the cancer risk, therefore, to prevent the spread of those altered gene, treatments should be taken. Up to now, the most common ways to cure retinoblastom are listed below:

Treatments of retinoblastoma varies from country to country. In general, ultrasonography, CT scan, X-rays, MRI, blood tests, spinal tap, bone marrow biopsy and so on so forth are options for its treatment. Which one to choose usually depends on the size and location of the tumor. It the tumor is not large, a laser surgery can be applied, and if the tumor is large that has spread beyond the eye, radiation and chemotherapy are more suitable choices. Chemotherapy, which can be administered locally through a thin catheter that is threaded through the groin through the aorta and the neck into the optic vessels, are for most unilateral cases.




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2012年5月27日 星期日

Neurological Conditions Are Evident In Multiple Myeloma


Should you be told you have multiple myeloma, you could be somewhat perplexed as to what it actually is or what types of treatment that you may have to undergo. Multiple myeloma is also known as plasma cell myeloma or more commonly known as Kahler's disease. This illness is a cancer of the plasma cells of the body.

Plasma cells are actually forms of white blood cells that are critical to producing antibodies. The physiology of this illness is when large quantities of abnormal cells collect within the bones of the body. Here they cause damage in the bone marrow. This major damage results in the interference of normal blood cell creation.

You can see several different signs and symptoms of multiple myeloma an individual can experience when they are affected by this disease. One of the symptoms include pain in the bones. The most frequent areas of this bone pain happens in the backbone and the ribs and may actually worsen with physical activity. Infection is also another sign of this disease. The most common kinds of infections include pneumonias and pyelonephritis.

Renal failure may also develop in the body to those suffering from this cancer. The renal failure can be acute or chronic. In most cases caused by the hypercalcemia or a deficiency or certain proteins. Another common symptom is anemia. Do not automatically panic if you discover you have anemia, because anemia can be because of many other complications within the body. Even so, anemia is also a symptom that is from this disease.

Some people will also suffer neurological complications like weakness, confusion, fatigue; and are caused by hyperglycemia, headaches, visual changes, radicular pain, loss of bowel and bladder control, carpal tunnel syndrome along with other neurological conditions.

There are often a range of tests conducted in order to diagnose someone with multiple myeloma. Among the first and basic tests are blood samples. Next a skeletal study will be done. The skeletal survey involves an x-ray series of the skull, axial skeleton, and proximal long bones. If lesions do not show up on the x-ray series than an MRI or CT scan could be ordered for more detection of lesions within the bones.

Also with these tests a bone marrow biopsy is generally carried out in order to get an idea for the percentage of bone marrow populated by plasma cells. The ratio of the bone populated by plasma cells is analyzed in the diagnostic criteria for myeloma.

The therapy for multiple myeloma is concentrated on the containment of the disease as well as suppression. Treatment may actually be deferred if the cancer entirely asymptomatic in the individual. According to the individual's age, chemotherapy and stem cell transplantation are very used therapy for this type of illness.




There are treatment options when it comes to a Nebraska Medical Center. The best Nebraska Medical Center information can be discovered with a little research.





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What is Lung Cancer - Incidence, Signs, Symptoms, Causation, Prognosis and Treatment


INTRODUCTION

Lung cancer may also be the most tragic cancer because in most cases, it might have been prevented, 87% of cases are caused by smoking. Lung cancer has long been the most common cause of cancer death in men and since 1987 it has also become the most common cause of cancer death in women. It is the second most commonly occurring form of cancer in most western countries and although the lung cancer incidence is less common in developing countries, the rapid increase in the popularity of smoking will see the number of sufferers in those countries quickly catch up with the western world.

Lung cancers can arise in any part of the lung, and 90%-95% of cancers of the lung are thought to arise from the epithelial, or lining cells of the larger and smaller airways (bronchi and bronchioles); for this reason, lung carcinomas are sometimes called bronchogenic carcinomas or bronchogenic cancers.

The most common types are epidermoid carcinoma, small cell carcinoma, adenocarcinoma and large cell carcinoma.

Most experts agree that lung cancer is attributable to inhalation of carcinogenic pollutants by a susceptible host. Who is most susceptible? Any smoker over the age of 40, especially if they began smoking before the age of 15, have smoked 20 or more for 20 years, or worked with or near asbestos. Two other factors also increase susceptibility: exposure to carcinogenic industrial and air pollutants (asbestos, uranium, arsenic, nickel, iron oxides, chromium, radio active dust, and coal dust.) and familial susceptibility.

SIGNS AND SYMPTOMS

Because early lung cancer usually produces no symptoms, the disease is often in an advanced stage when first diagnosed. Late stage signs are: with epidermoid and small cell carcinoma; smokers cough, hoarseness, wheezing, dyspnea, hemoptysis and chest pain. With adenocarcinoma and large cell carcinoma; fever, weakness, weight loss, anorexia and shoulder pain. In addition, hormone production which regulates various body functions may also be affected.

DIAGNOSIS

Firm diagnosis requires chest x rays, sputum cytology, CT scanning, bronchoscopy the examination of pleural fluid and biopsies. Other tests to detect metastasis include bone scans, bone marrow biopsy and CT scans of the brain and abdomen.

METASTASES

The disease most often spreads to the liver, the adrenal glands, the bones, and the brain. Cancer that has metastasized to the bone causes bone pain, usually in the backbone (vertebrae), the thighbones, and the ribs. Cancer that spreads to the brain can cause difficulties with vision and weakness on one side of the body.

The cancer may grow into certain nerves in the neck, causing a droopy eyelid, small pupil, sunken eye, and reduced perspiration on one side of the face; together these symptoms are called Horner's syndrome (see Autonomic Nervous System Disorders: Horner's Syndrome). It may grow directly into the esophagus, or it may grow near it and put pressure on it, leading to difficulty in swallowing. It may also spread through the bloodstream to the liver, brain, adrenal glands, spinal cord, and bone.

TREATMENT

Treatment depends on the cancer's specific cell type, how far it has spread, and the patient's performance status. If investigations confirm lung cancer, CT scan and often positron emission tomography (PET) are used to determine whether the disease is localised and amenable to surgery or whether it has spread to the point where it cannot be cured surgically. Treatment is usually a combination of surgery, chemotherapy and radiation therapy.

Surgery is usually the first option. Chemotherapy can be used as a first line treatment for or as additional treatment after surgery. Radiation therapy can be directed at your cancer from outside your body (external beam radiation) or it can be put inside needles, seeds or catheters and placed inside your body near the cancer (brachytherapy). Radiation therapy can be used alone or along with other lung cancer treatments. Radiation therapy can also be used to lessen side effects of lung cancer.

Treatment may not be as effective for patients with bone or liver metastases from lung cancer, excessive weight loss, ongoing cigarette use, or pre-existing medical conditions such as heart disease or emphysema. At some point, if you and your oncologist or primary care physician agree that treatment no longer is advisable, hospice care can provide comfort.




Dick Aronson has been involved in the healthcare industry for 35 years.He has written numerous articles on the subject and runs a number of informative websites, visit: http://www.life-wave-patches.com and http://www.healthinnovationsonline.com





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2012年5月26日 星期六

Symptoms And Diagnosing In Leukemia


No human is alike another on this planet. Because of the this the way that the disease leukemia affects people is also very different. Some patients may experience severe or acute symptoms, while in others the action of the symptoms may be so mild that a long time passes till the disease is actually found and diagnosed; this can go on for years or even decades. All of us know that leukemia is the worst cancer that exist in this days and that affects people. Properly diagnosing this disorder can prove quite tricky some times, the fact being that many of its symptoms do resemble the symptoms of other very common and not life threatening illnesses.

Some of the most usual symptoms found in leukemia patients are fever, chills or other symptoms that resemble the ones of flu; weakness or fatigue may also appear in patients. Because of the heavy tole that the disease has on the body the patient may experience loss of appetite and normally after this, the weight might severely drop. Severe sweating may also be present, especially during sleep, at night time. Swollen or bleeding gums may be some of that symptoms to show us that the disease is getting serious and taking a heavy tole on the patient. Because of the lack of oxygen and nutrients that the body is receiving, bone or joint pain may also make them selves felt. Because the fact that the brain is also affected, headache, paralysis, seizures may sometimes trouble the patient with different intensities. In men the case might also include the swelling of the testicles, witch is a very nasty thing. Skin symptoms may also appear like rashes, loss of hair.

To be sure of the diagnose he makes, the doctor will most certainly run a wide variety of tests to rule out any other disease that is suspected to cause trouble to the patient. As long with physical test the doctor will also take blood samples to be more shore of the diagnose that he makes. High white blood cell count would most certainly indicate an over production of the bone marrow, but this does not necessarily mean the person has leukemia. A further more thorough test will actually include the extraction of some bone marrow for a bone marrow biopsy. If in this case a problem is discovered than the patient is in for some bed news. Still these test are extremely painful, often making patients to think again about taking them.




For more info about acute leukemia please visit this website http://www.leukemia-guide.com/leukemia-causes.htm or even http://www.leukemia-guide.com/leukemia-symptoms.htm





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Bone Cancer - Causes, Symptoms, Diagnosis, Treatment and Prognosis


Bone cancer is rare and accounts for less than 1% of all new tumors. Not all bone tumors are fatal in fact benign (non cancerous) abnormalities are more common than malignant ones. Most are secondary and have been spread from another site. Primary bone cancer which starts in the bone is quite rare constituting less than one per cent of all malignant tumors. They are more common in males, especially in children and adolescents. The most common type of primary cancer is osteosarcoma. This type of carcinoma usually affects young adults. It can affect any bone, but the arms, legs and pelvis are more commonly affected. Other less common forms of primary bone cancer include Ewing sarcoma, malignant fibrous histiocytoma and chondrosarcoma.

Primary Bone Cancer

The causes of primary bone tumours are not known; however, adults who have Pagets disease (a bone disease) may have an increased risk.

Secondary bone cancer

Secondary bone cancer is the most common bone cancer. It is a carcinoma that starts somewhere else in the body and spreads (metastasises) to the bone. The most common cancers that spread to the bone originate in the breast, prostate, lung, kidney and thyroid.

Reticulum cell sarcoma of the bone

A cancerous tumor of the bone marrow presenting in more males than females.

Leukaemia

Cancer of the blood, which starts in the bone marrow

Symptoms of bore cancer

Symptoms tend to develop slowly and depend on the type, location, and size of the tumor. The signs and symptoms of bone carcinoma include: painful bones and joints, swelling of bones and joints, problems with movement, susceptibility to fractures. Less common symptoms include: unexplained weight loss, tiredness, fever and sweating.

Remember this conditionr is very rare so if you have any of these symptoms it is likely to be caused by another condition. Always see your doctor if you have for a diagnosis.

Causes

Although bone cancer does not have a clearly defined cause, researchers have identified several factors that increase the likelihood of developing these tumors. A small number of bone cancers are due to heredity.

Diagnosis

Bone cancer can present itself in any of the bones of the body, but it is diagnosed most often in the long bones of the arms and legs.

Diagnosing bone cancer involves a number of tests, including: X-rays and bone scans to show the exact location and size of the cancer (these are always done prior to biopsy), bone biopsy where a small sample of the cancer is removed from the bone and examined in the laboratory for the presence of malignant cells, Magnetic Resonance Imaging (MRI) scan similar to a CT scan but uses magnetism instead of x-rays to build three-dimensional pictures of your body.

Treatment

The treatment and prognosis depends upon multiple factors including the type and extent of the cancer, the patient's age and overall health status. Tumors may be treated with surgery, radiation therapy, chemotherapy, or a combination of these.

Primary bone cancers:

The tumor, surrounding bone tissue and nearby lymph nodes are surgically removed. In severe cases, the affected limb may need to be amputated, but this is rare. Treatment may also include radiotherapy (x-rays to target and kill the cancer cells) and chemotherapy (anti-cancer drugs). These may be given before surgery, to shrink the cancer and/or afterward to destroy any remaining cancer cells.

Secondary bone cancer:

Treatment depends on the treatment for the original tumor, but usually includes chemotherapy, radiotherapy or hormone therapy. Surgery may be needed to strengthen the affected bone.

Prognosis

Overall, the chance of recovery (prognosis) for bone cancers has improved significantly since the development of modern chemotherapy. The chance of recovery will depend on a variety of influences; if the cancer has spread, the type of cancer, the size of the tumour, location, the person's general health and other individual factors.

If the tumor is very small and localized, the five-year survival rate is close to 90 percent. If the cancer has begun to spread, however, survival becomes more difficult. The five-year survival rate is only about 60 percent, and the prognosis is poor once the cancer spreads.

Bone cancer in cats and dogs

Bone carcinoma in dogs and cats can be a challenging disorder. Osteosarcoma is by far the most common bone tumour if dogs, usually striking the leg bones of larger breeds. Chemotherapy significantly prolongs the survival of animals with osteosarcoma when used in conjunction with surgery. For dogs Cisplatin alone or in combination with doxorubicin markedly improves survival time to a median of 8-10 months with the percentage of dogs alive after11 months at 50%.

Feline Osteosarcoma unlike its canine counterpart it has a much lower rate of metastasis and longer term survival can be expected with complete excision. Median survival for cats with osteosarcoma is approximately 2 years with many cats outreaching that.




Dick Aronson has a background of over 35 years in various facets of the Healthcare industry. He set up and ran clinical trials in more than 20 countries and he has also founded a number of small private health related businesses. Dick now runs a number of informative health websites Go to http://www.life-wave-patches.com and http://www.healthinnovationsonline.com





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Symptoms for Cancer


When I started to research cancer after I started to feel ill a few years ago I noticed a few distinct categories.

The cancer would always fall in four to five categories. They are Leukemia, Lymphomas, Sarcomas and Carcinomas. The fifth is Melanomas or just skin type cancer's. Some will say Adenocarcinoma is on the list instead of the skin cancers, so we will just leave it at these 6 categories.

If you are feeling really ill and weak a definite action to take is to rule out cancer especially if the symptoms last for a lengthy period of time. Symptoms to look for cancer would be weakness, paleness, fever and flu-like symptoms that wont go away. This could be a sign of cancer in your blood or bone marrow which is basically your immune system.

Symptoms for cancer in the bones could be the most obvious, bone pain. Common areas for cancer to start are the thigh bones or long bones. Also in the long bones of the arms which is the forearm area. If the bone pain is not noticeable in normal situations like watching TV or walking but is aggravated when picking something up or when walking up a flight of stairs where the legs have to bend and put stress on the thighs, that is definite sign to get yourself checked.

My thigh bone pain is what set me to investigate the possibilities of cancer in my body. I was hiking to a waterfall on my 40th birthday and the bone pain in my legs was getting worse. I had noticed it before but decided to ignore it. That was the tipping point, the pain was too much for hiking rather than just walking around the house and I decided to get myself to a doctor.

I ignored the pain for 2 years because it was slight and it had a gradual build up as I was too busy working to go to a health provider. That was my first mistake, I almost waited for too long to get myself checked. The cancer discovered was Lymphoma that had spread to my bones. The treatments and procedures I experienced to get well and are currently still doing will be shared in another article. The focus for this article will be for symptoms for cancer so you the reader will not avoid what your body is telling you.

Other symptoms to be aware of also are rectal bleeding, abdominal cramps, loss of appetite, constipation alternating with diarrhea, weight loss and weakness with pale complexion. These can be general symptoms for many disease but the difference with cancer is they usually get worse and do not resolve itself like the flu will.

As common sense dictates concerning lumps or masses in any part of the body they must be taken seriously. The masses that do not go away and that have a strange type of pain you have not experienced before must be an area of concern for you. I had a small bump on the side of my head above my ear in the hair that kept getting bigger and had pain involved when touched. After a checkup and biopsy it turned about to be a type of skin cancer and was promptly removed. I also ignored this for about two and half years until it got to about an inch in size.

Cancer is very common today with all the chemicals, heavy metals and dyes used in today's goods and food. Knowing this and knowing some symptoms for cancer it should be imperative to protect yourself and the things around you (cancer causing products). To prevent cancer do a self-diagnoses for symptoms and be aware of the chemicals you use and the foods you eat. You are the one who knows your self the best.

Do research on the internet of your symptoms. Don't be afraid to check with your health care provider even if you have to tell them what you have found on the internet concerning what your body is telling you.

I have a growing list of symptoms for cancer that is available for those who might need a quick list to look over.




For more cancer information got to [http://symptoms-for-cancer.com] and get access to alternative cancer treatments!





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2012年5月25日 星期五

Lung Cancer Diagnosis - How This Works


What produces a lung cancer diagnosis? The physician evaluates a person's medical history, smoking history, exposure to environmental and occupational substances, and family history of cancer as well as a physical examination and chest X-ray to find the cause of the symptoms. Other tests may also be performed as needed.

Patient's history - If the doctor suspects lung cancer, they will: Investigate your medical history; Perform a thorough physical examination; Order further specialized medical tests. As part of your medical history, your doctor will ask: If you smoke or have smoked previously;?Your occupation and

place of work; If you have been exposed to occupational hazardous substances or radiation; Whether you have a family history of lung cancer.

Diagnosing Lung Cancer

Screening helps to discover cancer at an earlier stage when it is treatable by a series of tests performed before a person shows any symptoms. Early detection of abnormal tissue or cancer proves favorable of curing the cancer completely as opposed to detection during symptoms when the cancer might have spread.

There are several ways of diagnosing if someone is in the early stages of lung cancer. A physical examination and history taking: A physical examination checking for general signs of health or ill health such as disease and unusual lumps, bumps and anything else that seems atypical. The doctor will also get the history of personal health habits, any past illnesses and treatments given for those illnesses.

Laboratory tests: Procedures for testing samples of tissue, blood, urine, and other substances in the body. The tests will also help to diagnose the disease as well as assist in the planning, management and monitoring of it.

Sputum test: This can show evidence of cancer cells in the lungs. To ensure a more accurate diagnosis with a single sputum collection, the sputum is usually collected over a three-day period.

Fiberoptic bronchoscopy: An examination using a small flexible lighted tube to pass into the nasal canal and then into the appropriate bronchus (airway) down to the cancer. If cancer is detected then a small piece of the cancer is removed for a biopsy examination so the exact type of cancer can be determined and appropriate treatment given.

Percutaneous needle biopsy: This examination involves inserting a thin needle through the skin and chest wall into the tumor. This test is for tumors that are close to the surface of the lung and often used in conjunction with a CAT scan to assists in guiding the needle into the tumor.

Excision or surgical removal: This process can lead to further diagnosis of the suspected tumor via a small incision into the chest. A small thin video camera is inserted into the chest to assist in removing a small block of lung tissue using a mechanical surgical stapling device or laser with this clinical procedure.

Mediastinoscopy: This test helps evaluate how extensive the tumor is by looking into the mid portion of the chest through a small incision made just below the collar line. Samples are taken from the lymph nodes in the central part of the chest (mediastinum). The chance of surgically curing the lung cancer is automatically eliminated if the cancer has spread to the lymph nodes.

Mediastinotomy: Unlike mediastinoscopy, the chest cavity is opened by cutting through the sternum (breastbone) and/or the ribs allowing the surgeon to reach and test more lymph nodes by removing samples of mediastinal lymph nodes. This is a complex test, and the patient has to undergo general anaesthesia.

Thoracentesis: A sample of fluid surrounding the lungs is taken using a needle to check for cancer cells.

Thoracotomy: To test for malignancy the chest wall has to be opened so this procedure is performed in hospital as a major operation.

Thoracoscopy: A procedure using a thin, lighted tube connected to a video camera to monitor and view the space between the lungs and the chest wall.

Bone marrow biopsy: With a needle a sample of bone is removed usually measuring about 1/16 inch across and 1 inch long. This is often taken from the back of the hip bone. Microscopically the sample is checked for cancer cells. This procedure is performed predominantly to diagnose small cell lung cancer.

Blood tests: A complete blood test checks for an accurate number of different cell types by showing whether you have anaemia or other related problems. Blood chemistry tests show abnormalities in organs and other parts of the body. Blood tests are repeated regularly especially if someone is undergoing chemotherapy treatment. Chemotherapy drugs affect the blood-forming cells of the bone marrow and sometimes cause lots of problematic side effects. If cancer has spread to the liver and bones, it might cause certain chemical abnormalities in the blood and exacerbate any problems already suffered by the patient.

Other Tests and Procedures to Detect Lung Cancer Include:

Chest x-ray: Chest x-rays account for about half of all x-rays obtained in hospitals. The x-rays are typically performed to obtain an assessment of the lungs, heart and chest wall. A chest x-ray is the first test a physician will order to look for any tumor or spots on the lungs. If it is normal there is a high probably there is no lung cancer, but if anything suspicious is spotted, the doctor will order further tests. Pneumonia, heart failure, emphysema, other medical conditions, and lung cancer can all be located with a chest x-ray.

CT Scanning or Computed Tomography also known as CT or CAT Scan: This equipment is to obtain multiple cross-sectional images of organs and tissues of the body. A CAT scan is especially useful for diagnosing tumors as it is far more detailed than a conventional chest x-ray. It shows different types of body tissue including the lungs, heart, bones, soft tissues, muscle, and blood vessels at the same time.

Modern CT scans capture images of the chest from many different angles using a method called spiral (or helical) CT. With the assistance of a computer, it processes the images to create cross-sectional pictures or "slices" of the area causing concern. The images can then be printed out or examined on a monitor. To achieve a better picture, after the first set of scans are taken an intravenous injection of a radio-contrast agent is administered to help outline the structures within the body. A second set of pictures is then taken so they can be examined together.

Information on the size, shape, and position of a tumor are provided by the CT scan. This helps discover any enlarged lymph nodes, which could contain cancer, which has spread from the lung. When looking for early lung cancers and to ensure patients receive the treatment they need as soon as possible, CT scans are much more sensitive than an ordinary routine chest x-ray. In looking for tumors in the adrenal glands, brain, and other internal organs usually affected by lung cancer spread a CT scan is also useful.

Magnetic resonance imaging (MRI): MRI scans use radio waves and strong magnets instead of x-rays. The energy released from the radio waves is absorbed and re-released in a pattern shaped by the type of tissue and the disease being investigated.

A pattern of radio waves is given by the tissues and organs forming very detailed images of the parts of the body using a very sophisticated computer. This can also produce slices parallel with the length of the body just as a CT scanner produces cross sectional slices of the body.

Positron emission tomography (PET): This scan uses glucose, which is a form of sugar containing a radioactive atom. Large amounts of radioactive sugar are absorbed by the cancer cells and a special camera is then able to detect the radioactivity.

To discover if someone is suffering from early stage lung cancer a PET scan is a very useful test. It is often used to discover if the cancer has spread to the lymph nodes. PET scans are valuable in ascertaining whether a shadow on a chest x-ray is cancer or not. PET scans are also helpful when a doctor thinks the cancer has spread, but isn't sure where the spread may be.

Because PET scans scan your whole body sometime they are used instead of several different x-rays. Bone scans: A radioactive substance (usually technetium diphosphonate) is injected into a vein. The radioactive substance builds up in bone areas suspected of having cancer metastasis, (spread). Due to the small amount of radioactivity used this does not cause any long-term effects.

Bone scan results need to be read in conjunction with results of other tests performed as other bone diseases can also cause abnormal scan results. Bone scans are usually performed on patients with small cell lung cancer and also in non-small cell lung cancer patients when other test results or symptoms suggest the cancer has spread to the bones - lung cancer diagnosis




I for one know there's a ton of lung cancer information scattered all around the web, and I know it can be somewhat depressing to go through much of it. I have compiled all that researched so it might benefit others. I put many months of research into a useful guide. There's no charge of course and I think you'll appreciate the simplicity of it. Its at MyLungCancerGuide.com. While you are there, you'll find this article about Lung Cancer Diagnosis and many other very straight forward, helpful articles.





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Lymphoma in Dogs - Symptoms, Diagnosis and Treatment Options


Dog lymphoma is a disease that occurs when the lymph tissue is damaged by cancer cells. As this lymph tissue can be found in any organ or part of your pet's body the disease can grow and affect almost every organ of the dog. Lymphoma can be found more commonly in middle-aged dogs.

Symptoms of Lymphoma in Dogs

The most visible symptom is swelling of the lymph nodes. Depending on the area that is affected the dog will show symptoms in that area. Probably the most common areas affected by the disease are gastrointestinal tract and chest. If your dog shows loss of appetite, vomiting, diarrhea, and weight loss it may suffer from gastrointestinal tract lymphoma. If you notice shortness of breath in you dog it may be suffering from chest lymphoma.

Diagnosis

In our days there are many types of cancer and also many causes. Lymphoma in dogs can be diagnosed with a biopsy of the affected lymph nodes or organs. The stage of the disease is very important when it comes to treatment and prognosis. To discover how bad the disease is, there can be performed also tests like bone marrow biopsy, x-rays, ultrasound, blood analysis. You'll never know the cause of the condition. The best thing you can do is to focus on the treatment. Untreated dogs die usually after 2 months from the discovery of the disease. If the disease was discovered early, immune modulation in most cases offers the greatest chances of recovery. Early diagnosis gives your dog 50% chances of survival.

Treatment

The best treatment you can get only from a veterinarian. As in humans with cancer, lymphoma in dogs is treated with chemotherapy. Although only a small percentage of dogs are hospitalized due to side effects, nausea or infections may occur due to chemotherapy. Ask your veterinarian for more information on side effects and emergency hospitalization. If your dog is in later stages of the disease it is very likely that it won't respond to this treatment type. Fatty acids, like those found in fish oil, may help slow down the growth and spread of cancer tumors, and also prevent weight loss and muscle wasting. Studies have shown that dogs rarely die of cancer. They usually die of liver or kidney failure. These conditions are cancer's side effects and they can be avoided by controlling the pet's diet in most cases.

Prognosis

The treatment of lymphoma in dogs can be effective in most cases. However, this is one of the diseases that will likely recur in the future. A second treatment with chemotherapy can be given, but the effect will last even less that the last one. Although the disease seems curable it keeps on coming back. You should also know that this chemotherapy treatment protocol can be very expensive. No matter how many treatments you administer to your pet if the disease keeps on coming back your dog may pass away in a couple of years from diagnosis. If you have any doubts and you think that your dog might have this deadly disease called lymphoma don't hesitate and visit immediately a veterinarian for a full diagnosis.




Want to learn more about dog lymphoma? On CanineLymphoma.Net you can find articles about canine lymphoma dealing with the main symptoms of canine lymphoma, treatment of canine lymphoma and about the effects of chemotherapy on dogs.





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