Spinal cord tumors are tumors developing from parenchyma of spinal cord, its radices, membranes or vertebras. They are subdivided into extra- and subdural, extra- and intramedullary. Pains in vertebral area (both drawing pain and shooting pain), which get stronger in the lying position and less intense- when the person stands up, can be the symptoms of spinal cord cancer. In the course of the further tumor growth the symptoms depend on the tumor location - depending on what part of spinal cord is damaged by the disease, there can be severe pains, decrease in sensitivity in the neck area, clavicles, top and bottom extremities; often motor disturbances occur such as paresis and even paralyses.
Cancer it not a sentence!
We hope that you will think so after reading this article.
Tumor, cancer - people hear this diagnosis more and more often these days, and it sounds like a verdict – but is it really so?
Tumoris called superfluousaccrementition of tissues consisting of qualitatively changed cells of the organism, which have losttheir differentiation. Out of all the terms accepted in medicine which designate tumoral process, the following are used most often: tumores, neoplasma, blastomata – the latter displays the essence of the process in the most complete way.
Atumor can emerge in any place of the organism - but whence and how does it appear there? Our organism consists of millions of cells:muscles consist of muscular cells, brain - of brain cells, bones - of bone cells etc. Cells do not remain the same all life long - they are constantly renovated. Some grow old and die off, others come instead,getting numerous and replacing the old ones. It is a well-coordinated process of growth and renewal. Cell fission or reproduction usually occurs in the following way: a cell is divided in the middle and two absolutely identical cells emerge which can multiply on in just the same way. However sometimes it happens so that one cell becomes ill and changes, not conforming to the rules of the organism anymore. It starts to divide more often, without any need, and consequently there appears a congestion of cells which endlessly grow and divide. Thus healthy neighboringcells are pushed aside, and because of that after a while already externally you can notice a place - for example, in a mammary gland - which differs from itsenvironment by feel. This istumor. In their turn, tumors can be benignant and malignant, according to the character and rates of growth.
Benignant tumors - tumor benignum - grow slowly,they can exist for years without getting bigger. They are surrounded by their own membrane. While growing, such tumor pushesthe surrounding tissuesaside without destroying them. Histologic structure ofsuch tumor only slightly differs from thetissue in which it has developed. Therefore benignant tumors carry the names of their own tissues from which they have developed, with addition of the suffix "oma" coming from the Greek term "оncoma" (tumor). For example, fat tissue tumor is called lipoma, connective tissue tumor- fibroma, muscular tissue tumor - myoma, bone tissue tumor–ostheoma etc. Removal of a benignant tumortogether with its membraneleads to the patient’s complete recovery. Other tumors which destroy the neighboring cells are called malignant.
Malignant tumors - tumor malignum - grow much faster. They have no membrane. Tumoralcells and their tenia get into surrounding tissues (infiltrative growth), damaging them. Sprouting intolymphatic or blood vessels, they can be transferred bythe blood or lymph current to lymph nodes or a remote organ and form there the secondary center of tumoral growth - metastasis. The histologic picture of malignant tumor considerably differs from thetissue from which it has developed. Its cells are atypical, polymorphous, with a considerable quantity of mitoses. A typical sign of tumoraltissue is anaplasia - return to a more primitive type. Morphologically it is displayed as differentiation loss, functionally – as the loss of specific function.
There are malignant tumors of epithelial nature - cancers, and mesenchymas which have arisen from the derivatives - sarcomas.
Up to 90 % of all malignant tumors are cancers. Therefore all malignant formationsare calledcancers, and activityaimed at fighting malignant tumors – cancer activity.
From this point on our conversation will be about malignant tumors only.
Until now the exact cause of occurrence of some kinds of cancer has not been completely discovered; it might be connected with:
- Genetic disorders;
- Improper nutrition (too many fatty foods, vinegar-pickled products, moldy products, tinned meat (with nitrites and nitrates as preservatives), smoked products, and insufficient quantities of fruit, vegetables and fibers);
- Too frequent alcohol intake;
- Unhealthy sexual behavior (too frequent change of partners);
- Viruses (hepatitis B and C);
- Impact of ultra-violet rays;
- Impact of radiation;
- Impact of chemicals;
as well as because of the effect of substances named carcinogens.
Cancer can stay dormant for a long time, without manifesting itself. Since we are not under constant supervision of doctors, we should be more attentive to the organism not to miss any symptoms, especially if certain signs are observed during a long time.
There is a number of features typical for development of any kind of cancer.
1. Soreness. At the initial stage it is not pain, but sensation of discomfort in a certain organ.
2. Rapid weight loss. Tumor forces the organism to produce substances which disturb metabolic processes, due to which the person grows thin within several months.
3. Constant weakness. Waste products of a cancer tumor cause intoxication, weakness, anemia.
4. Fever. Immune system which is oppressed by tumor reacts by rising the body temperature.
5. Change of the hair and skin condition. Because of the metabolic processes disorder there occur external changes as well.
If you suspect you havesome of these symptoms, you should turn at least to the general practitioner first off.
Be attentive to your condition and pay attention to all changes in the organism:
- Such symptoms as the change of functions of intestines or bladder can be the signs of cancer of intestines, bladder, prostate or kidneys. Blood in urine is the very first and basic sign.
- Skin cancer can remind of bleeding ulcers which stay for long, and also can be expressed by the change of color and shape of a birthmark.
- Unusual bleeding, blood in saliva or phlegm, persistent cough can be a sign of lung cancer.
- Blood in excrements can be a sign of colon cancer or rectum cancer.
- Vaginal bleeding can be a sign of cancer of uterus or uterus neck.
- Bloody discharge from nipples, indurations and bosselations in the breast can be a sign of breast cancer.
- Constant ulcers in mouth can be a sign of mouth cancer.
- Symptoms which specify throat cancer, thyroid gland cancer or stomach or gulletcancer, can be not only digestion disorders or complicated swallowing, but also hoarsevoice.
Unfortunately, all these disease signs occur at quite late stages of the disease.
What you can do
First of all it is necessary to always remember about self-checking methods, namely to conduct independent examination of mammary glands, testicles. At least once a year you should undergo prophylactic medical examination, the plan of which should be made with the doctor’s help – since cancer diagnostics at early stages and treatment considerably increases the chances of recovery. You should turn to the doctor at once if you notice any signs or symptoms. Nowadays there are many simple screeningexamination types which make it possible to detect the development of a malignant tumor at early stages of the disease. Many of them are simple and affordable. There are tests which make it possible to detect cancer development looking at the level of certain fibers (oncogenes) in blood.
What the doctor can do
The doctor can carry out a complete outpatient examination, and if necessary this examination can be made in the hospital. Judging from the data received in the course of the examination, if the diagnosis “cancer” is confirmed, the doctor should explain to the patient his/her condition, give him/her appointment to a hospital, a specialized branch, for treatment. Treatment (operative intervention, chemotherapy, beam therapy or a combination of various methods) is prescribed depending on the stage and prevalence of tumoral process which in the diagnosis is designated by Roman figures (I, II, III, IV), reflecting both the tumor size and its distribution within the organ (usually, the depth of invasion) or outside. There is also a uniform international classification by the system of three letters - TNM, which define each disease: Т (tumor) - the size of tumor, N (nоdulus) – the regional lymph nodes condition, M (metastasis) –remote cancer spread.
I stage - limitedtumoral process (up to 2 cm) when the nearest lymph nodes are not affected;
II stage - mobile tumor (from 2 cm), a single mobile metastasis in the nearest lymph nodes;
III stage – a tumor is limited in its mobility, there are metastases in the nearest (regional) lymph nodes;
IV stage - a tumor of any size with remote metastases or a tumor sprouting in the neighboring organs.
The doctor also provides the rehabilitation period.
The success of treatment of oncological patients, especially with malignant new formations, depends first of all
There is an international classification according to which 7 basic groups of tumors are defined:
- Epithelial tumors without specific localization (organo-non-specific)
- Tumors of exo- and endocrine glands, and epithelial membranes (organo-specific)
- Mezenchymal tumors
- Tumors from melanin-forming tissue
- Tumors of nervous system and brain lining
- mors of blood system
If we ask the patients on the oncologist’s file about the history of their disease, almost each of them will specify that before the detection of tumoral process he/she suffered from a certain chronic disease. Those who are illwithmalignant tumor of stomach specify chronic anacid gastritis, ulcer or gastric polyp; those who suffer from mammary gland cancer – fibrosingadenosis; uterus neck cancer– long-term erosion.
Only in rare instances the patients who are illwith malignant tumors can not name any diseases which preceded the tumor occurrence, because malignant growth only in rare instances arises in absolutely healthy tissues. Almost always tumor growth begins in the tissues changed by a preceding pathological process or under the influence of long traumatization. Therefore these chronic processes are calledpretumoral, or precancer diseases. But occurrence of a malignant tumor in the organism of a person who suffers from diseases is not inevitable. There are also such pretumoral processes which always lead to malignant growth in the end. They are called obligate (obligatory) precancers. Among such diseases there are polyposis and callous gastric ulcer, local hyperplastic rigid gastritis, family polyposis of large intestines, fibrosingadenosis of mammary glands.
Metastases and relapses of malignant tumors
Because of insufficient or untimely treatment of tumor, many patients have secondary tumoralnodes in the nearby and remote organs - metastases. Relapses and metastases of a malignant tumor area heavy complication, which is more life-threatening for the patient thana primary tumor. Early revealing of these complications and specialized treatment is the main way of fighting for oncological patients’ life.
Various methods of diagnostics are used for revealing of tumoral processes and metastases.
Methods of malignant tumors diagnostics:
- Consultation of the doctor.
- Radiological methods.
- Computer tomography.
- Ultrasound tomography.
- Endoscopic method.
- Laboratory research.
- Cyto-histologic methods.
- Cytologic method.
- Radio isotope diagnostics.
- Radionuclide methods.
- Magnetic and resonant tomography.
- NMR spectroscopy in vivo.
- Positron tomography.
The first essential stage in recognition of a malignant tumor is consultation of the doctor who examines the patient, learns the history of the diseasedevelopment ,the change of its displays in the course of time (anamnesis). In the process of the patient’s examination the doctor examines the tumor or the area of its prospective localization, the condition of regional and remote lymph nodes.
Radiographic examination is the main method of revealing of lung cancer, gastric cancer, colon cancer
Mammography - is a special x-ray examination of mammary gland with the use of a small dose of X-rays. It helps to find gland indurations in thetissue, which can be hardly detected by means of palpation, and which may indicate possible development of tumor before it is possible to palpate anything at all. Pictures are made of the mammary glandwhen it is squeezed a little. It is done to reduce the dose of radiation and to get pictures of higher quality. Normally two pictures of each gland are made. It is better to conduct the examinationon the 7th– 10th day from the first day of menstrual cycle when the breast is less painful to touch. Women who have menopause can undergo mammography procedure at any convenient time. As a rule, it is recommended for every woman after 45 years of age to have mammography made annually.
Computer tomography - is a method which makes it possible to obtain images of different body areas; it gives a chance to receive within a short time period a lot of cross-section projections which is especially valuable for localization of the area from which later a tissue sample for biopsy is taken, and also to planoperative intervention and the subsequent radiotherapy. The advantage of CТ is contrast resolution which is higher in comparison with other methods of visualization. Computer tomography (CТ) is given a special role, namely the role of standard.
Ultrasound diagnostics - is a highly informativeexamination method; it is used for diagnosing of tumors of abdominal cavity organs (especially liver, gall bladder, pancreas head) and retroperitoneum(kidneys, adrenal glands), small pelvis ( bladder, uterus and its appendages: prostate gland), thyroid gland, soft bodytissues etc. In the process of research target puncture of tumor can also be performed. Since ultrasound tomography combines high informativity with simplicity and safety of research, it is widely used as an obligatory method of examinationwhen there is a possibility of cancer of any localization,to exclude the spreading of metastases into internal organs and first of all liver.
Endoscopic method of examination, thanks to the achievements of modern electronics and optics has got crucial importance for early diagnostics of cancer of internal localization: stomach, gullet, colon and rectum, bronchi; it gives a possibility to examine carefully mucous membranes of internal organs, to make cytologicexamination, and if there is suspicion of having cancer - to take a piece oftissue for histologic examination.Endoscopically it is possible to examine not only cavity organs, but also the chest (pleural) cavity, abdominal cavity, joint cavities, mediastinum etc.
Cytologic method of examination has obtained well-deserved recognition and is widely spread. Simplicity and availability of its usage in polyclinic establishments and its reliability first of allmakes it possible to recognize early forms of malignant process in many cases. For the first time it was used for diagnostics of uterus neck cancer.
Biopsy - ex-section of a piece of tumor or a suspicious tissue for histologic examination. It can be total when a wholetumoralnode or a suspicious lymph node which might be affected by metastasis is removed entirely. If with the aim of examination only a part of the tumor ora suspicious tissue is ex-sected, it is called incisional biopsy.
Radio isotope diagnostics. In oncological practice there is a method of organ scanning when there is a suspicion oftumoraldamage (primary or metastatic). The method of contact beta radiometry is used in the diagnostics of skin melanomas, in the case of superficially located tumors of mammary gland, for diagnosing of Paget disease.
Radionuclide methods. Nowadays to diagnosethe disease scintigraphy of skeleton bones, brain, lungsis used; to characterize functional condition - scintigraphy of kidneys, liver is used.
Radio immunological research is based on the analysis of the content of monoclonal antibodies in the examinedtissues; it makes it possible to reveal many kinds of tumors at early stages of development of the process when the sizes of tumors are still small.
Magnetic and resonant tomography (МRТ) - is a method of reception of the images induced by a nuclear magnetic resonance signal. Advantages of МRТ: the method makes it possible to reach exceptionally high contrasting of tissues, during one examination only to receive the image in all anatomic projections, to study the dynamic processes connected with movement of biological liquids (blood, neurolymph, urine, bile), and also, thanks to the usage of contrast substances, with high accuracy to distinguish peritumoral edema and actual tumor.
Positron tomography (PТ) - is exclusively effective method of clinical examination of patients with oncopathologies; it has become widespread in the last decade, which is connected first of all with the development and technical improvement of the devices intended for the whole body examination. PТ makes it possible to obtain information about the metabolic activity of tumors and changes of metabolism connected with the therapy. Looking at the speed and intensity of accumulation of isotopy-marked metabolites or special medical products it is possible to judge about the biological features of tumoraltissue in comparison with intact tissue, and also - which is especially important - to evaluate the efficiency of treatment and to make the forecast of the further process development.
Тhermography is creation by means of a special device,which is sensitive to infra-red (thermal) radiation, of images of the human body where the sites with different skin temperature are shown with different colors. Thermographicexamination of mammary glands makes it possible to diagnose cancer in 80-87 % of the examined patients. The combination of thermography with radiological examination enhances the accuracy of diagnostics of this localization up to 99 %. Thermographicexamination is effective for diagnostics of thyroid gland cancer, skin melanoma.
General principles of oncological patients’ treatment
For successful treatment of oncological patients, close interaction of oncologists, radiologists, analysts, histologists, immunologists, functional diagnostics specialists etc. is necessary.
The choice of a certain method of treatment or their combination in each separate case is determined solely individually, after a careful examination of the patient.The treatment of oncological patients is considered radical when the tumor is removed within healthy tissues together with the regional metastasing zones, or when the tumor with metastatic nodes has been completely resolved under the influence of beam energy. Upon termination of radical treatment the patients are considered to be initially cured. The fact of stable recovery is established after five years’ supervision of the patient – if he/she does not demonstrate any occurrences of relapse or metastasis. It is called palliative - if the treatment has not achieved such result and has led only to temporary improvement. Symptomatic treatment is aimed at liquidation of separate symptoms, not the tumor itself.
Today surgical, radial, hormonal methods, as well as chemotherapy and biotherapy are used for the treatment of oncological patients. They can be used both independently, and like a combination of two or three treatment methods. The combination of these methods can be different: surgical and radial methods; radial, surgical and chemotherapeutic methods, etc.
Radical operation is performed basically at the early stages of the disease, as well as in the case of regional tumor after effective radial therapy or chemotherapy. Palliative operation is aimed at tumor size reduction - which essentially alleviates the patients’ condition (for example, in the case of intestinal obstruction, bleeding etc.), enhances the efficiency of therapeutic influence.
Radial therapy is used in the case of tumors which are sensitive to radial influence: small celled lung cancer, cancer of mammary gland, nasopharynx, throat, other tumors of head and neck, Ewing tumor, uterus neck cancer etc., independently or in the combination with operation, chemotherapy. There are such methods of radial therapy as remote gamma therapy, endocavitary radial therapy, neutrons, protons, radioactive isotopes etc.
Chemotherapy as of today in most cases is the major method of treatment of malignant tumors. In the case of some diseases modern chemotherapy, being the basic component of treatment, provides treatment of a considerable number of patients (malignant seminomatous and non-seminomatous testicle tumors, chorionic carcinoma of uterus, localized forms of osteogene sarcoma, mammary gland cancer, Ewing tumor, children’s nephroblastomas etc.). Adjuvant chemotherapy is prescribed in the cases of inoperable tumors, after operationswith the aim of prevention of metastases development or if there are metastases. Neoadjuvant chemotherapy is prescribed in the cases of operable tumors with the subsequent continuation of treatment after the operation.
Peculiarities of children's oncology
Recently according to most statistical data, in all countries there has been detected an absolute growth of children’s tumor diseases, including malignant tumors – therefore a great deal of attention is given to the organization of specialized oncological assistance to children. In big cities there have been created children's oncological branches and clinics; it is connected with the fact that child age tumors have their features in terms of frequency of occurrence in certain organs, clinical symptoms and development process, as well as the methods of recognition and treatment which appreciably distinguishthem from adults’ tumors.
Children most often suffer from tumors of blood-forming organs and lymphatic apparatus (leukemia, adenoid disease, retothelial sarcoma), which make up about 40 % of malignant new formations. More than 25 % are tumors of kidneys (Wilms tumor) and non-organ extraperitoneal tumors originating from the elements of sympathetic nervous system.
The reasons and peculiarities of development of malignant tumors in children are thesame as in adults, although there is a bigger importance of non-mature developing tissues, hormonal factors and developmental anomalies which at a certain stage show the inclination to malignant transformation.
In rare instances there is occurrence of congenital malignant tumors, in particular melanomas, when malignant cells are transferred to the fetus from the sick mother through the healthy or disease-affected placenta. One of the major features of children's oncology is the existence of family predisposition to certain tumors - retinoblastoma, dyschondroplasia and intestines polypose.
Prostate gland (the synonym of which is "prostate") is an important component of male reproductive system, which is responsible for many functions, ranging from synthesis of men's sexual hormone (testosterone) to pleasant sensations during orgasm. Therefore the diagnosis “prostate gland cancer” (prostate cancer) is a serious challenge for a man, both from physiological and psychological point of view.
Kidney cancer (renal cancer) is a malignant formation of nephritic tissue (parenchyma) which makes 3 % of all malignant tumors.
Very often the disease has no symptoms, irrespective of the tumor size, prevalence and clinical displays. The majority of patients show deterioration of the general health condition which is displayed by general weakness, appetite loss, growing thin, "causeless" rise in body temperature - most often in the evening, arterial hypertensia, increased disposition to sweating,polycythemia, anemia, hypercalcemia, nephritic dysfunction.
The liver cancer emerges as abnormal growth of cells inthe liver,as a result of which liver tumor is formed. If abnormal cancer cellsemerge in the liver, such liver cancer is called primary. Some liver tumors are benignant — they do not spread onto other body parts. Malignant liver tumors can sprout in other organs and spread all over the organism.
Mammary gland cancer is a malignant tumor of glandular tissue of mammary gland which occupies the first place among all malignant new formations in women and has an expressed tendency to grow. The reasons of mammary gland cancer.The cancer develops against the background ofthe pretumoral diseases: masthopathy and fibroadenoma.
Lung cancer is a widespread disease which is more typical for smokers. In about 8 out of 10 cases lung cancer develops in people who are over 60. Lung cancer can be central and peripheral. According to histologic structure there are 2 big groups: non-small-cell and small-cell lung cancer. The major factor of the disease risk is smoking – probability of death from lung cancer is 8 times higher in people who smoke 1-14 cigarettes a day, in comparison with non-smokers.
Colon cancer (colorectal cancer) is a malignant tumor which grows from the mucous membrane covering the colon walls. Large intestine cancer tends to get more frequent, and death rate from it increases. Out of various parts of the large intestine, cancer most often occurs in rectum, less often– in sigma, blind gut, hepatic and splenic flexure of the transverse colon.