What are the risk factors of nervous system/brain cancer?

What are the risk factors of nervous system/brain cancer?

A risk factor is anything that can affect your chances of developing a disease. While certain risk factors can influence the development of a nervous system/brain tumor, most of them do not directly cause the tumor to form. However, knowing your risk factors and speaking with your doctor about them can help you work towards making better choices and informed decisions.

The following risk factors can increase a person’s risk of developing a nervous system/brain tumor:

  • Age: Brain tumors are more common in children and older adults. That being said, brain tumors can develop at any age.
  • Gender: Men are more likely than women to develop brain tumors.
  • Race/Ethnicity: In the United States, white people are at a higher risk of developing certain kind of cancers such as gliomas
  • Exposure to chemicals: Pesticides, oil products, rubber, or vinyl chloride may increase the risk of developing a brain tumor. Even if these elements are often under discussion, there is still no scientific evidence that supports this link.
  • Family history: Approximately 5% of the brain tumors may be linked to hereditary genetic conditions such as neurofibromatosis, Li-Fraumeni syndrome, nevoid basal cell carcinoma syndrome, tuberous sclerosis, Turcot syndrome, and von Hippel-Lindau disease
  • Exposure to infections, viruses and allergens: Infection with Epstein-Barr virus (EBV) increases the risk of developing central nervous system lymphoma. Several other types of viruses have been shown to cause brain tumors in animals.
  • Electromagnetic fields: Studies that have evaluated the role of electromagnetic fields, such as energy from cell phones, have not shown a link between developing brain tumors. However, the World Health Organization has recommended limiting the use of cell phones for both adults and children.
  • Ionizing radiation: Previous treatments to the brain with ionizing radiation, such as X-rays, have shown to increase the risk of a brain tumor in people.
  • Head injury: Serious head trauma has been studied for its relationship to brain tumors. Some studies have shown a link between head trauma and meningioma.
  • Seizures: Seizures have long been associated with brain tumors, as it is one of the symptoms. However, it is not fully known if seizures increase the risk of brain tumors or not.
  • N-nitroso compounds: Dietary N-nitroso compounds are are formed in the body from nitrites or nitrates found in some grilled meats, cigarette smoke, and cosmetics. Some studies indicate that presence of N-nitroso compounds may increase the risk of both childhood and adult brain tumors.
  • Exposure to nerve agents: A study has revealed that some Gulf-War veterans have an increased risk of brain tumor from exposure to nerve agents (neurotoxic gases). However, more research needs to be conducted.





What is nervous system/brain cancer?

What is nervous system/brain cancer?

HiResCancers affecting the brain and the spinal cord are collectively known as nervous system cancers. Together, the brain tissue and the spinal cord make up the central nervous system (CNS). The CNS is responsible for elaboration and transmission of specific functions such as thought, speech, and body movements. When a tumor grows in the CNS, it can affect a person’s thought process, their speech, or their movement.

There are two types of brain tumors: primary and secondary. Primary brain tumors start in the brain and can either be low-grade, or high-grade tumors. A low-grade tumor grows slowly, but has the potential to turn into a high-grade tumor. A high-grade tumor is more likely to grow faster.

Secondary brain tumors, also known as brain metastases, are more common than primary brain tumors. These generally start in another part of the body (such as the breast, colon, liver) and then spread to the brain. Tumors can also be benign.. Both of benign and malignant tumors cause signs and symptoms and need treatment. Benign tumors grow and press on nearby areas of the brain but rarely spread to other parts of the brain. Malignant tumors, on the other hand, can spread to other parts of the brain.

Types of brain tumors:

There are many types of brain and spinal cord tumors that can form in different areas of the brain and the spinal cord. In general, gliomas are the most common type of brain tumor.

A glioma is a tumor that grows from a glial cell (a supportive cell in the brain). A glioma is given a grade that represents how much the tumor looks like a healthy brain tissue. The higher the grade, the more likely the tumor will grow quickly. The types of gliomas are:

  • Astrocytoma: The most common type of glioma. It begins in cells called astrocytes located in the cerebrum or cerebellum. There are four grades of astrocytoma namely Grade I, II, III and IV. Grade IV corresponds to the worst case, i.e. glioblastoma.
  • Oligodendroglioma: This type of tumor develops from cells called oligodendrocytes which make up myelin.
  • Mixed glioma: This type of tumor is made up of more than one of the glial cell types
  • Ependymoma: This type of tumor begins in the passageways of the brain where the cerebrospinal fluid is made and stored.
  • Brain stem glioma: This type of tumor begins in the glial cells located in the brain stem

Non-glioma tumors are those that arise from cells in the brain that are not part of the glial or supportive tissue. Types of non-glioma tumors include:

  • Meningioma: This type of tumor is the most common primary brain tumor and begins in the meninges.
  • Pineal gland and pituitary gland tumors that are located in the pineal gland and pituitary gland
  • Primary CNS lymphoma: This is a type of lymphoma that begins in the lymphatic system inside the cerebrum.
  • Medulloblastoma: This type of tumor begins in the granular cells in the cerebellum.
  • Craniopharyngioma: This type of tumor begins near the pituitary gland located near the base of the brain.
  • Acoustic schwannoma: This type of tumor begins in the vestibular nerve, which is located in the inner ear. This nerve controls balance.




What are the symptoms of nervous system/brain cancers?

What are the symptoms of nervous system/brain cancers?

People that have developed a brain tumor may experience general or specific symptoms. A general symptom is the consequence of the increased intracranial pressure due to the mechanical push of the tumor on the brain or the spinal cord tissue. Specific symptoms are those caused when a specific part of the brain isn’t functioning well because of the tumor.

For people who have developed a brain tumor, the following general signs or symptoms may occur:

  • Headache: which can be severe or gradually get worse with main episodes occurring in the mornings
  • Seizures: sudden involuntary movements
  • Memory changes
  • Nausea and/or vomiting
  • Fatigue

For certain people, the following signs of symptoms may occur which may be specific to the location of the tumor:

  • Pressure or headache
  • Loss of stability and balance (linked to a tumor in the cerebellum)
  • Difficulty with fine motor skills (due to a tumor in the cerebellum)
  • Changes in judgment, loss of initiative, sluggishness and muscle weakness (caused by a tumor in the frontal lobe of the cerebrum)
  • Partial or complete loss of vision (due to a tumor in the occipital or the temporal lobe of the cerebrum)
  • Changes in speech, hearing, memory, or emotional state (due to a tumor in the frontal or temporal lobe of the cerebrum).
  • Difficulty swallowing, facial weakness, or numbness (as a result of a tumor in the brain stem)
  • Inability to look upward (due a tumor in the pineal gland)
  • Vision changes (attributed to a tumor in the frontal lobe, occipital lobe, or brain stem).

The brain and the central nervous system are responsible for controlling other organs, including those responsible for hormone production. Thus, brain tumors can cause other symptoms not listed here.

If you experience any of these symptoms, and/or changes consult your physician, who will then assess the reasons behind these changes. Together both of you can come up with a course of action to reduce the symptoms and treat the tumor.





What are Skin Cancer’s Symptoms?

What are Skin Cancer’s Symptoms?

Skin cancer symptoms can be divided into two types. The non-melanoma skin cancer symptoms and the melanoma skin cancer symptoms

Non-melanoma skin cancer symptoms generally start with a lasting unusual skin growth (a bump or a sore)

  • Basal cell carcinoma (BCC) symptoms usually begin with translucent bumps on sun-exposed areas such as the head, neck or shoulders. It is common to see blood vessels within the bump. As the center starts to crust and bleed, these bumps tend to be mistaken for sores.
  • Squamous cell carcinoma (SCC) symptoms are most commonly seen on sun-exposed body parts, but can also be found on genitals and inside the mouth. If left untreated these patches can grow into larger masses. This type of tumor can appear under several forms including:
    • A firm, red nodule
    • A flat lesion with a scaly crust
    • An ulceration in the mouth
    • A red, raised patch on the anus or genitals
    • Intense itching that can lead to an infection

Melanoma skin cancer symptoms include the appearance of new spots or the change in size, shape or color of an existing mole. Using the ABCD rule will help detect any abnormal growths:

  • A is for Asymmetry: if the mole or freckle is uneven (or asymmetrical), meaning one half of the mole does not match the other half.
  • B is for Border: if the edges are rough, blurred or irregular, this could be a sign of cancerous change.
  • C is for Color: a change in the shade or distribution of color throughout the mole or freckle.
  • D is for Diameter: any mole larger than ¼ inch (6 mm) across could be a sign of skin cancer.

Other sign include:

  • Redness or swelling that spread to the surrounding skin beyond a spot
  • Itching or pain of a spot
  • Changes in texture or bleeding/oozing from an existing mole
  • Lack of healing/bleeding of a growth

Be aware that skin cancer signs can exhibit in different shapes and forms, some more discreet than others, with growths happening in body parts that are not necessarily exposed to the sun. It is therefore very important to get yourself checked on a regular basis. These symptoms can be caused by conditions other than cancer, but it is important to discuss any noticeable changes with your doctor.






What Are The Treatments of Skin Cancer?

What Are The Treatments of Skin Cancer?

Generally, skin cancer can be treated through surgery. However, many treatment options are made available to the patient. Sometimes, depending on the size, type, depth and location of the cancer, one treatment is recommended over another.

In the presence of small skin cancers (or precancerous lesions), treatment can be limited to simply removing the entire growth (by incision or with a scraping tool). If further intervention is needed, options include:

  • Cryosurgery. Usually used for small or early stage cancers by freezing them with liquid nitrogen. The dead tissue just falls off after it thaws.
  • Excisional surgery. This is when the doctor cuts out the cancer, along with some healthy surrounding skin.
  • Mohs Micrographic surgery is used when dealing with larger, recurring or difficult to treat skin cancers. It is generally used for basal and squamous cell carcinomas but is increasingly being used for melanoma as well. One thin layer of tissue is removed at a time and evaluated for cancer detection. The surgery ends when the removed layer becomes cancer-free.
  • Curettage and electrodesiccation or cryotherapy is used as a follow-up once the growth is removed. Here, a needle-shaped electrode is used to freeze or destroy cancer cells surrounding the wound area. This is mainly used to treat basal cell cancers or thin squamous cell cancers.
  • Radiation therapy is used when surgery cannot completely remove all cancer cells. It is also used when cancer cells have spread to lymph nodes or other parts of the body or in the case of a recurring cancer an initial treatment through surgery.
  • Chemotherapy can be used in a variety of ways for treatment. Topical ointments/creams can be used for cancers that are limited to the top layer of skin. In the case where cancers have spread, IV-chemo is used, mostly to alleviate symptoms, rather than cure the cancer.
  • Photodynamic therapy consists of using drugs that make cancer cells sensitive to light and then destroying them with laser light. This is a relatively new type of treatment and is most successful with basal skin cancers that are not too deep.
  • Immunotherapy targets skin cancer cells by manipulating the body’s immune system into using its natural defenses to kill these cancer cells. It is being used for non-melanoma as well as advanced melanoma.






What is Skin Cancer?

What is Skin Cancer?

The main function of our skin is to protect our body from damage, injury and infection. Our skin is also responsible for maintaining our body temperature in a normal range and for storing water and fat. Skin cancer takes place when there is a development of abnormal cells at the top layer of the skin, known as the epidermis (made up of squamous cells, basal cells and melanocytes).

There are 3 main types of skin cancer:

  1. Basal cell skin cancers (basal cell carcinomas)
  2. Squamous cell skin cancers (squamous cell carcinomas)
  3. Melanomas

Basal and squamous cell skin cancers (also known as nonmelanoma skin cancers) are the most common types of cancer, and generally develop due to sun exposure, in body parts like the head and the neck. These types of cancers rarely spread to other parts of the body, and are known to have a high response rate to treatment. Nevertheless, it is important to find and treat them early, because if left untreated, these cancers are likely to slowly spread to nearby tissues and organs, causing damage, and in rare cases, even death.

Melanomas develop in melanocytes, the cells that produce our pigment and give us our color. It is these melanocytes that form moles, also known as benign growths (non-cancerous).  Melanomas are the most dangerous type of skin cancers and can form anywhere in the body, but are generally found in the chest and back area in men, and in the legs in women. Even though melanomas are not as common as nonmelanoma skin cancers, they tend to be more serious. Just like basal and squamous cell skin cancers, if detected early, melanomas can be curable. However, if left alone, this aggressive cancer is highly likely to spread to other parts of the body, making treatment much harder.

Other less common types of skin cancers exist, such as Merkel cell tumors or Kaposi sarcomas.




What Are The Risk Factors of Skin Cancer?

What Are The Risk Factors of Skin Cancer?

Just like its symptoms, the risk factors for skin cancer can be divided into 2 different sections, for melanoma and for non-melanoma skin carcinoma. And even though not all risk factors are related to lifestyle, it is believed that up to 86% of skin cancer cases can be preventable, based on healthy lifestyle choices.

BCC and SCC risk factors include:

  • Ultra Violet (UV) light: this is the major risk factor for most skin cancers. The UV rays (from the sun or tanning beds) damage the skin cell’s DNA. The duration of sun exposure as well as skin protection weight heavily on the risks.
  • Fair skin: Anyone is at risk of skin cancer. However, white people are at a higher risk than people with darker skins. This is because darker skins contain much more melanin, which helps protect the skin against UV radiation. The fairer the skin, the higher the risk.
  • Older age: It is believed that older people are at a higher risk for developing skin cancer, due to the accumulated exposure to UV radiation over the course of their lives.
  • Men are twice as likely as women to develop BCC and 3 times more likely to have SCC.
  • Chemical exposure: Certain chemicals are known to lead to non-melanoma skin cancers, such as arsenic, industrial tar, coal, paraffin, as well as certain types of oil.
  • Radiation exposure: People who have gone through skin treatment by radiation are at a higher risk of developing BCC, particularly in that exposed area.
  • A history of skin cancer means an increased risk of developing the disease again.
  • Long-term or severe skin injuries such as scars from burns, or damaged skin by a severe inflammatory skin disease slightly increase the risk of developing skin cancer.
  • Psoriasis treatment: this UV light treatment can increase the chances of getting SCC.
  • Inherited conditions, such as Xeroderma Pigmentosum (XP), which reduces the ability for the skin to heal from sun damages, can lead to a high risk for developing skin cancers.
  • Weakened immune system: people with weakened immune systems (from disorders or medication) are more likely to develop many types of cancers, including BCC and SCC.
  • Human Papilloma Virus (HPV): infections due to certain types of HPV, especially in the genital/anal area, may increase the risk for skin cancer.
  • Smoking is a significant risk for squamous skin cancer.
  • Genetics: people with a family history of skin cancer (especially first degree relatives) are at a higher risk of getting skin cancer too.

Melanoma Skin cancer risks have a few similarities with BCC and SCC risks and include:

  • UV light: Here too, exposure to the sun over long periods of time can increase the risk of getting MSC.
  • Moles in themselves are benign tumors, and the chance of one turning into cancer is low. That being said, a person with several moles is more likely to develop melanoma.
  • Fair skin: Here again, the whiter the skin, the higher the risk. So much so that white people are 10 times more likely to develop melanoma than African Americans, with redheads having the highest risk.
  • Family history of melanoma: 10% of cases diagnosed with melanoma have a close relative with this disease.
  • A personal history of melanoma increases the risk of getting another one.
  • With a weakened immune system, people are also more likely to develop melanoma.
  • Age: Older people are at a higher risk of getting melanoma. However, this is also the most common skin cancer found in people younger than 30.
  • Gender: men are also more likely to develop melanomas than women.
  • Xeroderma pigmentosum (XP) also increases the risk of developing melanoma.








Can Skin Cancer Be Prevented?

Can Skin Cancer Be Prevented?

Fortunately, the answer is: most of the time, yes!

Since skin cancers are linked to lifestyle choices, there are many measures that can be taken to make sure we reduce our risks as much as possible. Here is a list of prevention tips to follow:

  • Avoid direct sun exposure in the middle of the day. For most of the world, this means from 11:00AM to 4:00PM (when UV index is 3 or more). Try to limit your outdoor activities within this timeframe. This way you will reduce the risk of absorbing too much UV rays or burning your skin.
  • Seek shade. If you must be outdoors, the best way to protect yourself from the damaging UV light is to stay in the shade.
  • Another way to protect yourself outdoors is to remember the “Slip! Slop! Slap!…and Wrap” This stands for:
    • Slip on a shirt
    • Slop on sunscreen (use a broad spectrum of UVA/UVB with an SPF of 15 or higher, and reapply every 2 hours)
    • Slap on a hat
    • Wrap on sunglasses to protect your eyes and the sensitive skin around them
  • Avoid tanning beds. These machines emit UV rays that are known to increase the risk of skin cancer
  • Protect children. Since they are at a higher risk of sun damage and they spend more time outdoors, it is important to protect them regularly but to ask explain to them the dangers of too much sun exposure.
  • Spot-check your moles regularly. Keep an eye on your moles on a regular basis, and have routine check-ups at the doctors on a yearly basis.





Questions To Ask Your Oncologist

Questions To Ask Your Oncologist

Regarding Diagnosis:

  • Name and stages
    • What is the exact name of my diagnosis?
    • Can I have a copy of my diagnosis reports? Like this I have the exact name of my diagnosis.
    • Is there a stage, if yes, what stage do I have?
    • Is the disease local (in some organ), or does/did it spread?
    • What tests are needed to fine tune or confirm the diagnosis?
    • Can you give me the list for what biomarkers I have been tested for and the results of that testing?
  • Progression
    • How does the disease progress?
    • Should I go for additional tests?
    • What is my prognosis?
    • What can I expect next?
  • Second opinion:
    • Who do you recommend for a second opinion? Should I have new tests if I go that way?
    • Can I have a copy of all my test results for a second opinion?

Regarding Treatment:

  • When your oncologists talks about a treatment:

    • What are the symptoms of my diagnosis?
    • What are my treatment options?
    • When should I start treatment?
    • What does my treatment entail: should I be treated in the hospital or should I take medication at home, or both?
    • How long will my treatment be?
    • Are there alternatives for the treatment you prescribe?
    • Will the treatment get rid of my cancer, or just protect it from further growth?
    • Is the treatment already on the market or is it in a testing phase? (see questions on clinical trials if in testing phase)
    • What support do I need during my treatment?
    • Do you suggest any complementary treatment (supplements, diet, sports,…) ? See questions on lifestyle.
  • Fertility:
    • Does the treatment have an impact on my fertility?
    • If I want children, is this still possible during or after the treatment?
  • Clinical Trials
    • What are clinical trials?
    • Are there risks attached to participating in a trial?
    • What happens during a clinical trial?
    • What happens once the clinical trial is finished?
    • Are there any costs related to participating in a clinical trial?
    • For what am I insured when I participate in a trial?
    • Do you recommend me participating in a specific trial?
    • Are there any clinical trials for my condition?
    • Could I be eligible for a clinical trial?
  • Side effects
    • What are the most common side effects for my treatment?
    • Can I prevent or manage certain side effects?
    • How long will I experience side effects?
    • Are there long terms side effects?
    • Can I prevent fatigue?
    • Can I prevent cognitive issues (chemo brain)?

Regarding Lifestyle:

  • Should I be aware about my lifestyle?
    • Can I be physically active?
    • Should I be physically active, if yes –what do you recommend?
    • What food can I eat, and what not?
    • Can I drink alcohol if I would consider doing it?
    • If I smoke, should I stop?
    • Can I take supplements? If yes, what kind?
    • Should I avoid certain supplements?

Regarding Cost of Treatment:

  • Will my treatment be covered by my insurance?
  • How much will it cost?
  • Will it be temporary or will there be long-term costs associated to my disease and treatment?
  • Who can help me with my questions on costs of treatment?

Tips for Before, During, and After Your Oncologist Appointment

Tips for Before, During, and After Your Oncologist Appointment

Sometimes it can be very difficult to get all the information you need with the short time you spend duringiStock_000063343045_XXXLarge your consultation with your oncologist.  Especially the first time you get the diagnosis, this can be hard, as your mind will not be very aware of everything your oncologist is telling you at that moment.  Once in treatment, or even in follow-up once in remission, it can be good that you are prepared before you see your physician.

Being able to ask all the questions you want will help you to be better informed on your condition.  In order to help you, we provide a set of questions that you could ask to your physician. Pick out the ones you like or you feel are more relevant for the situation you are in.

The aim is that you learn to take an active role in your treatment planning and in your survivor planning once you are there.

Preparing your appointment

  • Take your notebook, a piece of paper or print a list of questions and write down or indicate what information you would like to know.
  • Write down words that you do not understand, or words that you don’t know how to interpret in a specific context.
  • Think about going for a second opinion. Ask yourself if you would like to ask this to your physician, maybe he/she can redirect you.
  • Do you have enough material about your disease? Would you like to know what material is around there? Ask your nurse and oncologist for such information if available.
  • Not all information on the internet is reliable. If you have doubts about anything, mention to your physicians what your worries are, they will help you out or refer you with credible information.
  • Mentally rehearse asking the questions you want to your nurse or physician. This might help you if you have some mental barrier to ask these questions. Alternatively, you can try to mail them prior to your consultation to you nurse or physician if you have the contact details.
  • If you wish, make a copy of the questions you have to hand over to your physician during the consultation.
  • Tip: don’t print all the internet pages you have found. This will end up in a big pile, and might evoke the opposite reaction. Just one A4 page with your questions should do.

During your appointment

  • Before going in, rehearse the questions you want to ask. This again will help to cross the mental barrier if there is one.
  • Have your list of questions ready in your hand when you go into the consultation room.
  • The first thing when seeing your nurse or oncologist, say that you have some questions you would like to ask before the consultation ends. Say this at the beginning of your consultation while shaking hands, so he/she is prepared and might anticipate on you having questions. If you have printed your questions, hand it over to him.
  • If there are terms that you do not understand, interrupt and simply ask to explain that term.
  • Before going out, ask yourself if all your questions have been answered.

After your appointment

  • If you can, sit down in the waiting room to write down as much as you can, as it is still fresh in your memory.
  • Once home, go over your questions and notes, and check if you have all your answers.
  • Write down your answers in your journal or notebook.
  • Go online to complete your information in treatment plans or survivor plans. On Esperity, you can
    • enter your medication history
    • enter your complementary treatments
    • enter your diagnosis
    • schedule your new appointments and add comments (and get email reminders)
  • Talk about your appointment with a loved one. Talk about how you feel and what the oncologists and nurses told you.
  • Sometimes, it can help to go online and talk to other people, preferably with the same condition. Sharing experiences might re-enforce you and educate you on your condition. This will lead to more questions that you can share with your oncologist during your next visit.