The therapeutic method of gastric cancer is mostly performed by surgical operations. However, surgical operations should not be performed in case intraabdominal dissemination, rectal shelf and virchow node are manually felt, the same as distantmetastasis.
1. Endoscopic Therapy
It is largely divided into local coagulation and endogastrectomy. In the case of local coagulation, laser therapies such as endoscopic YAG laser, photodynamic therapy and local laser hypertheramia (42-45 degree) are used as well as absolute alcohol, 5-FU and OK-432 are locally injected. In the case of endogastrectomy (EMR), snare polypectomy, strip biopsy, EMR-C (transparent cap), EMR-L (rubber band) and EMR-P (electrotome) and hot biopsy are mostly used.
2. Indicant of Endoscopic Therapy
Lymph node metastasis or distantmetastasis should not be being in the abdomen in order that endoscopy may be performed, and carcinoma should be laid at the endoscope’s length as well as infiltration should be shallow. It was reported that mcosal cancer accounts for 2 to 6 percent and submucosal cancer accounts for 20 to 25 percent and the rate of lymph node metastasis reaches 10 to 15 percent. It was reported that lymph node metastasis can be excluded in the protrudent differentiated cancer of which major axis is less than 20mm, the depressed differentiated cancer that has no ulcer and has the major axis of 10mm and downward, the local gastric cancer generated on a gastric adenoma and the gastric-like cancer of which major axis is less than 20mm. Such things can be the targets of endoscopic therapy. In the case of the patients whose general conditions are not normal, who are aged, who get multiple cancers and who refuse to undergo surgical operations, it may be comparative indicant. The 515 patients diagnosed with early gastric cancer (1990 ? 1996) were analyzed in Seoul Central Hospital. In result, lymph node metastasis was not observed in the mucosal cancer that has the major axis of 20mm and downward and has no ulcer, irrespective of cell differentiation. Also, lymph node metastasis was not observed in protrudent early cancer. According to Takekoshi, the five-year survival and ten-year survival rate of the patients who underwent endoscopic operations before 1991 were 86% and 72% respectively. Also, there were no patients who died due to relapse of cancer during 14 years’ follow-up study. The result is behind laparotomy (90~95% and 80~85%), but it is not bad at all in consideration of the age of patients and their systemic diseases.
3. Surgical Operation
Surgical operations are also divided into laparoscopic resection and laparotomy. Laparoscopic resection can be finished within a short time, and patients can be rapidly recovered after the operation. However, laparoscopic resection can be performed in case lymph node metastasis is not observed in the abdomen. Further, it has been scarcely applied to early cancer because endoscopic therapy has been advanced. Laparotomy was succeeded for the first time by Billroth in 1881, and afterwards it has been used most widely. As it dissects lymph nodes, postoperative diagnosis and staging can be correctly derived. It has been regarded as the optimum therapeutic method and as the unique method to heighten survival rate, irrespective of lymph node metastasis. The five-year survival rate of Korean patients reaches only 30 to 40 percent, despite radical operations, because their cancers are mostly detected at the tertiary stage. As early gastric cancer has been increased, recently it accounts for 30 percent and upward. However, the value is remarkably lower than Japan of which early cancer reaches 50 to 60 percent. Prevention and early detection are critical to heighten survival rate.
4. Cancer Chemotherapy
Cancer cannot be completely recovered only by cancer chemotherapy, but it is effective to remedy minute metastasis or residual cancer and to prevent relapse. Also, it is used to palliate carcinoma in case a surgical operation cannot be performed. The cases where cancer chemotherapy came to good reaches 10 to 20 percent in the West, and reaches about 30 percent in Korea. Furthermore, the cases where lifespan was stringed out were very small.
5. Radiotherapy: Ordinarily, radiotherapy shows high effect to gastric cancer. In the case of the cancer generated at the esophagus-stomach copula, preoperative treatment can be performed restrictively.
from: http://www.hidoc.co.kr/
8.13.2009
Cholangioma
Cholangioma means the cancer generated on the cell surrounding the inside of the bile duct (epithelial cell). The bile duct is classified into the intrahepatic bile duct and the extrahepatic bile duct, and so cholangioma is called ‘intrahepatic bile duct cancer’ and ‘extrahepatic bile duct cancer’ respectively. As the gallbladder is a part of the biliary system, gallbladder cancer and cholangioma are of the same kind in a broad sense. However, gallbladder cancer is ordinarily regarded as different due to histological differences. Intrahepatic bile duct cancer is ordinarily regarded in the same light as hepatoma because it is also generated on the intrahepatic bile duct, but it should be differentiated from hepatoma because two cancers are remarkably different from each other in characteristics and therapeutic methods. The liver is constituted by various cells, and the cancer generated on the hepatocyte is called ‘hepatoma’ and the cancer generated on the intrahepatic bile duct is called ‘intrahepatic bile duct cancer’. Also, two cancers are strikingly different from each other in the causal cell. Cholangioma is mostly characterized by jaundice. In the case of serious jaundice, feces become white and the skin becomes itchy as well as right epigastric pains, pyrexia, weight loss, anorexia, nausea and emesis may be arisen. In the case of cholangioma, blood bilirubin and alkaline phosphatase are increased as well as CA19-901, the tumor marker, is increased by 55 to 65 percent. In the case of radiotherapies, ultrasonography, CT scan, magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) are mostly used. Therapeutic methods are largely divided into two, that is, a method to excise or decrease carcinoma, such as a surgical operation, cancer chemotherapy and radiotherapy, and another method to open the obstructed bile duct. Among such methods, only surgical excision is expected to make patients survive for a long time but the problem is that many patients miss the opportunity to undergo surgical operations. In case the bile duct is obstructed by cholangioma, bile cannot run to the duodenum and so jaundice is arisen. The same as standing water rots, standing bile causes cholangitis and eventually sepsis is arisen by disease germs running through blood vessels. The sepsis patients mostly die, and sepsis accounts for the highest rate of the death of cholangioma patients. Surgical operations, drug treatment or radiotherapy all can open the obstructed bile duct, but such methods cannot be applied to the patients who have serious jaundice due to the risk of cholangitis. In the case of the jaundice caused by cholangioma, the obstructed bile duct should be opened emergently. Other treatments depend on the failure or success of the surgery.
Definition
The bile duct is to run off bile from the liver to the duodenum. Bile is produced by hepatocytes (the cells that constitute the liver) and is secreted into a very narrow tube (canaliculi), and it becomes gradually thicker the same as branches gather toward the trunk. It comes out of the liver, and discharges bile through the papillary part of the duodenum. As foresaid, the bile duct is classified into the intrahepatic bile duct and the extrahepatic bile duct that is stretches into the duodenum. The extrahepatic bile duct, which is about 8cm long, is classified into the hepatic portal part, the upper part, the middle part and the lower part. The cancer generated on such parts is called ‘cholangioma’ and it is a malignant tumor generated on the epithelial cell of the gallbladder. Cholangioma is classified into intrahepatic bile duct cancer and extrahepatic bile duct cancer according to region. In some cases the intrahepatic bile duct cancer generated in the canaliculi is regarded as hepatoma, but it is remarkably different from hepatoma.
Symptoms
In case the bile duct is obstructed by cancer, bile cannot run and the bile duct above the obstructed duct is filled with bile and so pressure is heightened. Eventually, bile flows backward into blood vessels. In such a case, jaundice is arisen and the skin and eyes turn yellow due to the pigment called ‘bilirubin’. Jaundice is divided into two kinds; a jaundice arisen due to the obstructed bile duct, the same as cholangioma and pancreatic caner, and another jaundice arisen due to hepatitis or a certain medicine. The first jaundice is medically called ‘obstructive jaundice’, and the second is arisen as hepatocytes are damaged by hepatitis viruses or drugs. In the case of obstructive jaundice, bile cannot run into the duodenum and so feces turns white due to the pigment ‘bilirubin’ as well as urine turns red and dark as the concentration of bilirubin is heightened in blood. In the case of serious jaundice, pruritus may be arisen because the bile acid in bile is absorbed into blood and deposited under the skin concurrently with bilirubin. In addition, weight loss, anorexia, nausea and emesis may be arisen.
Cause, conditions and physiological
The cause of cholangioma is not clarified as yet, but it is presumed that cholangioma is caused by various conditions that are likely to inflame the cells surrounding the inside of the bile duct. Also, biliary calculus is regarded as a cause by reason it is detected in 20 to 30 percent of cholangioma patients. In addition, congenital disorders such as liver fluke, inflammatory colon diseases and biliary cyst are presumed to be related with cholangioma.
Diagnosis
Cholangioma is characterized by blood bilirubin and the enzyme ‘alkaline phosphatase’ that are increased after onset. The tumor marker is not secreted in normal tissues but is secreted after the onset of cancer, and various tumor markers had been found out in various carcinomas. As it can be simply used with blood test, it has been widely used. Nevertheless, there is no the tumor marker that is of help to diagnose cholangioma directly, as yet. Some tumor markers have been actually used in about 50 percent of cholangioma patients, but it is difficult to entirely depend on such tumor markers because they are not increased in early cancer as well as some advanced cancers do not show increase. As cholangioma is stealthily metastasized into surrounding tissues and conspicuous mass is not shown in many cases, it is not easy to correctly diagnose cholangioma. However, the advance of image analysis is of help to diagnose cholangioma. Radiotherapies are divided into non-invasive methods, such as ultrasonography, CT scan and MRCP, and invasive methods such as ERCP and PTC. Ultrasonography does not give pain to patients, and does not expose them to radial rays, and can be repetitively performed with ease. In addition, ultrasonography is suitable to monitor the bile duct, and is of help to calculate the obstructed par. For these reasons, ultrasonography is preferentially performed. Although ultrasonography is of help to track down cholangioma, it should be examined more correctly in order that the progress of cancer may be clarified. CT scan or MRI scan is typical examination that is performed to analyze the progress of cancer and distant metastasis. ERCP (endoscopic retrograde cholangiopancreatography) is to examine the shape of the bile duct or the pancreatic duct. To perform this method, an endoscope is inserted into the duodenum and a thin tube is put into the papillary part of the duodenum and a contrast medium is injected. Through this method, the obstructed bile duct can be opened as well as biopsy can be performed. ERCP can diagnose the jaundice caused by cholangioma, and can basically treat it. PTC is to contrast the bile duct by penetrating a needle through the skin and the liver. As the stricture and obstruction of the bile duct can be monitored in detail, the position and progress of carcinoma can be analyzed. In case the bile duct is obstructed, a serious complication may be arisen. In such a case, bile can be drained by the drainage tube.
Progress, prognosis
Cholangioma is one of the cancers of which prognoses are not satisfactory. Of course it can be completely recovered by surgical operations in case it is early detected, but patients mostly miss the opportunity to undergo surgical operations. 25 percent of cholangioma patients can undergo surgical operations, and five-year survival rate reaches just 5 percent. Nevertheless, the foregoing result is nothing but a numerical value. As the response of patients is different from each other, therapeutic methods are difficult to be applied to patients in the same light.
Complication
In case obstructive jaundice is arisen by cholangioma, secondarily cholangitis and sepsis are arisen and eventually the patient meets its death. Cholangitis and sepsis, caused by cholangioma, are complications needing emergency treatment. In case cholangioma is metastasized into other organs, various complications are arisen.
Treatment
The therapeutic methods to cholangioma become different as to progress, the same as other cancers. Cholangioma is classified into primary, secondary, tertiary and terminal stage according to progress. The progress of cancer is graded by infiltration, the metastasis into lymph nodes and distantmetastasis. During the primary stage, cancer is limited to the bile duct and the muscle layer. During the secondary stage, cancer is developed more than the primary stage but is not metastasized into adjacent organs and adjacent lymph nodes. During the tertiary stage, cancer is metastasized into other organs but is metastasized into lymph nodes. During the terminal stage, cancer is directly metastasized into other organs including the liver and the peritoneum. Specifically, stages are classified as to the progress of metastasis. Surgical operations, cancer chemotherapy and radiotherapy are typical therapeutic methods that directly remedy cancer, and there is a subsidiary remedy that alleviates the pain. Among such methods, surgical excision is expected to make long-term survival possible. Despite criticism, radiotherapy is of help to alleviate jaundice or the pains after excision. Cancer chemotherapy is not effective to remedy cholangioma, so it should be reviewed with time. It has been recently reported that new anticancer medicines have been developed and such medicines have come to good. The cancer in the primary or secondary stage should be surgically excised. It is desirable to surgically excise the cancer in the tertiary stage if possible, but it is advisable to simultaneously use surgical therapy, radiotherapy and anticancer medicine in case it is widely metastasized. In the case of the terminal stage, in many cases it aims ate relieving symptoms through chemotherapy or radiotherapy. In case obstructive jaundice is arisen by cholangioma, the bile duct should be opened in order that bile may be run down. The bile duct can be linked to the liver by a surgical operation, but recently bile was impossible to be drained by an endoscopic technique or radiological therapy. To perform endoscopic drainage, an endoscope should be inserted into the duodenum and a plastic or metal tube should be inserted from the ampulla of vater into the bile duct. It needs hi-tech skills, but it the obstructed duct can be effectively opened within 20 to 30 minutes. In case endoscopic drainage is difficult to be performed, a drainage tube should be selectively inserted into the bile duct through the skin and the liver.
Preventions
There is no method to fundamentally preventive cholangioma.
Consult a doctor in the following cases
In the following cases, you should immediately go to the doctor.
- A case where a mass is felt at the right abdomen or where a dull pain is repetitively felt
- A case where the eye or the skin turns yellow and where urine turns brownish
- A case where pruritus is arisen concurrently with jaundice
- A case where weight is lost
- A case where fever is developed concurrently with the right epigastric pain
from: http://www.hidoc.co.kr/
Definition
The bile duct is to run off bile from the liver to the duodenum. Bile is produced by hepatocytes (the cells that constitute the liver) and is secreted into a very narrow tube (canaliculi), and it becomes gradually thicker the same as branches gather toward the trunk. It comes out of the liver, and discharges bile through the papillary part of the duodenum. As foresaid, the bile duct is classified into the intrahepatic bile duct and the extrahepatic bile duct that is stretches into the duodenum. The extrahepatic bile duct, which is about 8cm long, is classified into the hepatic portal part, the upper part, the middle part and the lower part. The cancer generated on such parts is called ‘cholangioma’ and it is a malignant tumor generated on the epithelial cell of the gallbladder. Cholangioma is classified into intrahepatic bile duct cancer and extrahepatic bile duct cancer according to region. In some cases the intrahepatic bile duct cancer generated in the canaliculi is regarded as hepatoma, but it is remarkably different from hepatoma.
Symptoms
In case the bile duct is obstructed by cancer, bile cannot run and the bile duct above the obstructed duct is filled with bile and so pressure is heightened. Eventually, bile flows backward into blood vessels. In such a case, jaundice is arisen and the skin and eyes turn yellow due to the pigment called ‘bilirubin’. Jaundice is divided into two kinds; a jaundice arisen due to the obstructed bile duct, the same as cholangioma and pancreatic caner, and another jaundice arisen due to hepatitis or a certain medicine. The first jaundice is medically called ‘obstructive jaundice’, and the second is arisen as hepatocytes are damaged by hepatitis viruses or drugs. In the case of obstructive jaundice, bile cannot run into the duodenum and so feces turns white due to the pigment ‘bilirubin’ as well as urine turns red and dark as the concentration of bilirubin is heightened in blood. In the case of serious jaundice, pruritus may be arisen because the bile acid in bile is absorbed into blood and deposited under the skin concurrently with bilirubin. In addition, weight loss, anorexia, nausea and emesis may be arisen.
Cause, conditions and physiological
The cause of cholangioma is not clarified as yet, but it is presumed that cholangioma is caused by various conditions that are likely to inflame the cells surrounding the inside of the bile duct. Also, biliary calculus is regarded as a cause by reason it is detected in 20 to 30 percent of cholangioma patients. In addition, congenital disorders such as liver fluke, inflammatory colon diseases and biliary cyst are presumed to be related with cholangioma.
Diagnosis
Cholangioma is characterized by blood bilirubin and the enzyme ‘alkaline phosphatase’ that are increased after onset. The tumor marker is not secreted in normal tissues but is secreted after the onset of cancer, and various tumor markers had been found out in various carcinomas. As it can be simply used with blood test, it has been widely used. Nevertheless, there is no the tumor marker that is of help to diagnose cholangioma directly, as yet. Some tumor markers have been actually used in about 50 percent of cholangioma patients, but it is difficult to entirely depend on such tumor markers because they are not increased in early cancer as well as some advanced cancers do not show increase. As cholangioma is stealthily metastasized into surrounding tissues and conspicuous mass is not shown in many cases, it is not easy to correctly diagnose cholangioma. However, the advance of image analysis is of help to diagnose cholangioma. Radiotherapies are divided into non-invasive methods, such as ultrasonography, CT scan and MRCP, and invasive methods such as ERCP and PTC. Ultrasonography does not give pain to patients, and does not expose them to radial rays, and can be repetitively performed with ease. In addition, ultrasonography is suitable to monitor the bile duct, and is of help to calculate the obstructed par. For these reasons, ultrasonography is preferentially performed. Although ultrasonography is of help to track down cholangioma, it should be examined more correctly in order that the progress of cancer may be clarified. CT scan or MRI scan is typical examination that is performed to analyze the progress of cancer and distant metastasis. ERCP (endoscopic retrograde cholangiopancreatography) is to examine the shape of the bile duct or the pancreatic duct. To perform this method, an endoscope is inserted into the duodenum and a thin tube is put into the papillary part of the duodenum and a contrast medium is injected. Through this method, the obstructed bile duct can be opened as well as biopsy can be performed. ERCP can diagnose the jaundice caused by cholangioma, and can basically treat it. PTC is to contrast the bile duct by penetrating a needle through the skin and the liver. As the stricture and obstruction of the bile duct can be monitored in detail, the position and progress of carcinoma can be analyzed. In case the bile duct is obstructed, a serious complication may be arisen. In such a case, bile can be drained by the drainage tube.
Progress, prognosis
Cholangioma is one of the cancers of which prognoses are not satisfactory. Of course it can be completely recovered by surgical operations in case it is early detected, but patients mostly miss the opportunity to undergo surgical operations. 25 percent of cholangioma patients can undergo surgical operations, and five-year survival rate reaches just 5 percent. Nevertheless, the foregoing result is nothing but a numerical value. As the response of patients is different from each other, therapeutic methods are difficult to be applied to patients in the same light.
Complication
In case obstructive jaundice is arisen by cholangioma, secondarily cholangitis and sepsis are arisen and eventually the patient meets its death. Cholangitis and sepsis, caused by cholangioma, are complications needing emergency treatment. In case cholangioma is metastasized into other organs, various complications are arisen.
Treatment
The therapeutic methods to cholangioma become different as to progress, the same as other cancers. Cholangioma is classified into primary, secondary, tertiary and terminal stage according to progress. The progress of cancer is graded by infiltration, the metastasis into lymph nodes and distantmetastasis. During the primary stage, cancer is limited to the bile duct and the muscle layer. During the secondary stage, cancer is developed more than the primary stage but is not metastasized into adjacent organs and adjacent lymph nodes. During the tertiary stage, cancer is metastasized into other organs but is metastasized into lymph nodes. During the terminal stage, cancer is directly metastasized into other organs including the liver and the peritoneum. Specifically, stages are classified as to the progress of metastasis. Surgical operations, cancer chemotherapy and radiotherapy are typical therapeutic methods that directly remedy cancer, and there is a subsidiary remedy that alleviates the pain. Among such methods, surgical excision is expected to make long-term survival possible. Despite criticism, radiotherapy is of help to alleviate jaundice or the pains after excision. Cancer chemotherapy is not effective to remedy cholangioma, so it should be reviewed with time. It has been recently reported that new anticancer medicines have been developed and such medicines have come to good. The cancer in the primary or secondary stage should be surgically excised. It is desirable to surgically excise the cancer in the tertiary stage if possible, but it is advisable to simultaneously use surgical therapy, radiotherapy and anticancer medicine in case it is widely metastasized. In the case of the terminal stage, in many cases it aims ate relieving symptoms through chemotherapy or radiotherapy. In case obstructive jaundice is arisen by cholangioma, the bile duct should be opened in order that bile may be run down. The bile duct can be linked to the liver by a surgical operation, but recently bile was impossible to be drained by an endoscopic technique or radiological therapy. To perform endoscopic drainage, an endoscope should be inserted into the duodenum and a plastic or metal tube should be inserted from the ampulla of vater into the bile duct. It needs hi-tech skills, but it the obstructed duct can be effectively opened within 20 to 30 minutes. In case endoscopic drainage is difficult to be performed, a drainage tube should be selectively inserted into the bile duct through the skin and the liver.
Preventions
There is no method to fundamentally preventive cholangioma.
Consult a doctor in the following cases
In the following cases, you should immediately go to the doctor.
- A case where a mass is felt at the right abdomen or where a dull pain is repetitively felt
- A case where the eye or the skin turns yellow and where urine turns brownish
- A case where pruritus is arisen concurrently with jaundice
- A case where weight is lost
- A case where fever is developed concurrently with the right epigastric pain
from: http://www.hidoc.co.kr/
Cervical Cancer
What is Cervical Cancer?
This is the cancer that is generated on the uterine cervix, and that is developed into infiltrating cancer in case it is kept intact for a long time. As the precancerous lesion of the uterine cervix has been early detected and effectively remedied, the incidence of cervical cancer has been also decreased. Also, its recover rate is comparatively high as it slowly progresses. Cervical cancer ranks top in Korea’s female cancers, and accounts for about 22 percent of female cancers.
Etiology
Cervical cancer is mostly caused by Human Papillomavirus (HPV) through sexual intercourse. In the case of the women who had early sexual intercourse or who have many sex partners, cervical cancer is influenced by male factors or may be influenced by human immunodeficiency virus (HIV). In the case of the females in the lower stratum of society or economy, the possibility of getting cervical cancer is five times higher than the women of the upper classes. Smoking and oral contraceptive may be risk factors. It was reported that the deficiency of vitamin A, vitamin C, carotene and folic acid may be related with cervical cancer.
Symptoms and Diagnoses
Cervical cancer is frequently generated in the pluripara aged 45 to 55, and its typical symptom is postcoital elytrorrhagia or postmenopausal elytrorrhagia. Hemorrhage is increased in proportion as the lesion is developed. Leucorrhea with fetor, abdominal pains or melosalgia may be arisen. In case cancer cells are metastasized into the urinary bladder or the rectum, dysuria, hematuria and constipation may be arisen. The same as the precancerous lesion of the uterine cervix, it can be diagnosed by cytodiagnosis or colposcopy. In case of need, biopsy is performed.
Treatment
Cervical cancer is basically treated by surgical operations and radiotherapy. The surgical operation is performed at the early stage. In the case of the young women whose ovarian and sexual functions should be protected, it is desirable to perform surgical operations. Likewise, surgical operations are applied to the cases where a pregnant woman got cervical cancer or to the cases where intestinal inflammations or pelivic inflammations is accompanied with cervical cancer. In case cervical cancer is developed into the middle stage, radiotherapy should be performed in consideration of metastasis. As the probability of its relapse reaches about 90 percent despite medical treatment, the follow-up should be periodically performed. In case weight loss, serious crural edema, pelvic aches, crural aches and iliac aches are arisen, medical examination should be performed as it is likely to be relapsed. Although special symptoms are not shown, it is necessary for the childbearing women who began to have sexual intercourse to undergo cytodiagnosis once half-yearly. Medical treatment is desirable to be performed at the precancerous lesion.
from: http://www.hidoc.co.kr/
This is the cancer that is generated on the uterine cervix, and that is developed into infiltrating cancer in case it is kept intact for a long time. As the precancerous lesion of the uterine cervix has been early detected and effectively remedied, the incidence of cervical cancer has been also decreased. Also, its recover rate is comparatively high as it slowly progresses. Cervical cancer ranks top in Korea’s female cancers, and accounts for about 22 percent of female cancers.
Etiology
Cervical cancer is mostly caused by Human Papillomavirus (HPV) through sexual intercourse. In the case of the women who had early sexual intercourse or who have many sex partners, cervical cancer is influenced by male factors or may be influenced by human immunodeficiency virus (HIV). In the case of the females in the lower stratum of society or economy, the possibility of getting cervical cancer is five times higher than the women of the upper classes. Smoking and oral contraceptive may be risk factors. It was reported that the deficiency of vitamin A, vitamin C, carotene and folic acid may be related with cervical cancer.
Symptoms and Diagnoses
Cervical cancer is frequently generated in the pluripara aged 45 to 55, and its typical symptom is postcoital elytrorrhagia or postmenopausal elytrorrhagia. Hemorrhage is increased in proportion as the lesion is developed. Leucorrhea with fetor, abdominal pains or melosalgia may be arisen. In case cancer cells are metastasized into the urinary bladder or the rectum, dysuria, hematuria and constipation may be arisen. The same as the precancerous lesion of the uterine cervix, it can be diagnosed by cytodiagnosis or colposcopy. In case of need, biopsy is performed.
Treatment
Cervical cancer is basically treated by surgical operations and radiotherapy. The surgical operation is performed at the early stage. In the case of the young women whose ovarian and sexual functions should be protected, it is desirable to perform surgical operations. Likewise, surgical operations are applied to the cases where a pregnant woman got cervical cancer or to the cases where intestinal inflammations or pelivic inflammations is accompanied with cervical cancer. In case cervical cancer is developed into the middle stage, radiotherapy should be performed in consideration of metastasis. As the probability of its relapse reaches about 90 percent despite medical treatment, the follow-up should be periodically performed. In case weight loss, serious crural edema, pelvic aches, crural aches and iliac aches are arisen, medical examination should be performed as it is likely to be relapsed. Although special symptoms are not shown, it is necessary for the childbearing women who began to have sexual intercourse to undergo cytodiagnosis once half-yearly. Medical treatment is desirable to be performed at the precancerous lesion.
from: http://www.hidoc.co.kr/
Lung Cancer
Diagnosis
1. The mass (bump) in the hilar or paraseptal pulmonary parenchyma is shaded on the chest X-ray photograph. Also, the atelectasis and pneumonia caused by bronchial obstruction, mediastinal lymphaednopathy and pleural effusion fluid are accompanied with lung cancer in the progress of the disease. In some cases, lung cancer is needed to be distinguished from pulmonary cystoma, pulmonary tuberculosis or pulmonary abscess, due to the necrosis of the mass.
2. CT is very useful to analyze the cancer position, progress and the proliferation of mediastinal lymph nodes.
3. Sptum cytology is effective to diagnose lung cancer through squamous ephithelial cell.
4. Bronchoscopy is necessary for all the patients who show symptoms of lung cancer. Lung cancer can be correctly diagnosed by biopsy, and is of help to delimit surgical resection.
5. Percutaneous needle aspiration is used in case the bronchoscope is difficult to reach the mass as it is laid at the end of the lung. Its diagnosis rate reaches about 90 percent, but a complication such as pneumothorax and bloody phlegm may be arisen.
Treatment
1. The curability of surgical operations is highest in remedying lung cancer, but it is applied to about 30 percent of patients because the 70 percent miss the opportunity of surgical operations. Prognosis remarkably becomes different as to the progress of lung cancer, and so it has been reported that the primary cancer indicates the recovery rate between 70 and 80 percent and the secondary cancer is between 40 and 45 percent and the tertiary cancer is between 15 and 25 percent. Consequently, it is important for patients to undergo medical treatments between primary or secondary stage. Specifically, periodic checkup and early diagnosis is critical to remedy lung cancer. In the case of the aged and those who have cardiovascular diseases or diabetes, postoperative recovery may take a long time but they have no difficulty in undergoing surgical operations. For more information, refer to ‘Attached File 1’.
2. Anticancer medicines are used for the patients diagnosed with small cell lung cancer, who account for about 20 percent of lung cancer. On the other hand, in the case of non-small cell lung cancer accounting for 80 percent, anticancer medicines are used in combination with other treatments because it is not effective for non-small cell lung cancer as well as lumpectomy is more effective. Anticancer medicine-centered remedy is used for the lung cancer in the 4th stage that shows distant metastasis. High-efficacy medicines have been continuously developed, and those are expected to go a long way with such patients.
3. Radiotherapy
A. With regard to small cell lung cancer, the range of irradiation is effectively delimited as to the progress of cancer.
B. The radiotherapy for non-small cell lung cancer is largely divided into fives.
- Radical Radiotherapy: It is ordinarily irradiated to lymph nodes or the lesion of the lungs. This radiotherapy is performed once a day and five times a week, and so 6,000 to 6,500cGy of radial rays are irradiated covering 6 to 7 weeks. Recently, radial rays have been irradiated twice a day through multi-fraction radiotherapy.
- Preoperative Radiotherapy: This is effective to remedy superior sulcus carcinoma.
- Postoperative Radiotherapy: This is used in case cancer is metastasized into hilar or mediastinal lymph nodes.
- Palliative Radiotherapy: This is used for superior vena caval syndrome, the pooling of pericardial or pleural fluid, the damage of chest wall, ideomotor abnormality and the ache caused by brain metastasis.
- Preventive Radiotherapy: This is used to prevent cancer cells from being metastasized into the brain.
4. GenetherapyAs molecular biology has been remarkably developed, causal genes have been found out in various genetic diseases and so the defect of causal genes are expected to be corrected as well as problematic genes are expected to be replaced by sound ones. In particular, genetherapy has been actively applied to cancer and AIDS, and in result, various genetic abnormalities have been gradually clarified through the gene that proliferates cancer cells, the gene that inhibits the proliferation of cancer cells, the gene that is able to recover the defect of DNA, the gene that interferes metastasis and infiltration, tumor marker factors and otherwise. Genetherapy, which applies such characteristics of genetic abnormalities to remedy, is expected to effectively remedy lung cancer. However, it is on a tentative stage yet and also therapeutic method, efficacy and safety are not secured as yet.
5. ImmunotherapyThe human body has two kinds of immune bodies against cancer cells or foreign substances. One is the specific immunomechanism that attacks the tumor-specific antigen or the tumor-associated antigen on the surface of the cancer cell membrane. Another is the non-specific immunomechanism that detects the change of autologous somatic cells and attacks such cells. Such immunocytes are composed of T helper cells, cell-hindrance T cells and natural killer cells. Immunotherapy is to inject such cells into the human body or the tumor in order that the immunity to cancer may be strengthened and that the tumor may be gone down, but its effect is not satisfactory yet.
6. Endoscopic Laser SurgeryThe endoscopic YAG laser is used to urgently open up the airway in case more than half of the airway is obstructed by a tumor, but hemorrhage or perforation may be arisen. The superficial tumor, which has the inside diameter of 2cm and downward and which is being in the bronchus within the range of the bronchoscope, can be remedied by endoscopic photodynamic therapy.
Preventions
It is most important to stop smoking to prevent lung cancer, and polluted air is needed to be purified at state levels. Likewise, the adults aged 50 and upward are needed to undergo the chest X-ray examination once a year.
from: http://www.hidoc.co.kr/
1. The mass (bump) in the hilar or paraseptal pulmonary parenchyma is shaded on the chest X-ray photograph. Also, the atelectasis and pneumonia caused by bronchial obstruction, mediastinal lymphaednopathy and pleural effusion fluid are accompanied with lung cancer in the progress of the disease. In some cases, lung cancer is needed to be distinguished from pulmonary cystoma, pulmonary tuberculosis or pulmonary abscess, due to the necrosis of the mass.
2. CT is very useful to analyze the cancer position, progress and the proliferation of mediastinal lymph nodes.
3. Sptum cytology is effective to diagnose lung cancer through squamous ephithelial cell.
4. Bronchoscopy is necessary for all the patients who show symptoms of lung cancer. Lung cancer can be correctly diagnosed by biopsy, and is of help to delimit surgical resection.
5. Percutaneous needle aspiration is used in case the bronchoscope is difficult to reach the mass as it is laid at the end of the lung. Its diagnosis rate reaches about 90 percent, but a complication such as pneumothorax and bloody phlegm may be arisen.
Treatment
1. The curability of surgical operations is highest in remedying lung cancer, but it is applied to about 30 percent of patients because the 70 percent miss the opportunity of surgical operations. Prognosis remarkably becomes different as to the progress of lung cancer, and so it has been reported that the primary cancer indicates the recovery rate between 70 and 80 percent and the secondary cancer is between 40 and 45 percent and the tertiary cancer is between 15 and 25 percent. Consequently, it is important for patients to undergo medical treatments between primary or secondary stage. Specifically, periodic checkup and early diagnosis is critical to remedy lung cancer. In the case of the aged and those who have cardiovascular diseases or diabetes, postoperative recovery may take a long time but they have no difficulty in undergoing surgical operations. For more information, refer to ‘Attached File 1’.
2. Anticancer medicines are used for the patients diagnosed with small cell lung cancer, who account for about 20 percent of lung cancer. On the other hand, in the case of non-small cell lung cancer accounting for 80 percent, anticancer medicines are used in combination with other treatments because it is not effective for non-small cell lung cancer as well as lumpectomy is more effective. Anticancer medicine-centered remedy is used for the lung cancer in the 4th stage that shows distant metastasis. High-efficacy medicines have been continuously developed, and those are expected to go a long way with such patients.
3. Radiotherapy
A. With regard to small cell lung cancer, the range of irradiation is effectively delimited as to the progress of cancer.
B. The radiotherapy for non-small cell lung cancer is largely divided into fives.
- Radical Radiotherapy: It is ordinarily irradiated to lymph nodes or the lesion of the lungs. This radiotherapy is performed once a day and five times a week, and so 6,000 to 6,500cGy of radial rays are irradiated covering 6 to 7 weeks. Recently, radial rays have been irradiated twice a day through multi-fraction radiotherapy.
- Preoperative Radiotherapy: This is effective to remedy superior sulcus carcinoma.
- Postoperative Radiotherapy: This is used in case cancer is metastasized into hilar or mediastinal lymph nodes.
- Palliative Radiotherapy: This is used for superior vena caval syndrome, the pooling of pericardial or pleural fluid, the damage of chest wall, ideomotor abnormality and the ache caused by brain metastasis.
- Preventive Radiotherapy: This is used to prevent cancer cells from being metastasized into the brain.
4. GenetherapyAs molecular biology has been remarkably developed, causal genes have been found out in various genetic diseases and so the defect of causal genes are expected to be corrected as well as problematic genes are expected to be replaced by sound ones. In particular, genetherapy has been actively applied to cancer and AIDS, and in result, various genetic abnormalities have been gradually clarified through the gene that proliferates cancer cells, the gene that inhibits the proliferation of cancer cells, the gene that is able to recover the defect of DNA, the gene that interferes metastasis and infiltration, tumor marker factors and otherwise. Genetherapy, which applies such characteristics of genetic abnormalities to remedy, is expected to effectively remedy lung cancer. However, it is on a tentative stage yet and also therapeutic method, efficacy and safety are not secured as yet.
5. ImmunotherapyThe human body has two kinds of immune bodies against cancer cells or foreign substances. One is the specific immunomechanism that attacks the tumor-specific antigen or the tumor-associated antigen on the surface of the cancer cell membrane. Another is the non-specific immunomechanism that detects the change of autologous somatic cells and attacks such cells. Such immunocytes are composed of T helper cells, cell-hindrance T cells and natural killer cells. Immunotherapy is to inject such cells into the human body or the tumor in order that the immunity to cancer may be strengthened and that the tumor may be gone down, but its effect is not satisfactory yet.
6. Endoscopic Laser SurgeryThe endoscopic YAG laser is used to urgently open up the airway in case more than half of the airway is obstructed by a tumor, but hemorrhage or perforation may be arisen. The superficial tumor, which has the inside diameter of 2cm and downward and which is being in the bronchus within the range of the bronchoscope, can be remedied by endoscopic photodynamic therapy.
Preventions
It is most important to stop smoking to prevent lung cancer, and polluted air is needed to be purified at state levels. Likewise, the adults aged 50 and upward are needed to undergo the chest X-ray examination once a year.
from: http://www.hidoc.co.kr/
Esophageal Cancer
Outline
Esophageal cancer is a tumor that is generated on the esophagus. The risk of esophageal cancer is heightened in case it is exposed to smoking, excessive drinking and Barret’s esophagitis for a long time. Patients are difficult to swallow solids, and feel pains. It can be diagnosed by esophagography and endosopy-based biopsy. Medical treatment becomes different as to tumor size, position, metastasis, and patient’s physical condition and age.
Examinations
- Image Analysis: Chest X-Ray Examination, Esophagus and Stomach X-Ray Examination, and Esophagoscopy
- Biopsy: Esophageal Biopsy
from: http://www.hidoc.co.kr/
Esophageal cancer is a tumor that is generated on the esophagus. The risk of esophageal cancer is heightened in case it is exposed to smoking, excessive drinking and Barret’s esophagitis for a long time. Patients are difficult to swallow solids, and feel pains. It can be diagnosed by esophagography and endosopy-based biopsy. Medical treatment becomes different as to tumor size, position, metastasis, and patient’s physical condition and age.
Examinations
- Image Analysis: Chest X-Ray Examination, Esophagus and Stomach X-Ray Examination, and Esophagoscopy
- Biopsy: Esophageal Biopsy
from: http://www.hidoc.co.kr/
Colon Cancer
Outline
Colon cancer is a malignant tumor that is generated on the inner wall of the colon. Heredity, adenomatous polyposis and ulcerative colitis are regarded as the risk factors of colon cancer. As adenomatous polyposis and early colon cancer do not show symptoms, medical checkup should be periodically undergone. The surgical operation is the best therapy.
Examinations
- Clinicopathological Examination: Fecal Occult Blood Test, and Cytoscopy
- Biopsy: Biopsy and Cytoscopy
- Image Analysis: X-Ray Examination, Endoscopy, X-Ray Examination, Ultrasonography, and CT Scan
from: http://www.hidoc.co.kr/
Colon cancer is a malignant tumor that is generated on the inner wall of the colon. Heredity, adenomatous polyposis and ulcerative colitis are regarded as the risk factors of colon cancer. As adenomatous polyposis and early colon cancer do not show symptoms, medical checkup should be periodically undergone. The surgical operation is the best therapy.
Examinations
- Clinicopathological Examination: Fecal Occult Blood Test, and Cytoscopy
- Biopsy: Biopsy and Cytoscopy
- Image Analysis: X-Ray Examination, Endoscopy, X-Ray Examination, Ultrasonography, and CT Scan
from: http://www.hidoc.co.kr/
8.11.2009
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