RIHMs types of cancer

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The Health Protector
Types Of Cancer

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Types of Cancer - List
Cancer by Name
1. Actinic Keratosis, 2. Acute Lymphoblastic Leukemia
3. Acute Myeloid Leukemia 4. Basal Cell Carcinoma
5. Bladder Cancer 6. Bone Cancer
7. Brain Tumors in Adults 8. Brain Tumors in Children
9.Breast Cancer 10. Cervical Cancer
11. Chronic Lymphocytic Leukemia 12. Chronic Myeloid Leukemia
13. Colon Cancer 14. Endometrial Cancer
15. Esophageal Cancer 16. Eye (Retinoblastoma)
17. Gallbladder Cancer 18.Gastric Cancer
19.Hodgkin Lymphoma 20.Kidney Cancer
21.Liver Cancer 22.Lung Cancer
23.Melanoma 24.Metastatic Brain Tumor
25.Multiple Myeloma 26.Non-Hodgkin Lymphoma
27.Oral Cancer 28.Ovarian Cancer
29.Pancreatic Cancer 30.Prostate Cancer
31.Skin Cancer 32.Soft Tissue Sarcoma
33.Squamous Cell Skin Cancer 34.Testicular Cancer
35.Thyroid Cancer 36.Wilms Tumor (Kidney)

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Actinic Keratosis:-
Symptoms
Found on sun exposed areas of the face, ears, scalp and hands.
Scaly or Crusted firm red nodule, Often persistent sores or non-healing lesions.
Know that skin cancer can occur anywhere on the body, even on the soles of
the feet or between the toes.
A skin growth that is new, painful, non-healing or changing is a cause for
suspicion.
Similarly, a spot that itches, erodes, bleeds or scabs are potential warning
signs.
Diagnosis
How is actinic keratosis diagnosed?
Dermatologist will do an examination of the area. Tests, such as a biopsy, may
be needed.

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Treatment
Depend on the type, size, location and extent of the skin cancer.
Certain skin cancers on the face or of a large size skin may require Mohs surgery
and/or multidisciplinary care.
Treatment options may include:
Cryotherapy or freezing lesions with liquid nitrogen, used to destroy small
precancerous lesions.
Electrodesiccation and curettage: Used for superficial skin cancers. The doctor will
scrape away cancer cells using a curette and use an electric needle to destroy cancer
cells.
Excisional surgery: Surgical removal of the tumor and a margin. The margin of
tissue will depend on the type and extent of the skin cancer.
Mohs surgery: A surgery that is used for skin cancers that need to be removed
from areas such as the face or digits, where the sparing of the normal skin is
imperative. This procedure allows the skin cancer to be removed without taking an
excessive amount of surrounding normal tissue. Mohs surgery allows for excellent
curative rates as 100 percent of the margin is evaluated. This technique is ideal for
larger, recurrent or more aggressive tumors.

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Blu-U photodynamic therapy: Uses a topical medicine that turns pre-cancer
cells sensitive to light.
Chemotherapy, topical and systemic, and biologic therapies: A variety of topical
medications, such as 5 fluorouracil (Efudex, Carac), and systemic medications that
can be used to destroy precancerous cells.
Radiation therapy: Used for patients in whom surgery is not the best option as well
as for adjuvant treatment.
Care: We plan for our actinic keratosis patients long after their treatments are
done with surveillance and regular follow-up visits to provide the best long-term
survivorship care.

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Causes/Risk Factors
Skin cancer occurs when there is uncontrolled growth of the cells that make up the
outer layer of skin.
There are many factors that may increase the risk of developing skin cancer. These
are some factors to consider:
Chronic sun exposure, history of sunburns and indoor tanning
Fair skin and light hair/eyes such as blond or red hair and blue or green eyes
Family history of skin cancer
Personal history of a previous skin cancer
Personal history of precancerous skin lesions, which occur on sun-damaged skin
History of multiple atypical moles, called dysplastic moles
History of radiation treatments
History of immunosuppression, such as organ transplant patients requiring chronic
medications to weaken their immune system

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Acute Lymphoblastic Leukemia
Symptoms
Symptoms are often nonspecific, but some patients have experienced:
Tiredness ,Fevers,Profuse sweating at night,Unexplained weight loss
Shortness of breath,Dizziness,Infections,Easy bruising or bleeding
Diagnosis
How is acute lymphoblastic leukemia diagnosed?
A significant number of leukemia cells in the blood, bone marrow and other biopsy
materials must be apparent before we can accurately determine a diagnosis of
acute lymphoblastic leukemia.
Immunophenotyping, a test performed using a sample of tissue or blood, is
performed to diagnose the type of leukemia.
Cytogenetics testing—in which chromosomal abnormalities are identified—and
molecular profiling are also routinely performed. The results of these tests form an
essential part of the diagnosis and care plan for our patients.
Your care team will explain the steps involved in each diagnostic test and answer
questions that you may have about how a diagnosis is determined.

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Treatment
Acute lymphoblastic leukemia treatment at the CTRC
The following treatments are offered to patients:
Induction chemotherapy: Chemotherapy that is designed to rid the body of all
visible evidence of leukemia
Consolidation chemotherapy: Chemotherapy designed to get rid of microscopic
clones of leukemia after a patient appears to be in remission from induction
therapy
Maintenance chemotherapy: Chemotherapy given in specific doses over a
prolonged period of time to help ensure that the leukemia remains in remission
Survivorship care: Our patients are provided with long-term surveillance and
regular follow-up visits are planned to provide the best long-term survivorship
care.
Follow-up and surveillance: An important part of the follow-up and surveillance
for acute lymphoblastic leukemia is Minimal Residual Disease (MRD) detection
using techniques designed to detect leukemia clones that cannot be detected
by conventional methods

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The Health Protector Acute Myeloid Leukemia
Symptoms
Tiredness, Fevers,Shortness of breath,Dizziness,Infections, Easy bruising or bleeding
Some patients may have neurological symptoms, such as headache, double vision
and signs of nerve injury.
Diagnosis
How is acute myeloid leukemia diagnosed?
Because leukemia cells are found in blood and bone marrow, blood work and other
tests must be performed to properly diagnose this disease.
Specialized tests that define the immunological origin of the leukemia cells, called
immunophenotyping, and tests that define the genetic basis of this leukemia, called
cytogenetics and molecular profiling, are routinely performed and form an essential
part of the diagnosis and care of patients with acute myeloid leukemia

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The Health Protector Treatment
Discuss treatment options, which may include:
Induction chemotherapy and consolidation chemotherapy: After your treatment
team observes signs that you appear to be in remission after induction
chemotherapy treatment, consolidation chemotherapy may be recommended to
assure there are no microscopic clones of leukemia still in your body.
Maintenance chemotherapy: Selected patients with certain types of acute
myeloid leukemia may receive chemotherapy given in specific doses over a
prolonged period of time to suppress the recurrence of leukemia and to prevent
new leukemia clones from emerging.
Stem cell transplantation: Stem cell transplantation may be identified by your
treatment team as the best option based on your diagnosis. Our goal at the CTRC
is to provide seamless care between the leukemia treatment team and the stem
cell transplant team, so you can expect good communication between your
doctors if this treatment.
care

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The Health Protector Basal Cell Carcinoma
Symptoms
Basal cell carcinomas have varying appearances, but usually are found on chronically
sun exposed areas such as the face, ears and scalp. Common appearances include
pearly or translucent bump, a crusted or ulcerated nodule, or scar-like lesion.
Skin cancer is often related to sun exposure. It tends to occur on areas exposed to
the sun, particularly the face, arms, upper chest, back and lower legs. However, it is
important to know that skin cancer can occur anywhere on the body, even on the
soles of the feet or between the toes.
A skin growth that is new, painful, non-healing or changing is a cause for suspicion.
Similarly, a spot that itches, erodes, bleeds or scabs are potential warning signs.
Diagnosis
How is basal cell carcinoma diagnosed?
Your dermatologist will do an examination of the area. Tests, such as a biopsy, may
be needed.

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Depend on the type, size, location and extent of the skin cancer. Certain skin cancers on the
face or of a large size skin may require Mohs surgery and/or multidisciplinary care.
Cryotherapy or freezing lesions with liquid nitrogen:
Electrodesiccation and curettage: Used for superficial skin cancers. The doctor will scrape
away cancer cells using a curette and use an electric needle to destroy cancer cells.
Excisional surgery: Surgical removal of the tumor and a margin. The margin of tissue will
depend on the type and extent of the skin cancer.
Mohs surgery: A surgery that is used for skin cancers that need to be removed from areas
such as the face or digits, where there sparing of the normal skin is imperative. This
procedure allows the skin cancer to be removed without taking an excessive amount of
surrounding normal tissue. Mohs surgery allows for excellent curative rates as 100 percent of
the margin is evaluated. This technique is ideal for larger, recurrent or more aggressive
tumors. Blu-U photodynamic therapy: Uses a topical medicine that turns pre-cancer cells
sensitive to light. Chemotherapy, topical and systemic, and biologic therapies: A variety of
topical medications, such as 5 fluorouracil (Efudex, Carac), and systemic medications that can
be used to destroy precancerous cells. Radiation therapy: Used for patients in whom surgery
is not the best option as well as for adjuvant treatment. Survivorship care: Our basal cell
carcinoma patients are provided with long-term surveillance and regular follow-up visits are
planned to provide the best long-term survivorship care.

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Causes/Risk Factors
What causes basal cell carcinoma?
Skin cancer occurs when there is uncontrolled growth of the cells that make up
the outer layer of skin.
There are many factors that may increase the risk of developing skin cancer.
These are some factors to consider:
Chronic sun exposure, history of sunburns and indoor tanning.
Family history of skin cancer
Personal history of a previous skin cancer
Personal history of precancerous skin lesions such as actinic keratoses, which
occur on sun-damaged skin
History of multiple atypical moles, called dysplastic moles
History of radiation treatments
History of immunosuppression, such as organ transplant patients requiring
chronic medications to weaken their immune system

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Bladder Cancer
Symptoms
Frequent urination, Urgency to urinate, Painful urination, Recurrent bladder
infections
Diagnosis
How is bladder cancer diagnosed?
The diagnosis of bladder cancer requires confirmation, usually by an insertion of a
scope into the bladder (cystoscopy) and biopsy of suspicious areas.
While initial biopsies may be performed in a doctor’s office, a more detailed biopsy
may need to be done with a cystoscopy under anesthesia.
Some patients may need removal of the tumor or portions of the tumor through the
same scope. This is called transurethral resection of bladder tumor or TURBT.
Other tests include blood tests, CT scans and other scans will be performed to
determine extent of disease, a process also called staging. The stage of the cancer
determines the ideal primary treatment.
The stage of the cancer determines how we’ll approach your treatment.

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Treatment
For bladder cancer that does not involve the muscle of the bladder (also called
non-muscle invasive cancer): Treatment is directed at preventing recurrences.
After TURBT, or biopsy, chemotherapy or other medicines may be instilled in
the bladder at periodic intervals with careful monitoring by cystoscopy and
urine examination. Clinical trial-based therapy is available to improve
outcomes, reduce recurrence rates and prevent transformation to the more
aggressive muscle-invasive bladder cancer.
For bladder cancer that does involve the muscle of the bladder (also called
muscle-invasive cancer): Your care team will determine if your bladder can be
preserved or if it must be removed. Surgical treatment, chemotherapy and
radiation treatments may be used. Clinical trials are available to help improve
the outcomes for patients with muscle-invasive cancer.
care.

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Bone Cancer
Symptoms
Most patients will experience a pain in the bone.
Some patients find a painful bony or hard swelling near a bone.
Diagnosis
How is bone cancer diagnosed?
We use a combination of X-rays and MRI scans to evaluate a painful bony lesion. We
also perform a biopsy. Procedures to obtain biopsy samples for bone tumors are
done by our orthopedic oncologists because the biopsy site may need to be chosen
carefully. Orthopedic oncologists specializing in bone cancer will obtain the best
specimen without compromising the ability to perform curative surgery.
Biopsy specimens are handled with great care so that we can determine specific
markers, called biomarkers. The sarcoma team may perform molecular profiling of
your tumor.
Blood tests, PET/CT scans, and other scans are performed to determine extent of
disease, a process also called staging. The location, type of cancer and other features
help us develop the best treatment for each patient.

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Treatment
Bone cancer-
Clinical decision- Made at weekly multidisciplinary sarcoma conferences. The
possible treatment options include:
Surgery: Removal of the tumor with clean margins —or leaving no cancer behind—
will be discussed
Radiation therapy: This is an important part of treatment for many bone cancer
patients. Radiation therapy is given before surgery for some of our patients. For
other patients, radiation therapy is more appropriate after complete removal of the
tumor.
Chemotherapy: We offer a variety of options for chemotherapy. The development of
chemotherapy regimens has had a dramatic improvement in the outcome for
patients with osteosarcoma and Ewing's sarcoma. Clinical-trial based options are
considered.
Survivorship care: Our patients are provided with long-term surveillance and regular
follow-up visits are planned to provide the best long-term survivorship care.

,
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Brain Tumors
Symptoms
Depending upon the location of the tumor and type of tumor, your symptoms
may include:
Headache, Seizures, Double vision, Confusion, Changes in personality
Psychiatric symptoms, Fatigue, Nausea, Vomiting
Diagnosis
How are brain tumors diagnosed?
A brain scan such as an MRI or CT scan can be expected as your diagnosis is being
narrowed down. A biopsy or sample of the tumor is collected from most patients.
The biopsy procedure is usually performed by the neurosurgical members of the
CTRC’s neuro-oncology team.
Blood tests, functional MRI or other MRI scans, and other imaging will be
performed to determine extent of disease. This is called staging. The location,
type of cancer and other features help us determine a treatment plan.

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Surgery: Our neurosurgeons guide surgical treatment and are able to plan for
maximal removal of the brain tumor with minimal risk and establish the diagnosis
and extent of the disease. Options we offer can include special biopsy techniques
called stereotactic biopsy—where a thin needle is inserted surgically to remove a
small piece of tissue—or open biopsy, to removal of the tumor completely. Radiation
therapy: This is an important part of treatment for many patients with this cancer.
Techniques used include brachytherapy, stereotactic radiosurgery and standard
whole brain or external beam radiation therapy.Chemotherapy: We have a variety of
options available for chemotherapy for select patients with specific types of brain
tumors. Clinical trial-based options will routinely be considered.
Advanced stage disease and recurrent disease: Chemotherapy treatments and other
treatments on well-designed clinical trials and developing new treatments for this
stage of the cancer is a priority for the neuro-oncology . Our neuro-oncology team is
pioneering new treatments for the deadliest forms of brain tumors with unique
delivery systems capable of targeting the tumors.Survivorship care: Our patients are
provided with long-term surveillance and regular follow-up visits are planned to
provide the best long-term survivorship care.

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The Health ProtectorBrain Tumors in children
Symptoms
If your child has a brain tumor, the symptoms may be very subtle at first, or they
may occur very quickly.
Headache is perhaps the most common symptom. Symptoms that may occur
with brain tumors include:
Double vision, weakness or numbness
Headache that gets worse when waking up in the morning and then clears up
within a few hours
Headaches that may get worse with coughing or exercise or with a change in
body position
Headaches that occur at night and with at least one other symptom, such as
vomiting or confusion
Other symptoms may include:
Seizures
Mental changes, such as shifts in personality and behavior, memory loss or
problems with reasoning and concentration

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Diagnosis
How are brain tumors in children diagnosed?
If a brain tumor is suspected, the doctor will usually refer your child to a pediatric
neurologist, neuro-oncologists or neuro-surgeon for a complete physical exam. Key
additional components of the diagnosis will likely include:
Computed Tomography (CT or CAT) scans, which use X-rays to determine any
evidence of both local and distant tumor spread.
The recording of electrical activity of the brain, known as an EEG, may also be
performed for children who have experienced seizures.
Magnetic resonance imaging (MRI), which uses electromagnetic waves and strong
magnets to produce detailed pictures of the brain and spinal cord.
Examination of the cerebral spinal fluid (CSF) may also be done.
Laboratory tests such as blood and urine tests will be conducted check the general
health of your child.

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Treatment
Optimal treatment for pediatric brain tumors is determined by many factors. The key
first step is to obtain an accurate diagnosis of exactly the type of brain tumor your
child may have. In almost all cases, a brain biopsy is required. Sometimes, though, a
biopsy is not possible because of the location of the tumor. Once the type of brain
tumor is determined and the extent of cancer is known, a treatment plan for your
child’s specific cancer is developed.
Treatment options depend on the size and location of the tumor:
Surgery is very commonly a key component of any treatment strategy for pediatric
brain tumors. However, because of the location of some tumors, surgery may not be
feasible for all tumors.
Radiation is used to treat a variety of pediatric brain tumors. This may also
sometimes include radiation to the spinal cord.
Chemotherapy may also be used depending on the type of brain cancer your child
has.

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Causes/Risk Factors
Unfortunately, the exact cause of pediatric brain tumors is unknown;
however, much work has been done recently exploring a variety of genetic
changes or mutations that are associated with the common brain tumors of
childhood.

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Breast Cancer
Symptoms
Early breast cancer usually does not cause symptoms. This is why regular breast
exams are important. As the cancer grows, symptoms may include:,Breast lump or
lump in the armpit, Changes in breast size, shape, skin color or texture,Skin redness,
Fluid coming from nipple ,Nipple changes, Scaliness on the breast
Diagnosis
How is breast cancer diagnosed?
Advanced digital mammogram machines that expose you to less radiation and allow
computer image enhancement techniques.Radiologists specializing in breast image
interpretation who provide immediate assessment of your tests,In addition to a
mammogram, other tests may include:.Breast MRI (magnetic resonance imaging) to
help better identify the breast lump,Breast ultrasound to show whether the lump is
solid or fluid-filled.Breast biopsy or breast lump removal for closer examination by a
laboratory specialist. If a needle biopsy is needed, it can be done immediately,
before leaving the mammography office.,CT scan,PET scan,If you do have breast
cancer, additional tests will be done to determine if the cancer has spread.

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Will see a team of breast specialists that includes the breast medical oncologist, the
breast radiation oncologist and a surgeon. Our specialists meet weekly at our
internal tumor board conference to discuss newly diagnosed patients. Together, we
will discuss a plan of treatment for you based on your type and stage of cancer and
make sure you receive the best and most informed care possible.
Your treatment plan may include:
Chemotherapy and chemotherapeutic agents to kill cancer cells
Radiation therapy to destroy cancerous tissue
Surgery to remove cancerous tissue (a lumpectomy removes the breast lump; a
mastectomy removes all or part of the breast and possible nearby structures)
Hormonal therapy
Clinical trials
Survivorship care: We plan for our breast cancer patients long after their treatments
are done with surveillance and regular follow-up visits to provide the best long-term
survivorship care.

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Cervical Cancer
Symptoms
Women with very early stages of cervical cancer may not experience any
symptoms. Some women may have a watery vaginal discharge and experience
some spotting or bleeding after sexual intercourse. These symptoms are not
cancer-specific and may not be recognized by a patient with early stage cancer.
Because symptoms are hard to identify, regular testing is an important way to
identify cervical cancer early.
Diagnosis
How is cervical cancer diagnosed?
Regular gynecological examinations, with the use of Papanicolaou (Pap) smears
and cervical biopsies, often lead to a clear diagnosis. A special biopsy called the
cone biopsy may be recommended to help define this cancer. A gynecological
oncologist can help determine an exact diagnosis.
.

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Treatment
Surgical techniques to treat cervical cancer while allowing you to plan future
pregnancy (fertility-sparing techniques): This type of treatment is possible for some,
but not all, cervical cancer patients. Techniques such as conization or trachelectomy
may be considered in highly selected patients after thorough counseling regarding
the risks and benefits involved in this procedure.
Surgical techniques when future pregnancy is not being considered: A hysterectomy
and removal of lymph nodes will be discussed by the gynecological oncology team.
This type of surgery is the treatment of choice for many women with early stage or
small cancers.
Radiation therapy: Usually combined with chemotherapy, in treatments called
chemoradiation therapy, this technique is commonly used for those patients who do
not undergo a hysterectomy. This course of treatment is best delivered by highly
trained gynecological oncology teams working with specialized radiation oncology
teams, as is routinely the case .
Radiation therapy or chemoradiation after surgery: Some patients may require
treatment after initial surgery. Gynecological oncology and radiation oncology teams
will work with you and your family to decide if this treatment is an option for you.

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Treatment for advanced stage cervical cancer: Chemotherapy, and, in some patients,
careful use of radiation treatments designed to relieve symptoms, are important
treatments to control advanced cervical cancer. Your treatment team will work with
you to identify options, including, the option of a clinical trial.
Follow-up and surveillance: Observation and careful regular monitoring for
recurrence is recommended for those patients without evidence of disease after
surgery and chemotherapy.
Causes/Risk Factors
Persistent infection with the human papilloma virus (HPV) is an important risk factor
in the development of this cancer. Immunization against strains of this virus will
prevent HPV-associated cancer.
Another important risk factor is smoking. If you are a smoker, quitting can help
reduce your risk of developing cervical cancer. If you’ve never smoked, don’t start. If
you have successfully quit smoking, don’t start again.

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The Health ProtectorChronic Lymphocytic Leukemia
Symptoms
Chronic lymphocytic leukemia is often found after an abnormal blood count is
discovered during a routine blood test. This is the first step in a determining that
someone has the disease. Symptoms of this type of leukemia are often nonspecific
and may include fever, profuse sweating at night and unexplained weight loss.
Tiredness, abdominal discomfort, swollen lymph nodes and feeling full after a small
meal can sometimes be clues that lead to a diagnosis of this disease. As a result of
the weakened immune system associated with chronic lymphocytic leukemia, you
may be susceptible to serious infections.
Diagnosis
How is chronic lymphocytic leukemia diagnosed?
Lab tests, including an analysis of your blood, will reveal an excess of small
lymphocytes if you have chronic lymphocytic leukemia. Other tests of your blood,
bone marrow and other tissue will help doctors determine the type and severity of
your disease.

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Treatment
Primary treatment: Some patients do not need immediate treatment because
leukemia progress may be slow and stable. You won’t feel a certain symptom or take
a certain test to determine when treatment will begin. You treatment team will
communicate with you to determine when it makes sense to start treating your
disease. Your treatment may include specific types of chemotherapy and
immunotherapy using antibodies designed to attack the leukemic lymphocytes in the
hopes that your cancer will go into remission.
Stem cell transplantation: If your diagnosis determines that you have high-risk
chronic lymphocytic leukemia, you may be referred to a stem cell transplantation
team. The team works closely with transplant teams. We understand how important
communication is at every stage of your treatment.
Clinical trial-based treatment: Partnership with the National Cancer Institute, is
testing the addition of newer drugs like ibrutinib, along with rituximab, versus
standard treatments in a clinical trial called a Phase III or randomized clinical trial
(RCT).

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The Health Protector Chronic Myeloid Leukemia
Symptoms
Some patients with this disease, especially those who are in what is known as the chronic
phase, may not feel any symptoms and the diagnosis is made based on abnormal blood counts
on routine blood tests.
The typical symptoms of chronic myeloid leukemia are often nonspecific, and may
include tiredness, abdominal discomfort, feeling full after a small meal, fevers, shortness of
breath, and easy bruising or bleeding.
If you have what is known as the accelerated phase of chronic myeloid leukemia, or the blast
crisis phase, your symptoms may be similar to those of someone with acute leukemia,
meaning that you are seriously ill and your disease will likely require more aggressive
treatment.
Diagnosis
How is chronic myeloid leukemia diagnosed?
A tissue or blood sample showing the Philadelphia Chromosome and its molecular
signature (referred to as bcr-abl) in the blood or bone marrow and other biopsy materials will
confirm a chronic myeloid leukemia diagnosis. Doctors will also look for other signs of the
disease in your blood or tissue and will conduct tests to determine the type and severity of
your disease.

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Treatment
Chronic myeloid leukemia-
Primary treatment: Medications taken by mouth called tyrosine kinase inhibitors are the
treatment of choice for this disease. Most patients are treated with imatinib, nilotinib, or
dasatanib. This chemotherapy is designed to eradicate all evidence of leukemia and to result
in a remission known as a molecular remission, meaning that test results will no longer show
evidence of the Philadelphia chromosome and the bcr-abl proteins in the blood and bone
marrow.
Follow-up chemotherapy: You’ll be monitored after treatment concludes and you’ll be asked
to submit to a specific set of blood and bone marrow on a set schedule of three months, six
months, one year and beyond. Your treatment team will look at your test results to confirm: a
normal blood count, disappearance of the Philadelphia chromosome and undetectable bcr-
abl. You doctor may pursue further treatment depending on the results of your periodic tests.
Chemotherapy for accelerated or blast phase leukemia: Treatment is more aggressive for
accelerated or blast phase leukemia and your care team may opt to treat your disease in the
same way they would attack acute leukemia in another patient.
Stem cell transplantation: In some cases, stem cell transplantation is identified as the most
viable treatment option. If that’s the case based on your diagnosis, Treatment team will work
closely with your transplant team throughout the process.
Survivorship care: Our patients are provided with long-term surveillance and regular follow-
up visits are planned to provide the best long-term survivorship care.

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The Health Protector Colon Cancer
Symptoms
Abdominal pain, Black-colored stool, Blood in the stool, Constipation, Distention of
the abdomen, Nausea, Vomiting, Unexplained weight loss
Some colorectal cancers may be detected only through screening colonoscopies.
Diagnosis
How is colon cancer diagnosed?
A colon cancer diagnosis is confirmed by colonoscopy, which is the insertion of a
special fiber-optic instrument into the colon. A biopsy will also be taken so that the
tissue may be examined.
A biopsy under CT-scan or ultrasound guidance may be required to examine some
suspicious areas. Specialized staining techniques are performed by gastrointestinal
pathologists to determine the exact nature of the cancer.
Tumor specimens will be studied by special genetic tests to help guide treatment in
select patients.
Blood tests, CT scans and other scans will be performed to determine extent of
disease. This process, called staging, allows your team to determine the ideal
treatment for your cancer.

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Treatment
Patients are carefully screened and a detailed family history is taken as part of your treatment.
High-risk patients at the CTRC have full access to our Cancer Genetics and High-Risk Screening
Clinics, which have expert genetic counselors available to patients.
Patients may have the following:
Primary treatment: Surgery is the primary treatment for cancers that are deemed to be
completely removable.
Chemotherapy: Also called adjuvant therapy, this may be required for selected patients after
surgery.
Treatment for advanced stage cancer: Chemotherapy is delivered by your multidisciplinary
gastrointestinal oncology team, which has specific knowledge of your prior treatment. Clinical
trials may be discussed as the best option for care and control of advanced stage colon cancer.
Treatment of recurrent colon cancer: Colon cancer that is resistant to standard treatments may
require clinical trial options.
Survivorship care: Our patients are provided with long-term surveillance and regular follow-
up visits are planned to provide the best long-term survivorship care.
Causes/Risk Factors
Some of the risk factors for colon cancer include:
Smoking, Obesity, Dietary factors,Inflammatory bowel disorders, such as Crohn disease and
ulcerative colitis. Familial or genetic conditions, such as familial polyposis or Lynch syndrome,
represent about 20 percent of colon cancers.

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Endometrial Cancer
Symptoms
The most common symptom is abnormal vaginal bleeding, mainly in post-
menopausal women.
Diagnosis
How is endometrial cancer diagnosed?
Your gynecologist will perform an endometrial biopsy in his or her clinic.
These biopsies may test as a false negative about 10 percent of the time. As a result,
a negative endometrial biopsy with abnormal bleeding after menopause should be
followed by a procedure to obtain more tissue for examination called a fractional
dilation and curettage, more commonly called a D&C. You will be put under
anesthesia for a D&C, which will be performed by a gynecologist.

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Treatment
Surgery: Removal of the uterus or a total abdominal hysterectomy with removal of
both fallopian tubes and ovaries.
Radiation therapy: Adjuvant radiation therapy may be indicated for some patients
after surgery.Chemotherapy: Selected patients may require chemotherapy treatment
after initial surgery. Gynecological oncology teams facilitate this complex decision-
making process. Your CTRC team will work with you to determine the treatment that
best fits your needs.Treatment for advanced stage endometrial cancer:
Chemotherapy—and for select patients, radiation therapy—is used to control the
cancer. Hormone therapy may be used to treat specific types of endometrial cancer.
Clinical trials: Clinical trial options will always be considered, especially for advanced
stage endometrial cancer.
Causes/Risk Factors
Conditions that persistently elevate estrogen levels in the blood, such as:
Obesity, Starting menstrual periods at an early age, Starting menopause later in life,
Never having been pregnant

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Esophageal Cancer
Symptoms
Difficulty swallowing, Pain while swallowing, Chest discomfort, Loss of appetite,
Unexplained weight loss, Upper abdominal pain and discomfort
Diagnosis
How is esophageal cancer diagnosed?
The diagnosis of esophageal cancer requires testing to confirm the cancer.
Endoscopy—the insertion of a special fiber-optic instrument into the
esophagus—and a biopsy of suspicious areas are usually performed.
If we find that you have esophageal cancer, gastrointestinal pathologists will use
specialized staining techniques to determine if the cancer is squamous cell
carcinoma or adenocarcinoma. Other tests, including blood tests, CT scans and
other scans will be performed to determine the extent of disease, during a
process also called staging. The stage of the cancer determines the type and
aggressiveness of your treatment.

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Treatment
Primary treatment: If your cancer is in the early stages, endoscopic techniques may
be performed to remove the tumor. This type of surgery, called esophagectomy, may
be recommended with or without chemotherapy plus radiation. Chemotherapy and
radiation may come before or after surgery.
Treatment for advanced stage cancer: If your cancer is determined to be in an
advanced stage, your treatment plan may be chemotherapy, or radiation therapy
delivered by the same multidisciplinary gastrointestinal oncology team.
Treatment of recurrent esophageal cancer: If the cancer returns or is resistant to
standard therapy options, our team will advise you on next steps, which may include
a clinical trial. , Survivorship care: Osophageal cancer patients long after their
treatments are done with surveillance and regular follow-up visits to provide the
best long-term survivorship care.
Causes/Risk Factors
Smoking and alcohol abuse are major risk factors for squamous cell carcinoma of the
esophagus.Tobacco use is a moderate risk factor for adenocarcinoma.
Gastroesophageal reflux disease (GERD) and a condition called Barrett’s esophagus
are also two major risk factors for adenocarcinoma of the esophagus.

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Retinoblastoma
Symptoms
Most children do not show any signs of cancer of the eye prior to diagnosis. Often, a
parent or family member may identify the tumor as a white tint in the pupil of the
child eye. This is seen in contrast to red eye usually observed during flash
photography. Sometimes, as the tumor grows within the eye, it can be observed
altering the shape, color, vision and normal movements of the eye.
Diagnosis
How is retinoblastoma diagnosed?
If retinoblastoma is suspected, the doctor will usually refer your child to a pediatric
ophthalmologist. This doctor will examine the retina directly by dilating the eye,
sometimes under general anesthesia. Key additional components of the diagnosis
will likely include:Computed Tomography (CT or CAT) scans use X-rays to determine
any evidence of both local and distant tumor spread.
Magnetic resonance imaging (MRI) uses electromagnetic waves and strong magnets
to produce detailed pictures of the internal parts of the body.
Laboratory tests, such as blood and urine tests, are conducted to check the general
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Treatment
Treatment for retinoblastoma is determined by many factors, the most important
being the stage or extent of spread of the cancer at diagnosis. The staging system
considers a child's disease severity and predicts what type of treatment will be most
effective while still preserving the eye. The faculty and staff at the CTRC are pleased
to continue to be a part of this cooperative effort advancing knowledge and
improving cancer therapies for children.
Small tumors may be treated by laser or cryotherapy
Radiation is sometimes used for both local tumors and for larger tumors
Chemotherapy may be needed if the tumor has spread beyond the eye or is at high
risk of spreading beyond the eye
The eye may need to be removed (a procedure called enucleation), followed by
placement of a prosthesis. This is recommended when there is no likelihood of
reestablishing vision in the eye. The procedure is often curative and cosmetic results
can be excellent.
Retinoblastoma patients long after their treatments are done with surveillance and
regular follow-up visits to provide the best long-term survivorship care.

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Causes/Risk Factors
Retinoblastoma is caused by a mutation in a gene that controls how cells
divide and multiply. In the majority of cases, retinoblastoma develops in a
child whose family has never had eye cancer.
In some children, the mutation that causes retinoblastoma occurs in family
members. If the mutation is found in other family members, a 50 percent
chance exists that an affected person’s children will also have retinoblastoma.
If the cancer affects both eyes, the affected patient’s children and siblings
could also be at risk for retinoblastoma, even if no family members have had
retinoblastoma previously. For this reason, it is important for every child with
retinoblastoma to have a genetic evaluation.

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Gallbladder Cancer
Symptoms
Abdominal pain, Distention of the abdomen, Nausea, Vomiting, Unexplained weight
loss
Jaundice ,Sometimes, gallbladder cancer is discovered after a gallbladder has been
removed because of gallstones or suspected or proven gallstone disease.
Diagnosis
How is gallbladder cancer diagnosed?
CT scans
MRI scans
Imaging tests: These are reviewed and interpreted by radiologists, who work closely
with our Liver and Gallbladder Cancer Treatment Team
Biopsy
Blood tests, CT scans and other scans are used to stage, or determine extent of
disease. The stage of the cancer determines the ideal primary treatment.

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Treatment
Gallbladder cancer.
In one appointment, our Liver Cancer Clinic members will explain possible treatment
options:
Surgery: Surgery to remove the cancer may be the first step for some patients.
Chemotherapy: Patients who are not candidates for surgery may receive standard
chemotherapy options or clinical trial-based options will be discussed with you. Your
treatments will be tailored to your specific needs and to your specific cancer.
Causes/Risk Factors
Gallstones with chronic inflammation
Gallbladder polyps
Some types of inflammatory bowel disease, including ulcerative colitis and Crohn’s
disease

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Gastric Cancer
Symptoms
Upper abdominal pain and discomfort
Worsening reflux symptoms
Dark or black-colored stool, Bloating, Nausea, Vomiting, Chest discomfort, Loss of
appetite
Abdominal swelling, Unexplained weight loss
Diagnosis
How is gastric cancer diagnosed?
Gastric cancer is usually confirmed by endoscopy (the insertion of a special fiber-
optic instrument into the stomach) and biopsy of suspicious areas.
Gastrointestinal pathologists use specialized staining techniques to determine the
exact nature of the cancer.
Tests, including blood tests, CT scans and other scans, will be performed to
determine extent of disease. This is called staging. The stage of the cancer
determines the approach our team will take for your treatment.

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Treatment
Primary treatment: Depending upon the extent of the cancer (stage), and your overall general
condition or fitness, treatment may include surgery alone or ideal chemotherapy plus
radiation before or after surgery.
Treatment for advanced stage cancer: Chemotherapy is delivered by the same
multidisciplinary gastrointestinal oncology team. Clinical trials may be the best option for care
and control of an advanced-stage gastric cancer.
Treatment of recurrent gastric cancer: Gastric cancer that is resistant to standard therapies.
Survivorship care: Long-term surveillance and regular follow-up visits are planned to provide
the best long-term survivorship care.
Causes/Risk Factors
Environmental risk factors include:
Infection by the bacterium Helicobacter pylori, Smoking tobacco , High salt intake and other
dietary factors . Most gastric cancers do not have a familial or genetic origin.
About 5 to 10 percent of gastric cancers may have a genetic origin, including:
Hereditary diffuse gastric cancer, Lynch syndrome, Juvenile polyposis syndrome, Peutz-
Jeghers syndrome, Familial adenomatous polyposis ,High-risk patients have access to the
CTRC’s Cancer Genetics and High-Risk Clinic, where genetic counselors can answer questions
and offer guidance.

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Hodgkin lymphoma
Symptom
Some people with Hodgkin lymphoma may not feel any symptoms. Others have
fever, profuse sweating at night and unexplained weight loss. Your diagnosis may
have only been made after swollen lymph nodes or an enlarged spleen was
discovered. Symptoms may occur at sites with swollen lymph nodes.
Diagnosis
How is Hodgkin lymphoma diagnosed?
To determine a diagnosis of classical Hodgkin lymphoma, a unique cell or set cells
must be found in biopsy specimens of lymph nodes or bone marrow. The unique cell
is called the Reed-Sternberg cell.
Nodular Hodgkin lymphoma, the rarer form of Hodgkin lymphoma, lacks these cells
and is characterized by a dominant population of lymphocytes. These are sometimes
referred to as popcorn cells. Other tests—including blood tests, bone marrow
biopsies, CT scans and PET scans—help define the extent of Hodgkin lymphoma in
your body and are referred to as staging tests. Your cancer stage will play a role in
the treatment plan you and your care team develop.

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Treatment
Primary treatment: Specific types of treatment using chemotherapy, radiation
therapy or both are delivered after staging and based on a set of tests that
determine good-risk versus high-risk conditions. All treatments are designed to
achieve a complete remission with the smallest chance for short-term or long-term
side effects.
Stem cell transplantation: Some patients with Hodgkin lymphoma, who are resistant
to standard primary treatment or who have seen a return of the disease soon after
achieving a remission, are referred to a stem cell transplantation team. Your initial
treatment team will remain in constant communication with you and the transplant
team, if this option is seen as best for you.
Survivorship care: Hematology teams follow comprehensive guidelines for ideal care
of survivors and partner with National Cancer Institute standards to provide the best
long-term survivorship care. Treatment of recurrent Hodgkin lymphoma: Ideal
treatment of recurrence of Hodgkin lymphoma or for Hodgkin lymphoma that is
resistant to standard therapy is also available. Often delivered in the context of the
best new clinical trials. Follow-up and surveillance: Observation and careful regular
monitoring for recurrence is now routine following national guidelines and
exceptionally high standards for care.

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Kidney Cancer
Symptoms
Common signs and symptoms of kidney cancer include:
Blood in the urine
Enlargement of the veins around a testicle (known as varicocele), Flank (back and
side) pain, Swelling or enlargement of the abdomen, Unintentional weight loss
Other symptoms that can occur with this disease include:
Constipation, Cold intolerance, Excessive hair growth in females, Paleness, Vision
abnormalities
In patients with kidney cancer, one or both kidneys may be involved. Unfortunately,
this cancer spreads easily, most often to the lungs and other organs. In about one-
third of patients, the cancer has already spread (metastasized) at the time of
diagnosis. That is why it is important to see a doctor if you have symptoms of this
disorder, especially blood in the urine.
Diagnosis
How is kidney cancer diagnosed?

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Your doctor will examine your abdomen and look for an enlarged kidney, liver or
other organ. The exam may include one or more of the following tests:
Abdominal CT scan: An imaging method that uses X-rays to create cross-sectional
pictures of the belly area,
Blood, urine or tissue tests: Tests to look for tumor markers (substances that can
indicate cancer), Ultrasound of the abdomen and kidney, Urine tests
Treatment
Kidney cancer treatment
Surgery to remove part of the affected kidney, known as a partial nephrectomy, is
the most common treatment for renal cell carcinoma. In some cases the entire
kidney needs to be removed.
Surgeons are fellowship trained to specifically manage advanced urologic cancers.
Our surgeons are able to perform surgeries using advanced, minimally invasive
techniques, such as laparoscopy and robotic surgery. This results in faster healing
times, less discomfort and less risk.
Our patients are provided with long-term surveillance and regular follow-up visits
are planned to provide the best long-term survivorship care.

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Live Cancer
Symptoms
Abdominal pain, Distention of the abdomen, Nausea, Vomiting, Unexplained weight
loss, Jaundice .
Diagnosis
How is liver cancer diagnosed?
Liver cancer can be a silent cancer. Tests are necessary to confirm diagnosis.
Blood tests can show tumor markers such as alpha feto-protein (AFP) or other liver
function tests.
Ultrasounds and other scans also may be used.
CT or MRI scans and other imaging tests will be reviewed and interpreted by expert
radiology staff in partnership with Liver Cancer team.
Biopsy: This may be necessary for select patients.
Tests, including blood tests, CT scans and other imaging scans, will be performed to
determine extent of disease. This is called staging. The stage of the cancer and the
assessment of liver function determines the ideal primary treatment.

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Treatment
Our liver cancer experts will discuss treatment options at one appointment:
Surgery: The cancer is removed by a team that includes liver transplant surgeons and
other surgeons who specialize in liver cancer surgery.
Radiology or image-guided treatments: Radiofrequency ablation, chemo-
embolization and use of radioactive isotopes are placed directly into the liver cancer
by interventional radiology doctors who specialize in liver cancer treatments.
Radiation therapy: Techniques that are specific to liver cancer are available.
Chemotherapy: Standard chemotherapy options are used with some patients.
Clinical trial-based new treatment: Options will be discussed and treatments will be
tailored to each patient’s needs.
Causes/Risk Factors
Risk factors for liver cancer include:
Hepatitis B virus infection, Hepatitis C virus infection, Related liver disease
Chronic liver disorders: These may also predispose a person to liver cancer.
Screening programs for early detection may be recommended for specific

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lung cancer
Symptoms
Depending upon the location of the tumor and type of tumor, your symptoms may
include:
Chest pain, Cough, Phlegm with flecks of blood
Hoarseness, Trouble swallowing, Shortness of breath
Rib or other bone pain, Loss of appetite and weight loss
Diagnosis
How is lung cancer diagnosed?
Diagnose lung cancer using a combination of CT scans and a biopsy usually
performed by radiologists, lung specialists or thoracic surgeons. We handle biopsy
specimens with great care to determine specific markers, called biomarkers, for
molecular profiling.
Other tests—including blood tests, PET/CT scans and other scans—to determine
extent of disease, a process also called staging. The location, type of cancer and
other features help us determine the ideal primary treatment for your cancer.

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Treatment
Surgery: For patients with early stage, non-small cell lung cancer, surgery provides
the best chance for cure.
Radiation therapy: This is an important part of treatment for many patients with
lung cancer. Techniques include brachytherapy, stereotactic body radiation therapy
(SBRT) and standard external beam radiation therapy. Some lung cancer patients
need chemotherapy along with radiation therapy, called chemoradiation.
Chemotherapy: We have a variety of chemotherapy options available for select
patients. The choice of chemotherapy treatment depends on the type of lung cancer.
Advanced stage disease and recurrent disease: Lung cancer team partners with the
National Cancer Institute on unique new groundbreaking clinical trials designed to
advance the efficient development of targeted therapy for lung cancer, such as the
Lung Master Protocol (called Lung-MAP).

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Lung cancer is in an advanced stage or returns, your treatment team will look at
other approaches and explain each step of treatment to you. Developing new
treatments for this stage of the cancer is a priority option including clinical trials will
be discussed and planned with you. Survivorship care: Lung cancer patients long
after their treatments are done with surveillance and regular follow-up visits to
provide the best long-term survivorship care.
Causes/Risk Factors
The primary risk factor for lung cancer is smoking tobacco.
Other risk factors include exposure to
Asbestos
Chromium
Nickel
Cadmium
Radon gas

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Melanoma
Symptoms
Melanoma can occur on sun exposed areas, but depending on type, may be found anywhere
on the body. People with darker skin types should pay particular attention to the hands, feet
and nails. Although melanomas can arise from a pre-existing mole, many appear as new
pigmented lesions. One should pay close attention to a mole that changes in size, shape or
color.
A common tool to use is the ABCDEs that may help you detect skin cancer early.
A = Asymmetry. Is the lesion asymmetric with one side different than the other?
B = Border. Is the border of the lesion very irregular?
C = Color. Are there different colors within the lesion?
D= Diameter. Is the lesion growing larger? Is it greater than six millimeters?
E= Evolution. Is the lesion changing or growing larger?
If you discover any worrisome spot, consider consulting a medical professional. A skin growth
that is new, painful, non-healing or changing is a cause for suspicion. Similarly, a spot that
itches, erodes, bleeds or scabs are potential warning signs.
Diagnosis
How is melanoma diagnosed?
Your dermatologist will do an examination of the area. Tests, such as a biopsy, may be needed.

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Treatment
Melanoma
Treatment for skin cancer will depend on the type, size, location, and extent of the skin cancer.
Certain skin cancers on the face or of a large size skin may require Mohs surgery and/or
multidisciplinary care.
Cryotherapy or freezing lesions with liquid nitrogen: Often used to destroy small precancerous
lesions. Electrodesiccation and curettage: Used for superficial skin cancers. The doctor will scrape
away cancer cells using a curette and use an electric needle to destroy cancer cells. Excisional
surgery: Surgical removal of the tumor and a margin. The margin of tissue will depend on the type
and extent of the skin cancer. Mohs surgery: A surgery that is used for skin cancers that need to be
removed from areas such as the face or digits, where there sparing of the normal skin is imperative.
This procedure allows the skin cancer to be removed without taking an excessive amount of
surrounding normal tissue. Mohs surgery allows for excellent curative rates as 100 percent of the
margin is evaluated. This technique is ideal for larger, recurrent or more aggressive tumors. Blu-U
photodynamic therapy: Uses a topical medicine that turns pre-cancer cells sensitive to light.
Chemotherapy, topical and systemic, and biologic therapies: A variety of topical medications, such
as 5 fluorouracil (Efudex, Carac), and systemic medications that can be used to destroy precancerous
cells. Radiation therapy: Used for patients in whom surgery is not the best option as well as for
adjuvant treatment. Survivorship care: Melanoma patients long after their treatments are done
with surveillance and regular follow-up visits to provide the best long-term survivorship care.

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Causes/Risk Factors
What causes melanoma?
Melanoma arises from our pigmented cells. Although melanomas are less common
than the other two types of skin cancer, it is can be more dangerous. Skin cancer
occurs when there is uncontrolled growth of the cells that make up the outer layer
of skin.
For all skin cancers, the earlier you detect them, the easier and more successful
treatment can may be.
There are many factors that may increase the risk of developing skin cancer. These
are some factors to consider:
Family history of skin cancer. Personal history of a previous skin cancer
Personal history of precancerous skin lesions such as actinic keratoses, which occur
on sun-damaged skin. History of multiple atypical moles, called dysplastic moles
History of radiation treatments. History of immunosuppression, such as organ
transplant patients requiring chronic medications to weaken their immune system

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Metastatic Brain Tumors
Symptoms
Depending upon the location and type of tumor, you may experience symptoms such
as:
Headache, Seizures, Double vision, Confusion, Changes in personality, Psychiatric
symptoms, Fatigue, Nausea, Vomiting.
Diagnosis
How are metastatic brain tumors diagnosed?
We usually determine a diagnosis through a combination of brain scans, using an
MRI or CT scan, and, in most patients, by a biopsy usually performed by
neurosurgical members of the neuro-oncology team.
Blood tests, functional MRI or other scans will be performed to determine the extent
of disease in a process also called staging. The location, type of cancer and other
features help us develop your treatment plan.

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Treatment
Surgery: Our neurosurgeons guide surgical treatment and are able to plan for
maximum removal of the metastatic brain tumor with minimal risk, especially if it is
a single tumor or a few small tumors grouped in a relatively silent area of the brain.
Options can include special biopsy techniques, called stereotactic biopsy, which
involves using a small needle to take a sample of tissue, or open biopsy, or
complete surgical removal of the tumor.
Radiation therapy: This is an important part of treatment for many of our patients.
Techniques include brachytherapy, stereotactic radiosurgery and standard whole
brain or external beam radiation therapy.
Chemotherapy: A variety of options exists for chemotherapy if this is needed as
part of your treatment plan. Your course of treatment will depend on the location
of the primary tumor in your body, but we’ll help you understand the risks and
steps involved in chemotherapy.
Survivorship care: Metastatic brain tumor patients long after their treatments are
done with surveillance and regular follow-up visits to provide the best long-term
survivorship care.

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The Health Protector Multiple Myeloma
Symptoms
Elevated blood calcium levels caused by multiple myeloma can cause nausea,
seizures, confusion and disorientation. Other strong indicators of the presence of
multiple myeloma are a low blood count that results in anemia, kidney damage
resulting in kidney failure and significant trouble in the bones, causing pain and
fractures.
Diagnosis
How is multiple myeloma diagnosed?
A diagnosis of multiple myeloma comes after tests reveal abnormal plasma cells in
the bone marrow, along with specific patterns of abnormal immunoglobulin proteins
in the blood or urine, called monoclonal proteins. You can expect tests that involve
drawing samples of your blood or a bone marrow biopsy as part of this process.
Other tests to determine the type and severity of cancer may include X-rays, MRIs or
other scans.

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Treatment
Primary treatment: Chemotherapy, radiation therapy or both may be recommended
after doctors determine the severity of your cancer. All treatments are designed to
achieve a complete remission with the smallest chance for short-term or long-term
side effects.
Stem cell transplantation: Some patients with multiple myeloma are good candidates
for stem cell transplantation. Will keep in close communication with the transplant
experts.
Survivorship care: Multiple Myeloma patients long after their treatments are done
with surveillance and regular follow-up visits to provide the best long-term
survivorship care.

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The Health Protector non-Hodgkin lymphoma
Symptoms
Symptoms aren’t always distinct when it comes to non-Hodgkin lymphoma. Some
patients learn of the cancer only after swollen lymph nodes or enlarged spleens are
discovered by a doctor. Those who do experience symptoms of non-Hodgkin
lymphoma have fever, profuse sweating at night and unexplained weight loss. Other
symptoms around the area of swollen lymph nodes are also possible.
Diagnosis
How is non-Hodgkin lymphoma diagnosed?
A sample of tissue from a lymph node or bone marrow will be examined in search of
unique patterns of abnormal lymphocytes. In some cases, an entire abnormal lymph
node is removed so that your doctor can get the best chance to determine an
accurate diagnosis, including:
Blood tests, Bone marrow biopsies, CT scans, PET scans
In select patients, examination of the cerebrospinal fluid through a spinal tap
These additional tests help determine the extent of non-Hodgkin lymphoma in your
body. Doctors are trying to determine the severity and type of cancer when they
conduct these tests.

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Treatment
Primary treatment: Specific types of treatment using chemotherapy, radiation
therapy or both are delivered after a diagnosis is confirmed. The goal is to
achieve a complete remission while reducing, as much as possible, the chance for
short-term or long-term side effects or toxicity.
Stem cell transplantation: Some patients with non-Hodgkin lymphoma are
referred to our stem cell transplantation team if the cancer is resistant to
standard primary treatment or see a return of disease soon after achieving
remission. Team will keep in close contact with the transplant team to create a
solid partnership.
Survivorship care: non-Hodgkin lymphoma patients long after their treatments
are done with surveillance and regular follow-up visits to provide the best long-
term survivorship care

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Oral Cancer &Head and Neck Cancer
Symptoms
Depending upon the location of the cancer, you may notice symptoms including:
Mouth sores that do not heal, Swelling or sore on the tongue, Trouble swallowing
Hoarseness, Neck swelling, Bleeding from the mouth or nose, Headache, Change in
voice, Facial deformity, Shortness of breath, Bone pain, Double vision, Symptoms of
sinusitis, Paralysis of muscles of the face, Loss of appetite, Weight loss .
Diagnosis
How is oral cancer diagnosed?
A diagnosis of oral or head and neck cancer must be confirmed. This is usually done
by a biopsy of suspicious areas. A biopsy takes a sample of the suspect tissue to
allow for analysis under a microscope or with other laboratory tests. Initial biopsies
may be performed in the office.
Further examination will need endoscopy procedures and examination under
anesthesia to allow for more detailed biopsies. This will also accurately determine
the extent of the disease.

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Endoscopy allows us to examine you more thoroughly using a flexible tube with a
light and camera. This tube is placed in the back of the mouth and throat.
Tests, including blood tests, CT scans and other imaging scans, will be performed to
determine extent of disease. This is called staging. The stage of the cancer
determines the ideal primary treatment.
Oral Cancer
Treatment
Surgery: Although small tumors may require simple surgical procedures, some
cancers may require multiple surgical teams working together. This can ensure an
ideal outcome — completely removing the tumor and reconstructing face and neck
tissues to allow functional and cosmetic results.
Radiation therapy: We may use radiation techniques alone without surgery or in
combination with chemotherapy before or after surgery. This is called
chemoradiation.
Chemotherapy: We have a variety of options available for chemotherapy. We
routinely consider clinical trial-based options.

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Ovarian Cancer
Symptoms
Non-specific pelvic discomfort
Bloating
Abdominal pain
Urinary symptoms that are frequent
Feeling full after eating
Loss of appetite
Diagnosis
How is ovarian cancer diagnosed?
For patients with specific symptoms consistent with ovarian cancer, or when a pelvic
mass that warrants evaluation is found during a gynecological examination, tests
such as a pelvic ultrasound examination, CT scan, and a blood test—a tumor-marker,
called CA-125—will confirm a diagnosis.
Routine screening tests such as blood tests, ultrasounds, or scans are not
recommended for healthy women without risk factors.

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Treatment
Surgery (total abdominal hysterectomy and bilateral salpingoophorectomy): The
uterus and the ovaries are removed and surgeons carefully review your abdominal
and pelvic organs during surgery in search of signs that the disease has spread. The
treatment team attempts to remove as much of the cancer as possible through
surgery.
Chemotherapy after surgery: Most, but not all, ovarian cancer patients will need
chemotherapy after surgery.
Survivorship care: Ovarian cancer patients long after their treatments are done with
surveillance and regular follow-up visits to provide the best long-term survivorship
care.
Causes/Risk Factors
Women who have never been pregnant and women who have had their first
pregnancy at or after the age of 35 appear to be at higher risk of the disease.
About 5 percent of ovarian cancer cases may be caused by genetic conditions, such
as BRCA1 and BRCA2 mutations.

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Pancreatic Cancer
Symptoms
Upper abdominal pain and discomfort, Bloating, Nausea, Vomiting, Loss of appetite,
Jaundice, Unexplained weight loss
Diagnosis
How is pancreatic cancer diagnosed?
Endoscopy, the insertion of a special fiber-optic instrument into the stomach and
small intestine, and biopsy, the removal and study of a tissue sample, are the
procedures typically performed to diagnose pancreatic cancer. Your doctor may also
want to examine suspicious areas by asking you to undergo a biopsy performed
under CT scan or with ultrasound guidance.
Specialized staining techniques are performed by gastrointestinal pathologists to
determine the exact nature of the cancer.
Special tests to look for biomarkers—such as CA 19.9 or hENT1—may provide
guidance in how to treat pancreatic cancer. Other tests, such as blood tests, CT and
other scans, will be used to determine the stage, or severity level, of your cancer.

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Treatment
Surgery: Surgery remains the treatment of choice in patients whose cancers are deemed to be
completely removable at surgery. Chemotherapy alone, or chemotherapy plus radiation, may
be used before or after surgery in selected patients.
Treatment for Advanced Stage Cancer: Treatment may be chemotherapy delivered by the
same multidisciplinary gastrointestinal oncology team often in the context of clinical trials as
the best option for care and control of the cancer.
Survivorship care: Pancreatic cancer patients long after their treatments are done with
surveillance and regular follow-up visits to provide the best long-term survivorship care.
Causes/Risk Factors
Risk factors include:
Smoking, Exposure to chemicals (benzidine, beta-napthylamine), Obesity, Heavy alcohol
consumption, History of chronic pancreatitis
About 10 percent of cases may be familial or genetic in origin. People with a family history of
pancreatitis, Peutz-Jeghers syndrome, Lynch syndrome or patients with BRCA2 and BRCA1
mutations are at risk for pancreatic cancer.
High-risk patients should have full access to cancer genetics clinics and expert genetic
counselors.

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Prostate Cancer
Symptoms
Prostate cancer almost never causes symptoms until it has spread. A man may have an early or
even a very late prostate cancer and not know it until the cancer has spread. Unfortunately,
once this has occurred, prostate cancer is usually not curable. However, there are treatments
to slow prostate cancer’s spread.
Diagnosis
How is prostate cancer diagnosed?
Physicians have recommended regular physicals for men older than 50 to find the cancer early,
treat it and prevent problems or death from the disease. These physicals include:
Digital Rectal Examination: A physician inserts a gloved finger into the patient’s rectum and
feels the prostate, seeking any firm areas (called nodules) that might indicate the presence of
cancer.Prostate Specific Antigen (PSA) test: A blood test that looks at the levels of prostate
specific antigen, which is used in conjunction with other information to determine the
possibility of prostate cancer. Prostate Cancer Risk Calculator: Scientists and physicians
developed the Prostate Cancer Risk Calculator . The Prostate Cancer Risk Calculator combines
the following six factors: Age, Race/ethnicity, PSA, Rectal examination findings (normal or
abnormal)Family history of prostate cancer (yes or no), History of a prior negative prostate
biopsy (yes or no),.

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An important aspect of the calculator is that it not only estimates the risk of
prostate cancer but also estimates the risk of aggressive prostate cancer — one that
spreads more quickly and has a higher risk of causing death
Treatment
A minimum of four treatment options should be offered to the patient:
Surgery (radical prostatectomy): The prostate gland is removed.
Radiation therapy with external beam: A high-dose X-rays or other types of rays may be used
after surgery to prevent the tumor from returning.
Radiation therapy with implanted radioactive seeds: Doses of radioactive material are placed
near the cancer cells or placed directly within the tumor. This is known as brachytherapy.
Active surveillance: Watchful monitoring of the cancer using regular checkups, blood tests and
periodic prostate biopsies to determine if the tumor is growing or becoming more aggressive.
Survivorship care: Our patients are provided with long-term surveillance and regular follow-up
visits are planned to provide the best long-term survivorship care. Physicians have extensive
experience in all four forms of treatment of prostate cancer. Patients treated take advantage
of many years of experience in caring for individuals with prostate cancer by physicians who
oftentimes conducted the clinical studies that set the standard-of-care for physicians around
the world

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The Health Protector Skin Cancer
Symptoms
A common tool to use is the ABCEs that may help you detect skin cancer early.
A = Asymmetry. Is the lesion asymmetric with one side different than the other?
B = Border. Is the border of the lesion very irregular?
C = Color. Are there different colors within the lesion?
D= Diameter. Is the lesion growing larger, - greater than 6mm.?
E= Evolution. Is the lesion changing or growing larger?
There are other less common cancers that can be found on the skin, such as merkel
cell carcinoma, which are found on sun-exposed areas of older individuals on the
head, neck, arms and legs.
If you discover any worrisome spot, consult a medical professional.
Skin cancer is often related to sun exposure. It tends to occur on areas exposed to
the sun, particularly the face, arms, upper chest, back and lower legs. However, it is
important to know that skin cancer can occur anywhere on the body, even on the
soles of the feet or between the toes.
A skin growth that is new, painful, non-healing or changing is a cause for suspicion.
Similarly, a spot that itches, erodes, bleeds or scabs are potential warning signs.

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Diagnosis
How is skin cancer diagnosed?
Your dermatologist will do an examination of the area. Tests, such as a biopsy, may be needed.
Treatment
Treatment for skin cancer will depend on the type, size, location and extent of the skin cancer.
lesions
Electrodesiccation and curettage: Used for superficial skin cancers. The doctor will scrape away
cancer cells using a curette and use an electric needle to destroy cancer cells.
Excisional surgery: Surgical removal of the tumor and a margin.. The margin of tissue will
Mohs surgery: A surgery that is used for skin cancers that need to be removed from areas such
as the face or digits, where there sparing of the normal skin is imperative. This procedure
allows the skin cancer to be removed without taking an excessive amount of surrounding
normal tissue.

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Mohs surgery allows for excellent curative rates as 100 percent of the margin is evaluated.
This technique is ideal for larger, recurrent or more aggressive tumors.
Blu-U photodynamic therapy: Uses a topical medicine that turns pre-cancer cells sensitive to
light.. Chemotherapy, topical and systemic, and biologic therapies: A variety of topical
medications, such as 5 fluorouracil (Efudex, Carac), and systemic medications that can be used
to destroy precancerous cells. Radiation therapy: Used for patients in whom surgery is not the
best option as well as for adjuvant treatment. Survivorship care: Skin cancer patients long
after their treatments are done with surveillance and regular follow-up visits to provide the
best long-term survivorship care.
Causes/Risk Factors
What causes skin cancer?
Skin cancer occurs when there is uncontrolled growth of the cells that make up the outer layer
of skin. Many factors may increase the risk of developing skin cancer, including:
Chronic sun exposure, history of sunburns and indoor tanning. Fair skin and light hair/eyes
such as blond or red hair and blue or green eyes. Family history of skin cancer,Personal history
of a previous skin cancer. Personal history of precancerous skin lesions such as actinic
keratoses, which occur on sun-damaged skin. History of multiple atypical moles, called
dysplastic moles. History of radiation treatments. History of immunosuppression, such as
organ transplant patients requiring chronic medications to weaken their immune system

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Sarcoma
Symptoms
Symptoms may vary, depending on the location and type of the. Some patients have
minimal symptoms, even when they have large, slow-growing sarcomas.
Patients may experience:
Pain, Discomfort, Swelling, Pressure symptoms caused by the sarcoma on
neighboring organs or structures
Diagnosis
How is soft tissue sarcoma diagnosed?
An orthopedic oncologist or surgeon will perform a biopsy. The biopsy specimens will
determine specific markers, called biomarkers. Biopsy specimens are also used for
molecular profiling.
Other testing will include blood tests, PET/CT scans and other scans to determine
extent of disease. This is called staging. The location, type of sarcoma and other
details help us determine the ideal primary treatment.

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Treatment
Surgery: Removal of the tumor with clean margins—leaving no cancer behind.
Radiation therapy: Given before surgery for some patients; for others, it is used after
complete removal of the tumor.
Chemotherapy: We offer a variety of options for select patients. Treatment depends
on the sarcoma. Clinical trial-based options will be considered.

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Squamous Cell Skin Cancer
Symptoms
Squamous cell carcinomas are found on sun exposed areas of the face, ears, scalp
and hands with scaly or crusted firm red nodule. These are also often persistent
sores or non-healing lesions. Skin cancer is often related to sun exposure. It tends to
occur on areas exposed to the sun, particularly the face, arms, upper chest, back and
lower legs. However, it is important to know that skin cancer can occur anywhere on
the body, even on the soles of the feet or between the toes. Skin growth that is new,
painful, non-healing or changing is a cause for suspicion. Similarly, a spot that itches,
erodes, bleeds or scabs are potential warning signs.
Diagnosis
How is squamous cell skin cancer diagnosed?
Your dermatologist will do an examination of the area. Tests, such as a biopsy, may
be needed.

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Treatment
Squamous cell skin cancer
Treatment for skin cancer will depend on the type, size, location and extent of the skin cancer.
lesions.
Electrodesiccation and curettage: Used for superficial skin cancers. The doctor will scrape away
cancer cells using a curette and use an electric needle to destroy cancer cells.
Excisional surgery: Surgical removal of the tumor and a margin. The margin of tissue will
Mohs surgery: A surgery that is used for skin cancers that need to be removed from areas such
as the face or digits, where there sparing of the normal skin is imperative. This procedure
allows the skin cancer to be removed without taking an excessive amount of surrounding
normal tissue. Mohs surgery allows for excellent curative rates as 100 percent of the margin is
evaluated. This technique is ideal for larger, recurrent or more aggressive tumors.
Blu-U photodynamic therapy: Uses a topical medicine that turns pre-cancer cells sensitive to
light.

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The Health ProtectorChemotherapy, topical and systemic, and biologic therapies: A variety of topical medications,
such as 5 fluorouracil (Efudex, Carac), and systemic medications that can be used to destroy
precancerous cells. Radiation therapy: Used for patients in whom surgery is not the best
option as well as for adjuvant treatment. Survivorship care: Squamous cell skin
cancer patients long after their treatments are done with surveillance and regular follow-up
visits to provide the best long-term survivorship care.
Causes/Risk Factors
What causes squamous cell skin cancer?
Skin cancer occurs when there is uncontrolled growth of the cells that make up the outer layer
of skin.
There are many factors that may increase the risk of developing skin cancer.
Some risk factors you may consider:
Family history of skin cancer, Personal history of a previous skin cancer
Personal history of precancerous skin lesions such as actinic keratoses, which occur on sun-
damaged skin, History of multiple atypical moles, called dysplastic moles, History of radiation
treatments, History of immunosuppression, such as organ transplant patients requiring chronic
medications to weaken their immune system

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Testicular Cancer
Symptoms
Testicular cancer often has no signs or symptoms. Symptoms that may occur include:
Discomfort or pain in the testicle or a feeling of heaviness in the scrotum, Dull ache
in the back or lower abdomen
Enlargement of a testicle or a change in the way it feels
Excess development of breast tissue (note that this can occur normally in adolescent
boys who do not have testicular cancer)
Lump or swelling in either testicle
Diagnosis
How is testicular cancer diagnosed?
A physical examination typically reveals a firm lump (mass) in one of the testicles.
Other tests include:
Abdominal and pelvic CT scan
Blood, urine or tissue tests to look for tumor markers (substances than can indicate
cancer), Chest X-ray, Ultrasound of the scrotum.

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Treatment
Treatment planwill depend on the type of testicular tumor and the stage of your
tumor. Your doctors will determine the type of cancer cell by examining it under a
microscope. The cells can be seminoma, nonseminoma or both.
Your individualized care plan may include one or more of the following treatments:
Surgery: Our expert surgeons will remove the testicle (orchiectomy) and nearby
lymph nodes (lymphadenectomy).
Radiation therapy: High-dose X-rays or other high-energy rays may be used after
your surgery to prevent the tumor from returning. Radiation therapy is usually only
used for treating seminomas.
Chemotherapy: This treatment uses drugs to kill cancer cells. This treatment has
greatly improved survival for patients with both seminomas and nonseminomas.
Causes/Risk Factors
The exact cause of testicular cancer is unknown.

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Papillary and Follicular Cancers
Symptoms
Patients with papillary and follicular cancers may have thyroid nodules (or lumps in
the neck) that are painless. Some nodules may have been present for months to
years. These nodules can be too small to see or feel; they may not cause any
symptoms. They can only be detected on ultrasound.
Other tumors may cause pain, discomfort in the neck and—rarely—shortness of
breath or trouble swallowing.
Medullary thyroid cancer may present in the same manner as the more common
papillary and follicular carcinomas. In some patients, this medullary thyroid cancer
may be found when patients have symptoms or signs of parathyroid cancer, such as
elevated calcium or calcitonin levels, or uncontrolled blood pressure, and/or heart
palpitations.
Anaplastic thyroid carcinoma appears as a rapidly growing lump in the neck that
often within days to a few weeks causes redness of the skin, shortness of breath,
trouble speaking, hoarseness or trouble swallowing.

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Diagnosis
We diagnose thyroid cancer using a combination of careful physical examination,
ultrasound and other scans. A biopsy, or taking a sample of the suspected tumor, is
also normally a part of determining a diagnosis.
Biopsy specimens are used to determine specific markers, called biomarkers. Biopsy
samples also may be used for molecular profiling.
We use blood tests, PET/CT scans, and other imaging scans to determine extent of
disease. All of this helps us learn more about the stage of your tumor. Other
characteristics—such as the locations, type of cancer and other features—help us
develop a treatment plan designed for you.

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Papillary and Follicular Cancers
Treatment
Surgery: Surgery is the best option for cure for many of our thyroid cancer
patients. We have expert surgeons who are focused on thyroid cancer and
endocrine cancer surgery.
Radiation therapy: Radioactive iodine therapy is a mainstay for many patients with
thyroid cancer. If this treatment is necessary, it will be delivered by our thyroid
cancer team, which includes endocrinologists and radiation oncologists.
Chemotherapy: We have a variety of options available for chemotherapy
depending on the type of thyroid cancer.
Advanced stage disease and recurrent disease: If your thyroid cancer is
determined to be at an advanced stage or it is recurrent, clinical trials may be an
option. Chemotherapy treatments and other treatments on well-designed clinical
trials and developing new treatments for this stage of the cancer is a priority, all
treatment options including clinical trials will be discussed and planned with
you. All treatment options will be discussed and planned with you.
Survivorship care: Our patients are provided with long-term surveillance & regular

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Causes/Risk Factors
Papillary carcinoma: Exposure to radiation is the only known environmental risk for
developing thyroid cancer. Iodine deficiency increases the risk of radiation-
associated cancers.
Medullary thyroid cancer: About 80 percent of medullary thyroid cancer occurs
sporadically without a genetic or familial basis. Other cases may be linked to one of
the following categories:
Multiple endocrine neoplasia, another word for tumors, are also called MEN
syndromes. These tumors are associated with a genetic mutation of the RET
oncogene:
MEN Type-2A is associated with parathyroid tumors or pheochromocytomas
MEN Type-2B is associated with peculiar nerve tumors called neuromas
Familial medullary thyroid carcinoma occurs in multiple members of a family who do
not have a history of parathyroid tumors or other tumors
Anaplastic thyroid carcinoma: There are no clearly identifiable risk factors for this
type of cancer.

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Wilms Tumor
Symptoms
The most common initial symptom is the identification of an abdominal (stomach)
mass by you, your child or your pediatrician.
Other common symptoms your child may experience include:
Abdominal or stomach pain
Constipation, Fever, High blood pressure, Increased growth on only one side of the
body, Loss of appetite, Nausea and vomiting, Change in color of urine or blood in the
urine.

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Diagnosis
How is Wilms tumor diagnosed?
If Wilms tumor is suspected, the doctor will usually refer your child to undergo
abdominal ultrasound or a CT scan.
Your child may also be referred to a surgeon or a pediatric oncologist for a complete
physical exam. Our team at CTRC includes both of these specialties.
In addition, the diagnosis will likely include:
Computed Tomography (CT or CAT) scans: These scans use X-rays to determine any
evidence of both local and distant (lung) tumor spread.
A MRI scan
Potentially intravenous pyelogram: This imaging test allows the pediatric oncology
team to look at parts of the urinary tract using a contrast dye.
Laboratory tests such as blood and urine tests to check the general health of a
patient.
A tumor biopsy

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Treatment
Treatment of Wilms Tumor
A biopsy will be required in almost all cases.
Once the diagnosis of Wilms tumor is determined, and the extent of cancer is
known, our team of experts will develop a treatment plan specific to your child.
Surgery is a common treatment strategy for Wilms tumor, especially if it involves
only one kidney Radiation may be used depending on the extent or stage of the
tumor. Survivorship care: Our patients are provided with long-term surveillance and
regular follow-up visits are planned to provide the best long-term survivorship care.
Causes/Risk Factors
The exact cause of Wilms tumor is unknown in most children.
Some children with Wilms tumor have associated birth defects, such as a missing iris
in the eye. These children may have kidney abnormalities, such as enlargement of
one kidney compared to the other kidney.
Wilms tumor is also associated with a variety of syndromes:
Beckwith-Wiedemann, Denys-Drash, WAGR, Perlman syndrome

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