Anal cancer stage I was formerly treated with abdominoperineal resection. Current therapies in preserving the sphincter include wide local excision of the perianal skin or anal margin for small tumors, or definitive chemoradiation (fluorouracil, and mitomycin) for cancers of the anal canal. Salvage chemoradiation therapy (fluorouracil and cisplatin plus a radiation boost) may avoid permanent colostomy in patients with residual tumor after undergoing initial nonoperative therapy. Radical resection is reserved for patients with incomplete responses or recurrent disease. It is therefore important continuous surveillance with rectal examination every three months during the first two years and endoscopy / biopsy when indicated after completion of sphincter-preserving therapy.

Standard treatment options:

1. Small tumors of the perianal skin or anal margin not involving the anal sphincter may be adequately treated with local resection.

2. As evidenced in RTOG-9208 and RTOG-8314, all other types of cancer of the anal canal which stage I involving the anal sphincter or are too large for complete local excision receive external beam radiotherapy (EBRT) with or without chemotherapy.

Chemotherapy with fluorouracil and mitomycin combined with primary radiation therapy appears more effective than radiotherapy alone. The optimal dose of radiation with concurrent chemotherapy is under clinical evaluation (RTOG 9811).

Selected tumors are also suitable for interstitial radiation therapy.

3. The Radical resection is reserved for residual cancer or recurrent anal canal after nonoperative therapy.

4. Alternately, salvage chemotherapy with fluorouracil and cisplatin combined with a radiation boost may avoid permanent colostomy in selected patients with small amounts of residual tumor following initial nonoperative therapy.

5. Iridium-192 interstitial after EBRT may convert some patients with residual disease in patients who respond to treatment in a comprehensive manner.

Clinical Trials

Consult the Register of Clinical Trials NCI’s PDQ Cancer (NCI’s PDQ Cancer Clinical Trials Registry) to enter clinical trials performed in the United States and are accepting patients. To search, use the English word stage I anal cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

Standard treatment options:

1. Small tumors of the perianal skin or anal margin not
involving the anal sphincter may be adequately treated with local resection.

2. All other types of anal canal cancer in stage II complicating
the anal sphincter or are too large for complete local excision external radiation therapy plus chemotherapy.

Chemotherapy with fluorouracil and mitomycin combined with primary radiation therapy appears more effective than radiotherapy alone. The optimal dose of radiation with concurrent chemotherapy is under evaluation.

Selected tumors are also candidates to receive interstitial irradiation.

3. The Radical resection is reserved for the canal cancer
residual or recurrent anal after nonoperative therapy.

4. Alternately, salvage chemotherapy with fluorouracil and
cisplatin combined with a radiation boost may avoid a permanent colostomy in selected patients with small amounts of residual tumor.

CANCER OF THE YEAR – STAGE IIIA
In most cases of anal cancer in stage IIIA presents clinically as stage II and IIIA is determined that the presence of perirectal nodal disease or adjacent organ complication of clinically apparent. Endorectal or endoanal ultrasound may aid in the classification of the stage prior to treatment.

Standard treatment options:

1. Disease treatment as for stage I and II, using radiation therapy plus
chemotherapy.

2. Abdominoperitoneal resection combined with resection of lymph
femoral nodes, inguinal, groin, and iliac, followed by postoperative radiotherapy.

CANCER OF THE YEAR – PHASE IIIB
The presence of inguinal nodes that are complicated with metastatic disease (unilateral or bilateral) is a poor prognostic sign, although it is possible to achieve the cure of the disease at this time. Because of the poor prognosis associated with this stage, patients should be included in clinical trials whenever possible.

Standard treatment options:

Radiotherapy plus chemotherapy (as described for phase II) with surgical resection of residual disease at the primary site (local or abdominoperineal resection) and unilateral or bilateral dissection, both superficial and deep inguinal nodes to the residual or recurrent tumors.

CANCER OF THE YEAR – PHASE IV
Patients who are at this stage should be considered candidates for clinical trials. There is no standard chemotherapy for patients with metastatic disease. Palliation of symptoms caused by the primary lesion is of vital importance.

Standard treatment options:

1. Palliative surgery.

2. Palliative irradiation.

3. Combined chemotherapy and palliative radiotherapy.

4. Clinical trials.

CANCER OF THE YEAR – RECURRENT
Local recurrences after treatment with radiotherapy and chemotherapy or surgery as primary treatment can be controlled through the use of alternative treatment (surgical resection after radiation and vice versa) is being explored in clinical trials using radiotherapy chemotherapy and / or radiosensitizers to improve local control.

Anal cancer is an uncommon malignancy that represents only a small percentage (4%) of all cancers of the lower digestive tract. Some clinical trials have evaluated the role of chemotherapy, radiotherapy and surgery in the treatment of this disease. If you need information about ongoing clinical trials of the NCI.

In general, the risk of anal cancer is increasing, and there is evidence that individuals with human papillomavirus and gay men in particular are at increased risk of autism.

CELLULAR CLASSIFICATION
Squamous cell carcinomas (epidermoid) constitute the vast majority of all primary cancers of the anus, forming the rest are an important subgroup of tumors cloacógenos (basaloid transitional cell). These two histologic variants are associated with human papillomavirus infection. [1] Adenocarcinomas from anal glands or fistulae formation and melanomas are rare. This summary does not include information on the treatment of anal melanoma.

The ovarian cysts are benign tumors that usually disappear spontaneously. In the event that persist or grow, the doctor can remove them. There are three basic types of malignancies, which are formed on the surface of epithelial ovarian carcinoma are known and are the most common. Also, but much less common, can occur in cancer cells that produce eggs and tissues surrounding the ovary. The most common metastatic ovarian cancer occur in the peritoneum, which is the sac lining the intestines. In these cases there is ascites (accumulation of fluid in the abdomen), while if they reach the blood or lymphatic system, cancer cells can travel throughout the body, which increases the possibility of metastasis to other body parts. The neck of the uterus, also called cervix connects the vagina with the uterine cavity that is lined by the endometrium. Cervical cancer is also known as squamous cell carcinoma because the cells lining their surfaces are flat and thin, as if they were scales. Scientists believe that not all abnormal cells that appear in the cervix are carcinogenic, but recommended to conduct regular checkups, because it can be the first step toward cancer. Sometimes it is intraepithelial lesions formed by abnormal tissue that appears only on the surface of the cervix. It usually occurs primarily in women aged 25 to 35 years and sometimes disappear spontaneously. Severe cases develop in women 30 to 40 years and can take months or even years to cause cancer. If you go beyond the surface and grow deep into the cervix and are called invasive lesions usually appear after age 40. The uterus is the cavity in which a fetus develops. It consists of two layers of different tissues: the inner, very thin, which is called the endometrium and another external call composed of muscle and myometrium. Most tumors of the uterus occur after menopause. You can give three main cases of benign disorders, if not disappear naturally, can be solved with surgery. Fibroids are groups of cells that grow in the muscle of the uterus and never result in cancer. Another type of pathology is such endometriosis. Occurs mainly in women aged 30 to 40 who have never been pregnant and is in the growth of endometrial tissue outside the uterus or near other organs. Finally, the hyperplasia is an increase in the number of cells on the surface of the uterus that is usually treated with hormones or surgery. The most common metastatic cervical cancer occur in lymph nodes and other organs like lungs, liver and bones

When this multiplication of cells occurs in an uncontrolled manner, forming lumps. These masses are called tumors.
There may be benign and malignant tumors. Benign tumors are those that do not spread to other areas and do not compromise a person’s life.

Malignant tumors often spread to other parts of the body and cause damage to body tissues and organs and can even cause death of the person.

Malignant cells can move through the lymph or blood and reach anywhere in the body causing a second tumor, called metastatic, because it is the first originated.

Lung cancer is an abnormal growth of lung cells. The disease usually occurs on the inner walls of the bronchi, and growing up can obstruct the airway and impair breathing. For this reason, generally produces shortness of breath, breathlessness and fatigue.

There are two main types of lung cancer: small cell cancer and non-small cell cancer. There is another type that has characteristics of both, and which is called mixed large cell carcinoma and small.

This report was prepared with the collaboration of Dr. Carlos Garcia Giron (Hospital General Yagüe de Burgos), the Spanish Group for Lung Cancer

Ducts are called exocrine pancreatic juice to the common bile duct and, eventually, the small intestine. Only a small percentage of cells in the pancreas are endocrine glands, arranged in small groups or clusters called islets of Langerhans. The islet cells release three hormones (insulin, glucagon and somatostatin) which allow the body to metabolize (break down and digest) the food. Also regulate the body makes use of glucose, which is the energy source for many of the daily activities of all cells.

When the pancreas is functioning normally, the blood glucose concentration varies in response to a wide variety of events, stress or infections, but remains in its normal limits.

Causes

* Genetic Factor: The changes or mutations that occur in the DNA of people indicate that they might be responsible for pancreatic cells from becoming cancerous. It is therefore possible that changes in the DNA inherited from one generation to increase the risk not only to develop this cancer, but also others, and which involve the activation of oncogenes (cancer) or inactivation of tumor suppressor genes .

* Age: The risk of colon cancer increases after age 50. Most patients are between 60 and 80 years at the time of diagnosis.
* Sex: The probability of this disease is 30 percent higher in men than in women.
* Race: Black people are more likely to develop pancreatic cancer than whites or Asian.
* Snuff
* Food: A diet rich in meat and fat increases risk, while fruits, vegetables and foods containing fiber seem to have a protective effect.
* Pancreatic cancer is more common in people with diabetes.
* Pancreatitis crónicao persistent inflammation of the pancreas, is also associated with increased risk of developing cancer in this body, given the evidence that some families have a tendency to suffer from chronic pancreatitis, which is thought to be due to an inherited genetic mutation . Thus, this risk factor linked to the first, exposing the possibility that the offender is the gene that is responsible for making certain digestive enzyme.
* Intense exposure to certain chemicals (pesticides, dyes and chemicals related to gasoline) are considered risk factors working against the possibility of developing this cancer.

Symptoms

Over 90% of patients generally have the following symptoms:

* Pain in the upper or middle abdomen
* Jaundice (yellow skin)
* Weight loss
* Nausea.

Other symptoms may also occur, as the case are:

* Acute pancreatitis (inflammation of the pancreas)
* Diabetes mellitus
* Weakness
* Diarrhea
* Spasms

Prevention

The best way to prevent pancreatic cancer is to avoid some risk factors like smoking, a diet rich in meat and fat and exposure to certain chemicals (pesticides, dyes and petroleum products). People newly diagnosed with pancreatic cancer tend to respond by showing a state of shock and stress. These reactions may hinder the relationship between doctor and patient. For this reason, it is important to use the affected systems (annotations written or recorded) to remember the doctor’s instructions and, if it deems necessary, all the questions you want to make. The different ways of tackling the disease may include:

* Having the support of aid groups. It is also advisable that the patient contact with any of the associations devoted to advising and helping those affected by these diseases.
* Eat a balanced diet can help patients feel better, have energy to deal with treatment and coping as best as possible.
* Being immersed in a social environment (friends and family) offer understanding and moral support.

Diagnostics

If there are symptoms, the doctor makes a reconnaissance and orders tests to see whether cancer and determine what should be the treatment. The main diagnostic tests are:

* Ultrasound or ultrasound (sound waves are used to detect tumors).
* Computerized tomography (CT): a special type of x-ray with that obtained by computer, an image inside the abdomen.
* Magnetic Resonance Imaging (MRI), which uses magnetic waves to create an image inside the abdomen, and see if the cancer is partially blocking the blood supply to an organ not affected.
* Endoscopic retrograde cholangiopancreatography. It involves inserting a tube down his throat flexible passing through the stomach and reaches the small intestine. The doctor can look through the tube and inject a dye so that the area can be seen more clearly on a radiograph.
* Biopsy: Inserting a thin needle into the pancreas to remove some cells. The cells can then be seen under the microscope.
* The PTCA: a thin needle is inserted into the liver through the right side and injected dye into the ducts of the liver so they can see the locks on the radiograph.
* Surgery. The doctor makes a cut in the abdomen and observe the pancreas and surrounding tissues for the presence of cancer. If a cancer does not appear to have spread to other tissues, the doctor may remove the tumor.

Treatments

It used four kinds of treatment:

* 1. Surgery. You can use surgery to remove the tumor. The doctor may remove the cancer using any of the following:

Whipple’s operation, during which removes the head of the pancreas, part of the small intestine and some surrounding tissue. It leaves a sufficient portion of the pancreas to the body continues to produce digestive juices and insulin.

Total pancreatectomy, which is extracted through the entire pancreas, part of the small intestine, part of the stomach, bile duct, gallbladder, spleen and lymph nodes most of the region.

Distal pancreatectomy, which removes the body and tail of the pancreas. If the cancer has spread and can not be removed, the doctor may operate to relieve symptoms.

Biliary diversion: If cancer is blocking the small intestine and bile builds up in the gallbladder, the doctor may divert the whole small intestine or part of it. During this operation, cut the gallbladder or bile duct and joins the small intestine.

Tambiénpueden radiograph performed procedures to install a catheter to drain bile that has accumulated in the area. Through this procedure, the doctor may drain the catheter through an outer tube or catheter may go around the blocked area and drain the bile into the small intestine. Also, if the cancer is blocking the flow of food from the stomach, the stomach can bind directly to the small intestine so the patient can continue to eat normally.

* 2. Radioterapia.Consiste to use high-energy radiation to kill cancer cells and shrink tumors. Radiation may come from a machine (external radiation) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where cancer cells are found (internal radiation therapy).
* 3. Quimioterapia. Chemotherapy uses drugs to kill cancer cells. Can be taken orally or administered through a needle into a vein or muscle. Chemotherapy is a systemic treatment because the drug enters the bloodstream, travels through the body and can kill cancer cells also located outside the pancreas.
* 4. Therapy biológical, type of therapy is to establish the differences between cancerous cells and normal pancreatic tissue, and then try to get the body to fight cancer. It uses materials made by the body or made in a laboratory to boost, direct or restore the body’s natural defenses against disease. Some biological therapies therapies are also known as biologic response modifiers or immunotherapy.
The treatment for pancreatic cancer depends on both the stage of disease is found as the age and general health of the patient. The patient can follow the standard treatment in patients in past studies was effective, or choose to participate in a clinical trial of ongoing studies that are designed to find better ways to treat cancer patients and are based on the latest information.

Other information

Side effects. The side effects of cancer treatment depend on the type and extent thereof, the treatment has been followed and the patient’s health status.

* The side effects of surgery depend on the extent of the operation:
- Pain during the first days, which can be controlled with medication.
- Weakness or fatigue.
- Digestive problems, which are relieved by following a proper diet.
* The side effects of radiotherapy depend on the dose and intensity. Some common ones include:
- Weakness and fatigue.
- Hair loss.
- Itching.
- Digestive problems (diarrhea, vomiting …).
* The side effects of chemotherapy depend on the specific drugs being taken:
- Digestive problems (vomiting, diarrhea …)
- Bleeding
- Loss of appetite
- Weakness
- Rashes
* Side effects caused by biological therapy vary with the type of treatment received:
- Fever
- Nausea and vomiting
- Diarrhea
- Weakness
- Loss of appetite
- Rashes
- Purple and swelling

The lymphatic system is a system consisting of vessels and to carry lymph nodes.

Lymph is a colorless fluid containing white blood cells.

The three main types of white blood cells are monocytes, granulocytes and lymphocytes.

These cells are responsible for defending the body. The principal cells called lymphocytes. They recognize any substance foreign to the body and release substances that destroy the offending agent.

There are two types of lymphocytes, B and T. B-cell lymphomas are more common than T-cell lymphomas These two types are responsible for 85% to 15%, respectively, of all non-Hodgkin lymphomas. There are several types of T cells and B, as their development and morphology.
There are many types of lymphomas, more than twenty. Lymphomas are usually differentiate and resemble a type of lymphocyte.

Non-Hodgkin lymphomas are potentially curable tumors. Because there are many ways to identify what is important is the lymphoma presenting the person to be classified within a particular group and set the specific treatment of that disease.

Lymph nodes are located in different parts of the body, shaped like a bunch of grapes, contain lymph and are the point of arrival and departure of lymphatic vessels that run throughout the body.

Some nodes are found in shallower areas than others, such as the neck or underarm. Most surface can be felt, even seen, when inflamed. They can become inflamed when an infection occurs, but also when there is a lymphoma.

The spleen, blood vascular gland, located on the left side of the abdomen below the ribs, produces lymphocytes and other cells of the lymphatic system. It also stores healthy blood cells and filters out damaged cells, bacteria and waste products from cells.

The thymus is a gland at the base of the neck and also produces immune cells.

The tonsils and adenoids are clusters of lymphoid tissue located in the back of the throat. They produce antibodies against germs inhaled or swallowed.

The marrow inside the bones, is responsible for producing red blood cells, white cells and platelets.

The first sign is usually a lump, to touch, different note of the breast tissue around it. It is often noted with irregular, hard, painless to the touch. Sometimes color changes occur and tension in the skin of the affected area.

Not all malignant tumors have these characteristics as some have regular borders and are soft to the touch. For this reason, when any abnormality is detected you should consult your doctor.

In the early stages, the lump under the skin can move his fingers. In later stages, the tumor is usually attached to the chest wall or overlying skin and does not scroll. The nodule is often clearly palpable and even armpit nodes may enlarge. The symptoms of these steps are varied and depend on the size and extent of the tumor.

Other signs that may occur are:

- Pain or nipple retraction.
- Irritation of the skin or fissures.
- Inflammation of a portion of the breast.
- Redness or scaling of the skin or nipple.
- Discharge from the nipple than breast milk.

Benign tumors are related mostly to genetic factors. Symptoms that occur are pain and inflammation but not spread to the rest of the body and are not dangerous. In malignant tumors, there are several types depending on the location of the breast where there is abnormal growth of cells and depending on their stage.

Tumors may be localized or have spread through the blood vessels or through lymph vessels, and have led to metastasize, a cancer in an organ distant to the original. Of all cases of breast cancer, only 7-10% of them start metastases.

The breast cancers are classified as:

• Ductal carcinoma in situ in the cells of the walls of the ducts. It is a very localized cancer that has not spread to other areas or has metastasized. That is why this disease ‘premalignant’ can be removed easily. The cure rate close to 100%. This type of tumor can be detected through mammography.

Infiltrating ductal carcinoma (or invasive) is the one that begins in the milk duct but manages to pass through and adipose tissue of the breast and then can spread to other parts of the body. It is the most common breast cancers, occurs in 80% of cases.

• Lobular carcinoma in situ arises from the mammary glands (or lobes) and, although not a true cancer increases the risk that women can develop a cátumor in the future. Usually occurs before menopause. Once detected, it is important that women have a mammogram every year and control several clinical examinations to monitor the possible development of cancer.

Infiltrating lobular carcinoma (or invasive) begins in the mammary glands but it can spread and destroy other tissues. Between 10% and 15% of breast tumors are of this type. This carcinoma is more difficult to detect through mammography.

• Inflammatory carcinoma is a rare cancer, accounting for only 1% of all breast cancers. It is aggressive and fast growing. Ago breast skin reddening and increasing its temperature. The appearance of the skin becomes thick and hollow, like an orange, and can appear wrinkles and bumps. These symptoms are due to the blockade produced by cancer cells on the lymph vessels.