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Posts with tag needle

Core needle biopsies: What does borderline pathology mean?

Borderline pathology of a core needle biopsy for breast cancer seems to mean that its in a grey zone between benign diagnosis and a cancer diagnoses.

In an issue of the British Journal of Cancer it states that one-third of breast core needle biopsy (CNB) specimens with borderline pathology prove to be malignant.

Dr. Nehmat Houssami and Dr. Stefano said in an interview with Reuters Health "We want physicians to keep in mind that a CNB diagnosis of a borderline lesion is not 'negative' for cancer, and on the contrary, it is flagged that further management/treatment step is needed."

The article also states that the information to the patient should be balanced. Yes, this could be breast cancer but to reassure a bit ( I don't know if this would actually make me less anxious) but approximately one in three will actually be malignant and the other two will prove to be benign.

Take home message: Read you pathology report, get help understanding your pathology reports and make sure if the results need to be investigated further that you push for it.

And oh yes, I have been in that wonderful position pictured -- wasn't all that bad. That time it came back benign!

Testing for prostate cancer

A reader posted a comment on one of my blogs and asked "What tests positively determines prostate cancer?" It prompted me to do a little research. 80 percent of men over 70 years old will get prostate cancer. That is a devastating statistic. A lot of times in the medical field diagnosing something requires a multitude of tests to rule out things and to get a better diagnosis. Such is the case for prostate cancer.

There are several tests used to diagnose prostate cancer. Blood tests, rectal exams, rectal ultrasounds, needle biopsy, and cystoscopy. A high level of PSA in the blood can be a sign of prostate cancer. PSA is a protein produced by cancerous prostate cells. With a rectal exam your doctor can feel for lumpy or a hard prostate. If a lump or hardening is found then most often they will do a needle biopsy to examine under a microscope. A cystoscopy is an examination of your bladder and uretha but can help determine several types of cancer and not just bladder cancer.

With all kinds of cancer, it is important to stay up to date with yearly exams for prevention. I hope this information helps.

Journalist Leroy Sievers may just crush cancer

As Leroy Sievers says, "Most of you know me as someone with cancer. Google my name -- and yes, I confess, I've done that -- more often than not, it comes up linked to one other word: cancer. But what about all the other things I've been?"

Sievers has been a journalist for most of his adult life. He's also been a baker, a short-order cook, a teacher, and an aspiring author. Yet cancer is the word most often used to describe this man.

But maybe not for long.

Could it be that Sievers -- a man whose life has been derailed by a deadly cancer traveling throughout his body, a man who has been contemplating death with each passing day -- may soon be rid of cancer altogether?

Actually, Sievers already sees glimpses of cancer falling to the wayside.

Having undergone a new procedure called Radio Frequency Ablation -- where needles are stuck into tumors, burning them away from the inside out -- Sievers sees a brighter future. He's seen his latest scans. He's seen the black holes where tumors once lived. He's seen that no new tumors have appeared. He's seen that he may actually survive cancer.

Months ago, this man, who blogs his cancer journey for NPR, was told he would likely not survive the year. Now he realized he may outlive this prediction. And while this is great news, Sievers finds himself a bit unsure about a life without cancer.

"Will I be somebody who used to have cancer?" he says. "I think most cancer patients don't ever think it's really gone. It's just hiding, waiting to jump out and scare us when we least expect it. Will I be able to resume my old life? To rebuild my battered body into what it was before? I don't know. But I know this disease has changed me dramatically in so many ways. I am a different person. Hopefully a better person. You cannot go through an ordeal like this and not be profoundly affected."

Now that's what a call a fresh perspective.

To read previously-written posts about Leroy Sievers, click here.

Radiation side effects must be remembered

Just before my radiation therapy began, my oncologist ran through a long list of potential side effects I might experience from the treatment. The only two significant short-term possibilities were fatigue and burned, blistered skin -- I went on to encounter them both -- but there were other more long-term effects my doctor told me might one day creep up on me.

She told me the range of motion in my arm might be compromised -- it was -- and that lymphedema or swelling could occur -- not yet -- and that I could feel numbness and tingling in my arm -- I do -- and that I should forever take precautions on the left side of my body. No needle sticks, no blood pressure cuffs, no excessive lifting -- all because of radiation and the missing lymph nodes that further complicate matters.

My doctor also told me that while radiation would target one intended area -- my left breast, just where my cancer was found -- other areas would suffer some degree of exposure. My heart, my lung, and my ribs all bordered the location of my tumor and despite measures to protect these areas, they would be zapped, at least minimally.

This all seemed a bit overwhelming 18 months ago when it came barreling at me. But something fortunate happened with the passage of time -- I began to forget about most of this. And while this a blessing really -- to not be burdened by the what ifs -- I realized yesterday when my three-year-old son kicked me with all the force he could muster right in my ribcage that I really must remember the side effects of radiation -- because they could serve to haunt me at any moment.

I remember clearly now my oncologist telling me that my ribcage could be damaged by radiation in such a way that an injury to the area could easily result in broken ribs. But I don't think about this regularly. And I wasn't thinking of it when I snuggled up to my 35-pound baby boy, knowing full well he could strike at any time. But not until he struck did I recall one of the downsides of radiation.

I feel happy and healthy and strong. Like cancer never landed in my lap and threw me for a loop. But somewhere in the back of my chemo brain -- an entirely different side effect story -- I must remember the dangers of the treatments that are keeping me alive. Because the last thing I want is another complication from cancer. I just want smooth sailing -- and smooth snuggling.

Eye cancer and risk of metastasis

Researchers have pioneered the first technique to biopsy tissue from the living eye in order to predict what tumors possess a high chance of spreading to other parts of the body.

If the eye cancer metastasizes the patient will usually not survive the disease. Ocular melanoma attacks the pigment cells in the retina. Earlier studies discovered that patients who are missing one copy of chromosome 3 in their tumor tissue are more likely to have highly aggressive cancers.

This new procedure could offer huge medical and psychological benefits to the patients. Dr. Tara Young, assistant professor of ophthalmology at UCLA's Jules Stein Eye Institute and a Jonsson Comprehensive Cancer Center researcher, said "Identifying patients at high risk for metastasis is an important first step toward reducing the death rate of this cancer, which kills nearly half of its patients."

The technique of fine needle aspiration for collecting cancer cells from the living eye has been the standard of care at the Jules Stein Eye Institute since 2004, but adopted by only a handful of other ophthalmic centers in the nation.

Ocular melanoma is the most common eye cancer to strike adults. Some 2,000 cases are newly diagnosed every year in the United States and Canada.

Patients want to know about their prognosis. The patients that have a low chance of metastasis can breathe a sigh of relief and the high risk group can plan arrangements for their family and finances. The high risk group might also want to have more aggressive treatment and join a clinical trial to find better treatments to treat metastatic eye cancer.

Survivor Spotlight: Gayle Shlafer sets sights on normalcy

Gayle Shlafer is a 34-year-old wife and mother who lives in Gainesville, Florida. She is a technical writer and editor -- although her secret (or, not-so-secret anymore) ambition is to write novels. She is not ready to embark on her novel just yet, though, because breast cancer has put a lot of family plans on hold. But she considers this whole cancer thing a temporary set-back. And she is patiently waiting for a bit of normalcy to return to her world.

Gayle is my neighbor. She is an inspiration. She is a survivor. And the words that follow are her own.

Continue reading Survivor Spotlight: Gayle Shlafer sets sights on normalcy

A little hand holding eases departure from cancer treatment

My port -- that thing that pops up from under the skin on my collarbone, that thing that by default stays in place because I can't decide whether or not to remove it -- is now officially in maintenance mode, now that my treatment for breast cancer is complete. My last Herceptin infusion was on June 28. And my first port flush was today. For as long as I keep my port -- and for as long as it has no real use -- I must have it flushed one time each month. So today, I strolled into the cancer infusion center where I've spent many hours and this time spent just a few minutes -- enough time for my usual chemo nurse to puncture the skin on top of my port, push through a rather large needle, and inject a dose of blood thinner into the lines of the port to keep clots away. The whole procedure was harmless, painless, no big deal at all. And I will return one month from today for a repeat performance.

One day these once-a-month visits may become a hassle. After all, I have to find a place for this appointment in my already-busy schedule and find childcare for my kids and find a place to park. I have to numb my port and endure a needle stick and sometimes fight traffic to get home. And the whole trip to and from the cancer center takes longer than the procedure itself. Clearly, this may be a waste of time for a port I don't even need right now. But at the moment, this visit is just what I need while I sort out the details of my post-treatment world. I need to go back to the infusion center. I need the comfort of the drive. I need to feel part of the chemo community. I need medical people swirling around me. I need a bit of hand holding. For now anyway.

Port saves veins, eases discomfort of chemotherapy

This is my port. It looks to me like a bottle cap sewn under the skin on my chest. My son Joey -- he is five years old --  calls it my stone and his brother Danny -- he just turned three -- at one time thought everyone must have this same boo-boo. He would look for it, feel for it, hunt for it. But mine is the only port he could actually locate and now that he's getting older, he is not so concerned with it anymore.

My concern about the port is that everyone who needs chemotherapy should have one. It's the alternative to receiving IV sticks in the arms and hands and except for one quick stick that can sting -- I use a 5% lidocaine numbing cream prior to my infusion and with this miracle lotion, I don't feel a thing -- it is quick and painless. My port is a one-stop shop. Once accessed, blood can be drawn, drugs and fluids can be infused, shots can be injected, and at the end of treatment, an injection of blood thinner keeps the line clear and clean. The line attached to the port underneath my skin travels into large veins in a direct and efficient manner. While hospitalized for chemo-induced fever and low blood counts, I received antibiotics and a blood transfusion through this method. There was one stick when I was admitted and for my five-day stay, I never had to be poked again.

My port, called Infuse-a-Port®, was implanted during a minor outpatient surgery with use of a local anesthesia and it was ready for use immediately after the procedure.

My port has been used for 16 months now and will no longer be necessary at the end of July -- this is when the last drops of Herceptin will sail through my veins. Then I get to decide whether to keep my port or have it removed. It can stay for many years as long as it is flushed once each month. The superstitious part of me thinks I should keep it for future use -- if necessary -- and the rational part of me thinks I need to get rid of this bottle cap because I may never need it again. Regardless, I love my port. It has eased the discomfort of chemotherapy and for that, I am grateful.

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