Anus is a 3 cm muscular ring connected to the end of the rectum with the function of controlling the expulsion of feces.
Anal cancer
is a type of cancer arisen from the malignant cells of the anus. It is a
rare type of cancer in adulthood affected approximately 5000 men and
women in US in 2010.
Symptoms
1. Bleeding
It
may be caused by enlarged tumors affecting the capillaries in the anus
or the large intestine trying to push waste through the blockage of the
tumor.
2. Pain and pressure
As the feces trying to push through the blockage of the tumor or tumor has growth large enough to press onto the nerves.
3. Itching
May be due to infection
4. Lump
As the cancer has growth large enough to form a lump on the surface of the anus. This may be the early stage of the cancer.
5. Change of bowel habit
Due to affect of the tumor.
6. Weight loss
Any unintentional weight loss over 10% is the general symptoms of cancers.
7. Loss of appetite
Another symptom of cancer.
8. Lower back pain
The affect of tumor pressing to the nerve connect to the back.
9. Etc.
Causes and risk factors
1. Human papillomavirus (HPV virus)
In
a study of Detection of Multiple Human Papillomavirus Genotypes in Anal
Carcinoma by Sonia Ramamoorthy, Yu-Tsueng Liu, Linda Luo, Katsumi
Miyai, Qing Lu and
John M Carethers, researchers found that the majority of anal cancers
in our study associated with pathogenic HPV 16 and/or 18. Other HPV
genotypes are present simultaneously with HPV 16 and 18, and might
contribute to its pathogenesis.
2. Sexual activity
Anal sexual intercourse and sex with multiple partner can enhance the risk of HPV virus, leading to the disease.
3. Smoking
a.
In a study by Epidemiologist Janet Daling, Ph.D., a member of Fred
Hutchinson's Public Health Sciences Division, and her team, researchers
found that smoking appears to play a significant role in anal-cancer
development that's independent of other behavioral risk factors.
b.
In a study of tobacco smoking and risk of recurrence for squamous cell
cancer of the anus. researcher found that tobacco smoking appears to be
associated with anal carcinoma disease recurrence, and is related to
increased mortality. This data suggests that patients should be
cautioned about tobacco smoking once a diagnosis of anal carcinoma is
made in attempt to improve their long-term outcome.
4. Immunosuppression
The weaken immune system due to suppression of medicine insreaces riak of anal cancer as a result of HIV infection.
5. Inflammation
Inflammation
caused by begnin anal lesions, such as inflammatory bowel disease
(IBD), hemorrhoids, fistulae, hemorrhoids, anal fistulas, cicatrices,
etc. enhance the risk of the cancer
6. Age
Risk of the cancer increase after age of 50
7. Etc.
Diagnosis and tests
After
recording your family history and a complete physical exams for any
lump including anal pap smears similar to those used in cervical cancer
to detect the early stage of the anal cancer.
1. Anal pap smears
It
is a easy done test similar to cervical pap test by using a small brush
or cotton-tipped rod which is inserted into the anus to collect the the
cells and examined under microscope.
2. Endo-anal or endorectal ultrasound
It
is a test with the use of a probe which is inserted into the rectum to
generate high frequency sound waves (ultrasound waves) bouncing off
internal tissues or organs. The pattern of echoes bounced off tissues is
detected and converted into a picture on a screen of the computer to
determine the location, size and stage of the cancer.
3. CT scan
A
CT scan generates a large series of two-dimensional X-ray images taken
around a single axis of rotation, to create a three-dimensional picture
of the inside of the body in details. The pictures are viewed by your
doctor to see the extent of the tumors abnormalities, such as spreading
of cancer to the nearby structure and lymph nodes. Unfortunately, CT
scan can only review the existence of cancer, but can not tell it is a
primary or secondary cancer.
4. MRI (magnetic resonance imaging)
MRI
(magnetic resonance imaging) is one of many advanced technology used to
visualize internal structures cross sectional imaging of your body used
effectively in providing the better details of the metastasis of cancer
in the tissue, the organ and surrounding areas.
5. Etc.
Grades
The
grade of anal cancer is depending to the tendency of spreading. Low
grade cancers usually grow more slowly and are less likely to spread
while high grade cancer indicates otherwise.
Stages
Anal cancer is classified as 5 stages
1. Stage 0
If the cancerous cells have not penetrated into deeper tissue and remain on the surface of the anus.
2. Stage I
In
stage I, the cancerous cells are no longer in the surface but have
invaded into deep the inside tissue lining but still completely inside
the affected anus.
a. Stage IA
The cancer is not ≤ 3 mm (1/8 inch) deep and ≤ 7 mm (1/4 inch) wide.
a.1. Stage IA1:The spreading is not less than 3mm(1/8 inch) deep and & less than 7mm (1/4 inch) wide.
a.2. Stage IA2:The invasion area is ≥ 3 mm but ≤ 5 mm (about 1/5 inch) deep and & less than 7 mm (about 1/4 inch) wide.
b.Stage IB:
The cancer in this stage have invaded the connected tissue of the anus, & less than 5mm (1/5 inch).
b.1. Stage IB1:
Cancer is 4 cm large (1 3/4 inches).
b.2. Stage IB2:Cancer is ≥ 4 cm (1 3/4 inches) but & less than 5cm (1/5 inch)
3. Stage II
In stage II, the cancerous cells have spread to distant tissues, but is still within the affected anus.
4. Stage IIIIn this stage, cancerous cells has spread to the tissues immediately surrounding the affected anus.
5. Stage IV
In this stage, cancerous cells has spread to the tissue immediately outside of the anus to distant parts of the body.
Preventions
A. How to avoid
1. Early diagnosis
If
you feel that you have any of above symptoms, you should check with
your doctor. In general, cancer disceovered in the early stage can ce
treated without risk of colostomy.
2. Practice safe sex
If you have several partners or anal sexual preference, please use any precaution to be infected by sexual transmtting diseases.
3. Vaccine
At
22 December 2010, FDA has approved Gardasil vaccine to prevent anal
cancer and pre-cancerous lesions in males and females aged 9 to 26 years
to protect against anal cancer.
4. Quit Smoking
As it has been proven as one the risk factor of anal cancer.
5. Etc.
B. Diet
1. Omega 3 fatty acids
In
a study of The Effects of Omega-3 Fatty Acids on Cancer, researcher
found that that omega-3 fatty acids may affect tumor behavior by
competing with omega-6 fatty acids for the enzymes that metabolize them
to their bioactive products or by influencing the genes for these
enzymes; however, other evidence suggests an effect on intracellular
redox state and the integrity of membrane lipids.
2. Carrot
In
a study from the University of Newcastle upon Tyne (UK) and the
University of Southern Denmark (Odense) used a rat model to study the
effect of carrots and falcarinol on tumor development, researchers found
that found a diet rich in carrots provides anticancer benefits due to
the activity of the chemical falcarinol.
3. Soy
In laboratory
studies, saponins have shown the ability to inhibit the reproduction of
cancer cells and slow the growth of tumors in several different tissues.
4. Grape
Grape
contains high amount of resveratrol which in some clinical studies of
resveratrol, researchers found that resveratrol demonstrated an ability
to reduce tumors already in existence, prevent cellular damage, and work
to increase the effectiveness of chemotherapy.
5. Garlic
An
analysis of several case-controlled studies in Europe suggests an
inverse association between garlic consumption and risk of common
cancers.
6. Etc.
C. Nutritional Supplements
1. Antioxiadant - Free radical scavengers
Vitamin
A, C, E are free radical scavengers enhanced the immune system against
the forming of free radicals and prevent the alternation of cell DNA
cause of abnormal cell growth. For more information of how antioxidants
help to treat cancer, click here
2. Transferrin
In a study of
Transferrin Binding Protein Nanoparticles to Treat Cancer, researcher
found that the use of this technique (laboratory invented a “print”
technology, able to exact size and shape of human Zaochu meet the
expectations of the nano-particles.) to produce a kind of preclusion can
be combined with human transfer the biocompatibility of ferritin
nanoparticles, which can safely and accurately identify the spectrum of
cancer, in addition to B cell lymphoma,....
3. Phytochemicals
Phytochemicals
are under active research for possible benefits immune system, and as
anti-cancer agents. Flavonoids found abundant in berry, inhibit caner
cell in vitro study.
4. Beta -carotene
In some laboratory,
animal, and human studies, researchers found that vitamin A, certain
retinoids may also inhibit cancer development.
5. Zinc
In Zinc
and Cancer - Seminar by Belinda Hope indicated that epidemiologic
studies suggest zinc deficiency may be associated with increased cancer
risk and one way to do this is to improve general immunity using
nutrients such as zinc.
6. Etc.
Treatments
A. In conventional medicine
1. Surgery
a.
Depending to the location and size of the tumor, if the cancer is
small, the chance of cure is higher, as it can be removed with out
affect the anusfunctions.
b. In case of infeasibility,
abdominoperineal resection may be necessary with the removal of the
anus, rectum, and part of the sigmoid colon as an opening is made in the
surface of the abdomen to collect body feces in a disposable bag
outside of the body (colostomy)
c. Risks and side effects
Surgical and anesthesia risks
3. Radiotherapy
a.
By using high-energy x-rays or other types of radiation, radiation
therapy kills lung cancer cells and keep them from growing or regrowing.
Depending to stage, grade and location of the affected area. Radiation
may be used in situations when surgery isn't an option.
b. Risks and side effects
b.1.. Fatigue
b.2. Chest pain
b.3. Heart problem
b.4. Short of breath
b.5. Skin discoloration or pinkness, irritation.
b.6. Etc.
4. Chemotherapy
a.
Chemotherapy is most use to treat with advance stage of the cancer, as
it has spread to a distant parts of the body by using drugs such as
adriamycin, cis-platinum, cyclophosphamide, etc. taken by mouth or
injected into a vein or muscle of the patient to stop the growth of or
to kill cancer cells.
b. Risks and side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigueb.
5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.
B. Herbal medicine
1.
Allium tuberosumIn a study of A Pilot Study on Anticancer Activities of
Chinese Leek researchers found that Chinese leek extract inhibited
cancer cell growth and induced apoptosis in vitro. Oral administration
of leek extract significantly reduced lung metastases in the present
animal model.
2. Red clover
3. Allium sativum
An analysis
of several case-controlled studies in Europe suggests an inverse
association between garlic consumption and risk of common cancers.
4. Green tea
Leaves
of Camellia sinensis, in some clinical studies researchers suggested
that the polyphenols in green tea, may play an important role in the
prevention of cancer by killing cancerous cells and stopping their
progression.
5. Etc.
C. Traditional Chinese medicine
1. Dong ling Cao (Rabdosime Rubescentis)
In
laboratory animals study, reported by Joe Hing Kwok Chu, Dong ling
Cao's components rubescensine A and B inhibit Ehrlich-Ascites tumor,
sarcoma180 and esophageal carcinoma.
2. Yi Yi Ren and other herbs
In
clinical study with(100ml was equal to 50g crude drug), oral
administration, 20~40ml, 3 times daily, Yi Yi Ren combined with Teng
Liu, He Zi An Ling Tiao was used to treat alimentary tract cancers. 168
cases of patients were treated, 1 dose every day, taken in three
times.After treatment, the appetite and general condition were improved.
And this formula had certain therapeutic effects on 30 cases out of 36
cases who took over three months’ treatment.
3. Bai Hua She She Cao
The
Sanjiv Kumar YADAV, Shao Chin LEE(Yong Loo Lin School of Medicine,
National University of Singapore researcher results showed that the
ethanol extract from Bai Hua She She Cao effectively evokes cancer cell
apoptosis, possibly through burst-mediated caspase activation.
4. Jiu Zi (Chinese leek)
In
a study of A Pilot Study on Anticancer Activities of Chinese Leek
researchers found that Chinese leek extract inhibited cancer cell growth
and induced apoptosis in vitro.
5. Etc.
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