Testicular Cancer Risk Factors
Symptoms of Bladder Cancer
Cervarix Facts - HPV Vaccine
NCI Cancer Bulletin for June 30, 2009
Read the NCI Cancer BulletinThe latest issue of the NCI Cancer Bulletin is now available at http://www.cancer.gov/ncicancerbulletin. Keep up to date on the latest research and advances in the prevention, treatment, and understanding of cancer.
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High PSA Levels
What You Don't Know About HPV
What is HPV ?
Lung Cancer 101
Your First Pap Smear
What To Ask the Doctor
Penile Cancer Symptoms
Risk Factors for Cervical Canc
Cervical Cancer Screening
Carcinogens and Cancer
Genetic Cancer
FAQ - What is a PSA test?
Fitness for Prevention
How to Do Testicular Self Exam
Colposcopy
6 Common Pap Smear Mistakes
Head and Neck Cancer Overview
Prostate Cancer Symptoms
Clear Liquid Diet
Penile Cancer Risk Factors
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Nanomedicine--Revolutionizing the Fight against Cancer
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Breast Cancer Survivor Fights Back Through Volunteerism
For Sue Sgambato, volunteering is not just a way to give back -- it's a way to take back what she's lost to cancer.
Sgambato, 51, raised in New York and currently living in Mapleville, Rhode Island, has lost several members of her family to cancer, including her mother and a grandmother to breast cancer. Through her work as a volunteer with the American Cancer Society, she's been able to channel that grief to make a positive difference in people's lives.
Her mother died exactly 2 years before Sgambato, then 36, found a lump in her breast that turned out to be an aggressive form of breast cancer. Because of her family history, Sgambato opted to have the breast removed. When her doctor noticed thickening in her other breast, she decided to have it removed as well. During this period, she also had a total hysterectomy, after tests showed abnormalities in her left ovary.
"I just didn't want to risk it," she says, "And I have never regretted the surgery for even one day."
After the surgery and rounds of chemo, which Sgambato describes as "a blur -- somehow I put one foot in front of the other," she says she needed a way to channel all of her feelings of anger towards cancer, especially her feelings of grief and loss over her mother's 13 year battle with breast cancer. So she started volunteering with the American Cancer Society.
"I wanted to be with other women who were going through treatment and facing similar struggles," she recalls. "And I wanted to honor my mother's memory. The American Cancer Society offered me a way to do that."
Finding her voice
Sgambato was interested in volunteering with the American Cancer Society's Reach to Recovery program – a perfect fit. The program matches specially-trained breast cancer survivors with newly diagnosed breast cancer patients to provide emotional support and guidance.
"When you're diagnosed with cancer, you feel like your whole body has turned against you. Through Reach to Recovery, I felt like I was really helping someone through that trauma," she says.
During this time, a friend of hers, a reporter with Channel 10 in Providence, Rhode Island, asked her if she was interested in being profiled for a segment about breast cancer, and she agreed. Weeks later, someone from the Society called and asked her to speak at a Making Strides Against Breast Cancer event. Making Strides Against Breast Cancer is a non-competitive walk to raise funds and support to help fight breast cancer and provide hope to people facing the disease.
"You know it's strange to say, but it's almost as if when I lost my mom, I found my voice. Because I was speaking from the heart, I found I had no fear talking about very personal issues," Sgambato recalls.
In 2002, she went to Celebration on the Hill in Washington, DC. Thousands of people descended on the National Mall at the foot of the Capitol Building in a day-long event to remember loved ones lost and celebrate those who fight on. The event was also a call to action to the nation's elected officials to make cancer a priority.
"It was sort of a fluke that I went – another volunteer couldn't go, so I went in her place. I've never thought of myself as political, but as I stood there among 10,000 luminaria in front of the Capitol Building, I realized that as long as I have a voice, I'm going to speak for those who lost their lives to this disease."
And indeed she has. Sgambato has pushed the House Finance committee for higher cigarette taxes and was at the forefront of Rhode Island's successful campaign to defeat S.1955, legislation that would have eliminated insurance coverage for mammograms and other cancer tests.
Says a former staffer, "I'm not sure Sue knows how to say the word 'no' when it comes to an advocacy effort. She has made phone calls, written letters, and made personal visits to her elected officials on the state and federal level on numerous occasions."
Finding a purpose
In addition to her advocacy work, Sgambato is a longtime Relay For Life participant, often attending several events per year. In 2004, she and her husband actually decided to renew their vows on their wedding anniversary at a Relay event in Burrillville, RI.
"I had a cake and a veil – the whole bit. It felt like the right thing to do since for half our married life my husband had shared me with ACS," she joked.
What keeps Sgambato motivated?
"There are days when I feel overwhelmed. What keeps me going is that I'm part of huge group of volunteers at the American Cancer Society. I draw strength from knowing that I am not fighting this battle alone."
Sgambato feels strongly that being a volunteer fulfills her life's purpose. And in 2008, she was recognized for her dedication with an American Cancer Society St. George Award for distinguished service.
"Every time I volunteer with the American Cancer Society -- whether I'm holding a cancer patient's hand at an outpatient clinic or rallying a team for Relay For Life -- I feel like I'm fighting back. Volunteering turns all my feelings of grief and powerlessness towards cancer into real power."
Knowledge is Key, Says Breast Cancer Survivor
On November 8, 2005, Rita Gore, a high school math teacher from Pickerington, Ohio, was diagnosed with breast cancer in her left breast.
Gore, now 49, had gone to her doctor's office for a Pap smear and annual exam, and they suggested she get a mammogram while she was there. Gore knew she was due for one soon, so she agreed.
"Then they called and said, 'We found something. We need to do a biopsy. We just need to check it out,'" Gore recalls.
A few days later, while at school, Gore got crushing news: she had stage I breast cancer.
"It was like my whole world was falling apart," Gore says. "I felt like I had been punched in the stomach. I went into my office and I stood there and I just started crying."
Gore had a lumpectomy in late November, and started chemotherapy and radiation soon after. During treatment, she found strength in her students.
"I really saw a side of my kids that I hadn’t seen before: their compassion. They gave me a lot of strength as I went through the chemo and the radiation. They always had positive things to say. They gave me notes of encouragement. They gave me little gifts of appreciation."
She also had a lot of support from her family and colleagues. She also found comfort and strength in prayer.
"My diagnosis brought everyone that was a part of my life even closer. We are wiser, and we have a better appreciation now for life and our blessings."
Gore finished treatment in July 2007 and has been cancer-free since. She checks in with her doctors every 6 months to a year, strives to exercise regularly, grow in her faith, eat healthfully, limit her stress, and be happy.
She continues to teach at Gahanna-Jefferson Public Schools, and in addition to that work, she has taken on another role: cancer screening advocate.
She joined an American Cancer Society outreach program in her area that encourages African American women to get screened for breast cancer. They meet twice a month.
"I was blessed to be in Stage I," says Gore. "Many women of African American descent are in Stage III or IV before they get tested or diagnosed. Early detection is so important."
"We try to encourage women, especially young women, to be educated about screening and to invest in their health more seriously. That's the key – knowledge."
Weigh Your Options, Says Prostate Cancer Survivor
Beau Stubblefield-Tave, 52, is a Boston, Massachusetts-area consultant with a background in health care advocacy and the father of 2 teenage girls. And thanks to a reminder from his physician assistant, he’s also a prostate cancer survivor.
About 2 years ago, a diabetes diagnosis sent Stubblefield-Tave into his doctor’s office for regular blood sugar checks and by extension, regular check-ups.
He had had a high prostate-specific antigen (PSA) test in the past, and while it had taken him almost a year to follow up on it, he eventually got another test, which came back higher than the first. His doctors arranged for a biopsy. It came back negative, but they put him on a regular follow-up schedule. He says he probably wouldn’t have gone back had his PA not urged him to follow up on it when he was getting his blood sugar tested.
“Cheryl Whitney, my PA, got me back into periodic prostate biopsies and PSA testing. Fun? Hell no! Did it save my life? Yes,” Stubblefield-Tave says.
Stubblefield-Tave has a family history of cancer (his father, Beau, Sr., is living with prostate cancer, and his sister, Barbi, struggled with breast cancer), and he also worked in health care for a number of years, so he knew about the importance of following up on suspicious results. However, he had gotten busy and just put it off.
The fourth round of tests, which were done late in 2008, came back positive. He had stage I prostate cancer. Stubblefield-Tave weighed his options.
"Because they found the cancer early, I had time to find the right surgeon, follow him to Caritas St. Elizabeth’s Hospital, a small community hospital, and schedule the surgery for after New Year’s and before Inauguration Day,” Stubblefield-Tave recalls.
Making Sense of the Options
Stubblefield-Tave compared treatments (Surgery or radiation? If surgery, what type?) and sought advice of family, friends, and experts in the field. In the end, he chose to have robotic-assisted laparoscopic radical prostatectomy, a less invasive surgical procedure in which the surgeon uses robotic arms to make several small incisions to remove the prostate.
"I was lucky to have good health coverage, have access to the wonderful research centers here in Boston, and because we caught this early enough and I'm a consultant with flexible hours, some choice in when and where I'd schedule my surgery," he says.
"Deciding what kind of treatment to get is a balancing act. Every person is different. I chose what made me most comfortable, and that’s my advice to other men: do whatever it takes to feel confident and comfortable with the treatment, the doctor, the team, the hospital, and yourself."
Stubblefield-Tave tolerated the surgery well and is on the road to recovery. He’s had some complaints – the catheter was a great source of discomfort – and he’s had to learn to be patient with himself.
"I’m able to exercise, and I was able to get back to my work pretty quickly, but I do take naps, and I’ve had to learn to take it slow." Stubblefield-Tave is co-founder of a management consulting group called the Cultural Imperative, which helps clients create productive multicultural workplaces and reduce disparity.
He’s found great strength in his family – he and his wife, Janice, have been married 19 years and have 2 daughters, Hanna (17) and Rachel (14) – and through two churches and a Zen mediation group. He also consults a behavioral health professional.
“There’s still this hesitancy about talking about cancer, especially in the black community. It's so important to talk to people," he says.
Leukemia - Chronic Lymphocytic (CLL)
Chronic lymphocytic leukemia (CLL) is a type of cancer that starts in the white blood cells (lymphocytes) in the bone marrow. It then invades the blood. Leukemia always starts in the bone marrow. It can spread to the lymph nodes, the spleen, liver, and other parts of the body. In contrast, other types of cancer can start in these organs and then spread to the bone marrow (or elsewhere). Those cancers are not leukemia. Leukemia cells tend to build up in the body over time. In many cases people don't have any symptoms for at least a few years. Compared to other types of leukemia, CLL usually grows slowly.
Doctors have learned that there are probably 2 different kinds of CLL.
One kind is very slow growing and rarely needs to be treated. People with this kind of CLL survive an average of 15 years or more.
Another kind grows faster and is more serious. People with this form of CLL have an average survival of about 8 years.
The leukemia cells from these 2 types look alike. But certain new lab tests can tell them apart.
Normal Bone Marrow, Blood, and Lymph Tissue
In order to understand the different types of leukemia, it helps to have some basic knowledge about the blood and lymph systems.
Bone Marrow
Bone marrow is the soft inner part of some bones such as bones of the skull, shoulder blades, ribs, pelvis, and backbones. Bone marrow is made up of blood-forming cells, fat cells, and tissues that help cells grow.
Early blood cells are called stem cells. These stem cells only make new blood-forming cells. They cannot make any other kinds of cells. (This makes them different from embryonic stem cells, which are formed from a developing fetus and can develop into most other cells in the body.)
Stem cells normally divide to form new stem cells. But some of the stem cells go through a series of changes. During this process they can become red blood cells, white blood cells, or platelets.
Red Blood Cells
Red blood cells carry oxygen from the lungs to all other cells in the body. They also carry away carbon dioxide, a waste product of cell activity. A shortage of red blood cells (anemia) causes weakness, shortness of breath, and tiredness.
Platelets
Platelets help prevent bleeding by plugging up holes of blood vessels caused by cuts or bruises. A person with a shortage of platelets can bruise or bleed easily.
White Blood Cells
White blood cells help defend the body against infections. Lymphocytes are one type of white blood cell, but there are other types too. Lymphocytes are the main cells that make up lymphoid tissue, an important part of the immune system. Lymphoid tissue is found in lymph nodes, the thymus gland, the spleen, the tonsils and adenoids, and is scattered throughout the digestive and respiratory systems and the bone marrow.
There are two types of lymphocytes:
B lymphocytes protect the body from invading germs. B lymphocytes are the cells that most often develop into chronic lymphocytic leukemia (CLL) cells.
T lymphocytes destroy cells that are infected with viruses.
How Leukemia Starts
Any of the blood-forming or lymphoid cells from the bone marrow can turn into leukemia cells. Once this happens, the cells don’t go through their normal growth process. These cells do not die as they should. So they build up, spill into the bloodstream, and spread to other organs.
Types of Leukemia
Not all leukemias are the same. Leukemias are divided into 4 main types. Knowing the exact type of leukemia can help doctors better predict each patient's outlook (prognosis) and select the best treatment.
Acute Leukemia Versus Chronic Leukemia
In acute leukemia, the cells grow rapidly but they are not able to mature properly. The cells keep on reproducing and build up in the blood. Without treatment, most patients with acute leukemia would live only a few months. Some types of acute leukemia respond well to treatment, and many patients can be cured.
Chronic leukemia refers to a condition where the cells look mature but they are not really normal. The cells live too long, build up, and crowd out normal cells.
Myeloid Leukemia Versus Lymphocytic Leukemia
The second factor to consider in classifying leukemia is the type of bone marrow cells that are involved. Lymphocytic and myeloid (or myelogenous) refer to these cell types involved.
Myeloid leukemias start from any other type of white blood cell, red blood cell, or platelet-making cell in the bone marrow.
Lymphocytic leukemia: Lymphocytic leukemias develop from lymphocytes (a type of white blood cell) in the bone marrow.
What Causes Chronic Lymphocytic Leukemia? Can It Be Prevented?
A risk factor is something that increases a person's chance of getting a disease. Some risk factors, like smoking, can be controlled. Others, such as a person's age, can't be changed. There are very few known risk factors for chronic lymphocytic leukemia (CLL).
Certain Chemical Exposures
Exposure to Agent Orange, an herbicide used during the Vietnam War, has been linked to an increased risk of CLL. Some studies suggest that chemicals used in farming, such as herbicides and insecticides, may increase the risk of CLL. More research in this area is needed.
Family History
First-degree relatives (parents, siblings, or children) of CLL patients have an increased risk for this cancer.
Gender
CLL is slightly more common in men than women, although the reasons for this are not known.
Race/Ethnicity
CLL is more common in North America and Europe than in Asia.
There are no other proven risk factors for CLL. The risk of getting CLL does not seem to be affected by smoking, diet, radiation, or infections.
Can Chronic Lymphocytic Leukemia Be Prevented?
Although many types of cancer can be prevented by lifestyle changes to avoid certain risk factors, there are no known risk factors for CLL that a person can change. So right now there is no way to prevent CLL from developing.
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