Medizines

Stomach cancer is common throughout the world and affects all races, it is more common in men than women, and has its peak age range between 40 and 60 years old. Mortality is higher in Japan and Chile, presumably because of the different diets in those countries where they are less dependent on red meat.
Over the last 25 years the incidence of this type of cancer in the western world has decreased by 50% and the resulting death rate is less than a third of what it used to be but in less developed countries it is still a major cause of death, probably because in these countries by the time the disease is diagnosed (usually by means of a Barium meal) the stomach cancer is at a very advanced stage.
TYPES OF STOMACH CANCER
There are several different types of stomach cancer, some of which are very rare. The most common types start in the glandular cells of the stomach lining (adenocarcinomas), this is where stomach acid and digestive enzymes are made, and where most cancers start. When the tumor becomes more advanced, it can travel through the bloodstream and spread to organs such as the liver, lungs, and bones. Cancers that start in the lymphatic tissue (lymphoma), in the stomach's muscular tissue (sarcoma) or in the tissues that support the organs of the digestive system (gastrointestinal stromal tumors) are less common and are treated in different ways.
SIGNS AND SYMPTOMS
Early clues to stomach cancer are chronic dyspepsia and epigastric discomfort, followed in later stages by weight loss, anorexia, a feeling of fullness after eating, anemia and fatigue. Blood in the stools may also be present and if the Cancer is in the Cardia (top) vomiting may occur.
CAUSATION
The exact cause is unknown although the presence of the Helicopter pylori bacterium seems to be a major factor. Predisposing factors include environmental influences such as smoking and high alcohol intake. Because stomach cancer is more common amongst those with a family history and with people with type A blood, genetic factors are also implicated. Dietary factors, particularly methods of food preservation such as pickling, smoking or salting also have an influence on the prevalence.
DIAGNOSIS
Stomach cancer is diagnosed through an examination that may include an upper gastrointestinal (GI) series; endoscopy or gastroscopy where a thin flexible tube is passed down the throat so the doctor can see into the stomach, esophagus and upper part of the bowel Barium meals and Barium swallows. Because the cancer can spread to the liver, the pancreas, and other organs near the stomach as well as to the lungs, the doctor may order a CT scan, a PET scan, an endoscopic ultrasound exam, or other tests to check these areas.
The cancer can spread (metastasize) to the esophagus or the small intestine, and can extend through the stomach wall to nearby lymph nodes and organs. Metastasis occurs in 80-90% of individuals with stomach tumors, with a five year survival rate of 75% in those diagnosed in early stages and less than 30% of those diagnosed in late stages.
TREATMENT
Although the cancer may be treated with surgery, radiation therapy, or chemotherapy, in many cases surgery is the treatment of choice. Even in patients whose disease is not considered surgically curable, resection offers a palliative effect and improves potential benefits from chemotherapy.
The nature and extent of the cancer determines what kind of surgery is most appropriate. Common surgical procedures include, partial and total removal of the stomach.
Antiemetics can control nausea, which increases as the cancer advances. In the more advanced stages, sedatives and tranquilizers may be necessary to control anxiety. Narcotics are commonly necessary to control sever and unremitting pain.
In some cases of advanced stomach cancer, a laser beam directed through an endoscope can vaporize most of the tumor and relieve obstruction without an operation.
PROGNOSIS
Stomach cancer is curable if detected early, but most people don't seek medical help until the disease is quite advanced, possibly because symptoms occur late and are often vague and non-specific. Eating fresh fruits and vegetables that contain antioxidant vitamins (such as A and C) appears to lower the risk of stomach cancer. The rate of cancer is about doubled in smokers so the cessation of smoking is essential.
In the United States and most of the Western world, the 5-year survival rate ranges from 5-15%. In Japan, where stomach cancer often is diagnosed early, the 5 year survival rate is about 50%. Five year survival rates for more advanced stomach cancers range from, around 20% for those with regional disease to almost nil for those with distant metastases.
Treatment for metastatic stomach cancer can relieve symptoms and sometimes prolong survival, but long remissions are not common. The survival of inoperable stomach cancer is usually only a few months if untreated. With chemotherapy the average survival is about 12 months. If cancer is found before it has spread, the five-year relative survival rate is about 61%.

Toenail melanomas are similarly found on the skin but they are on the skin beneath the toenail or thumbnail. This makes them less noticeable especially for people who frequently wear dark nail polish. This is also the reason why most toenail melanomas are only treated or removed only when they have reached the more advanced stages of growth.
Fortunately, toenail melanoma is commonly benign, in which case a simple surgery can be done to remove the skin tumor. Since toenail melanoma is covered by the nail, the operation would require the partial or total removal of the covering nail as well.
This is all done under local anesthesia so there is nothing to worry about. With the advances in modern medicine, this surgery will only last about an hour.
The first symptom of this kind of skin cancer is a small dark spot resembling a mole. Oftentimes, a toenail melanoma is dark yellow, brown or black.
In rare cases, the spot is colorless, making it more difficult to detect. These types are the riskier ones especially if they turn out to be malignant. They can keep growing with the person not even knowing he has it.
To differentiate between a regular mole and a toenail melanoma, you will have to observe the spot for a few days or even weeks. If the spot grows in size, there is a large chance that it is in fact a toenail melanoma.
Although most toenail melanomas are benign, this is not a certainty. You need to go in for a biopsy to determine the kind of toenail melanoma you have.
Sometimes a toenail melanoma starts not as a spot but a streak, similar to the white streaks that sometimes appear on the nail following trauma. If you notice these streaks on your nails without undergoing any kind of nail trauma, you should have your nail checked as this can be the beginning stages of a tumor.
Although this condition is generally called toenail melanoma, it can actually occur in any of your other nails as well. They do appear much more frequently on the toenails and thumbnails but you should regularly check your other nails as well.
Once you begin to notice these changes in your nails, it is best to consult a doctor right away. Melanomas are still a kind of cancer, and just like other cancers, they are more easily treated if detected early. Also, since they are just like any other tumor, you will need to undergo chemotherapy and radiation in case the toenail melanoma turns out to be malignant.
Medical studies have shown that this particular kind of melanoma, also called acral lentiginous melanoma in the medical community, is more common in Asians and other people with darker skin. However, Caucasians are not totally risk-free as there have also been several cases of toenail melanoma in very fair-skinned people over the years.

By Chirs Parker