What medical experts are saying about the latest treatment options

The aim of neurosurgery has always been to gain the maximal benefit for the patient with the minimum amount of risk. Modern neurosurgery and radiosurgery can be used to treat a variety of conditions including brain tumours, brain haemorrhages, pain, epilepsyA tendency to have recurrent seizures., and movement disorders such as Parkinson’s disease and Multiple Sclerosis.

Most cases of nipple discharge are due to normal, benignNot dangerous, usually applied to a tumour that is not malignant. conditions and are usually hormoneA substance produced by a gland in one part of the body and carried by the blood to the organs or tissues where it has an effect.-related. Approximately one third of all women can produce a nipple discharge by gently massaging their breasts. This 'innocent' nipple discharge usually comes from multiple ducts in both breasts in pre-menopausalRelating to the menopause, the time of a woman’s life when her ovaries stop releasing an egg (ovum) on a monthly cycle. women. Blood-stained discharge from a single duct in one breast can be sinister in nature and may represent an underlying carcinomaA malignant tumour (cancer) that is formed from the epithelium, the tissue that covers the open surfaces of organs..

In this article Paediatric Surgeon, Mr Curry, explains how the technique of laparoscopicA keyhole surgical procedure. surgery can be applied to infants and children and what procedures can routinely be performed this way. Keyhole, also known as laparoscopic, surgery involves making small openings on the abdominalRelating to the abdomen, which is the region of the body between the chest and the pelvis. wall, usually no more than a few millimetres big. Through these openings special devices called ports are inserted that allow cameras and long instruments to be inserted into the abdominal cavityThe part of the body that contains the stomach, intestines, liver, gallbladder and other organs. to enable the surgeon to perform the operation.

For many women with breast cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. the standard treatment includes surgery together with radiotherapyThe treatment of disease using radiation., to reduce the chances of the cancer coming back. A new approach, TARGIT, involves radiationEnergy in the form of waves or particles, including radio waves, X-rays and gamma rays. given with a spherical device that is placed where the lump was, thus targeting the tissues that surrounded the tumourAn abnormal swelling., the ‘tumour bed’.

A cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. can be considered as the uncontrolled growth of the cells of the body. There is unlikely to be a single cause of breast cancer but there are two categories of risk factors. We can look at things that seem to be associated with an increased risk and see if we can change any of these to reduce the risk.

Gynaecological cancers are not common, particularly in the UK. If we add all the gynaecological cancers that occur each year together, they account for less than half of the cases of breast cancer. However, women may be concerned about the possibility of gynaecological cancers because, unlike breast cancer, the gynaecological organs are not easily visible. It is therefore important for women to be aware of the various screeningA way to identify people who may have a certain condition, among a group of people who may or may not seem to programmes for gynaecological cancers that exist and to also be aware of the symptoms so that the disease can be detected early where full cure is usually possible.

To be told you have breast cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. is always a huge shock. Before we consider some of the treatments available I want to make the important point of how much the treatment of breast cancer has improved over the years. In the 1970s only 50% of people with breast cancer survived for 5 years. In the best units that figure is now around 90%. Similarly the 10 year survival rate was only 40% in the 70s and it is now 80%, with a twenty year survival rate of nearly 70%. The fundamental fact is that most people will no longer die from their breast cancer; and the treatments continue to improve.

CANCER RESEARCH UK funded scientists have discovered four new geneticRelating to the genes, the basic units of genetic material. variants linked to bowelA common name for the large and/or small intestines. cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. by combining data from three major genome studies, reveals a study published in Nature Genetics*. Pooling the data in this way created the largest study of its kind, involving over 45,000 volunteers with and without bowel cancer, allowing previously undetected genetic sites to be pinpointed.

Many patients emailed us their questions after reading Adeola Olaitan's article on Cervical Cancer. Here are just a few of them together with Adeola's responses.

The cervixAny neck-like structure; most commonly refers to the neck of the uterus. is the lower part of the wombThe uterus.. It is sometimes referred to as the neck of the womb. Cervical cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body., is the second most common cancer in women world-wide, second only to breast cancer and in some developing countries, it is the commonest. An estimated half a million women are diagnosed with cervicalRelating either to the cervix (the neck of the womb) or to the cervical vertebrae in the neck (cervical spine). cancer each year, approximately 80% of whom are in the developing world. About 300 thousand women die of this condition every year.

As the most common cause of death from cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body., this article is essential reading for anyone who wants to know more about improving the outcome. In particular, it answers questions such as:

• Do I have symptoms of bowelA common name for the large and/or small intestines. cancer?
• What are the symptoms of bowel cancer?
• Should I be tested for bowel cancer?
• What’s involved in getting tested?
• What has been learned from bowel cancer screeningA way to identify people who may have a certain condition, among a group of people who may or may not seem to trials?
• Does inflammatory bowel diseaseA group of inflammatory conditions of the intestine. The two major forms are Crohn’s disease and ulcerative colitis. increase risk of cancer?
• Does the new bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. test for bowel cancer work?

Skin-sparing mastectomy (SSM) has become a valid option for women who are undergoing mastectomy and immediate breast reconstruction for early breast cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body.. With SSM most of the natural skin envelope is preserved during the immediate breast reconstruction leading to a much better aesthetic outcome. It also reduces the need for surgery on the other breast, which may otherwise be required to give a symmetrical appearance. 

Cancers can arise from any cellThe basic unit of all living organisms. in the body and therefore can take any form. When cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. forms a single solid tumourAn abnormal swelling. or mass, surgery can be straightforward, but what about when the cancer invades around other essential tissues and organs – especially in the head and neck? Many tumours, particularly of the head and neck have previously been effectively inoperable, and so major changes in treatment approach were needed.