types of cancer

Adrenal gland cancer


Adrenal cancer is a rare cancer that begins in one or both of the small, triangular glands (adrenal glands) located on top of your kidneys. Adrenal glands produce hormones that give instructions to virtually every organ and tissue in your body. Adrenal cancer, also called adrenocortical cancer, can occur at any age. Adrenocortical carcinoma could either be a functioning or non-functioning tumour. If the tumour is functioning, it may produce more than one hormone.


People with adrenal cancers may experience the following symptoms or signs. Sometimes, those with adrenal cancers do not have any of these changes. Or, the cause of a symptom may be another medical condition that is not a tumour.

  • Weight gain
  • Muscle weakness
  • Pink or purple stretch marks on the skin
  • Hormone changes in women that might cause excess facial hair, hair loss on the head and irregular periods
  • Fever
  • Loss of appetite
  • Vomiting
  • Abdominal bloating
  • Loss of weight without trying
  • Hormone changes in men that might cause enlarged breast tissue and shrinking testicles
  • Nausea
  • Back pain
  • Causes

    Although there is no sufficient information on what causes adrenal cancer. Adrenal cancers are seen among those with inherited syndromes that raise the risk of certain cancers. Following are some of the inherited syndromes:

  • Beckwith-Wiedemann syndrome
  • Carney complex
  • Li-Fraumeni syndrome
  • Lynch syndrome
  • Multiple endocrine neoplasia, type 1 (MEN 1)
  • Diagnosis

    Tests and procedures used to diagnose adrenal cancer are suggested based on the symptoms experienced by the patient. Following are common diagnostic procedures used to detect and confirm adrenal cancer:

    Blood and urine tests: Blood and urine tests are performed to check abnormal levels of cortisol, aldosterone and androgens/ oestrogens, which could point towards adrenal cancer.

    Imaging tests: The doctor may recommend ultrasound, CT, MRI or PET scans to better understand any growths on your adrenal glands, to analyse the size and exact location of the tumour and to see if cancer has spread to other areas of your body, such as your lungs or your liver.

    Biopsy: A biopsy has a critical role in learning if the tumour is benign or cancerous. A biopsy is only done in an adrenal cancer patient if the tumours are present on the outside of the adrenals and the doctor needs to know if these tumours are from the adrenal cancer or are caused by some other cancer or disease.


    Surgery: The doctor may recommend a procedure called adrenalectomy, which involves removing the adrenal gland. If the cancer has spread to other parts of the body, the surgeon may also remove nearby lymph nodes and tissue. Laparoscopy is another surgical procedure through which the adrenal tumours are removed through a thin, hollow, lighted tube called a laparoscope. This is a minimally-invasive procedure that helps the patients recover at a faster rate.

    Radiation therapy: Radiation therapy uses high-energy X-rays to kill cancer cells and stop new cancer cells from growing. However, this is not the main treatment line and is used along with chemotherapy and surgery to enhance the efficacy of the treatment.

    Chemotherapy Depending on the stage of the cancer, the patient may need to undergo chemotherapy. This form of cancer drug therapy helps stop the growth of cancer cells. Chemotherapy can be administered orally or injected into a vein or muscle. The doctor may combine chemotherapy with other types of cancer treatments.

    types of cancer

    Wilms’ Tumor


    Wilms’ tumor, a rare kidney cancer condition also known as nephroblastoma, is the most common cancer of the kidneys found in children. Wilms’ tumor most often affects children ages 3 to 4 and becomes much less common after age 5 affecting just one kidney, but at times can also be found in both kidneys at the same time. Advancements in the diagnosis and treatment of Wilms’ tumor have progressed and with appropriate treatment techniques.


    Though the symptoms for Wilms’ tumor vary widely , however few of the common Signs and symptoms of Wilms’ tumor are:

  • An abdominal mass you can feel
  • Abdominal swelling
  • Abdominal pain
  • Other more general symptoms include:
  • Fever
  • Blood in the urine
  • Nausea or vomiting or both
  • Constipation
  • Loss of appetite
  • Shortness of breath
  • High blood pressure
  • Causes

    In most of the cases, heredity may play a role in Wilms’ tumor, though this is rare. Cancer cells starts multiplying with increasing errors in their DNA. The errors allow the cells to grow and multiply nonstop with a longer life compared to other cells. The accumulating cells results into a tumor. In Wilms’ tumor, this process occurs mostly in the kidney cells. In rarest of the cases, the errors in DNA that lead to Wilms’ tumor are passed on genetically, from parents to children. While in most other cases, there is no known connection between parents and children that may lead to cancer.


    Few of the diagnostic techniques are conducted to detect this tumor are:

  • CBC
  • Chemistry profile – This includes kidney function tests and routine measurements of electrolytes and calcium
  • Urinalysis
  • Coagulation studies
  • Cytogenetics studies, including 1p and 16q deletion
  • Imaging studies conducted are:
  • Renal ultrasonography (often the initial study)
  • Four-field chest radiography (to detect lung metastases)
  • Abdominal and chest CT
  • Abdominal MRI
  • Treatment

    The major form of treatment undertaken for this type of tumours includes surgery, chemotherapyand radiation therapy. Since this is commonly found in children, there is a permutation of treatment that follows. Surgery is usually the first treatment that is applied to remove the tumor. In complicated cases of the tumor where in the cancer might have spread into the blood vessels or both kidneys either chemotherapy or radiation therapy (or both) might be used to try to shrink the tumor before surgery. The precise drugs and treatment course might vary from case to case depending on the condition of complication.

    types of cancer

    Vulvar Cancer


    Vulvar cancer is a type of cancer that affects the female external genitals or, the vulva. The vulvar region includes-

  • The labia – these are the inner and outer lips of the vagina,
  • The clitoris, and
  • The opening of the vagina,
  • The mons pubis: This is the soft area in front of the pubic bones that get covered with hair during puberty
  • The perineum: It is the patch of skin between the vulva and the anus Vulvar cancer commonly forms as a lump or sore on the vulva that often causes itching. It can also affect the glands in and around the vaginal opening. As the cancer spreads, it also starts affecting the outer lips of the vagina and the other parts of the vulva. Though it can occur at any age, vulvar cancer is most commonly diagnosed in older adults Cancers of these types undergo a slow growth, starting as vulvar intraepithelial neoplasia, which happens when the healthy skin cells around the vulva undergo asymmetrical changes. In absence of treatment, such abnormal growth of cells results in cancer. There are five types of vulvar cancers:
  • Squamous cell carcinoma is the most common. It starts in the skin cells. Some types of it are linked to HPV — human papilloma virus. That’s an infection you get from having sex with someone who has it. Younger women are more likely to get vulvar cancer that’s linked to HPV
  • Adenocarcinoma usually starts in cells located in the glands just inside the opening of the vagina. It can look like a cyst, so you might not pay attention to it at first
  • Melanoma forms in cells that make pigment, or skin colour. You’re more likely to get it on skin that’s exposed to sun, but it can show up in other areas too, like the vulva. It makes up about 6 out of every 100 vulvar cancers.
  • Sarcoma starts in bone, muscle, or connective tissue cells. It differs from other vulvar cancers because it can happen at any age, including childhood.
  • Basal cell carcinoma is the most common type of skin cancer. It usually appears on skin that’s exposed to sun. Very rarely, it occurs on the vulva.
  • Vulvar cancer treatment usually involves surgery to remove the cancer and a small amount of surrounding healthy tissue. Sometimes vulvar cancer surgery requires removing the entire vulva. The earlier vulvar cancer is diagnosed, the less likely an extensive surgery is needed for treatment.


    In its initial stages, symptoms of Vulvar cancer may be dormant. However, in early stages, they include:

  • Abnormal bleeding
  • Itching in the vulvar area
  • A discolored patch of skin
  • Pain with urination
  • Pain and tenderness in the vulvar area
  • A lump or wart-like sores on the vulva
  • Causes

    While specific causes remain undetected, few of the likely reasons for development of vulvar cancer could be:

  • Age & Gender– It mostly occurs in females above 55 years of age.
  • Smoking habits
  • Due to vulvar intraepithelial neoplasia
  • Due to HIV or AIDS
  • Due to human papillomavirus (HPV) infection
  • Due to a history of genital warts
  • Due to a skin condition that can affect the vulva, such as lichen planus
  • Diagnosis

    There are a number of tests to find the stage of the cancer, some of it includes:

  • Examining your vulva: The doctor will likely conduct a physical exam of the vulva to look for abnormalities.
  • Biopsy: To determine whether an area of suspicious skin on your vulva is cancer, your doctor may recommend removing a sample of skin for testing. During a biopsy procedure, the area is numbed with a local anaesthetic and a scalpel or other special cutting tool is used to remove all or part of the suspicious area. Depending on how much skin is removed, you may need stitches.
  • Pelvic examination: The doctor may do a more thorough examination of the pelvis for signs that the cancer has spread.
  • CT scan- to identify enlarged lymph nodes in the groin area.
  • MRI scan– to find pelvic tumours and tumours that may have spread to the brain or spinal cord.
  • Cystoscopy and proctoscopy- to determine whether the cancer has spread to the bladder or the rectum.
  • Basis the diagnosis, the doctor will be able to determine the stage of vulvar cancer. It can be broadly classified into:
  • Stage I: In this stage, there is a small tumour that is confined to the vulva or the area of skin between your vaginal opening and anus (perineum). This cancer hasn’t spread to your lymph nodes or other areas of your body.
  • Stage II: Here the tumours are those that have grown to include nearby structures, such as the lower portions of the urethra, vagina and anus
  • Stage III: In this stage the cancer has spread to lymph nodes
  • Stage IV: This stage signifies a cancer that has spread more extensively to the lymph nodes, or that has spread to the upper portions of the urethra or vagina, or that has spread to the bladder, rectum or pelvic bone. Cancer may have spread (metastasized) to distant parts of your body.
  • It is important to note that vulvar melanoma uses a different staging system.


  • Laser Therapy- Laser therapy uses high-intensity light to destroy cancer cells, while causing less scarring and bleeding than other forms of treatment.
  • Surgery- This is the most common treatment for vulvar cancer, depending on the stage of cancer and condition.
    • Local Excision- Local excision is performed only if the cancer hasn’t affected the distant nodes or organs. The process involves removal of the affected area, along with a minor quantity of normal tissue around it.
    • Vulvectomy- This is another surgical option where a part of the vulva may be removed (partial vulvectomy) or there could be complete removal of the vulva (radical vulvectomy).
    • Pelvic Exenteration: In case of advanced or severe vulvar cancer, pelvic exenteration may be performed. It is a radical surgical treatment that removes all organs from a person’s pelvic cavity. The urinary bladder, urethra, rectum, and anus are removed. The procedure leaves the person with a permanent colostomy and urinary diversion
  • Radiation Therapy: One of the most important forms of therapy is Radiation therapy, which uses high-energy radiation to shrink tumours or to destroy cancer cells. Radiation therapy for vulvar cancer is usually administered by a machine that moves around your body and directs radiation to precise points on your skin (external beam radiation). Radiation therapy is sometimes used to shrink large vulvar cancers in order to make it more likely that surgery will be successful. Radiation is sometimes combined with chemotherapy, which can make cancer cells more vulnerable to radiation therapy.
  • Chemotherapy: Chemotherapy is a common form of chemical drug therapy. It helps in slowing down or preventing cancer cells from growing further. It is administered usually through a vein in the arm or through the mouth. Chemotherapy is sometimes combined with radiation therapy to shrink large vulvar cancers in order to make it more likely that surgery will be successful. Chemotherapy may also be combined with radiation if there’s evidence cancer has spread to the lymph nodes.
  • Categories
    types of cancer



    Urologic Oncology is the field of medicine concerned with the research and treatment of cancers of the urinary system for both genders, as well as those affecting the male sexual organs. Most often, these include cancers of the kidneys and bladder, as well as the prostate and testes. Women’s cancers or cancers of the female reproductive systems are seen by gynecologic oncologists.


    Blood in the urine, painful or burning sensation during urination and needing to urinate frequently, particularly during the night, are all symptoms common to bladder, kidney and prostate cancers. Kidney cancer may also result in symptoms of fever, unexplained weight loss, fatigue and a pain in the side that does not subside. Prostate cancer will affect the flow of urine; patients may experience difficulty starting or stopping urination; as well as difficulty in achieving an erection. Testicular cancer often presents as an enlargement or swelling of the testicle, pain in the scrotum and/or pain in the groin, back or lower abdomen.


    Smoking, certain bacterial infections and occupational chemical exposure are among the risk factors for bladder cancer. For kidney cancer, the risk factors include smoking, obesity, high blood pressure and heavy metal exposure. The odds of developing prostate cancer are raised by age and family history, while testicular cancer risk factors include family history and congenital abnormalities or birth defects of the testes, kidneys and penis.


    Prostate Cancer This is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing, however, there are cases of aggressive prostate cancers. The cancer cells may metastasize (spread) from the prostate to other parts of the body, particularly the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, problems during sexual intercourse or erectile dysfunction. Other symptoms can potentially develop during later stages of the disease.Prostate cancer tends to develop in men over the age of fifty. Globally it is the sixth leading cause of cancer-related death in men. Prostate cancer is most common in the developed world with increasing rates in the developing world. However, many men with prostate cancer never have symptoms, undergo no therapy and eventually die of other unrelated causes. Many factors, including genetics and diet, have been implicated in the development of prostate cancer.The presence of prostate cancer may be indicated by symptoms, physical examination, Prostate-Specific Antigen (PSA) or biopsy. Prostate-specific antigen testing increases cancer detection but does not decrease mortality.Management strategies for prostate cancer should be guided by the severity of the disease. Many low-risk tumours can be safely followed with active surveillance. Curative treatment generally involves surgery, various forms of radiation therapy or less commonly, cryosurgery; hormonal therapy and chemotherapy are generally reserved for cases of advanced disease (although hormonal therapy may be given with radiation in some cases).The age and underlying health of the man, the extent of metastasis, appearance under the microscope and response of the cancer to initial treatment are important in determining the outcome of the disease. The decision whether or not to treat localised prostate cancer (a tumour that is contained within the prostate) with curative intent is a patient trade-off between the expected beneficial and harmful effects in terms of patient survival and quality of life. Kidney Cancer It is a type of cancer that starts in the cells in the kidney.The two most common types of kidney cancer are Renal Cell Carcinoma (RCC) and Urothelial Cell Carcinoma (UCC) of the renal pelvis. These names reflect the type of cell from which the cancer developed.The different types of kidney cancer (such as RCC and UCC) develop in different ways, meaning that the diseases have different outlooks (or prognosis), and need to be staged and treated in different ways. RCC is responsible for approximately 80% of primary renal cancers, and UCC accounts the majority of the remainder. Bladder Cancer This includes any of the several types of malignancy arising from the epithelial lining (i.e. the urothelium) of the urinary bladder. Rarely the bladder is involved by non-epithelial cancers, such as lymphoma or sarcoma, but these are not ordinarily included in the colloquial term ‘bladder cancer’. It is a disease in which abnormal cells multiply without control in the bladder. The bladder is a hollow, muscular organ that stores urine and is located in the pelvis. The most common type of bladder cancer recapitulates the normal histology of the urothelium and is known as transitional cell carcinoma or more properly urothelial cell carcinoma.


    There are three main categories of urologic cancer treatments: surgery, radiation and chemotherapy. A fourth option sometimes applied in the treatment of prostate cancer is termed active surveillance or watchful waiting. In this case, a prostate tumour that is determined to be of very small size and slow growth is not actively treated until such a time that it is determined to be of greater risk to the patient.

    types of cancer

    Urethral Cancer


    When one needs to pass urine, it is the urethra that carries the urine from the bladder. The urethra goes through the prostate and the penis in men. In women, the tube is shorter and ends just above the opening to the vagina. Urethral cancer is a rare cancer that occurs more often in women than in men. There are different types of urethral cancer that begin in cells that line the urethra. These cancers are named for the types of cells that become malignant (cancerous):

  • Squamous cell carcinoma is the most common type of urethral cancer. It forms in cells in the part of the urethra near the bladder in women, and in the lining of the urethra in the penis in men
  • Transitional cell carcinoma forms in the area near the urethral opening in women, and in the part of the urethra that goes through the prostate gland in men
  • Adenocarcinoma forms in glands near the urethra in both men and women
  • Urethral cancer can metastasize (spread) quickly to tissues around the urethra and is often found in nearby lymph nodes by the time it is diagnosed.


    There may not be any symptoms at first. Over time, you might notice may become hard to pee. There is a possibility of weak urine flow or sometimes an inability to hold it. It could also result in frequent visits to the bathroom, especially at night. Other symptoms include:

  • Bleeding from the urethra or blood in the urine
  • Weak or interrupted flow of urine
  • Urination occurs often
  • A lump or thickness in the perineum or penis
  • Discharge from the urethra
  • Enlarged lymph nodes in the groin area
  • Causes

    Doctors have not been able to clearly identify the causes of urethral cancer however, people over age 60, are have a higher risk of getting urethral cancer. The risk might be higher, if there has been a history of bladder cancer, frequent urinary tract infections, or sexually transmitted diseases that lead to an inflammation of the urethra. Urethral cancer has been linked to human papillomavirus, especially HPV 16. The HPV vaccine protects against type 16. Doctors recommend it for girls and boys at ages 11 or 12. Females can get the vaccine through age 26 and males through age 21. Some of the other causes of Urethral Cancer are the following:

  • Having conditions that cause chronic, swollen, reddened part in the urethra
  • Being a white skinned female
  • Diagnosis

    The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose the disease, plan and check treatment, or monitor the disease over time.
  • Urine cytology: Examination of urine under a microscope to check for abnormal cells.
  • Urinalysis: A test to check the colour of urine and its contents, such as sugar, protein, blood, and white blood cells. If white blood cells (a sign of infection) are found, a urine culture is usually done to find out what type of infection it is.
  • Digital rectal exam: An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual. This procedure may be performed while the patient is under anaesthesia.
  • Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. This may be done while the patient is under anaesthesia.
  • Cystoscopy: A procedure to look inside the urethra and bladder to check for abnormal areas. A cystoscope (a thin, lighted tube) is inserted through the urethra into the bladder. Tissue samples may be taken for biopsy.
  • Biopsy: The removal of cells or tissues from the urethra, bladder, and, sometimes, the prostate gland, so they can be viewed under a microscope by a pathologist to check for signs of cancer.
  • Treatment

    Different types of treatments are available for patients with urethral cancer. Some treatments are standard, and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. Three types of standard treatment are used: Surgery Surgery is the most common treatment for cancer of the urethra. One of the following types of surgery may be done:

  • Open excision: Removal of the cancer by surgery.
  • Electro-resection with fulguration: Surgery to remove the cancer by electric current. A lighted tool with a small wire loop on the end is used to remove the cancer or to burn the tumour away with high-energy electricity.
  • Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove or destroy tissue.
  • Lymph node dissection: Lymph nodes in the pelvis and groin may be removed.
  • Cystourethrectomy: Surgery to remove the bladder and the urethra.
  • Cystoprostatectomy: Surgery to remove the bladder and the prostate.
  • Anterior exenteration: Surgery to remove the urethra, the bladder, and the vagina. Plastic surgery may be done to rebuild the vagina.
  • Partial penectomy: Surgery to remove the part of the penis surrounding the urethra, where cancer has spread. Plastic surgery may be done to rebuild the penis.
  • Radical penectomy: Surgery to remove the entire penis. Plastic surgery may be done to rebuild the penis.
  • If the urethra is removed, the surgeon will make a new way for the urine to pass from the body. This is called urinary diversion. If the bladder is removed, the surgeon will make a new way for urine to be stored and passed from the body. The surgeon may use part of the small intestine to make a tube that passes urine through an opening (stoma). This is called an ostomy or urostomy. If a patient has an ostomy, a disposable bag to collect urine is worn under clothing. The surgeon may also use part of the small intestine to make a new storage pouch (continent reservoir) inside the body where the urine can collect. A tube (catheter) is then used to drain the urine through a stoma. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way radiation therapy is given depends on the type and stage of the cancer being treated. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is given directly to the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way chemotherapy is given depends on the type and stage of the cancer being treated. Follow-up tests may be needed Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

    types of cancer

    Trigeminal Neuralgia


    Trigeminal Neuralgia also known as the suicide disease, is universally regarded as one of the most painful and unpredictable condition. It is characterised by facial pain resulting from overreaction to everyday stimuli such as talking, eating, cold breeze, smiling & light touch. These stimuli lead to intense, electric shock like one-sided head pain that bores into the forehead and often spreads down to the eye, face, mouth, gums and teeth. It is more painful than kidney stones, giving birth or a heart attack. Initially the attacks are short and mild however, with time they increase in intensity, frequency and duration Trigeminal Neuralgia is disease of elderly aged 50-70yrs with incidence being 5.2 per 1,00,000 females and 3.0 per 1,00,000 males.


    One may feel as though the pain came out of nowhere. Some people with this condition start out thinking they have an abscessed tooth and go to a dentist. The symptoms of Trigeminal Neuralgia are:

  • Episodes of severe, shooting or jabbing pain that may feel like an electric shock
  • Spontaneous attacks of pain or attacks triggered by things such as touching the face, chewing, speaking or brushing teeth
  • Bouts of pain lasting from a few seconds to several minutes
  • Episodes of several attacks lasting days, weeks, months or longer — some people have periods when they experience no pain
  • Constant aching, burning feeling that may occur before it evolves into the spasm-like pain of trigeminal neuralgia
  • Pain in areas supplied by the trigeminal nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead
  • Pain affecting one side of the face at a time, though may rarely affect both sides of the face
  • Pain focused in one spot or spread in a wider pattern
  • Attacks that become more frequent and intense over time
  • Doctors consider these sudden and intense bouts of pain be signs of classical case of trigeminal neuralgia (TN1). At times the pain could be less intense but constant, like an aching and burning sensation. This is referred to as “atypical” trigeminal neuralgia (TN2). Some people with this condition also have anxiety because they are uncertain when the pain will return.


    Primary Trigeminal Neuralgia is caused in by tiny blood vessel impinging on the trigeminal nerve, 5th nerve – Neurovascular conflict (50%) or sometimes without any causes – Idiopathic (40%). Secondary Trigeminal Neuralgia in 10% of patients is caused by herpes infection, multiple sclerosis, tumours or nerve injuries. This condition usually surfaces when there is a contact between a blood vessel and the trigeminal nerve at the base of your brain. This contact puts pressure on the nerve and causes it to malfunction. Very rarely, Trigeminal Neuralgia can be caused by a tumour compressing the trigeminal nerve. While in few cases, a cause can’t be found. The triggers for Trigeminal Neuralgia could be:

  • Shaving
  • Touching your face
  • Eating
  • Drinking
  • Brushing your teeth
  • Talking
  • Putting on makeup
  • Encountering a breeze
  • Smiling
  • Washing your face
  • Diagnosis

    The diagnosis of trigeminal neuralgia is mainly based on the description of the pain, including:

  • Type: Pain related to trigeminal neuralgia is sudden, shock-like and brief.
  • Location: The parts of your face that are affected by pain will tell your doctor if the trigeminal nerve is involved.
  • Triggers: Trigeminal neuralgia-related pain usually is brought on by light stimulation of your cheeks, such as from eating, talking or even encountering a cool breeze.
  • The doctor may recommend certain tests to diagnose trigeminal neuralgia and determine underlying causes for the condition, including:
  • A neurological examination: Touching and examining parts of the face can help the doctor determine exactly where the pain is occurring and, if you appear to have trigeminal neuralgia, which branches of the trigeminal nerve may be affected. Reflex tests also can help the doctor determine if the symptoms are caused by a compressed nerve or another condition.
  • Magnetic resonance imaging (MRI): The doctor may order an MRI scan to determine if multiple sclerosis or a tumour is causing trigeminal neuralgia. In some cases, the doctor may inject a dye into a blood vessel to view the arteries and veins and highlight blood flow (magnetic resonance angiogram).
  • It’s important to note that the facial pain may be caused by other conditions also, so an accurate diagnosis is essential. The specialists may suggest additional tests to rule out the possibilities of other conditions.


    The treatment for Trigeminal neuralgia usually starts with medications, and in some cases no additional treatment is required. However, over time, some people with the condition may stop responding to medications, or they may experience unpleasant/intolerable side effects. For those people, injections or surgery provide other trigeminal neuralgia treatment options. Medicinal Treatment The treatment of Trigeminal Neuralgia can be very challenging despite the numerous options patients and physicians can choose from. This multitude of treatment options poses the question as to which treatment fits which patient best.

  • Anticonvulsant medicines: Used to block nerve firing, are generally effective in treating TN1 but often less effective in TN2.
  • Antispasmodic agents: Muscle-relaxing agents may be used alone or in combination with anticonvulsants. Side effects may include confusion, nausea and drowsiness.
  • Botox Injections: Studies have shown that Botox injections may reduce pain from trigeminal neuralgia in people who are no longer helped by medications. However, more research needs to be done before this treatment is widely used for this condition.
  • Surgical Treatment
  • Non-Ablative Options:
    • Open Microsurgery: This procedure is called Microvascular decompression is usually contemplated when there is abnormal vessel pressing the nerve resulting in a process called demyelination. The Surgeon would place a Teflon sponge between the vessel and the nerve and minimises the damage. The recurrence rate for the condition may be 50?ter 10 years of the procedure.
    • Neurectomy: Usually involves cutting of the superficial branches of the nerves. The effect caused by this procedure is typically temporary and pain recurs in 1-2 years.
    Ablative Options: Few of these procedures are usually done on an outpatient basis under local anaesthesia / General anaesthesia. The side-effects of the same may include – facial numbness
  • Balloon Compression: Here a hollow needle is inserted through the face and guided to a part of the trigeminal nerve that goes through the base of the skull. Then, the doctor threads a thin, flexible tube (catheter) with a balloon on the end through the needle. The balloon is inflated with enough pressure to damage the trigeminal nerve and block pain signals. This procedure is done under general anaesthesia. Usually the pain relief lasts for 1-2 years
  • Glycerol Injection: During this procedure, a sterile needle is inserted through the face and into an opening in the base of the skull. The needle is guided into the trigeminal cistern, a small sac of spinal fluid that surrounds the trigeminal nerve ganglion — where the trigeminal nerve divides into three branches — and part of its root. There a small amount of sterile glycerol is injected, which damages the trigeminal nerve and blocks pain signals
  • Radiofrequency lesioning: This procedure selectively destroys nerve fibres associated with pain. An electrode is used to locate the area causing the pain. Once located, the heat is applied through the electrode to damage the nerve fibres creating an area of injury (lesion). The pain recurrence usually happens at 3-4 years.
  • Radiation Therapy
  • Stereotactic Radiosurgery: Stereotactic radiosurgery uses advanced computer and MR imaging to direct highly focused beams of radiation at the site where the trigeminal nerve exits the brain stem. This causes the slow formation of a lesion on the nerve that disrupts the transmission of sensory signals to the brain.
  • Advantages of Frameless Radiosurgery:
  • Non-invasive treatment
  • Non-invasive – No need for anaesthesia, No need for Blood, No risk of infections
  • Day-care procedure – Uses the most advanced FFF technology which enables fastest treatment delivery from 20-30mts
  • Uses Robotics which gives sub mm. Precision and accuracy in targeting the nerve
  • Allows flexi-scheduling
  • Categories
    types of cancer

    Thyroid Cancer


    The thyroid gland is shaped like a butterfly and is located in the front of the neck. It makes hormones that regulate the way the body uses energy and that help the body to work normally. Thyroid cancer occurs when abnormal cells have uncontrolled growth in the thyroid gland. Though thyroid cancer is a relatively uncommon people who have suffer from it have higher probability of a favourable outcome if the cancer is found early.

    The 4 different types of thyroid cancer are:

  • Papillary thyroid cancer: It’s accounts for up to 80% of all thyroid cancer cases. While it tends to grow slowly, this thyroid cancer metastasizes to the nymph nodes in the neck. The chances of a favourable outcome from this type of cancer is usually high
  • Follicular thyroid cancer: It makes up between 10% to 15% of all thyroid cancers. It can metastasize into your lymph nodes and is also more likely to spread into your blood vessels as well.
  • Medullary cancer: It is found in about 4% of all thyroid cancer cases. It’s more likely to be found at an early stage because it produces a hormone called calcitonin, which doctors keep an eye out for in blood test results.
  • Anaplastic thyroid cancer:This could be the most severe type of thyroid cancer because it’s aggressive and spreads to other parts of the body. It’s rare, and it is the hardest to treat.
  • Symptoms

    Thyroid cancer symptoms do not usually emerge in the early stages. That’s because there are very few symptoms in the beginning. As it grows however, the following problems may show:

  • Neck, throat pain
  • Lump in your neck
  • Difficulty swallowing
  • Vocal changes, hoarseness
  • Pain in the ears
  • Trouble breathing or having constant wheezing
  • Frequent cough that is not related to a cold
  • The lymph nodes in the neck are swollen
  • Causes

    The following can be the causes as well as the risk factors that can lead to thyroid cancer:

  • Radiation exposure: The exposure, especially during childhood, increases the risk of developing thyroid cancer. This could be due to an all-nuclear fallout that occurs after a nuclear explosion, or radiation treatment for medical conditions/diseases when radiation risks were not properly understood.
  • Gender: The gender of the patient plays a big role in thyroid cancer. Around three-quarters of all patients with thyroid cancer are female.
  • Some health conditions/diseases: People with the following conditions/diseases have a higher risk of developing thyroid cancer:
    • Hashimoto’s thyroiditis
    • Cowden’s syndrome
    • Thyroid adenoma and
    • Familial adenomatous polyposis.
    • Genetics: Some inherited conditions increase the risk of developing medullary thyroid cancer. Approximately one quarter of individuals, who develop medullary thyroid cancer, have an abnormal gene.
    • Iodine deficiency: If there is iodine deficiency in the diet, there is a higher risk for certain types of thyroid cancer.
    • Family history: Individuals with a family history of goitre (thyroid gland enlargement) have a higher risk of developing thyroid cancer.
  • Diagnosis

    Thyroid nodules, or lumps, are very common. Most aren’t cancerous. In order to diagnose thyroid cancer one or a combination of the following tests can be conducted:

  • Physical exam: The doctor conducts a physical examination of the thyroid for lumps (nodules). He may also check the neck and nearby lymph nodes for growths or swelling.
  • Blood tests: The doctor may also check for abnormal levels of Thyroid-Stimulating Hormone (TSH) in the blood. Too much or too little TSH means the thyroid is not working well.
  • Ultrasound: An ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off organs inside the neck. The echoes create a picture of the thyroid and nearby tissues. The picture can show thyroid nodules that are too small to be felt. Nodules that are filled with fluid are usually not cancer. Nodules that are solid may be cancer.
  • Thyroid scan: In a thyroid scan, the patient is made to swallow a small amount of a radioactive substance (such as radioactive iodine), and it travels through the bloodstream. Thyroid cells that absorb the radioactive substance can be seen on a scan. Nodules that take up more of the substance than the thyroid tissue around them are called ‘hot’ nodules. Hot nodules are usually not cancer. Nodules that take up less substance than the thyroid tissue around them are called ‘cold’ nodules. Cold nodules may be cancer.
  • Biopsy: A biopsy is the only sure way to diagnose thyroid cancer. A pathologist checks a sample of thyroid tissue for cancer cells, using a microscope.
  • A doctor may take tissue for a biopsy in one of the following two ways:
  • With a thin needle: The doctor removes a sample of tissue from a thyroid nodule with a thin needle. An ultrasound device can help your doctor see where to place the needle. Most people have this type of biopsy.
  • With surgery: If a diagnosis can’t be made from tissue removed with a needle, a surgeon removes a lobe, or the entire thyroid. For example, if the doctor suspects follicular thyroid cancer, the lobe that contains the nodule may be removed for diagnosis.
  • Treatment

    There are multiple ways to treat thyroid cancer. The treatment you get will depend on the type and stage of the cancer. It also depends on the age and general health of the patient. The doctor may recommend surgery, radioactive iodine and/or radiotherapy. In most cases, especially during the early stage of the cancer, treatment is effective with a favourable outcome

    Surgery: If thyroid cancer is detected at an early stage, then the doctors recommend one of the following surgical procedures:

  • Thyroidectomy: The surgical removal of part or all of the thyroid gland. During this operation, the surgeon may also remove the lymph nodes in the neck and the some of the tissue around the thyroid gland.
  • Lobectomy (hemithyroidectomy): The surgical removal of a lobe (one of the wings of the thyroid gland).
  • Tracheostomy: Making an incision in the front of the neck and opening a direct airway through an incision in the trachea (windpipe), allowing the patient to breathe.
  • After surgery the patient may experience pain when swallowing and will be on a special diet of soft foods.

    Thyroid Hormone Therapy: If the thyroid gland is completely or partially removed, the patient will need to take replacement hormone tablets for the rest of his/her life. The patient will need regular blood tests to make sure hormone levels are right.

    Radioactive Iodine Ablation: The thyroid gland and most thyroid cancers absorb iodine. Radioactive iodine (RAI) ablation is used to destroy any thyroid tissue that’s left after a thyroidectomy.

    The iodine goes to the thyroid tissue and the radiation destroys it. It may also be used for cancer that spreads to nearby lymph nodes, spreads to other parts of the body, or returns. The level of radiation in this treatment is far higher than what is used in a radioiodine scan.

    The patient usually has a special diet that is low in iodine for 1 or 2 weeks before you get the treatment. If the patient is on thyroid hormone pills, they are usually stopped during this treatment.

    External Radiation Therapy: Radiotherapy is usually only used for medullary or anaplastic thyroid cancers.

    Chemotherapy: Chemotherapy, typically, refers to the destruction of cancer cells. It is usually only used to treat anaplastic thyroid cancer that has metastasized. However, chemotherapy may also include the use of antibiotics or other medications to treat any illness or infection.

    types of cancer

    Throat Cancer


    Throat cancer primarily affects the organs that help breathe, swallow and speak. About 50% of these cancers happen in the throat. Throat, also called the pharynx, is the tube that starts behind the nose and ends in the neck. The remaining ones occur in the voice box (larynx). Throat cancer can also affect the piece of cartilage (epiglottis) that acts as a lid for your windpipe. Tonsil cancer, another form of throat cancer, affects the tonsils, which are located on the back of the throat. Throat cancer tends to grow quickly therefore it is recommended to get treatment early. This provides the best chance of beating the disease and maintaining a good quality of life. Most throat cancer types grow in the flat thin cells that line the throat and voice box. They are identified by their location which are Nasopharynx, Oropharynx and Hypopharynx. Throat cancer can grow in three parts of the voice box as well, namely the Glottis, Supraglottis and Subglottis. Throat Cancer in India and many other developing countries is on a rise and the risk of throat cancer can be reduced by not smoking, chewing tobacco and limiting alcohol consumption.


    The occurrence of a few symptoms may not explain the problem. However, symptoms that are persistent or increase or gradually become severe tend to reveal the presence of throat cancer. Some of the common symptoms include:

  • Hoarseness: a rough quality of the voice
  • Throat discomfort, sensation of a foreign body in the throat, a feeling of lump in the throat
  • Sore throat or throat pain, aggravated by swallowing
  • Coughing purulent bloody sputum with smelly odour, even coughing up blood
  • Bad breath
  • Difficulty in swallowing
  • Cough
  • Weight loss for unknown reasons
  • A lump in the back of the mouth, throat or neck
  • Causes

    The reasons for the mutation that leads to throat cancer are not completely clear. However, factors that can increase the risk of throat cancer include:

  • Tobacco use, including smoking and chewing tobacco
  • Excessive alcohol use, which translates to more than two drinks a day for men and more than one drink a day for women
  • A virus called Human Papillomavirus (HPV)
  • A diet lacking in fruits and vegetables
  • Other risk factors are:
  • Men are five times more likely to get throat cancer than women
  • Most people get diagnosed with throat cancer after the age of 65
  • African-American men are at the biggest risk of getting throat cancer
  • Exposure to chemicals such as asbestos, nickel and sulphuric acid fumes increase the chances of getting throat cancer.
  • Diagnosis

    In order to determine if a person is suffering from throat cancer or not, the dentist advices one of the following methods for diagnosis:

  • Endoscopy: This test is performed to determine the extent of the tumour. During the procedure, the upper portion of the gastrointestinal tract and respiratory tract are visualised with endoscopes – long, thin and flexible tubes equipped with a tiny video camera and light on the end. Other areas which can be examined include the oesophagus, trachea and bronchi of the lungs. In many cases, endoscopy is a more precise examination than X-ray studies.
  • Imaging Tests: Another method that is generally used by the doctors are imaging tests, such as a Computed Tomography (CT) scan, Positron Emission Tomography (PET) scan or Magnetic Resonance Imaging (MRI), which provide additional information regarding the stage of the tumour and whether the cancer has spread to surrounding lymph nodes in the neck or elsewhere in the body.
  • A Biopsy: It is done to collect tissue samples that get examined under a microscope. It is the only way to know for sure if the tumour is cancerous or not. A biopsy procedure can be done with a surgery or a fine needle or through the endoscope.
  • Treatment

    Multi-disciplinary approach is known to have improved the quality of cancer care and ensures that the patient has access to the best current thinking on cancer management. Surgery or radiation therapy by themselves or a combination of these therapies may be part of the treatment plan. The treatment plan is based on the staging, location and other health factors of the patient. The stages of throat cancer are: Stage 1 and 2: The cancer is this stage is smaller and remains in one location Stage 3: The cancer may have spread to the lymph nodes and/or other parts of the throat Stage 4: Here the cancer may have spread to lymph nodes and different parts of the throat, head, neck, or chest. The most serious stage 4 throat cancer is when it has metastasised to distant parts of the body like the lungs or liver. Medical Oncology for Throat Cancer: Chemotherapy is a process where medical drugs are used to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. For advanced stage tumours, chemotherapy is often given in combination with radiation therapy, typically in the setting of a therapeutic clinical trial. Surgical Oncology for Throat Cancer: Surgery can be performed by an incision with a scalpel, by an endoscope, through laser or robotic surgery. Very early stage throat cancer is usually taken out by endoscopic or laser surgery. However, if the tumour is advanced and has spread to surrounding areas, surgery will be more extensive and may involve the removal of parts of the throat, mouth, jaw or voice box. In these cases, the ability to speak, chew, swallow and breathe may be affected. Reconstructive surgery in throat cancer treatment can help in restoring the appearance of the organ and rehabilitate the ability to speak and swallow. In more advanced cases, the patient may need to use tubes for feeding and breathing and an artificial voice aid for speaking. In addition, one may have to work with a dietician who will help in developing a nutrition plan that includes healthy foods that are easy to swallow and chew. With the advancements in the technology, robotic surgery in treatment of throat cancers is now used to deliver best possible outcome in a minimally invasive way. Radiation Oncology for Throat Cancer: Sometimes radiation is the only treatment needed for early stage throat cancer. Radiation Therapy uses high-energy particles or waves (like x-rays, gamma rays, electron beams) to destroy or damage cancer cells. Radiation therapies could be used with chemotherapy and surgery, in the treatment of stage 3 and 4 throat cancer. Radiation therapies are painless, do not require surgery and are aimed at destroying cancer cells in a specific area. It can either come from a high energy x-ray machine or from a small source of radioactive material placed close to or on the tumour.

    types of cancer

    Testicular Cancer


    The cells of your testicles, which produce sperms and other male hormones, can grow out of control, causing Testicular Cancer, like any other type. But the condition is rare and mostly affects young men of the 20-35 age group. It can affect both testis and can also spread to surrounding nodes, called the lymph nodes, which drain fluid from them, and other organs. The risk of having the disease increases in persons who have/had undescended testis (AKA cryptorchidism), a condition in which one side of the scrotum remains empty and testis can be found in groin or abdomen, or in people who are immediate relatives of proven testicular cancer patients.


    Most common symptoms are:

  • Lump or swelling in the testicle
  • Heaviness or aching in the lower belly or testicles
  • Voice changes and facial and body hair growth in a very young boy (early puberty)
  • In some cases, there may be fluid collection in the scrotum which can be identified in children easily. The lump can be painless, and any painless lump should be seen by a doctor.
  • Causes

    Anything that can increase the risk of getting a disease is called a risk factor. Different cancers have different risk factors.­ Having one or more of these risk factors doesn’t necessarily mean one will get that cancer. As testicular cancer is rare, the risk of developing it is small even if one has any risk factors.

  • Undescended testicles
  • Abnormal cells in testicle
  • Fertility problems
  • Previous testicular cancer
  • Family history
  • Hypospadias
  • Inguinal hernia
  • Diagnosis

  • Ultrasound scan of the scrotum/inguinal area/abdomen: Often the first test to be performed, an ultrasound can detect the size and nature (fluid filled/cystic or solid) of the swelling, its position in case of undescended testis, and a hydrocoele.
  • Blood tests: This includes routine blood tests as well as ‘tumor markers’ which are certain proteins/hormones which get elevated in certain cancers, depending upon the cancer site. In testicular cancers, important ones are Alpha Feto Protein (AFP), beta – Human Chorionic Gonadotropin (beta HCG), and Lactate Dehydrogenase (LDH). The elevated levels are not specific or confirmatory but can still help doctors to arrive at a diagnosis and to assess post treatment status.
  • Other scans: Once the doctor sees that the swelling is suspicious, body scans should be performed, to assess the extent of local and distant spread, which include CT abdomen and chest, X-ray of the lungs which are the most common site of distant spread, or a PET-CT scan, if whole body imaging is required.
  • Biopsy and pathological examination: This is the confirmatory and mandatory test. Biopsy is done by unilateral or bilateral orchidectomy (removal of the testis through surgery), after which a pathologist checks under the microscope to find out the types of cells that are out of control. The treatment modalities are entirely dependent on this.
  • Types, Grades and Stages of Testicular cancer The cancer can be classified into-
  • Seminomas -Tumors that grow and spread slower than most other testicular cancers.
  • Non-seminomas – Tumors that are often found in younger men, who are in their late teens and early 30s.
  • Grading This helps doctors to predict how fast the cancer is likely to grow and spread. Cancer cells are graded based on how much they look like normal cells. Usually grades 1, 2, and 3 are given, based on how different the cells look from normal cells. Cells that look very different from normal cells are given a higher grade (3) and tend to grow the fastest. Staging It depicts the status of spread. Testicular cancers can be staged into 0-III stages and subsets A-C, depending upon the size of testicular cancer, number and site of lymph nodes involved. As the stage increases, disease severity also increases, with stage III being the most advanced form of this disease.


    Fortunately testicular cancer patients respond well to both chemotherapy (medicines) and radiation. Treatment modalities are decided based on the stage of the disease and other risk factors. Stage 1:

  • Surgery (orchidectomy) – Followed by surveillance.
  • Chemotherapy – Indicated in certain patients, if the possibility of recurrence of the disease is high due to cryptorchidism and/or family history.
  • Stage 2: Seminoma – Surgery and radiotherapy, or chemotherapy may be required in later stages. Non-seminomas (teratomas) – Surgery (orchidectomy) and chemotherapy may be required. Stage 3: After orchidectomy- Chemotherapy. If seminoma – After chemotherapy, only follow ups are required. If non-seminoma – The patient might need surgurical removal of lymph nodes and lung lesions. Recurrent Tumor – Chemotherapy or High dose chemotherapy with stem cell transplant – A stem cell transplant lets doctors use higher doses of chemo. The cells that make blood (called stem cells), are taken out of the blood using a special machine. Then very strong chemo is given, which can lead to side effects like severe reduction in blood counts. So, the stem cells are given back to the person, after chemo, to aid his system. Clinical trials- Clinical trials are research studies that test new drugs or other treatments in people. They compare standard treatments with others that may be better. These mostly have to be given to people in whom the disease has relapsed.

    types of cancer

    Stomach Cancer


    Stomach cancer or gastric cancer, refers to cancer developing in any part of the stomach. These cancers are classified according to the type of tissue they originate in. The most common type of stomach cancer is adenocarcinoma, which starts in the glandular tissue of the stomach and accounts for 90-95% of all stomach cancers.

    Other forms of stomach cancer include lymphomas, which involve the lymphatic system and sarcomas, which involve the connective tissue (such as muscle, fat or blood vessels). Stomach cancer is often curable, if found and treated in an early stage.


    In the early stages of stomach cancer, the symptoms are not very clear. But in the later stages the following symptoms manifest themselves:

  • Indigestion and stomach discomfort
  • A bloated feeling after eating
  • Mild nausea
  • Loss of appetite
  • Heartburn
  • These symptoms are similar to those caused by a peptic ulcer. If you are experiencing any of these symptoms, you should see your health care provider so that a proper diagnosis can be made and timely treatment given. A stomach cancer can grow very large before it causes other symptoms.

    In more advanced cancer, you may have:

  • Discomfort in the upper or middle part of the abdomen.
  • Blood in the stool (which appears as black, tarry stools).
  • Vomiting or vomiting blood.
  • Weight loss.
  • Pain or bloating in the stomach after eating.
  • Weakness or fatigue associated with mild anaemia (a deficiency in red blood cells).
  • Causes

    The exact cause of stomach cancer is unknown, but a number of factors can increase the risk and causes of the disease, including:

  • Gender: According to studies, men have more than double the risk of getting stomach cancer in comparison to their female counterpart.
  • Race: The occurrence of stomach cancer is on the higher side among African-American or Asian.
  • Genetics: Genetic abnormalities and some inherited cancer syndromes may increase an individual’s risk towards developing stomach cancer.
  • Blood type: Individuals with blood group A may be at increased risk.
  • Advanced age: Stomach cancer occurs more often around ages 70 and 74 in men and women, respectively.
  • Family history of gastric cancer can double or triple the risk of stomach cancer.
  • Lifestyle factors such as smoking, drinking alcohol and eating a diet devoid of fruits and vegetables or high in salted, smoked or nitrate-preserved foods may increase risk.
  • Helicobacter pylori (H. pylori) infection of the stomach: H. pylori is a bacterium that infects the lining of the stomach and causes chronic inflammation and ulcers.
  • Certain health conditions, including chronic gastritis, pernicious anaemia, gastric polyps, intestinal metaplasia and prior stomach surgery.
  • Work-related exposure due to coal mining, nickel refining and rubber and timber processing and asbestos exposure.
  • Diagnosis

    If anyone of the following symptoms occurs, such as indigestion, weight loss, nausea and loss of appetite, screening tests may be recommended. These tests may include:

  • Upper GI series: These are X-rays of the oesophagus, stomach and first part of the intestine taken after you drink a barium solution. The barium outlines the stomach on the X-ray, which helps the doctor, using special imaging equipment, to find tumours or other abnormal areas.
  • Gastroscopy and biopsy: This test examines the oesophagus and stomach using a thin, lighted tube called a gastroscope, which is passed through the mouth to the stomach. Through the gastroscope, the doctor can look directly at the inside of the stomach. If an abnormal area is found, the doctor will remove some tissue (biopsy) to be examined under a microscope. A biopsy is the only sure way to diagnose cancer. Gastroscopy and biopsy are the best methods of identifying stomach cancer.
  • Once stomach cancer is diagnosed, more tests may be performed to determine whether the cancer has spread. These tests may include CT scans, PET scans, bone scans, laparoscopy and endoscopic ultrasound.

    Other tests undertaken:
  • Physical exam: The doctor feels the abdomen for fluid, swelling or other changes. The doctor will also check for swollen lymph nodes.
  • Endoscopy: The doctor uses a thin, lighted tube (endoscope) to look into the stomach. He first numbs the patient’s throat with an anaesthetic spray. The tube is then passed through the mouth and oesophagus to the stomach.
  • Biopsy: An endoscope has a tool for removing tissue. The doctor uses the endoscope to remove tissue from the stomach. A pathologist checks the tissue under a microscope for cancer cells. A biopsy is the only sure way to know if cancer cells are present.
  • Treatment

    Cancer of the stomach is difficult to cure unless it is found in an early stage. Unfortunately, because early stomach cancer causes few symptoms, the disease is usually advanced when the diagnosis is made. Treatment for stomach cancer may include surgery, chemotherapy and/or radiation therapy. New treatment approaches such as biological therapy and improved ways of using current methods are being studied in clinical trials.


    Surgery is the most common treatment. The surgeon removes part or all of the stomach, as well as the surrounding lymph nodes, with the basic goal of removing all of the cancer tissue and a margin of normal tissue. Depending on the extent of invasion and the location of the tumour, surgery may also include removal of part of the intestine or pancreas. Tumours in the lower part of the stomach may call for a Billroth I or Billroth II procedure.

    Endoscopic Mucosal Resection (EMR) is a treatment for early gastric cancer (tumour only involves the mucosa) that has been pioneered in Japan, but is also available in the United States at some centres. In this procedure, the tumour, together with the inner lining of stomach (mucosa), is removed from the wall of the stomach using an electrical wire loop through the endoscope. The advantage is that it is a much smaller operation than removing the stomach. Endoscopic Submucosal Dissection (ESD) is a similar technique pioneered in Japan, used to resect a large area of mucosa in one piece. If the pathologic examination of the resected specimen shows incomplete resection or deep invasion by tumour, the patient would need a formal stomach resection.

    Surgical interventions are currently curative in less than 40% of all cases, and in cases of metastasis may only be palliative.


    The use of chemotherapy to treat stomach cancer has no firmly established standard of care. Unfortunately, stomach cancer has not been particularly sensitive to these drugs and chemotherapy, if used, palliatively reduces the size of the tumour, relieves symptoms of the disease and increases survival time.


    Radiation therapy is the use of high-energy rays to damage cancer cells and stop them from growing. When used, it is generally in combination with surgery and chemotherapy, or used only with chemotherapy in cases where the individual is unable to undergo surgery. Radiation therapy may be used to relieve pain or blockage by shrinking the tumour for palliation of incurable disease.