Best possible cancer treatment for you

Colorectal cancer, also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum . The colon is the final part of the digestive tract.

Globally more than 1 million people get colorectal cancer every year. As of 2012, it is the second most common cause of cancer in women (9.2% of diagnoses) and the third most common in men (10.0%)

Colon cancer typically affects older adults, though it can happen at any age. It usually begins as small, noncancerous (benign) clumps of cells called polyps that form on the inside of the colon. Over time some of these polyps can become colon cancers.

Polyps may be small and produce few, if any, symptoms. Regular screening tests may help prevent colon cancer by identifying and removing polyps before they turn into cancer. Several tests can be used to screen for colorectal cancer , such as FIT tests.

Signs and symptoms of colon cancer include:

• a persistent change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool
• rectal bleeding or blood in your stool
• persistent abdominal discomfort, such as cramps, gas or pain
• a feeling that your bowel doesn’t empty completely
• weakness or fatigue
• unexplained weight loss

If colon cancer develops, many treatments are available to help control it, including surgery, radiation therapy and drug treatments, such as chemotherapy, targeted therapy and immunotherapy.

1.  Colon cancer – Symptoms and causes – Mayo Clinic
2. Cancer.Net Editorial Board, 10/2019
3. Colon Cancer Treatment (PDQ®). NCI. May 12, 2014. 
4. Cunningham D, Atkin W, Lenz HJ, Lynch HT, Minsky B, Nordlinger B, Starling N (March 2010). “Colorectal cancer”. Lancet. 375 (9719): 1030–1047.

Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm.

Prostate cancer is one of the most common types of cancer. Many prostate cancers grow slowly and are confined to the prostate gland, where they may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

Prostate cancer may cause no signs or symptoms in its early stages. Prostate cancer that’s more advanced may cause signs and symptoms such as:

• Trouble urinating
• Decreased force in the stream of urine
• Blood in the urine
• Blood in the semen
• Bone pain
• Losing weight without trying
• Erectile dysfunction

There are several risk factors that can be correlated to prostate cancer:

• Age – about 6 in 10 cases are found in men older than 65
• Race/ethnicity
• Geography – besides others most common in North America and northwestern Europe
• Having a family history of prostate cancer
• Gene changes (inherited mutations of the BRCA1 or BRCA2 genes or men with Lynch syndrome)

Prostate cancer that’s detected early — when it’s still confined to the prostate gland — has the best chance for successful treatment.

Depending on the stage in that the cancer is detected and other factors such as general health condition, there are several treatment options:

• Observation or Active Surveillance
• Surgery
• Radiation
• Cryotherapy
• Hormone Therapy
• Chemotherapy
• Immunotherapy
• Targeted therapies

1. Prostate cancer – Symptoms and causes – Mayo Clinic
2. Prostate Cancer Risk Factors
3. Considering Prostate Cancer Treatment Options

Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale.

People who smoke have the greatest risk of lung cancer, though lung cancer can also occur in people who have never smoked. Other risk factors include

• exposure to secondhand smoke,
• previous radiation therapy,
• exposure to radon gas,
• exposure to asbestos and other carcinogens and
• family history of lung cancer

Lung cancer typically doesn’t cause signs and symptoms in its earliest stages. Signs and symptoms of lung cancer typically occur when the disease is advanced and may include:

• a new cough that doesn’t go away
• coughing up blood, even a small amount
• shortness of breath
• chest pain
• hoarseness
• losing weight without trying
• bone pain
• headache

In case your doctor suspects the possibility of lung cancer, he/she will first discuss your medical history and initiate an initial physical examination. If this results in a further suspicion of lung cancer, the necessary examinations (laboratory tests, X-rays, bronchoscopy, CT scan and ultrasound) will be initiated. Then it can be clarified whether it really is a tumor and if so, what type of tumor is present and how advanced the disease is.

If lung cancer is actually detected, further examinations follow. Their main purpose is to show how far the tumor has spread, whether lymph nodes are affected and whether metastases have formed in other parts of the body:

• Pulmonary function testing
• Magnetic resonance imaging
• PET-CT (combined examination of positron emission tomography and computer tomography)
• Mediastinoscopy
• Skeletal scintigraphy
• Testing for genetic alterations in the tumor: tissue biopsy and/or liquid biopsy followed by genetic testing for specific genetic characteristics of the tumor

The decision on the choice, combination and order of the right treatment – surgery, chemotherapy, radiotherapy, targeted therapy or immunotherapy – is determined by a so-called tumor board, where all relevant disciplines in the hospital are discussing each individual patient based on the latest care guidelines. Hereby, the type of tumor – non-small cell or small cell – the stage of the disease, the genetic changes in the tumor cells and the patient’s general state of health are key decision triggers. There has been a unprecedented progress achieved regarding the treatment options and outcomes for lung cancer patients throughout the past years.

1. Lung cancer – Symptoms and causes – Mayo Clinic
2. Lungenkrebs: Symptome, Untersuchung, Behandlung, Nachsorge (krebsinformationsdienst.de)
3. www.lungenkrebs.de
4. S3-Leitlinie Lungenkarzinom (awmf.org)

Malignant tumors of the uterus are the most common cancer of the female genital organs. Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina. Cervical cancer begins when healthy cells in the cervix develop changes (mutations) in their DNA and preferentially develops in the transition area (transformation zone) of the endometrium and the squamous epithelium of the vagina.

Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer. HPV is very common, and most people with the virus never develop cancer.  In a small percentage of people, however, the virus survives for years, contributing to the process that causes some cervical cells to become cancer cells. You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.

Other risk factors for cervical cancer include

• many sexual partners
• early sexual activity
• other sexually transmitted infections (STIs)
• a weakened immune system and
• smoking

Early-stage cervical cancer generally produces no signs or symptoms. Possible first symptoms of cervical cancer are:

• Vaginal discharge, which may be foul-smelling
• Bleeding after sexual intercourse
• Bleeding outside the menstrual cycle or after menopause

If cervical cancer is suspected, various examinations are necessary to determine whether the disease is actually cancerous. At the same time, it should be determined which type of tumor is present and how far the disease has progressed. Important examination steps for the detection of cervical cancer are:

• medical history and physical examination with a mirror examination (speculum) and palpation as well as taking a smear (Pap test).
• ultrasound examination through the vagina
• scraping of the mucous membrane of the cervix and uterus (fractional abrasion)
• hysteroscopy of the uterus with tissue sampling (biopsy)
• the fine tissue (histological) examination of the tissue is decisive for confirming the diagnosis.

If cancer is diagnosed, further examinations are performed even before surgery. They should clarify how far the tumor has already spread, whether lymph nodes are affected or whether metastases have formed in other parts of the body. 

The main goal of any therapy is the complete removal of the tumor. Various treatment methods are available for this purpose. The decision on the choice, combination and order of the right treatment – surgery, chemotherapy or radiotherapy– is determined according to the type of tumor – squamous cell carcinoma and adenocarcinoma – the stage of the disease and the patient’s general state of health. In addition, the treating physician will take into account the patient’s general condition. Any family planning that has not yet been completed will also be taken into consideration – as far as is responsible. In the early stage, treatment by means of conization can almost always be performed in a fertility-preserving manner, i.e. a subsequent pregnancy is possible.

1. Cervical cancer – Symptoms and causes – Mayo Clinic
2. Gebärmutterhalskrebs: Symptome, Untersuchung, Stadieneinteilung (krebsinformationsdienst.de)
3. Gebärmutterhalskrebs | DKG (krebsgesellschaft.de)
4. Gebärmutterhalskrebs / Zervixkarzinom » (frauenaerzte-im-netz.de)
5. 032-033OLp_S3_Gebaermutterhalskrebs_Zervixkarzinom_2020-08.pdf (awmf.org)

Thyroid cancer occurs in the cells of the thyroid — a butterfly-shaped gland located at the base of your neck, just below your Adam’s apple. The thyroid gland consists – similar to a sponge – of very many small vesicles and produces hormones that regulate your heart rate, blood pressure, body temperature and weight.

Thyroid cancer typically doesn’t cause any signs or symptoms early in the disease. As thyroid cancer grows, it may cause pain, changes to your voice, difficulty swallowing and swelling in the neck. Factors that may increase the risk of thyroid cancer include female sex, exposure to high levels of radiation and certain inherited genetic syndromes

Several types of thyroid cancer exist. Some grow very slowly and others can be very aggressive.

Thyroid cancer is usually discovered by chance through an ultrasound examination. However, the ultrasound examination alone is not sufficient for a reliable diagnosis of thyroid cancer. If the doctor classifies a thyroid nodule as conspicuous on ultrasound, further examinations follow, such as scintigraphy and possibly a fine needle biopsy. In addition, if thyroid cancer is suspected, various values are measured in the blood. 

Most cases of thyroid cancer can be cured with treatment. The first step to cure is usually surgical removal of the diseased thyroid gland and examination of the tissue. In most cases, this is followed by ablative radioiodine therapy to remove any residual tissue that could not be surgically removed. The therapy and aftercare of thyroid carcinoma consists of different measures that are required at certain intervals.

Thyroid cancer rates seem to be increasing. One assumed reason is that new technology is allowing the detection of small thyroid cancers that may not have been found in the past. Currently, there is tremendous development in thyroid cancer research.

1. Thyroid cancer – Symptoms and causes – Mayo Clinic
2. “Schilddrüsenkrebs” – (krebsinformationsdienst.de)
3. www.schilddrüsenkrebs.de
4. AWMF: Detail

Breast cancer is the most common cancer in women and can occur in both men and women. Currently, one in eight women will develop breast cancer during their lifetime.

The risk increases with age. Other factors that are associated with an increased risk of breast cancer include:

• A personal- and/or family history of breast cancer
• Inherited genes that increase cancer risk 
• Radiation exposure
• Obesity
• Beginning your period at a younger age
• Beginning menopause at an older age
• Having your first child at an older age
• Having never been pregnant
• Postmenopausal hormone therapy
• Drinking alcohol

Signs and symptoms of breast cancer may include:

• A (new) lump in the breast or underarm (armpit) that feels different from the surrounding tissue
• Any change in the size, shape or appearance of the breast
• Changes to the skin over the breast, such as dimpling
• A newly inverted nipple
• Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
• Redness or pitting of the skin over your breast, like the skin of an orange
• Pain in any area of the breast

Not every clinic is suitable for breast cancer treatment, and proximity to home should not be the deciding factor in choosing a facility. It is essential that the facility has sufficient experience in the treatment of breast cancer. In addition all necessary diagnostic and therapeutic specialties should be represented in the facility. Certified breast cancer centers (certified issued by the German Cancer Society in cooperation with the German Society for Senology (DGS)) meet these criteria. They must meet certain professional requirements and have a recognized quality management system. Compliance with the requirements is reviewed annually.

Treatment options for breast cancer are manifold and are steadily growing. Accompanying this, breast cancer survival rates have increased, and the number of deaths associated with this disease is steadily declining. Drivers for this development are also earlier detection, a new personalized approach to treatment and a better understanding of the disease.

1. Breast cancer – Symptoms and causes – Mayo Clinic
2. What Are the Symptoms of Breast Cancer? | CDC
3. Brustkrebs, Mammakarzinom | DKG (krebsgesellschaft.de)
4. Therapie bei Brustkrebs | DKG (krebsgesellschaft.de)A