Definition

Lymphoma is the name of a diverse group of cancers of the lymphatic system, a connecting network of glands, organs and vessels whose principle cell is the lymphocyte.

What is the lymph system?

The lymph system is an interconnected network of thin tubes and nodes that carries white blood cells. These cells fight infections and are vitally important for our well-being. You can read more about the lymph system in the article - What is the lymph system?. So when a lymphocyte (a type of white blood cell) that is a part of the lymph system becomes cancerous, it may grow and multiply to form a lymphoma.

Description

Cancer cells are the descendants of a single normal cell in which genetic errors, or mutations, have occurred. These errors cause the cancer cells to over- or under-produce proteins that abnormally affect the cell's behavior - causing these cells divide too fast or fail to die when they should.

Cancer cells are typically clonal meaning that the descendent cells share the defects of the parent cell, but they can acquire additional mutations.

The malignant behavior, such as how aggressive or slow growing it might be, is determined by the cell type, the kinds of mutations, and sometimes the host environment.

There are as many kinds of cancers as there are cell types: skin, lung cancer, and blood cell cancers, etc. In cells, genetic errors occur in the basic building blocks of DNA called genes. These errors might occur randomly when the cell divides, or they may result from exposure to environmental toxins called carcinogens - meaning able to cause cancer.

The successful rate in treatment of hypothyroidism by homeopathy is much higher than any other system of medicine. There are many homeopathic medicines for Hypothyroid disorders. As I always says, a homeopathic medicine is prescribed after a detailed case taking. Your complete physical and mental conditions are took in detail on case taking. After analyzing your symptoms a constitutional miasmatic remedy is prescribed by a homeopath. I am listing out some important medicines which can be given for hypothyroid disorders. In chronic cases you will have to continue the medicines for a little time as explained by your doctor.

It is a classical remedy for goitre, simple and the exophthalmic variety; in this

Iod individual is exceedingly thin, dark complexioned, with enlarged lymphatic glands, has voracious appetite but gets thin. Tubercular type.

Tremor. Iodine craves cold air.Acute exacerbation of chronic inflammation. Arthritis deformans. Acts prominently on connective tissue. The plague. Goitre.. Sluggish vital reaction, hence chronicity in many of its aspects.

Tincture internally and locally to swollen glands and rattlesnake bites.

Throat.--Larynx feels constricted. Eustachian deafness. Thyroid enlarged. Goitre, with sensation of constriction. Swollen submaxillary glands. Uvula swollen.

Specially indicated in infancy and old age. This remedy brings aid to scrofulous children, especially if they are backward mentally and physically, are dwarfish, do not grow and develop, have scrofulous ophthalmia, swollen abdomen, take cold easily, and then always have swollen tonsils.. Diseases of old men when degenerative changes begin;-cardiac vascular and cerebral;-who have hypertrophied prostate or indurated testes, very sensitive to cold.

 offensive foot-sweats, very weak and weary, must sit or lie down or lean on something. Very averse to meeting strangers. Often useful in the dyspepsias of the young who have masturbated and who suffer from seminal emissions. Affects glandular structures, and useful in general degenerative changes, especially in coats of arteries, aneurism, and senility.

Throat.--Submaxillary glands and tonsils swollen. Takes cold easily, with stitches and smarting pain. Quinsy. Suppurating tonsils from every cold. Tonsils inflamed, with swollen veins. Smarting pain when swallowing; worse empty swallowing. Feeling of a plug in pharynx. Can only swallow liquids. Spasm of œsophagus as soon as food enters œsophagus, causes gagging and choking

.Worse, while thinking of symptoms; from washing; lying on painful side.

 Better, walking in open air.

 In simple goitre in those of strumous diathesis this remedy has been used successfully. Cured cases on record are numerous. Various strengths are recommended from the 4th to the 30th.

Fatty flabby patients with slowness in every movements and actions. They are mild . It is more suited to chilly patients.

Children with fair complexion, lax fiber; swollen glands. Exhaustion and heaviness of the body after slight exertion, with orgasm of blood to chest, face. Anxiety and difficult breathing.

Throat.--Thyroid gland swollen. Stitches and dryness. Burning and stinging. Sore throat; worse after eating sweet things. Tickling causes cough. Clears throat constantly.

Worse, ascending, wind, before midnight.

Better, descending, lying with head low.

THROAT: GOITRE, exophtalmic (Calc, Iod, Spong), sensitive to touch and  pressure. Swelling of uvula.

Seems to be especially adapted to scrofulous and venous constitutions, old people, and after debilitating disease, with feeble circulation and lowered vitality. Glands are indurated, veins distended, skin blue. Stitch remaining after pleurisy. Easily strained from lifting. Weakness of nursing women. Ulceration and decomposition. All its secretions are offensive.

worse in evening, in bed and from cold. Verruca on hands and face of old people, with bluish color of extremities. Glands indurated, swollen, painful, in neck, axillæ, groin, mammæ; pains lancinating, cutting, burning (Con; Merc iod flav). Burning, rawness and fissures; moisture. Bubo.

Hypochondriasis, urinary troubles, weakened memory, sexual debility found here. Trouble at the change of life, old and bachelors. Growth of tumors invite it also. General feeling as if bruised by blows. Great debility in the morning in bed. Weakness of body and mind, trembling, and palpitation. Cancerous diathesis. Arterio-sclerosis. Caries of sternum. Enlarged glands. Acts on the glandular system, engorging and indurating it, altering its structure like scrofulous and cancerous conditions. Tonic after grippe. Insomnia of multiple neuritis.

Worse, lying down, turningor rising in bed; celibacy; before and during menses, from taking cold, bodily or mental exertion.

Better, while fasting, in the dark, from letting limbs hang down, motion and pressure.

 This is the silico-fluoride of Calcium and was first recommended by Grauvogl and later emphasized by Hale. It is a component part of the waters of valleys where goitre is prevalent. It corresponds to simple goitre of a soft doughy feel, rather than the hard indurated encapsulated varieties. The writer has seen the drug cure several cases of this description in the 6x trituration. It increases markedly the appetite. It suits well persons of anaemic tendency.

Throat:Inflammation and pain, starts on the LEFT SIDE.Tonsillitis-Diphtheria; submaxillary glands painfully engorged, fauces dark red; worse on left tonsil. Parenchymatous tonsillitis. Will often abort peritonsillitis if given frequently. Cough form elongated uvula, with sore throat, Laryngeal troubles with aphonia.

Like all snake poisons, Lachesis decomposes the blood, rendering it more fluid; hence a hæmorrhagic tendency is marked. Delirium tremens with much trembling and confusion. Very important during the climacteric and for patients of a melancholic disposition. Ill effects of suppressed discharges. Diphtheritic paralysis Diphtheria carriers. Sensation of tension in various parts. Cannot bear anything tight anywhere.

Throat.--Sore, worse left side, swallowing liquids. Quinsy. Septic parotiditis. Dry, intensely swollen, externally and internally.

Acts on the lymphatic system, increased leucocytosis. Quinsy. Indurated glands, especially tonsils and breasts. Strumous ophthalmia, with tumefaction of cervical glands and stunted growth. Tumors.

Exophthalmic goitre in subjects of a cachectic appearance; there is palpitation of the heart and the heart beat seems to shake the entire body. It is likely to be a very useful remedy to finish and fix the cure begun by some other remedy.

THROAT: Affections of thyroid. Goitre ,Sensation of a lump Stitching pains Emaciation of neck

 Sulphur has been found curative of exophthalmic goitre.

The patient is hot. Sulphur suits for those who are dirty and in filthy in look and who are prone to skin effections. Symptoms aggravates on washing and standing.

 Many observers speak highly of this remedy in the exophthalmic variety of goitre. Its chief indications seem to be constriction of chest, weak pulse, which is remittent, tremulous and rapid. Cyanosis. Sometimes the heart's action is tumultuous and forcible.

1. EXTERNAL THROATGOITRE, exophthalmic

exophthalmic : Aur-i., aur., bad., cact., calc., con., crot-h., ferr-i., ferr., Iod., lycps., nat-m., phos., sec., spong.

indurated : Iod., spong.

painful : Iod., plat., spong.

menses, during : Iod.

on swallowing : Spong.

sensitive : Kali-i.

vascular : Apis., calc.

2. EXTERNAL THROATPAIN pressing, sides

Thyroid gland : Bar-c.

5.EXTERNAL THROATSWELLING,

Thyroid gland : Ail., ars., aur-s., carb-an., caust., clem., kali-i., nat-c., nit-ac., ol-j., thuj.

right : Merc.

sensation of : Mag-c.

6. EXTERNAL THROAT GOITRE: Ail., aloe., am-c., ambr., apis., aur-i., aur., bad., bell., brom., calc-f., calc-i., calc-s., Calc., carb-an., carb-s., caust., cist., con., crot-c., ferr-i., fl-ac., form., hep., Iod., kali-c., kali-i., lach., lap-a., lyc., lycps., mag-c., merc-i-f., merc-i-r., nat-c., nat-m., nat-p., nat-s., phos., plat., podo., sep., sil., Spong., stram., tab., tarent., tub., urt-u.

right sided : Iod., lyc., merc-i-f., nat-c., phos., sep., sil., spong.

left : Lach.

constriction : Calc-s., Crot-c., iod., lyc., spong.

7.EXTERNAL THROAT  INDURATION of glands : Alumn., am-c., ant-c., bar-c., bar-i., Bar-m., Bell., calc-f., Calc-i., calc-p., Calc., Carb-an., carb-s., carb-v., cist., Con., cupr., dulc., graph., hecla., hep., Iod., kali-i., lyc., merc., nat-c., nat-m., nit-ac., puls., rhus-t., sars., sep., Sil., spong., staph., Sulph., Tub.

like knotted cords : Bar-i., Bar-m., Calc-i., calc., cist., dulc., hecla., hep., iod., lyc., merc., psor., rhus-t., sil., sulph., Tub.

Definition

Leukemia is a cancer of the blood cells. A progressive, malignant disease of the blood-forming organs, characterized by distorted proliferation and development of leukocytes and their precursors in the blood and bone marrow. Leukemias were originally termed acute or chronic based on life expectancy but now are classified according to cellular maturity. Acute leukemias consist of predominately immature cells; chronic leukemias are composed of more mature cells.

Description

Leukemia accounts for about 2% of all cancers. It strikes 9 out of every 100,000 people in the United States every year. Men are more likely to develop leukemia than women, and white people get the disease more than other racial or ethnic groups. Adults are 10 times more likely to develop leukemia than children. Leukemia occurs most often in the elderly. When leukemia occurs in children, it happens most often before age 4.

Acute Leukemia

With acute leukemia, immature blood cells reproduce quickly in the bone marrow, where they eventually crowd out healthy cells. When present in high numbers, these immature, abnormal cells sometimes can spread to other organs, causing damage, especially in a type of leukemia called acute myeloid leukemia. The two main types of acute leukemia involve different types of blood cells:

• Acute myeloid leukemia accounts for 50% of leukemia diagnosed in teenagers and in people in their 20s. It is the most common acute leukemia in adults. It occurs when primitive blood-forming cells called myeloblasts reproduce without developing into normal blood cells. Immature myeloblast cells crowd the bone marrow and interfere with the production of healthy normal blood cells. This leads to anemia (not having enough red blood cells), bleeding and bruising (due to a lack of blood platelets, which help the blood to clot), and frequent infections because there are not enough protective white blood cells.
• Acute lymphoid leukemia is the most common type of leukemia that affects children, mainly those younger than 10. Adults sometimes develop acute lymphoid leukemia, but it is rare in people older than 50. It occurs when primitive blood-forming cells called lymphoblasts reproduce without developing into normal blood cells. These abnormal cells crowd out healthy blood cells. They can collect in the lymph nodes and cause swelling.

Chronic Leukemia


Chronic leukemia is when the body produces too many blood cells that have developed part way but often cannot function like mature blood cells. Chronic leukemia usually develops more slowly and is a less dramatic illness than acute leukemia. There are two main types of chronic leukemia:

• Chronic myeloid leukemia occurs most often in people between ages 25 and 60. In this form of leukemia, the abnormal cells are a type of blood cell called myeloid cells. Chronic myeloid leukemia cells usually involve an abnormality in the genetic code called the Philadelphia chromosome. However, this disease is not an inherited defect. Chronic myeloid leukemia sometimes can be cured with a bone marrow transplant.
• Chronic lymphoid leukemia is rare in people younger than 30. It is more likely to develop the older a person gets. The greatest number of cases occur in people between ages 60 and 70. In this form of leukemia, the abnormal cells in the bone marrow are a type of blood cell called lymphocytes. These abnormal cells cannot fight infection as well as normal cells can. With chronic lymphoid leukemia, cancerous cells live in the bone marrow, blood, spleen and lymph nodes, where they cause swelling that appears as swollen glands.

The vast majority of leukemias occur in people without any family history of leukemia and are not believed to be inherited. However, some forms of the disease, especially chronic lymphoid leukemia, occasionally strike close relatives in the same family. Certain genetic abnormalities (such as Down syndrome) have been linked to the development of specific forms of leukemia. In cases of myeloid leukemia, an increased risk of the illness has been linked to excessive exposure to radiation and to heavy exposure to benzene, a chemical found in unleaded gasoline.

Definition

Hodgkin's disease is a cancer of the lymphatic system, which is part of your immune system.

In Hodgkin's lymphoma, cells in the lymphatic system grow abnormally and may spread beyond the lymphatic system. As Hodgkin's lymphoma progresses, it compromises your body's ability to fight infection.

Hodgkin's lymphoma is one of two common types of cancers of the lymphatic system. The other type, non-Hodgkin's lymphoma, is far more common.

Advances in diagnosis and treatment of Hodgkin's lymphoma have helped to give people with this diagnosis the chance for a full recovery. The prognosis continues to improve for people with Hodgkin's lymphoma.

Description

Hodgkin's disease, or Hodgkin's lymphoma, was first described in 1832 by Thomas Hodgkin, a British physician. Hodgkin clearly differentiated between this disease and the much more common non- Hodgkin's lymphomas. Prior to 1970, few individuals survived Hodgkin's disease. Now, however, the majority of individuals with this cancer can be cured.

The lymphatic system is part of the body's immune system, for fighting disease, and a part of the blood- producing system. It includes the lymph vessels and nodes, and the spleen, bone marrow, and thymus. The narrow lymphatic vessels carry lymphatic fluid from throughout the body. The lymph nodes are small organs that filter the lymphatic fluid and trap foreign substances, including viruses, bacteria, and cancer cells. The spleen, in the upper left abdomen, removes old cells and debris from the blood. The bone marrow, the tissue inside the bones, produces new red and white blood cells.

Lymphocytes are white blood cells that recognize and destroy disease- causing organisms. Lymphocytes are produced in the lymph nodes, spleen, and bone marrow. They circulate throughout the body in the blood and lymphatic fluid. Clusters of immune cells also exist in major organs.

Hodgkin's disease is a type of lymphoma in which antibody- producing cells of the lymphatic system begin to grow abnormally. It usually begins in a lymph node and progresses slowly, in a fairly predictable way, spreading via the lymphatic vessels from one group of lymph nodes to the next. Sometimes it invades organs that are adjacent to the lymph nodes. If the cancer cells spread to the blood, the disease can reach almost any site in the body. Advanced cases of Hodgkin's disease may involve the spleen, liver, bone marrow, and lungs.

There are different subtypes of Hodgkin's disease:

• lymphocyte depleted (less than 5% of cases)
• lymphocyte predominant (5-10% of cases)
• mixed cellularity (20-40% of cases)
• nodular sclerosis (30-60% of cases)
• unclassified

Definition

Prostate cancer is a form of cancer that develops in the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum). 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.

Description

Prostate cancer is a malignancy of one of the major male sex glands. Along with the testicles and the seminal vesicles, the prostate secretes the fluid that makes up semen. The prostate is about the size of a walnut and lies just behind the urinary bladder. A tumor in the prostate interferes with proper control of the bladder and normal sexual functioning. Often the first symptom of prostate cancer is difficulty in urinating. However, because a very common, non- cancerous condition of the prostate, benign prostatic hyperplasia (BPH), also causes the same problem, difficulty in urination is not necessarily due to cancer.

Cancerous cells within the prostate itself are generally not deadly on their own. However, as the tumor grows, some of the cells break off and spread to other parts of the body through the lymph or the blood, a process known as metastasis. The most common sites for prostate cancer to metastasize are the seminal vesicles, the lymph nodes, the lungs, and various bones around the hips and the pelvic region. The effects of these new tumors are what can cause death.

As of the early 2000s, prostate cancer is the most commonly diagnosed malignancy among adult males in Western countries. Although prostate cancer is often very slow growing, it can be aggressive, especially in younger men. Given its slow growing nature, many men with the disease die of other causes rather than from the cancer itself.

Prostate cancer affects African- American men twice as often as white men; the mortality rate among African-Americans is also two times higher. African-Americans have the highest rate of prostate cancer of any world population group.

Definition

The definition of lung cancer is a cancer (malignancy) that originates in the tissues of the lungs or the cells lining the airways. Lung cancer originates when normal lung cells become abnormal, usually after a series of mutations, and begin to divide out of control.

A malignant (cancerous) lung tumor is distinguished from a benign (non- cancerous) lung tumor in that it can spread (metastasize) to areas of the body distant from the original tumor.

It is important to distinguish primary lung cancer from other forms of cancer that may spread to the lungs. Primary lung cancer begins in the lungs, but may spread to other regions of the body. If it spreads to the brain, it would be referred to as lung cancer metastatic to the brain. Likewise, if a cancer begins in the breast and spreads to the lungs, it would be referred to as breast cancer metastatic to the lungs.

Description

Lung cancer is divided into two main types: small cell and non-small cell. Small cell lung cancer is the least common of the two, accounting for only about 20% of all lung cancers. In the past, the disease was called oat cell cancer because, when viewed under a microscope, the cancer cells resemble oats. This type of lung cancer grows quickly and is more likely to spread to other organs in the body.

The lungs are located along with the heart in the chest cavity. The lungs are not simply hollow balloons, but have a very organized structure consisting of hollow tubes, blood vessels, and elastic tissue. The hollow tubes, called bronchi, are multi-branched, becoming smaller and more numerous at each branching. They end in tiny, blind sacs made of elastic tissue called alveoli. These sacs are where the oxygen a person breathes in is taken up into the blood, and where carbon dioxide moves out of the blood to be breathed out.

Normal, healthy lungs are continually secreting mucus that not only keeps the lungs moist, but also protects the lungs by trapping foreign particles like dust and dirt in breathed air. The inside of the lungs is covered with small, hair-like structures called cilia. The cilia move in such a way that mucus is swept up out of the lungs and into the throat.

Small cell lung tumors usually start to develop in the central bronchi. They grow quickly and prevent the lungs from functioning at their full capacity. Tumors may block the movement of air through the bronchi in the lungs. As a result, less oxygen gets into the blood and patients feel short of breath. Tumors may also block the normal movement of mucus into the throat. As a result, mucus builds up in the lungs and infection may develop behind the tumor.

Lung cancer is a growing global epidemic. Worldwide, lung cancer is the second most common cancer among both men and women and is the leading cause of cancer death in both sexes. The worldwide mortality rate for patients with lung cancer is 86%. Of the 160,000 deaths from lung cancer that occur annually in the United States, about 40,000 are caused by small cell lung cancer. Although there are differences in mortality rates between ethnic groups, this is mainly due to differences in smoking habits.

Survival rates are often used by doctors as a standard way of discussing a person's prognosis (outlook). Some patients may want to know the survival statistics for people in similar situations, while others may not find the numbers helpful, or may even not want to know them.

The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Of course, many people live much longer than 5 years (and many are cured).

In order to get 5-year survival rates, doctors have to look at people who were treated at least 5 years ago. Improvements in treatment since then may result in a more favorable outlook for people now being diagnosed with colon cancer.

Survival rates are often based on previous outcomes of large numbers of people who had the disease, but they cannot predict what will happen in any particular person's case. Knowing the type and the stage of a person's cancer is important in estimating their outlook. But many other factors may also affect a person's outlook, such as the grade of the cancer, the genetic changes in the cancer cells, and how well the cancer responds to treatment. Even when taking these other factors into account, survival rates are at best rough estimates.

Management of colon cancer relies primarily on surgical removal of the tumor and some of the surrounding tissues. The need for further treatment with chemotherapy or radiation therapy is determined upon evaluation of the resected cancer. Surgery is the oldest method of treating this cancer with the idea being complete removal of the cancer from the body. Cure is possible in cases where the cancer is limited to the bowel, with no spread to the other tissues. Surgery is done in the hospital and under general anesthesia. Patients may stay in the hospital for 7-10 days after surgery. Chemotherapy may be needed, as indicated by the stage of the illness, and patient's overall condition.

In the laboratory, the pathologist will examine the margins the removed piece of bowel. He will also determine the depth of penetration of the cancer as well as any lymph node involvement. This is referred to as Pathological Staging. The need for further treatment is dependent on the full staging of the cancer.

Treatment depends on many things, including the stage of the cancer. In general, treatments may include:

• Chemotherapy to kill cancer cells
• Radiation therapy to destroy cancerous tissue
• Surgery (most often a colectomy) to remove cancer cells

* Chemotherapy

Almost all patients with stage III colon cancer should receive chemotherapy after surgery for approximately 6 - 8 months. This is called adjuvant chemotherapy. The chemotherapy drug 5-fluorouracil has been shown to increase the chance of a cure in certain patients.

Chemotherapy is also used to improve symptoms and prolong survival in patients with stage IV colon cancer.

• Irinotecan, oxaliplatin, capecitabine, and 5-fluorouracil are the three most commonly used drugs.
• Monoclonal antibodies, including cetuximab (Erbitux), panitumumab (Vectibix), bevacizumab (Avastin), and other drugs have been used alone or in combination with chemotherapy.

You may receive just one type, or a combination of these drugs. There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery. You should discuss this with your oncologist.

** Radiation

Although radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer.

For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used. This may include:

• Burning the cancer (ablation)
• Delivering chemotherapy or radiation directly into the liver
• Freezing the cancer (cryotherapy)
• Surgery

*** Surgery

Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous.

There are actually 2 types of staging for colon cancer:

1. The clinical stage is your doctor's best estimate of the extent of your disease, based on the results of the physical exam, biopsy, and any imaging tests you have had.
2. If you have surgery, your doctor can also determine the pathologic stage, which is based on the same factors as the clinical stage, plus what is found as a result of the surgery.

   The clinical and pathologic stages may be different in some cases. For example, during surgery the doctor may find cancer in an area that did not show up on imaging tests, which might give the cancer a more advanced pathologic stage.

Most patients with colon cancer have surgery, so the pathologic stage is most often used when describing the extent of this cancer. Pathologic staging is likely to be more accurate than clinical staging, as it allows your doctor to get a firsthand impression of the extent of your disease.

AJCC (TNM) Staging System

A staging system is a standardized way in which the cancer care team describes the extent of the cancer. The most commonly used staging system for colon cancer is that of the American Joint Committee on Cancer (AJCC), sometimes also known as the TNM system. Older staging systems for colon cancer, such as the Dukes and Astler-Coller systems, are mentioned briefly below for comparison. The TNM system describes 3 key pieces of information:

1. T describes how far the main (primary) tumor has grown into the wall of the intestine and whether it has grown into nearby areas.
2. N describes the extent of spread to nearby (regional) lymph nodes. Lymph nodes are small bean-shaped collections of immune system cells that are important in fighting infections.
3. M indicates whether the cancer has spread (metastasized) to other organs of the body. (colon cancer can spread almost anywhere in the body, but the most common sites of spread are the liver and lungs.)

Numbers or letters appear after T, N, and M to provide more details about each of these factors. The numbers 0 through 4 indicate increasing severity. The letter X means "cannot be assessed because the information is not available."

1. T categories for colon cancer

T categories of colon cancer describe the extent of spread through the layers that form the wall of the colon and rectum. These layers, from the inner to the outer, include:

• A thick muscle layer (muscularis propria) that contracts to force the contents of the intestines along
• A thin muscle layer (muscularis mucosa)
• The fibrous tissue beneath this muscle layer (submucosa)
• The inner lining (mucosa)
• The thin, outermost layers of connective tissue (subserosa and serosa) that cover most of the colon but not the rectum

Tx: No description of the tumor's extent is possible because of incomplete information.

Tis: The cancer is in the earliest stage (in situ). It involves only the mucosa. It has not grown beyond the muscularis mucosa (inner muscle layer).

T1: The cancer has grown through the muscularis mucosa and extends into the submucosa.

T2: The cancer has grown through the submucosa and extends into the muscularis propria (thick outer muscle layer).

T3: The cancer has grown through the muscularis propria and into the outermost layers of the colon or rectum but not through them. It has not reached any nearby organs or tissues.

T4a: The cancer has grown through the serosa (also known as the visceral peritoneum), the outermost lining of the intestines.

T4b: The cancer has grown through the wall of the colon or rectum and is attached to or invades into nearby tissues or organs.

2. N categories for colon cancer

N categories indicate whether or not the cancer has spread to nearby lymph nodes and, if so, how many lymph nodes are involved. To get an accurate idea about lymph node involvement, most doctors recommend that at least 12 lymph nodes be removed during surgery and looked at under a microscope.

Nx: No description of lymph node involvement is possible because of incomplete information.

N0: No cancer in nearby lymph nodes.

N1: Cancer cells are found in or near 1 to 3 nearby lymph nodes

• N1a: Cancer cells are found in 1 nearby lymph node.
• N1b: Cancer cells are found in 2 to 3 nearby lymph nodes.
• N1c: Small deposits of cancer cells are found in areas of fat near lymph nodes, but not in the lymph nodes themselves.

N2: Cancer cells are found in 4 or more nearby lymph nodes

• N2a: Cancer cells are found in 4 to 6 nearby lymph nodes.
• N2b: Cancer cells are found in 7 or more nearby lymph nodes.

3. M categories for colon cancer

M categories indicate whether or not the cancer has spread (metastasized) to distant organs, such as the liver, lungs, or distant lymph nodes.

M0: No distant spread is seen.

M1a: The cancer has spread to 1 distant organ or set of distant lymph nodes.

M1b: The cancer has spread to more than 1 distant organ or set of distant lymph nodes, or it has spread to distant parts of the peritoneum (the lining of the abdominal cavity).

Stage grouping

Once a person's T, N, and M categories have been determined, usually after surgery, this information is combined in a process called stage grouping. The stage is expressed in Roman numerals from stage I (the least advanced) to stage IV (the most advanced). Some stages are subdivided with letters.

- Stage 0
Tis, N0, M0: The cancer is in the earliest stage. It has not grown beyond the inner layer (mucosa) of the colon or rectum. This stage is also known as carcinoma in situ or intramucosal carcinoma.

- Stage I
T1-T2, N0, M0: The cancer has grown through the muscularis mucosa into the submucosa (T1) or it may also have grown into the muscularis propria (T2). It has not spread to nearby lymph nodes or distant sites.

- Stage IIA
T3, N0, M0: The cancer has grown into the outermost layers of the colon or rectum but has not gone through them (T3). It has not reached nearby organs. It has not yet spread to the nearby lymph nodes or distant sites.

- Stage IIB
T4a, N0, M0: The cancer has grown through the wall of the colon or rectum but has not grown into other nearby tissues or organs (T4a). It has not yet spread to the nearby lymph nodes or distant sites.

- Stage IIC
T4b, N0, M0: The cancer has grown through the wall of the colon or rectum and is attached to or has grown into other nearby tissues or organs (T4b). It has not yet spread to the nearby lymph nodes or distant sites.

- Stage IIIA
One of the following applies.

• T1-T2, N1, M0: The cancer has grown through the mucosa into the submucosa (T1) and it may also have grown into the muscularis propria (T2). It has spread to 1 to 3 nearby lymph nodes (N1a/N1b) or into areas of fat near the lymph nodes but not the nodes themselves (N1c). It has not spread to distant sites.
• T1, N2a, M0: The cancer has grown through the mucosa into the submucosa (T1). It has spread to 4 to 6 nearby lymph nodes (N2a). It has not spread to distant sites.

- Stage IIIB
One of the following applies.

• T3-T4a, N1, M0: The cancer has grown into the outermost layers of the colon or rectum (T3) or through the visceral peritoneum (T4a) but has not reached nearby organs. It has spread to 1 to 3 nearby lymph nodes (N1a/N1b) or into areas of fat near the lymph nodes but not the nodes themselves (N1c). It has not spread to distant sites.
• T2-T3, N2a, M0: The cancer has grown into the muscularis propria (T2) or into the outermost layers of the colon or rectum (T3). It has spread to 4 to 6 nearby lymph nodes (N2a). It has not spread to distant sites.
• T1-T2, N2b, M0: The cancer has grown through the mucosa into the submucosa (T1) or it may also have grown into the muscularis propria (T2). It has spread to 7 or more nearby lymph nodes (N2b). It has not spread to distant sites.

- Stage IIIC
One of the following applies.

• T4a, N2a, M0: The cancer has grown through the wall of the colon or rectum (including the visceral peritoneum) but has not reached nearby organs (T4a). It has spread to 4 to 6 nearby lymph nodes (N2a). It has not spread to distant sites.
• T3-T4a, N2b, M0: The cancer has grown into the outermost layers of the colon or rectum (T3) or through the visceral peritoneum (T4a) but has not reached nearby organs. It has spread to 7 or more nearby lymph nodes (N2b). It has not spread to distant sites.
• T4b, N1-N2, M0: The cancer has grown through the wall of the colon or rectum and is attached to or has grown into other nearby tissues or organs (T4b). It has spread to at least one nearby lymph node or into areas of fat near the lymph nodes (N1 or N2). It has not spread to distant sites.

- Stage IVA
Any T, Any N, M1a: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to nearby lymph nodes. It has spread to 1 distant organ (such as the liver or lung) or set of lymph nodes (M1a).

- Stage IVB
Any T, Any N, M1b: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to nearby lymph nodes. It has spread to more than 1 distant organ (such as the liver or lung) or set of lymph nodes, or it has spread to distant parts of the peritoneum (the lining of the abdominal cavity) (M1b).

Colon cancer may be detected in its very early stages by any of the following screening tests:

1. Digital Rectal Examination is very simple to perform and can detect lesions in rectum and prostate. It should be done in a routine physical exam for adults. The physician examines the area by inserting his finger inside the rectum and feeling for abnormalities.
2. Flexible Sigmoidoscopy is a simple test that has a higher accuracy in detecting lower colon and rectal cancer. A tube is inserted inside the rectum and advanced into lower part of the large bowel. The performing physician can look for any abnormalities and take a biopsy from the abnormal area. Almost 50% of colon cancers are detected with this procedure.
3. Stool Occult Blood Test. Annual screening for colon cancer with a stool occult blood test for adults over age 50 is a must. Incidence of this cancer rises with age. This test is a rather simple test. Small amounts of stool are placed on a paper card and delivered to the physician's office for testing. A positive test mandates a complete work-up, including a Colonoscopy.

When colon cancer is suspected, a careful workup should be done to establish the diagnosis or to rule it out. It is empirical to visualize the entire colon and rectum. This is achieved by:

• Barium Enema - A radiological study wherein patients are given a barium enema followed by a series of x-rays of the abdomen.
• Colonoscopy -This is by far the best method for evaluating the colon area. Biopsies can be taken of any abnormal areas at the same time. A diagnosis is established by laboratory examination of the cancer tissue.