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NYOH is pleased to provide two free cancer support groups.

Open to both newly diagnosed patients and those who have been managing

the disease for some time, we offer a cancer support group for those facing multiple types of cancer, as well as one specifically geared to those being treated for brain tumors.

During the sessions, participants are encouraged to share feelings, discuss coping strategies, address fears and worries and connect with others who are facing similar struggles.

Cancer Support Group

Leader:
Edward Dick LCSW, a psychotherapist in private practice serving Cancer Patients and Families for over 30 years.

Day/Time:
Every other Wednesday, from 4:30 p.m. – 5:30 p.m.
(if a holiday or day before a holiday, session moves to the following week)

Location:
NYOH – Albany office
400 Patroon Creek Blvd – Suite 1
Albany, NY 12206

Cost:
Free to NYOH patients and their caregivers

Dates:

2015

May 13, 2015
May 27, 2015
June 10, 2015
June 24, 2015
July 8, 2015
July 22, 2015
August 5, 2015
August 19, 2015
September 2, 2015
September 16, 2015
September 30, 2015
October 14, 2015
October 28, 2015
November 11, 2015
December 2, 2015
December 16, 2015

2016

January 6, 2016
January 20, 2015
February 3, 2016
February 17, 2016
March 2, 2016
March 16, 2016
March 30, 2015
April 13, 2016
April 27, 2016

Brain Tumor Support Group

Leader:
Katherine Rosenblatt, LMSW

Day/Time:
First Monday of each month, from 5:30 p.m. 7:00 p.m.

Location:
NYOH – Albany Medical Center Office

Cost:
Free to NYOH patients and their caregivers

Dates:

2015

May 4, 2015
June 1, 2015
July 6, 2015
Aug 3, 2015
September 7, 2015
October 5. 2015
November 2, 2015
December 7, 2015

2016

January 4, 2016
February 1, 2016
March 7, 2016
April 4, 2016
May 2, 2016
June 6, 2016

Read more about clinical trials from the National Cancer Institute. Download this helpful PDF

Call

For non-urgent medical questions, please call our Triage Nurses at the office where you see your physician.  For emergencies, please dial 911.

  • Albany: (518) 489-0044
  • Albany Medical Center: (518) 262-6696
  • Amsterdam: (518) 843-0020
  • Clifton Park: (518) 831-4434
  • Hudson: (518) 822-8484
  • Rexford: (518) 399-4600
  • Troy: (518) 272-2097

Email

Please do not send any patient information, doctor request or confidential material to this email address. The email below is for non-health related issues, comments, or questions regarding this website or the practice.

If your question or concern is regarding your care, please call your physician’s office or use the patient portal.

Your opinion matters to us. Please use the email below to suggest opportunities for improvement and to help us continue to provide outstanding service and care to our patients and their families.

Customer Service Email: NYOHCustomerService@usoncology.com.

Thank you!

Why patients trust NYOH

  • Comprehensive: Largest provider of oncology and hematology services in the area
  • Convenient: Seven convenient locations, with free parking, front-door drop-off and in-office dispensing
  • Team: A team of more than 35 physicians and 350 cancer care specialists
  • Specialized programs: Including stem cell transplant, hereditary risk assessment, neuro-oncology and in-office dispensing
  • Research & Drug Trials: Participation in more than 500 clinical trials, leading to FDA approval of 38 new cancer drugs
  • Personalized care: Private, physician-owned practice, focused exclusively on treatment of cancer and blood disorders
  • Hospital affiliation: Affiliated with every hospital in the area  
  • The US Oncology Network: The only practice in region that is affiliated with The US Oncology Network, one of the nation’s largest research and cancer care networks. NYOH physicians are connected to more than 1,000 leading oncologists and hematologists around the country, sharing breakthroughs and best practices.

At New York Oncology Hematology, we work closely with referring physicians to ensure a seamless continuity of patient care. We keep you informed of your patient’s progress and return the patient to you for follow-up care.

Below is a checklist of necessary medical records. Click here for a list of NYOH physicians with locations.

To refer a patient, please call location where the patient would be seen.

Albany
(518) 489-0044

Albany Medical Center
(518) 262-6696

Amsterdam
(518) 843-0020

Clifton Park
(518) 831-4434

Hudson
(518) 822-8484

Rexford
(518) 399-4600

Troy
(518) 272-2097

Checklist of Needed Medical Records

Below is the checklist for medical records we will need prior to the patient's first visit.

Thank you for providing all the appropriate records in advance. This makes it faster for us to begin treatment.

Oncology Visit:

  • Diagnosis
  • Referring physician notes, initial consult, operation notes, procedure notes, any hospital records and a copy of the patient’s current medications
  • All radiology reports (chest x-rays, CT, MRI, PET, mammograms, bone scans, EKG, venous doppler, ultrasounds)
  • Most recent lab work (last 3 visits)
  • Pathology reports (needle biopsy, ER/PR, Her2Neu)
  • Tumor Markers, if feasible, to assist with staging and treatment plan

Hematology Visit:

  • Diagnosis
  • Referring physician notes, initial consult, operation notes, procedure notes, any hospital records and a copy of the patient’s current medications
  • All radiology reports (chest x-rays, CT, MRI, PET, mammograms, bone scans, EKG, venous doppler, ultrasounds)
  • All lab work (CBC’s - previous 5 years, all others - 2 year history)
  • Pathology reports (needle biopsy, ER/PR, Her2Neu)

If you have questions, please contact us at the location where the patient will be seen.

American Cancer Society

ACS Hope Club

American Heart Association

American Lung Association

American Society of Clinical Oncology

Susan G. Komen For The Cure

Catholic Charities of the Diocese of Albany

Centers for Disease Control and Prevention

Clinical Trials.Gov

Community Hospice

Leukemia and Lymphoma Society

National Institutes of Health

Oncology Nursing Society

To Life!

US Oncology

Who we are:

NYOH Community Cancer Foundation is a not-for-profit foundation founded in March 2000 to help provide emergency financial support for Capital District Region residents undergoing cancer treatment. View our brochure to learn more and to find out how you can help. 

Why we were founded:

Recognizing an increasing need for patient and family support, both financially and emotionally, the physicians and staff of New York Oncology Hematology donated their time and talent to establish the NYOH Community Cancer Foundation.

The Foundation provides funding to support a variety of patient needs, both physical and emotional, during cancer treatment. This support helps reduce the stress of daily routines while maintaining dignity and quality of life.

We’re committed to doing all we can to help patients and their families as they experience the many challenges that come with the treatment of cancer.

What support services are provided:

Some patients undergoing cancer treatment may need financial assistance for daily living expenses, such as transportation, medication not covered by insurance, groceries or utilities. This assistance aims to lessen the physical and emotional burdens of patients and their families.

Where we get our funds:

NYOH Community Cancer Foundation receives funds from the following sources:

Individuals
Corporations
Bequests
Grants
Community fundraising events

Who can help?

You Can!

Your tax deductible gift helps ease the burdens that patients and their families experience during cancer treatment. All donations stay in the Capital District Region with 100% of the funds directly supporting patient and family needs.

Our mission statement:

To improve the quality of life during treatment for cancer patients and their families, by providing emergency financial support to those in need of help with daily living expenses.

Contact Us:

NYOH Community Cancer Foundation
449 Route 146
Suite 101
Clifton Park, New York 121065
(518) 373-3800

At NYOH, we believe Advance Care Planning (ACP) is an important topic, regardless of age or health status. Our trained ACP facilitators can help begin a dialogue about a patient’s preferences for life-sustaining treatment, in the event of illness or an accident.

We also help families establish a health care proxy to speak on a patient’s behalf and complete other important documents. By taking charge of these important decisions and creating a written document, our patients enjoy peace of mind, knowing their personal wishes will be honored.

Ask your nurse, physician or any NYOH staff for more information or to set up an appointment to discuss Advance Care Planning.

At NYOH, we want you to feel confident about your treatment. That means getting your questions answered. At our small group chemotherapy classes, patients beginning chemotherapy and their caregivers learn how chemotherapy affects the body and how to prepare for side effects like hair loss and fatigue. Taught by experienced nurse educators, these sessions also provide an opportunity to ask questions.

Your nurse or physician will set up a time for you to participate in a chemotherapy class. We strongly encourage a family member, friend, or caregiver to attend with you.

Genetic research plays an increasingly important role in the diagnosis and treatment of cancer. To help patients and their families understand and evaluate their risk for certain diseases, New York Oncology Hematology offers a comprehensive

hereditary risk assessment program, including:

  • In-depth personal and family history
  • Genetic testing, as appropriate
  • Education for patients and their families

Dr. Karen Tedesco is director of NYOH’s Hereditary Risk Assessment Program and many of our Advanced Practice Providers and nursing staff are part of our Hereditary Risk Assessment team. Dr. Tedesco recently completed the City of Hope Cancer Center Intensive Course in Hereditary Cancer Risk Assessment, ensuring NYOH patients have access to the very latest information and testing.

Although hereditary risk assessment and genetic testing cannot predict whether you will actually develop cancer, understanding your risk for developing the disease can help you and your family in making important decisions, including regular screenings that can detect cancer early, when it is most treatable.

To schedule a consultation with a member of the NYOH Hereditary Cancer Risk Assessment team, please call: 518-262-1068.

Hereditary Risk & Genetic Testing FAQ

What is genetic testing?

Today, tests are available that can detect certain gene mutations. Genetic testing can determine whether you have a hereditary predisposition that may put you at higher risk of developing cancer before any symptoms appear.

How do I know if I need genetic testing?

Although genetic testing cannot predict whether you will actually develop cancer, there are several conditions where a patient’s risk for developing cancer is higher. You may consider genetic testing if you or a family member has had the following:

  • Breast cancer before the age of 50 or male breast cancer
  • Ovarian cancer
  • Uterine (endometrial) cancer before the age of 50
  • Colon and/or rectal cancer before the age of 50
  • Ten or more adenomatous polyps at any age

Why is genetic testing important?

Although genetic testing cannot predict whether you will actually develop cancer, understanding your risk of developing the disease can be an important step in making medical and lifestyle decisions that can help prevent cancer or about getting regular screenings that can detect cancer early, when it is most treatable.

What happens during the test?

While the actual test involves a simple blood draw and lab analysis, the pre- and post-consultation with your healthcare team is a key component of your cancer risk assessment. These consultations will prepare you for the pre-test interview, which involves obtaining a comprehensive family cancer history, and the post-test results discussion, regarding the cancer risk options you have.

What happens after the test?

After the test results return from the lab, we will review the results with you and address your cancer risk options, which may include closer medical observation, more frequent testing, preventive surgery, and/or preventive medication, among others. Furthermore, as your life/needs change over time, so should your plan. NYOH’s dedicated team will be with you every step of the way.

Will insurance cover genetic testing?

HIPAA protects patient privacy and prohibits health insurance providers from discriminating based on genetic information. Most laboratories determine coverage prior to testing. Because the pre- and post-consultation is with a physician, most patients do have coverage. Our office can help with this process and answer any questions you might have regarding coverage.

To schedule a consultation with a member of the NYOH Hereditary Cancer Risk Assessment team, please call: 518-262-1068.

At New York Oncology Hematology, we believe caring for our patients extends beyond the treatment we provide. We are proud to offer a variety of programs to support you and your loved ones and we can help connect you with other groups in the community who also provide important services.

From support groups to chemotherapy classes, hereditary risk assessment to financial support through our NYOH Community Cancer Foundation, we are here for you every step of the way. We encourage you to learn more and take advantage of our supportive care services.

To learn more about our research operation, a particular study or to refer an eligible patient, please contact:

GerryAnn Currier
Manager of Clinical Research

Phone: (518) 489-3612 ext. 1045
Fax: (518) 489-4030

Email

Our Research Team

At New York Oncology Hematology, many of our physicians are deeply involved in research, including our clinical trials.

NYOH Principal Investigators

To learn more about a study or to refer an eligible patient, please contact:

GerryAnn Currier
Manager of Clinical Research

Phone: (518) 489-3612 ext. 1045
Fax: (518) 489-4030

Email

Stereotactic Body Radiotherapy (SBRT) is an advanced type of radiation technology. It is used to treat malignant or benign small to medium size tumors in the body, including the lung, liver, abdomen, spine, prostate, head and neck.

Using detailed imaging, computerized three-dimensional treatment planning, and precise treatment coordination, the radiation dose is delivered with extreme accuracy to limit effects on nearby organs.

Advantages of SBRT

  • Non-surgical, non-invasive and painless
  • Ideal for hard-to-reach tumors and those close to critical organs
  • Performed in an out-patient setting at one of NYOH’s offices
  • Shorter amount of treatment time, compared to traditional radiation regimen

Examples of SBRT Use

  • Early stage lung cancer
  • Pancreatic cancer
  • Brain tumors or, as alternative to whole brain radiation (for appropriate patients)
  • Spinal tumors
  • Cancers that have metastasized to the brain, lung or liver

How SBRT Works

Stereotactic Radiosurgery works in the same way as other forms of radiation treatment. The process does not actually remove the tumor, but the radiation causes it to shrink. By damaging the DNA of tumor cells, they cannot reproduce. Malignant and metastatic tumors may shrink more rapidly, even within a couple of months.

Specific technology is required to delivery SBRT treatment. Three-dimensional imaging is used to locate the tumor within the body and define the exact size and shape. This imaging guides the treatment plan and positioning of the patient for treatment. A linear accelerator is used to deliver treatment.

Stereotactic Radiosurgery (SRS) is an advanced type of radiation technology. Despite its name, SRS is a non-surgical procedure. It delivers precisely-targeted radiation at much higher doses than traditional radiation therapy – with minimal damage to surrounding tissue.

SRS is ideal for otherwise inoperable tumors, such as those in the brain that cannot be treated with traditional surgical methods.

Advantages of SRS

  • Non-surgical, non-invasive and painless
  • Ideal for hard-to-reach tumors and those close to critical organs
  • Performed in an out-patient setting at one of NYOH’s offices
  • Shorter amount of treatment time, compared to traditional radiation regimen

Examples of SBRT Use

  • Early stage lung cancer
  • Pancreatic cancer
  • Brain tumors or, as alternative to whole brain radiation (for appropriate patients)
  • Spinal tumors
  • Cancers that have metastasized to the brain, lung or liver

How SRS works

Stereotactic Radiosurgery works in the same way as other forms of radiation treatment. The process does not actually remove the tumor, but the radiation causes it to shrink. By damaging the DNA of tumor cells, they cannot reproduce. Malignant and metastatic tumors may shrink more rapidly, even within a couple of months.

Specific technology is required to delivery SRS treatment. Three-dimensional imaging is used to locate the tumor within the body and define the exact size and shape. This imaging guides the treatment plan and positioning of the patient for treatment. A linear accelerator is used to deliver treatment.

Three-dimensional (3-D) conformal radiation therapy utilizes a highly advanced technology that allows the radiation oncologist to more precisely target a tumor by conforming or shaping the radiation beams based on exact width, height, and depth measurements. A customized immobilization device is created for each patient that ensures consistent positioning of the patient during the planning/simulation phase and subsequent treatments. This precision delivery of radiation beams to the targeted areas helps minimize damage to nearby healthy tissue and organs. It is used to treat many types of cancer including, but not limited to those affecting the prostate, head and neck, lung and gastrointestinal tract.

NYOH Outpatient Stem Cell Transplant Program

New York Oncology Hematology offers the region’s only stem cell transplant program. The procedure, which combines high dose chemotherapy with autologous stem cell transplant, is used to treat:

  • Non-Hodgkin’s Lymphoma
  • Hodgkin’s Disease
  • Multiple Myeloma
  • Germ Cell Tumors

Unlike similar hospital-based programs in New York City and Boston, NYOH’s treatment is done at its outpatient facility at Albany Medical Center, allowing patients to stay at home, near family and friends, or at a nearby hotel. It also provides consistency, as patients can continue to see their primary oncologist during treatment.

The Transplant Team

The NYOH Stem Cell Transplant Program is staffed by a multidisciplinary team of cancer care professionals including: medical director program coordinator and pharmacist, and infusion therapy nurses. The team also includes home care nurses, inpatient oncology nurses, medical social workers, specialists in stem cell apheresis and patient benefits representatives.

Physician specialists include consultants in infectious diseases, cardiology, pulmonology, interventional radiology, renal disease, psychiatry and endocrinology.

Key Program Components

The transplant team is committed to providing a safe and supportive environment for its patients and offers a comprehensive program that includes:

Case management: from initial referral through transfer back to referring physician

Extensive education: for the patient, family and/or caregiver, as well as on-going support

Daily office visits: Patients are seen each day for evaluation, treatment (including mobilization chemotherapy, stem cell apheresis, high dose chemotherapy and stem cell reinfusion) and administration of all supportive therapies

Home care nursing: This includes evening and weekend visits for evaluation and treatment

Inpatient hospital care: When needed, patients have direct admission to the oncology unit at Albany Medical Center

Hotel accommodations: For patients who reside more than 30 minutes from the transplant unit, accommodations at an adjoining hotel are arranged

24/7 telephone access: A member of the transplant team is on-call at all times

Meeting National Standards for Quality Outcomes

The apheresis procedure is performed in the NYOH facility at Albany Medical Center under the supervision of the program’s medical director, Dr. Ira Zackon.

The transplant program adheres to national standards for the collection, processing and storage of stem cell products through the New York Blood Service (NYBS). The NYBS has an established record in the provision of stem cell apheresis and cryopreservation services. Services are provided in accordance with the Foundation for the Accreditation of Hematopoietic standards.

As a member of the US Oncology Network, New York Oncology Hematology participates in national data collection and outcomes analysis, protocol reviews and the sharing of educational and informational resources.

More information or a consultation

Call the NYOH Stem Cell Transplant program at: (518) 262-6696.

What is PET?

  • Positron Emission Tomography (PET) is an advanced imaging technique that produces images of the body’s biological functions.
  • Unlike X-rays, CTs (computed tomography), ultrasounds and MRIs (magnetic resonance imaging), PET does not show body structure (anatomy).  Instead, it reveals the chemical function (metabolism) of an organ or tissue.

Why is it used?

  • PET is used to diagnose and guide the treatment of a number of diseases including cancer, coronary heart disease, neurological disorders and seizure disorders.
  • Specifically, PET is a valuable tool for the early detection and diagnosis of lung, breast, melanoma, lymphoma, colorectal, head and neck, ovarian, pancreatic and esophageal cancer.  
  • It is also used for staging and restaging.
  • PET may reduce the need for further testing and diagnostic surgeries.

How is a PET scan planned and delivered?

  • A PET scan is painless and can be performed in just a few hours as an outpatient procedure. The time required varies depending on what type of scan is being performed, but in most cases, a torso scan from eyes to mid-thigh takes about 2 hours.  Some exams, such as brain or heart procedures, take as little as 60 minutes to complete.
  • When a patient arrives for a PET scan, he or she will be registered by office personnel and taken 
  • to the PET area where a technologist will ask a series of medical history questions.
  • A small blood sample is taken from the patient’s fingertip to check his or her blood-sugar or glucose level.
  • The patient is then injected with a small amount of radioactive glucose through an intravenous (IV) line. This substance is called a “tracer” and will be distributed throughout the patient’s body.  It is safe, effective and has no side effects. It will be metabolized by the patient’s kidneys and excreted through the bladder.
  • After injection, the patient relaxes and remains relatively still for about an hour.
  • For the scan, the patient lies on a “scanning bed” that moves slowly through the PET scanner while the machine detects the injected tracer. When the imaging procedure is complete, the scanner sends the resulting information to a computer that generates several images which are reviewed by a specially-trained physician. A report and picture detailing the findings are provided to the patient’s physician, usually within a day.

Because we focus exclusively on the treatment of cancer and blood disorders, many NYOH nurses, pharmacists and research staff are specially trained and certified in the latest techniques, therapies and best practices for oncology and hematology. This additional level of expertise translates into better care and communication for our patients.

NYOH is also the only practice in the region affiliated with The US Oncology Network, one of the nation’s largest networks of community-based oncology practices. This connection ensures NYOH has access to the very latest in cancer research, collaboration with more than 1,000 oncologists around the country.

In addition to treating patients, NYOH physicians also serve as the oncology and hematology instructors at Albany Medical College. Trusted for our expertise and clinical experience, the medical school also arranges for students to shadow our physicians in the office. NYOH is proud to teach the next generation of physicians, sharing our knowledge and commitment to care.

Now, you don’t have to make a separate trip to the pharmacy for prescriptions ordered by your physician. For your convenience, NYOH can fill many prescriptions right at our offices. Just pick up at the location where you see your doctor—or the medications may also be delivered directly to your home.

Cancer treatment is complex and requires close monitoring. It can also be very expensive. That is why our pharmacists are specially trained in cancer treatment and focus exclusively on NYOH patients. They work closely with your physician on an individualized treatment regimen, ensuring you receive medications in a timely manner.

At our NYOH Patient Prescription Center, we also take the time to verify your insurance coverage for medications. Our dedicated pharmacy staff investigates Medicare, supplemental plans, co-payment assistance programs and other options—to make sure you are getting the maximum drug benefits available.

To learn more, ask your nurse or physician about in-office dispensing.

FREQUENTLY ASKED QUESTIONS: In-Office Dispensing

Do you accept my prescription benefits coverage?

In most cases, yes, we do. We are able to process prescription claims with most major prescription benefits providers. We are also able to process Medicare Part B and Part D prescriptions, as appropriate.

Keep in mind that some plans require the use of a mail order pharmacy to fill prescriptions for long-term use. We can help you determine the best available option for filling your prescription.

Will it cost me more to fill my prescription here than at a retail pharmacy?

No. In fact, many times it can cost less to fill your prescription at our office because retail pharmacies often require immediate payment and may not be able to verify all coverage options before dispensing. These include Medicare, supplemental plans, co-payment assistance programs, etc.

Since we are able to do all of this before dispensing your medication, as well as investigate alternative co-payment assistance resources, it is possible you can save money.

Do I have to fill my prescription at your office?

No. You are always welcome to fill your prescription at any pharmacy that accepts your prescription benefit coverage. We are offering this service as a convenience for our patients.

Should you decide to fill your prescription at another pharmacy, your decision will not affect the medical care you receive from our team at New York Oncology Hematology.

How long will it take to receive my medication?

We will fill your prescription as quickly as possible, following verification of available prescription benefit coverage and alternative co-payment assistance resources.

It may be available immediately. If not, we will call you to arrange a time to pick-up your prescription and discuss your treatment plan with our pharmacy team.

When can I start using this service?

Talk to your doctor or nurse to get started today. Make sure you have provided your prescription benefit card to the receptionist to participate.

We will take care of the rest, and be there to help you every step of the way.

Why are you offering in-office dispensing?

At NYOH, we are committed to providing the best care and service for our patients. We know it can be confusing to deal with prescription benefit coverage for medications used in your treatment. That is why we are happy to do the work for you.

Our doctors know the sooner you can start treatment and more closely you follow your treatment plan, the better. That is why we are offering this service and our staff is here to help.

Nationally Accredited – Award Winning Laboratory Services

Located at each of the NYOH cancer centers and medical offices is a fully accredited and certified laboratory providing a wide range of services including phlebotomy, hematology, routine chemistry and immunochemistry (tumor markers).

NYOH laboratories are staffed by more than 30 New York State certified clinical laboratory technologists, technicians and support personnel who together perform thousands of testing procedures annually.

Utilizing advanced technologies and sophisticated information management systems, NYOH provides convenient access to essential laboratory services including immediate testing as patients’ needs arise and accurate, timely reporting of results.

NYOH laboratories are certified through the federal government’s Clinical Laboratory Improvement Amendments (CLIA) program and accredited by the Commission on Office Laboratory Accreditation (COLA).

Additional commendation includes the prestigious Laboratory of Excellence Award from COLA which has been awarded to the NYOH sites in Amsterdam, Hudson, Latham, Patroon Creek in Albany, and NYOH at Albany Medical Center.

Intensity Modulated Radiation Therapy (IMRT) is an advanced form of radiation treatment that allows radiation oncologists to precisely target tumor cells. It is a noninvasive therapy that uses Computed Tomography (CT) or other imaging modalities to build three-dimensional diagnostic images and map treatment plans to deliver tightly focused radiation beams of varying intensity to cancerous tumors without needles, tubes or catheters. Varying the intensity of these beams enhances the ability of IMRT to maximize dosage and minimize the amount of radiation distributed to surrounding healthy tissue.

What is IMRT?

  • IMRT involves varying (modulating) the intensity of the radiation being used as therapy for cancer.
  • It is an advanced form of 3-D conformal radiation treatment, which is a method of conforming a three-dimensional target plan to a tumor.
  • IMRT technology enables doctors to place precisely shaped beams of radiation into tumors, and to control the intensity of the radiation beams throughout the treatment area. Consequently, the dose can be higher in the most aggressive areas of the tumor and lower in areas where the beam is near or passing through healthy tissue or structures.
  • Conventional radiation therapy, on the other hand, targets a uniform shape to a total area to cover the tumor. Therefore, some healthy tissue is always irradiated and the target area receives an even dose of radiation across the entire target area.

Why is it used?

  • The end result is better tumor control, less damage to healthy tissues and structures in the treatment area, and a better quality of life for the patient.
  • Side effects tend to be more manageable.
  • IMRT can be used to treat tumors that might have been considered untreatable in the past due to close proximity of vital organs and structures.
  • The most commonly treated areas today are: prostate, spine, lung, breast, kidney, pancreatic tumors, liver, larynx, sinus and brain.

How is treatment planned and delivered?

  • IMRT begins with an intensive, computerized treatment planning process coordinated by a team of specially trained radiation oncology experts. A radiation oncologist uses 3-D scanning images to draw the shape, size and location of the tumor to be targeted. Then, a radiation physicist devises an individualized treatment plan.
  • A specialized computer program optimizes a treatment plan based on a physician’s dose instructions and the 3-D diagnostic images.
  • To assist in targeting with more accuracy, the patient is usually fitted with a reusable localization device, such as a mask, body frame, etc.
  • During treatment sessions, the high-energy radiation used in IMRT is generated by a linear accelerator. The treatment unit contains a multileaf collimeter consisting of 120 small metal leaves, or rods, that shape the radiation beam and move in and out during treatment. This varies the amount of radiation for each area, blocking radiation out or allowing it in according to the treatment plan.
  • The beams may be moved dozens or hundreds of times and each may vary with a different intensity, resulting in radiation sculpted in three dimensions.

Image Guided Radiation Therapy (IGRT) is an advanced form of radiation treatment that combines imaging and treatment capabilities on a single machine. Because tumors can move, IGRT allows a radiation oncologist to see and track the tumor at the time of treatment, and to make very fine adjustments to a patient’s position so as to greatly increase the precision and accuracy of radiation therapy treatment. Knowing exactly where the tumor is allows clinicians to irradiate only the tumor, sparing the surrounding normal tissue. This accuracy results in higher radiation doses to the tumor and thereby increases the likelihood of controlling or eliminating the cancer.

High Dose Rate (HDR) brachytherapy is an advanced treatment for of internal radiation that allows physicians to deliver precise radiation treatment to a patient’s cancerous tumors. It is frequently used in the treatment of cervical and uterine cancers, certain lung cancers causing bronchial obstructions and obstructing esophageal cancers. It has also recently shown to be effective for treatment of early stage prostate cancer.

What is HDR brachytherapy?

  • High Dose Rate (HDR) brachytherapy is a leading-edge treatment that allows physicians to deliver precise radiation treatment directly to a patient’s cancerous tumors through the use of catheters, thin, flexible needles or applicators inserted into a body cavity or directly into the tissue.
  • It is a computer-controlled delivery system that optimizes dose distribution to the target.
  • HDR brachytherapy is frequently used in the treatment of cervical and uterine cancers, intraluminal treatment of certain lung cancers causing bronchial obstructions and obstructing esophageal cancers.  It has also recently been shown to be effective for treatment of early stage prostate cancer.

Why is it used?

  • HDR brachytherapy delivers radiation with extreme precision.  Advanced imaging allows catheters to be precisely located so the intended dose can be delivered to a position with 1-millimeter accuracy.
  • Unlike low dose rate brachytherapy treatment, HDR brachytherapy can often be delivered on an outpatient basis and no radioactive material is left in the body.
  • Treatment times are typically several minutes in duration instead of several days that are required for low dose rate brachytherapy.
  • Because radiation is delivered directly to the tumor, a higher dose is used, yet exposure to surrounding healthy tissue is limited.  HDR brachytherapy results in less than a two percent chance for permanent damage to any of the adjacent normal tissue.

How is HDR brachytherapy treatment planned and delivered?

  • The physician determines whether HDR brachytherapy will be administered through a thin catheter, a flexible needle placed through the skin, or through applicators that are inserted into a body cavity such as the lung or esophagus.
  • Patients are treated in the physician’s office, with sedation if needed, or under anesthesia in the hospital operating room.
  • When catheters are used, treatment may be delivered intermittently over several days.  Depending on the type of cancer for which the patient is being treated, catheters could remain in place during treatment, which may last several minutes to several hours.
  • Following a computed tomography (CT) scan of the treatment area, a three-dimensional reconstruction of the target organ/cancer and adjacent tissue is made to confirm placement of the implant device and plan the delivery sequence of the radioactive source for ideal dose distribution.
  • The HDR brachytherapy equipment is programmed with the patient’s specific treatment and connected to the implant device with transfer tubes.
  • Each treatment will last between 10-15 minutes, and during the treatment, the physician and clinical staff continually monitor and communicate with the patient from a room directly outside the treatment room.
  • When treatment is complete, the radioactive source retracts back into the HDR brachytherapy machine, and the transfer tubes are disconnected.  For weekly implants or if doses will be delivered weekly, delivery devices are removed and the patient returns home after the procedure.  For an implant series extending over several consecutive days, the patient remains in the hospital for comfort and support between treatment deliveries, and delivery devices are removed once the final treatment is complete.

Computed tomography (CT) is a diagnostic procedure that uses special x-ray equipment to obtain cross-sectional pictures of the body. The CT computer displays these pictures as detailed images of organs, bones, and other tissues. This procedure is also called CT scanning, computerized tomography, or computerized axial tomography (CAT).

How is CT used in cancer?

Computed tomography is used in several ways:

  • To detect or confirm the presence of a tumor;
  • To provide information about the size and location of the tumor and whether it has spread;
  • To guide a biopsy (the removal of cells or tissues for examination under a microscope);
  • To help plan radiation therapy or surgery; and
  • To determine whether the cancer is responding to treatment.

Breast brachytherapy is a form of radiation therapy that is delivered from within the breast using catheters rather than external radiation  beams. It allows for a very precise, targeted approach to treatment that can be completed over the course of several days.

Chemotherapy is a group of medicines used to treat cancer. While surgery and radiation therapy target specific areas of cancer, chemotherapy works throughout the body and can destroy cancer cells that have spread (metastasized) from the original tumor site.

How does chemotherapy work?

Chemotherapy destroys cancer cells. Some cancer cells grow slowly; others, rapidly. As a result, different types of chemotherapy drugs are designed to target the growth patterns of specific types of cancer cells. Each drug has a different way of working and is effective at a specific time in the life cycle of the targeted cells. Your doctor will develop a treatment plan specifically for you, based on your type of cancer, its stage of advancement, and your overall health.

Depending on your individual condition, your chemotherapy may be designed to achieve one or more of the three goals: remission, controlling and/or relieving symptoms.

How is chemotherapy administered?

Your doctor will choose the method that will be most effective against your particular type of cancer and cause the fewest side effects. You may receive chemotherapy drugs in one or more of the following ways:

  • Shot (injections)
  • IV (intravenous or dripping medicine through a tube into the vein)
  • Pill (oral medication)

View our Chemotherapy Education Video.

New York Oncology Hematology is the region’s only provider of neuro-oncology services. This expertise in treating brain and spinal cord tumors, as well as other neurologic complications, resulting from cancer and cancer treatment, means our patients are able to stay close to home for treatment.

Through our close partnership with Albany Medical Center’s Department of Neurology, our patients continue to receive the specialized care they need during and after treatment.

Patient Rights:

  • Understand and use these rights. If for any reason you do not understand these rights or you need help, we will provide assistance, including an interpreter.
  • Receive treatment and services without discrimination as to race, color, religion, sex, national origin, disability, sexual orientation, source of payment, or age.
  • Be treated with consideration, respect, and dignity. This includes privacy and treatment in a clean and safe environment.
  • Be informed of the services available at our practice locations.
  • Receive emergency care when you need it.
  • Be informed of the provisions for off-hour emergency care.
  • Be informed of the names, positions and functions of any staff involved in your care and refuse their treatment, examination or observation.
  • Receive all the information that you need to give informed consent for any non-emergent procedure or treatment. This information shall include the possible risks and benefits of the procedure or treatment, and alternatives for care.
  • Refuse treatment and be told what effect this may have on your health.
  • Refuse to take part in research projects. In deciding whether to participate, you have the right to a full explanation of the project.
  • Receive complete information about your diagnosis, treatment and prognosis.
  • Voice grievances and recommend changes in policies and services to NYOH without fear of reprisal.
  • Express complaints about the care and services NYOH provides you without fear of reprisal. You may request an investigation and written response about the findings within 30 days of the investigation.  If you are not satisfied with the response, you may contact the New York State Health Department. NYOH must provide you with the State Health Department telephone number.
  • Privacy and confidentiality of all protected health information and records regarding your care.
  • Review your medical record without charge and obtain a copy of your medical record for which NYOH can charge a reasonable fee.
  • Receive an itemized copy of your account statement and explanation of all charges, upon request.

Patient Responsibilities:

  • Provide complete and honest information regarding your health and health concerns.
  • Tell the doctor or health care team if there are changes in your health status.
  • Inform us whenever you receive care from a specialist or any other provider outside of our practice.
  • Be an active partner and participate in your health care by following recommendations.
  • Share with the doctor or medical team any concerns about your medical care or service.
  • Keep appointments, or notify the office as soon as possible if you are unable to keep an appointment.
  • Refrain from abusive language and disruptive and/or violent behavior.
  • Respect all New York Oncology Hematology staff and other patients.

Public Health Law §2803(1)(g) Patient’s Rights, 10 NYCRR 405.7, 405.7(a)(1), 507.7(c)

New York Oncology Hematology participates with most major health care insurance plans in the Capital Region. If you are a member of a participating insurance plan, we will submit a claim to your insurer for the services provided by New York Oncology Hematology. It is each patient’s responsibility to provide accurate, up-to-date information about his or her coverage. Patients who are not covered by an NYOH participating insurance plan will be responsible for payment in full.

To ensure that you are well informed about treatment costs, co-pays and your responsibility for payments that are not covered by insurance, a Patient Benefits Representative will meet with you prior to beginning treatment. Our Patient Benefits Representatives are integral members of the patient care team, helping to address financial issues that often accompany an unexpected illness. Any patient who may be experiencing financial hardships is encouraged to discuss his/her concerns with a Patient Benefits Representative. Options may include payment plans, determination of Medicaid eligibility or identification of other resources that may be available based on individual needs and circumstances.

NYOH participates with most major insurance plans – see listing below. For information about plans not listed, contact a Patient Benefits Representative at any NYOH practice location.

Participating Plans

Aetna

Beech Street Network

Blue Shield of Northeastern New York

Capital District Physicians Health Plan

Community Hospice

Coventry Healthcare Network

Emblem Health (Group Health Inc.)

Empire Blue Cross Blue Shield Network

Eddy Senior Care

Excellus Blue Cross Blue Shield

Fidelis Care New York (excludes Exchange)

Health Net Federal Services/ Tricare

Humana (Choice Care Network)

MagnaCare Network

Martins Point

Medicaid-New York State

Medicare

MultiPlan Network

MVP Health Plan/ Cigna Network Products

National Health Administrators

Railroad Medicare

SmartHealth Network

Three Rivers Provider Network

United Health Care Network

United Health Care/Empire Plan

To ensure the most appropriate care for our patients who may require inpatient or outpatient services, NYOH physicians have been credentialed at the following hospitals:

My Care Plus

We know it is important—and reassuring—to keep close contact with your physician during treatment. That is why NYOH offers My Care Plus, our secure, online patient portal. My Care Plus provides NYOH patients and their caregivers with instant access

to our care team, including important information about your diagnosis, medications, lab results and more.

By enrolling in My Care Plus, patients can use the convenient Message Center for non-urgent topics such as:

  • Scheduling and changing appointments
  • Directions/preparations for diagnostic procedures
  • Questions about lab results
  • Non-urgent medication questions

Your physician or nurse can help you enroll in My Care Plus at your first appointment. Or, you can follow the directions below to enroll today.

Enroll in My Care Plus today:

To ensure your privacy and the security of your medical records, we are asking our patients to enroll while in the office.

  1. Sign a waiver form to give us permission to provide access to your health information via the internet (download the form, fill it out, and bring it in with you at your next appointment).
  2. Receive an email (usually within 72 hours of visiting NYOH) and follow the instructions to create your online account.
  3. Keep your password and login information. If you lose it, visit the site and use the “forgot password” or “forgot username” links to recover them.

Already a member?

Access your account at: http://www.mycareplusonline.com

My Care Plus Instructions

To send and receive messages through the Message Center:

To send a message:

  • Click Compose Message from the menu
  • Select your doctor, enter your subject and message, and click Send

To view and reply to your received messages:

  • Click the Inbox link
  • Click anywhere on the message to open and read
  • Use the Reply Message box at the bottom to enter your message, and click Reply

Having trouble?

  • Enrollment: If you have questions regarding enrollment in My Care Plus, please contact your NYOH practice.
  • Technical Issues: If you are experiencing technical issues, contact the My Care Plus site administrator Monday through Friday from 10:00 AM – 6:30 PM (Eastern Standard Time) at toll free 1-855-887-6788.

Click below to download all patient form PDFs:

Print all PDF Forms

 

OR print each form individually:

HIXNY Electronic Data Access Consent Form NYOH

Patient Portal Authorization Form: My Care Plus 

Assignment of Benefits/Financial Responsibilities

General Consent for Physician Services

Patient History Form

Notice of Privacy Practices

Authorization for Release of Health Information

The US Oncology Network is one of the nation's largest networks of integrated, community-based oncology practices dedicated to advancing high-quality, evidence-based cancer care.

A physician-led organization, The US Oncology Networks unites like-minded physicians and clinicians around a common vision of improving patient outcomes and quality of life. Leveraging healthcare information technology, shared best practices, evidence-based guidelines and quality measurements, physicians within The US Oncology Network are pioneering new ways to achieve this vision.

The US Oncology Network is committed to strengthening patient access to integrated care in local communities across the nation, including collaboration with a variety of payers, hospitals and academic institutions. The US Oncology Network is supported by McKesson Specialty Health, a division of McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system.

New York Oncology Hematology is proud to be the only practice in the region affiliated with The US Oncology Network. Our patients, physicians, staff and community benefit from this prestigious and valuable partnership.

What Are Clinical Trials?

  • Clinical trials are research studies that involve people. These studies occur after laboratory and animal testing has been completed.
  • Clinical trials are the only way new cancer treatments can be tested for efficacy and safety before being made available to the public.
  • Each study tries to answer specific scientific questions and find better ways to prevent, diagnose, or treat cancer.

Why Does NYOH Participate in Clinical Research and Drug Trials?

  • Research improves the current state of care by finding better ways to prevent and treat cancer.
  • Research improves the quality of life and extends survival for those diagnosed with cancer.
  • Research provides patients with access to new, potentially more effective therapies, not otherwise available.

Why Are Clinical Trials Important?

  • Clinical trials contribute to knowledge and progress against cancer. Today’s standard treatments are based on previous clinical trial results. Over the past 20 years, NYOH has been involved if FDA approval of 38 new cancer treatments.  
  • The more people participating in clinical trials, the faster we can answer critical research questions that will lead to better treatments. Only about 3% of adult cancer patients take part in clinical trials. NYOH offers the most comprehensive Clinical Trial program in the region.
  • Because of progress made, many people with cancer are living longer. In addition to improved survival rates, clinical trials have also contributed to:
    • Lower recurrence rates for many cancers
    • New treatment approaches for cancers that had no effective therapy
    • Fewer side effects and better quality of life

What are the types of Cancer Clinical Trials?

  • Treatment trials involve new investigational treatments such as new anticancer drugs.
  • Prevention trials involve new approaches to prevent cancer or prevent a recurrence of cancer.
  • Screening trials investigate the best way to diagnose cancer, especially in the early stages.
  • Quality-of-life/cancer control trials explore ways to improve the comfort and quality-of-life of cancer patients.

What is a Protocol?

  • A protocol specifically outlines the study’s purpose. It defines the study size, number of participants and describes the plan of care and collection of data.
  • A study’s protocol is carefully developed and reviewed by the Principal Investigator and the sponsoring organization. It is then reviewed and approved by an Institutional Review Board (IRB) to ensure trial procedures are consistently carried out.

What does the Institutional Review Board (IRB) review?

  • That risks to participants are minimized and reasonable in relation to anticipated benefits
  • Selection of participants is equitable
  • Informed consent is sought for each participant and is appropriately documented
  • Data collection is monitored to ensure safety, privacy and confidentiality

Why consider a Clinical Trial?

  • Many patients benefit from clinical trials, which provide an alternative to standard treatment
  • Participation may provide NYOH patients with early access to the next successful treatment
  • NYOH patients who participate in clinical trials are monitored very closely – even after the treatment is completed

 

Full list of NYOH’s current clinical trials.

More Information: Contact GerryAnn Currier, RN, OCN, Manager of Clinical Research at: 518-489-3612 x1045 or gerry.currier@usoncology.com.

Leading Research. Promising Drug Trials.

Over the past 20 years, New York Oncology Hematology patients have participated in clinical drug trials leading to FDA approval of 38 new cancer therapies. With the largest, most comprehensive clinical research operation in the region, NYOH is constantly offering eligible patients opportunities to join new trials.

About Clinical Research

Clinical trials are human research studies, conducted with volunteers who participate in the testing of new therapies. The purpose is finding new, more effective cancer treatment. NYOH is the largest organization in the area that participates in Phase I/II and III trials, including those for all major solid tumor types, hematologic malignancies and supportive care.

The NYOH Clinical Research Program

Through our affiliation with The US Oncology Network, one of the largest and most reputable community-based research networks in the world, NYOH has access to some of the most promising new trials being offered. We also participate in National Cancer Institute (NCI) sponsored research.

At New York Oncology Hematology, we are proud of our role in the research and development of vital new cancer therapies. And we are deeply committed to bringing clinical trials to our community, offering patients an opportunity to help shape the future of cancer treatment, while benefitting from the very latest in clinical trials.

Over the past two decades, NYOH patients and physicians have participated in clinical drug trials leading to FDA approval of 38 new cancer therapies:

Abraxane
Afinitor
Alimta
Aranesp
Arimidex
Aromasin
Avastin
Camptosar
Doxil
Eloxatin
Erbitux
Faslodex
Gazyva
Gemzar
Halaven
Herceptin
Hycamtin
Inlyta
Iressa

Ixempra
Kadcyla
Neulasta
Neupogen
Nexavar
Provenge
Rituxan
Sprycel
Sutent
Tarceva
Tasigna
Taxotere
Tykerb
Vectibix
Velcade
Vidaza
Votrient
Xeloda
Zometa

To learn more about a study or to refer an eligible patient, please contact:

GerryAnn Currier
Manager of Clinical Research

Phone: (518) 489-3612 ext. 1045
Fax: (518) 489-4030

Email

At NYOH, we know every patient is different. And so is your cancer or blood disorder. That is why we invest in the latest therapies and technology – to ensure our physicians can provide the best course of treatment for you or your family member. We consider your age, stage of disease, overall health, lifestyle and personal preferences when making recommendations – and always include you and your family members in the decision making process.

At NYOH, we recently invested in a brand new radiation suite in Amsterdam, and our new Clifton Park Cancer Center includes the only Varian TrueBeam Radiotherapy System in the area. Our highly successful Stem Cell Transplant and Clinical Research programs provide additional treatment options you won’t find anywhere else in the region.

At New York Oncology Hematology, we focus exclusively on the treatment of cancer and blood disorders. For more than 30 years, we have been providing the best treatment and services available, in a convenient, community-based setting. We know every patient is different. That is why we take the time to get to know you – and include you and your loved ones in every decision about your care.

At New York Oncology Hematology, our radiation oncologists are using leading-edge technology to deliver precise doses of radiation to treat cancer. Both internal and external radiation works on a molecular level, damaging cancer cell to prevent them from growing or dividing.

New advances in radiation technology are allowing NYOH physicians to pinpoint radiation with even greater accuracy, sparing more healthy tissue and reducing side effects. Today, radiation therapy is quicker, safer and more precise than ever before.

NYOH’s team of radiation oncologists bring advanced expertise in today’s complex radiation therapy techniques. We are constantly upgrading our technology and our convenient office settings mean our patients can coordinate treatments around work and family schedules.

Our radiation team includes board-certified radiation oncologists who bring years of experience in caring for cancer patients, assisted by medical physicists, dosimetry, radiation therapists and oncology nursing support staff.

NYOH radiation treatments include:

  • Intensity-Modulated Radiation Therapy (IMRT)
  • Image-Guided Radiation Therapy (IGRT)
  • Stereotactic Body Radiotherapy (SBRT)
  • Stereotactic Radiosurgery (SRS)
  • HDR Brachytherapy
  • Gated Radiation Therapy
  • Three-dimensional (3-D) Conformal Radiation Therapy and Treatment Planning
  • Breast Brachytherapy

New York Oncology Hematology’s team of hematologists provides high quality care – including the newest targeted therapies and stem cell transplantation – to patients with both malignant and benign diseases of the blood and immunologic disorders.

These include disorders of:

  • red blood cells
  • white blood cells
  • platelets
  • the immune system
  • bone marrow
  • hypercoagulable states (blood clots)
  • coagulation, such as hemophilia or Von Willebrand’s disease

NYOH also treats thousands of patients with hematologic malignancies, such as:

  • leukemia
  • lymphoma
  • multiple myeloma

With advances in medical knowledge and treatment methods, many hematologic disorders today, can be successfully treated and managed.

At NYOH, many of our physicians are dually certified in both medical oncology and hematology. Our team of hematologists also works closely with physicians both inside and outside our practice, including radiation oncology, internal medicine, family practice and surgery, ensuring continuity of care for the patient.

NYOH Outpatient Stem Cell Transplant Program

New York Oncology Hematology offers the region’s only stem cell transplant program. The procedure, which combines high dose chemotherapy with autologous stem cell transplant, is used to treat:

  • Non-Hodgkin’s Lymphoma
  • Hodgkin’s Disease
  • Multiple Myeloma
  • Germ Cell Tumors

Unlike similar hospital-based programs in New York City and Boston, NYOH’s treatment is done at its outpatient facility at Albany Medical Center, allowing patients to stay at home, near family and friends, or at a nearby hotel. It also provides consistency, as patients can continue to see their primary oncologist during treatment.

At New York Oncology Hematology, our medical oncologists use the latest in chemotherapy, hormonal therapy, biological therapy and targeted therapies to treat cancer patients. Medical oncology targets cancer cells with treatment that is delivered orally (in pill form) or via injection.

Working closely with our oncology-trained nursing staff, surgeons, radiation oncologists, primary care physicians, and you, the patient, our medical oncologists manage your personalized treatment plan, evaluating progress and combining therapies to produce the best outcomes.

At NYOH, our patients also benefit from our robust clinical research program, which brings promising new therapies to our practice as part of the FDA approval process. Over the past 20 years, our patients have participated in more than 500 drug trials.

For your convenience, and often at a lower cost, NYOH also offers in-office dispensing of many drug treatments at the time of your visit. Your prescriptions are filled by NYOH pharmacists, board-certified with specialized training in cancer treatment, who focus exclusively on our patients, working closely with your physician on your individualized treatment regimen.

New York Oncology Hematology is the region’s largest provider of treatment for both cancer and blood disorders. Our team of more than 30 board certified physicians offers the following specialties: medical oncology, hematology, radiation oncology and neuro-oncology. NYOH is the only provider of neuro-oncology in the area.

As a private, physician-owned practice, our team of doctors works closely, creating a custom treatment plan for every patient. Today, treatment typically includes a combination of therapies that may include: chemotherapy, radiation therapy, stem cell transplant, as well as new targeted therapies. Many of our physicians are also involved in research, bringing promising clinical trials to our patients as part of the FDA approval process.

Search NYOH Physicians by Specialty

Insurance

New York Oncology Hematology participates with most major insurance plans We ask that you inform us immediately if your insurance coverage or personal information has changed.

Payment

All co-pays are due at the time of your visit, per your insurance coverage. For your convenience, NYOH accepts cash, check and credit cards (Visa, MasterCard and Discover).

If you are experiencing financial hardship, please meet with a Patient Benefits Representative to discuss options such as a payment plan, Medicaid eligibility and other available resources.

Billing Questions

For questions regarding your bill, please call our business office at 518-612-4108, during regular business hours (Monday-Friday, 8:30 a.m.—4:30 p.m.).

Prescription Refills

We require 48 hours notice for renewal of prescriptions. Please note: routine refills are not available nights, weekends and holidays. Prescriptions for narcotics must be picked up. We also offer a convenient in-office dispensing service (see below).

In-Office Dispensing

Now, you don’t have to make a separate trip to the pharmacy for prescriptions ordered by your physician. For your convenience, NYOH can fill many prescriptions right here at our offices. Just pick up at the location where you see your doctor—or, the medications may also be delivered directly to your home.

Cancer treatment is complex and requires close monitoring. It can also be very expensive. That is why our pharmacists are specially trained in cancer treatment and focus exclusively on NYOH patients. They work closely with your physician on an individualized treatment regimen, ensuring you receive medications in a timely manner.

At our NYOH Patient Prescription Center, we also take the time to verify your insurance coverage for medications. Our dedicated pharmacy staff investigates Medicare, supplemental plans, co-payment assistance programs and other options—to make sure you are getting the maximum drug benefits available.

To learn more, ask your nurse or physician about in-office dispensing.

If you are experiencing a life-threatening emergency, please dial 9-1-1.

For emergency calls, NYOH physicians are on call 24 hours a day, including weekends and holidays.

Non-emergent Calls

Non-emergent calls will be returned by a nurse within 24 hours.

Please note: if your physician is returning the call, it may be in the late afternoon or evening, after office hours.

As a new patient at New York Oncology Hematology, we want you to feel comfortable and confident about your care. That is why we created the helpful checklists below, to help prepare for your first visit. We also ask that you also print out and complete a full set of patient forms before you arrive.

At NYOH, we take the time to thoroughly evaluate every new patient, so your initial consultation may take 1-2 hours. We ask that you plan accordingly.

What to bring:

  • Your insurance information: Bring your insurance card or any additional insurance information.
  • Photo ID: Bring two forms of identification, including one photo ID. This includes a driver’s license, passport, military/school ID card, etc.
  • New patient forms: Please fill out all new patient forms and bring them with you. Click here to print the forms.
  • Medications: Bring a full list of your current medications and dosage.
  • List of questions: Write down any questions you have, so you don’t forgot to ask your physician at your visit.
  • Paper and pen: Be sure to take notes during your visit, so you have them to refer to and share with loved ones.
  • A friend or loved one: Whenever possible, bring along a friend or loved one to your appointments. They provide valuable support and serve as an extra pair of eyes and ears to ensure good communication.

What to expect:

  • Your physician: The physician you are scheduled to see at your initial consultation will remain your primary provider throughout treatment. At your first visit, you meet the doctor for a new patient evaluation.
  • Length of visit: We take the time to conduct a thorough evaluation at your consultation, so a first visit can last one to two hours. We ask that you plan accordingly.
  • Additional tests, x-rays or scans: Your physician may request additional tests, x-rays or scans to best guide your treatment.
  • Your care team: In addition to your physician, you may also meet oncology nurses, advanced practice providers, radiation therapists, CT/PET technologists, pharmacists, laboratory technicians and clinical research coordinators who will be part of your treatment.
  • Your patient benefits representative: At the end of your visit, you’ll schedule your next appointment and meet with a patient benefits representative to discuss your insurance coverage and billing questions.

People with multiple myeloma have many treatment options. The options are watchful waiting, induction therapy, and stem cell transplant. Sometimes a combination of methods is used.

Radiation therapy is used sometimes to treat painful bone disease. It may be used alone or along with other therapies. See the Supportive Care section to learn about ways to relieve pain.

The choice of treatment depends mainly on how advanced the disease is and whether you have symptoms. If you have multiple myeloma without symptoms (smoldering myeloma), you may not need cancer treatment right away. The doctor monitors your health closely (watchful waiting) so that treatment can start when you begin to have symptoms.

If you have symptoms, you will likely get induction therapy. Sometimes a stem cell transplant is part of the treatment plan.

When treatment for myeloma is needed, it can often control the disease and its symptoms. People may receive therapy to help keep the cancer in remission, but myeloma can seldom be cured. Because standard treatment may not control myeloma, you may want to talk to your doctor about taking part in a clinical trial. Clinical trials are research studies of new treatment methods.

Watchful Waiting

People with smoldering myeloma or Stage I myeloma may be able to put off having cancer treatment. By delaying treatment, you can avoid the side effects of treatment until you have symptoms.

If you and your doctor agree that watchful waiting is a good idea, you will have regular checkups (such as every 3 months). You will receive treatment if symptoms occur.

Although watchful waiting avoids or delays the side effects of cancer treatment, this choice has risks. In some cases, it may reduce the chance to control myeloma before it gets worse.

You may decide against watchful waiting if you don’t want to live with untreated myeloma. If you choose watchful waiting but grow concerned later, you should discuss your feelings with your doctor. Another approach is an option in most cases.

Induction Therapy

Many different types of drugs are used to treat myeloma. People often receive a combination of drugs, and many different combinations are used to treat myeloma.

Each type of drug kills cancer cells in a different way:

  • Chemotherapy: Chemotherapy kills fast-growing myeloma cells, but the drug can also harm normal cells that divide rapidly.
  • Targeted therapy: Targeted therapies use drugs that block the growth of myeloma cells. The targeted therapy blocks the action of an abnormal protein that stimulates the growth of myeloma cells.
  • Steroids: Some steroids have antitumor effects. It is thought that steroids can trigger the death of myeloma cells. A steroid may be used alone or with other drugs to treat myeloma.

You may receive the drugs by mouth or through a vein (IV). The treatment usually takes place in an outpatient part of the hospital, at your doctor’s office, or at home. Some people may need to stay in the hospital for treatment.

Stem Cell Transplant

Many people with multiple myeloma may get a stem cell transplant. A stem cell transplant allows you to be treated with high doses of drugs. The high doses destroy both myeloma cells and normal blood cells in the bone marrow. After you receive high-dose treatment, you receive healthy stem cells through a vein. (It’s like getting a blood transfusion.) New blood cells develop from the transplanted stem cells. The new blood cells replace the ones that were destroyed by treatment.

Stem cell transplants take place in the hospital. Some people with myeloma have two or more transplants.

Stem cells may come from you or from someone who donates their stem cells to you:

  • From you: An autologous stem cell transplant uses your own stem cells. Before you get the high-dose chemotherapy, your stem cells are removed. The cells may be treated to kill any myeloma cells present. Your stem cells are frozen and stored. After you receive high-dose chemotherapy, the stored stem cells are thawed and returned to you.
  • From a family member or other donor: An allogeneic stem cell transplant uses healthy stem cells from a donor. Your brother, sister, or parent may be the donor. Sometimes the stem cells come from a donor who isn’t related. Doctors use blood tests to be sure the donor’s cells match your cells. Allogeneic stem cell transplants are under study for the treatment of multiple myeloma.
  • From your identical twin: If you have an identical twin, a syngeneic stem cell transplant uses stem cells from your healthy twin.

There are two ways to get stem cells for people with myeloma. They usually come from the blood (peripheral blood stem cell transplant). Or they can come from the bone marrow (bone marrow transplant).

After a stem cell transplant, you may stay in the hospital for several weeks or months. You’ll be at risk for infections because of the large doses of chemotherapy you received. In time, the transplanted stem cells will begin to produce healthy blood cells.

If the biopsy shows that you have multiple myeloma, your doctor needs to learn the extent (stage) of the disease to plan the best treatment. Staging may involve having more tests:

  • Blood tests: For staging, the doctor considers the results of blood tests, including albumin and beta-2-microglobulin.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your bones.
  • MRI: A powerful magnet linked to a computer is used to make detailed pictures of your bones.

Doctors may describe multiple myeloma as:

  • Smoldering
  • Stage I
  • Stage II
  • Stage III

The stage takes into account whether the cancer is causing problems with your bones or kidneys. Smoldering multiple myeloma is early disease without any symptoms. For example, there is no bone damage. Early disease with symptoms (such as bone damage) is Stage I. Stage II or III is more advanced, and more myeloma cells are found in the body.

Doctors sometimes find multiple myeloma after a routine blood test. More often, doctors suspect multiple myeloma after an x-ray for a broken bone. Usually though, patients go to the doctor because they are having other symptoms.

To find out whether such problems are from multiple myeloma or some other condition, your doctor may ask about your personal and family medical history and do a physical exam. Your doctor also may order some of the following tests:

  • Blood tests: The lab does several blood tests:
    • Multiple myeloma causes high levels of proteins in the blood. The lab checks the levels of many different proteins, including M protein and other immunoglobulins (antibodies), albumin, and beta-2-microglobulin.
    • Myeloma may also cause anemia and low levels of white blood cells and platelets. The lab does a complete blood count to check the number of white blood cells, red blood cells, and platelets.
    • The lab also checks for high levels of calcium.
    • To see how well the kidneys are working, the lab tests for creatinine.
  • Urine tests: The lab checks for Bence Jones protein, a type of M protein, in urine. The lab measures the amount of Bence Jones protein in urine collected over a 24-hour period. If the lab finds a high level of Bence Jones protein in your urine sample, doctors will monitor your kidneys. Bence Jones protein can clog the kidneys and damage them.
  • X-rays: You may have x-rays to check for broken or thinning bones.An x-ray of your whole body can be done to see how many bones could be damaged by the myeloma.
  • Biopsy: Your doctor removes tissue to look for cancer cells. A biopsy is the only sure way to know whether myeloma cells are in your bone marrow. Before the sample is taken, local anesthesia is used to numb the area. This helps reduce the pain. Your doctor removes some bone marrow from your hip bone or another large bone. A pathologist uses a microscope to check the tissue for myeloma cells.

There are two ways your doctor can obtain bone marrow. Some people will have both procedures during the same visit:

  • Bone marrow aspiration: The doctor uses a thick, hollow needle to remove samples of bone marrow.
  • Bone marrow biopsy: The doctor uses a very thick, hollow needle to remove a small piece of bone and bone marrow.

Myeloma begins when a plasma cell becomes abnormal. The abnormal cell divides to make copies of itself. The new cells divide again and again, making more and more abnormal cells. These abnormal plasma cells are called myeloma cells.

In time, myeloma cells collect in the bone marrow. They may damage the solid part of the bone. When myeloma cells collect in several of your bones, the disease is called “multiple myeloma.” This disease may also harm other tissues and organs, such as the kidneys.

Myeloma cells make antibodies called M proteins and other proteins. These proteins can collect in the blood, urine, and organs.

Visit the National Cancer Institute where this information and more can be found about Multiple Myeloma or ask your cancer care team questions about your individual situation.

Your doctor can describe your treatment choices and the expected results. You and your doctor can work together to develop a treatment plan that meets your needs.

Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat Hodgkin lymphoma include hematologists, medical oncologists, and radiation oncologists . Your doctor may suggest that you choose an oncologist who specializes in the treatment of Hodgkin lymphoma. Often, such doctors are associated with major academic centers. Your health care team may also include an oncology nurse and a registered dietitian.

The choice of treatment depends mainly on the following:

  • The type of your Hodgkin lymphoma (most people have classical Hodgkin lymphoma)
  • Its stage (where the lymphoma is found)
  • Whether you have a tumor that is more than 4 inches (10 centimeters) wide
  • Your age
  • Whether you’ve had weight loss, drenching night sweats, or fevers.

People with Hodgkin lymphoma may be treated with chemotherapy, radiation therapy, or both.

If Hodgkin lymphoma comes back after treatment, doctors call this a relapse or recurrence. People with Hodgkin lymphoma that comes back after treatment may receive high doses of chemotherapy, radiation therapy, or both, followed by stem cell transplantation.

Chemotherapy

Chemotherapy for Hodgkin lymphoma uses drugs to kill lymphoma cells. It is called systemic therapy because the drugs travel through the bloodstream. The drugs can reach lymphoma cells in almost all parts of the body.

Usually, more than one drug is given. Most drugs for Hodgkin lymphoma are given through a vein (intravenous), but some are taken by mouth.

Chemotherapy is given in cycles. You have a treatment period followed by a rest period. The length of the rest period and the number of treatment cycles depend on the stage of your disease and on the anticancer drugs used.

You may have your treatment in a clinic, at the doctor’s office, or at home. Some people may need to stay in the hospital for treatment.

Radiation Therapy

Radiation therapy (also called radiotherapy) for Hodgkin lymphoma uses high-energy rays to kill lymphoma cells. It can shrink tumors and help control pain.

A large machine aims the rays at the lymph node areas affected by lymphoma. This is local therapy because it affects cells in the treated area only. Most people go to a hospital or clinic for treatment 5 days a week for several weeks.

Stem Cell Transplantation

If Hodgkin lymphoma returns after treatment, you may receive stem cell transplantation. A transplant of your own blood-forming stem cells (autologous stem cell transplantation) allows you to receive high doses of chemotherapy, radiation therapy, or both. The high doses destroy both Hodgkin lymphoma cells and healthy blood cells in the bone marrow.

Stem cell transplants take place in the hospital. Before you receive high-dose treatment, your stem cells are removed and may be treated to kill lymphoma cells that may be present. Your stem cells are frozen and stored. After you receive high-dose treatment to kill Hodgkin lymphoma cells, your stored stem cells are thawed and given back to you through a flexible tube placed in a large vein in your neck or chest area. New blood cells develop from the transplanted stem cells.

The doctor considers the following to determine the stage of Hodgkin lymphoma:

  • The number of lymph nodes that have Hodgkin lymphoma cells
  • Whether these lymph nodes are on one or both sides of the diaphragm (see picture)
  • Whether the disease has spread to the bone marrow, spleen, liver, or lung.

The stages of Hodgkin lymphoma are as follows:

  • Stage I: The lymphoma cells are in one lymph node group (such as in the neck or underarm). Or, if the lymphoma cells are not in the lymph nodes, they are in only one part of a tissue or an organ
  • Stage II: The lymphoma cells are in at least two lymph node groups on the same side of (either above or below) the diaphragm. Or, the lymphoma cells are in one part of a tissue or an organ and the lymph nodes near that organ (on the same side of the diaphragm). There may be lymphoma cells in other lymph node groups on the same side of the diaphragm.
  • Stage III: The lymphoma cells are in lymph nodes above and below the diaphragm. Lymphoma also may be found in one part of a tissue or an organ (such as the liver, lung, or bone) near these lymph node groups. It may also be found in the spleen.
  • Stage IV: Lymphoma cells are found in several parts of one or more organs or tissues. Or, the lymphoma is in an organ (such as the liver, lung, or bone) and in distant lymph nodes.
  • Recurrent: The disease returns after treatment.

In addition to these stage numbers, your doctor may also describe the stage as A or B:

  • A: You have not had weight loss, drenching night sweats, or fevers.
  • B: You have had weight loss, drenching night sweats, or fevers.

If you have swollen lymph nodes or another symptom that suggests Hodgkin lymphoma, your doctor will try to find out what’s causing the problem. Your doctor may ask about your personal and family medical history.

You may have some of the following exams and tests:

  • Physical exam: Your doctor checks for swollen lymph nodes in your neck, underarms, and groin. Your doctor also checks for a swollen spleen or liver.
  • Blood tests: The lab does a complete blood count to check the number of white blood cells and other cells and substances.
  • Chest x-rays: X-ray pictures may show swollen lymph nodes or other signs of disease in your chest.
  • Biopsy: A biopsy is the only sure way to diagnose Hodgkin lymphoma. Your doctor may remove an entire lymph node (excisional biopsy) or only part of a lymph node (incisional biopsy). A thin needle (fine needle aspiration) usually cannot remove a large enough sample for the pathologist to diagnose Hodgkin lymphoma. Removing an entire lymph node is best.

The pathologist uses a microscope to check the tissue for Hodgkin lymphoma cells. A person with Hodgkin lymphoma usually has large, abnormal cells known as Reed-Sternberg cells. They are not found in people with non-Hodgkin lymphoma. See the photo of a Reed-Sternberg cell.

Hodgkin lymphoma is a cancer that begins in cells  of the immune system. The immune system fights infections  and other diseases.

Hodgkin lymphoma can start almost anywhere. Usually, it's first found in a lymph node above the diaphragm, the thin muscle that separates the chest from the abdomen. But Hodgkin lymphoma also may be found in a group of lymph nodes. Sometimes it starts in other parts of the lymphatic system.

Hodgkin lymphoma begins when a lymphocyte (usually a B cell) becomes abnormal. The abnormal cell is called a Reed-Sternberg cell. (See photo below.)

The Reed-Sternberg cell divides to make copies of itself. The new cells divide again and again, making more and more abnormal cells. The abnormal cells don't die when they should. They don't protect the body from infections or other diseases. The buildup of extra cells often forms a mass of tissue called a growth or tumor.

Visit the National Cancer Institute where this information and more can be found about  Hodgkin Lymphoma or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el linfoma de Hodgkin.

Your doctor can describe your treatment choices and the expected results. You and your doctor can work together to develop a treatment plan that meets your needs.

Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat non-Hodgkin lymphoma include hematologists, medical oncologists, and radiation oncologists. Your doctor may suggest that you choose an oncologist who specializes in the treatment of lymphoma. Often, such doctors are associated with major academic centers. Your health care team may also include an oncology nurse and a registered dietitian.

The choice of treatment depends mainly on the following:

  • The type of non-Hodgkin lymphoma (for example, follicular lymphoma)
  • Its stage (where the lymphoma is found)
  • How quickly the cancer is growing (whether it is indolent or aggressive lymphoma)
  • Your age
  • Whether you have other health problems

If you have indolent non-Hodgkin lymphoma without symptoms, you may not need treatment for the cancer right away. The doctor watches your health closely so that treatment can start when you begin to have symptoms. Not getting cancer treatment right away is called watchful waiting.

If you have indolent lymphoma with symptoms, you will probably receive chemotherapy and biological therapy. Radiation therapy may be used for people with Stage I or Stage II lymphoma.

If you have aggressive lymphoma, the treatment is usually chemotherapy and biological therapy. Radiation therapy also may be used.

If non-Hodgkin lymphoma comes back after treatment, doctors call this a relapse or recurrence. People with lymphoma that comes back after treatment may receive high doses of chemotherapy, radiation therapy, or both, followed by stem cell transplantation.

Watchful Waiting

People who choose watchful waiting put off having cancer treatment until they have symptoms. Doctors sometimes suggest watchful waiting for people with indolent lymphoma. People with indolent lymphoma may not have problems that require cancer treatment for a long time. Sometimes the tumor may even shrink for a while without therapy. By putting off treatment, they can avoid the side effects of chemotherapy or radiation therapy.

If you and your doctor agree that watchful waiting is a good idea, the doctor will check you regularly (every 3 months). You will receive treatment if symptoms occur or get worse.

Some people do not choose watchful waiting because they don’t want to worry about having cancer that is not treated. Those who choose watchful waiting but later become worried should discuss their feelings with the doctor.

Chemotherapy

Chemotherapy for lymphoma uses drugs to kill lymphoma cells. It is called systemic therapy because the drugs travel through the bloodstream. The drugs can reach lymphoma cells in almost all parts of the body.

You may receive chemotherapy by mouth, through a vein, or in the space around the spinal cord. Treatment is usually in an outpatient part of the hospital, at the doctor’s office, or at home. Some people need to stay in the hospital during treatment.

Chemotherapy is given in cycles. You have a treatment period followed by a rest period. The length of the rest period and the number of treatment cycles depend on the stage of your disease and on the anticancer drugs used.

If you have lymphoma in the stomach caused by H. pylori infection, your doctor may treat this lymphoma with antibiotics. After the drug cures the infection, the lymphoma also may go away.

Biological Therapies

People with certain types of non-Hodgkin lymphoma may have biological therapy. This type of treatment helps the immune system fight cancer.

Monoclonal antibodies are the type of biological therapy used for lymphoma. They are proteins made in the lab that can bind to cancer cells. They help the immune system kill lymphoma cells. People receive this treatment through a vein at the doctor’s office, clinic, or hospital.

Radiation Therapy

Radiation therapy (also called radiotherapy) uses high-energy rays to kill lymphoma cells. It can shrink tumors and help control pain.
Two types of radiation therapy are used for people with lymphoma:

  • External radiation: A large machine aims the rays at the part of the body where lymphoma cells have collected. This is local therapy because it affects cells in the treated area only. Most people go to a hospital or clinic for treatment 5 days a week for several weeks.
  • Systemic radiation: Some people with lymphoma receive an injection of radioactive material that travels throughout the body. The radioactive material is bound to monoclonal antibodies that seek out lymphoma cells. The radiation destroys the lymphoma cells.

Stem Cell Transplantation

If lymphoma returns after treatment, you may receive stem cell transplantation. A transplant of your own blood-forming stem cells allows you to receive high doses of chemotherapy, radiation therapy, or both. The high doses destroy both lymphoma cells and healthy blood cells in the bone marrow.

Stem cell transplants take place in the hospital. After you receive high-dose treatment, healthy blood-forming stem cells are given to you through a flexible tube placed in a large vein in your neck or chest area. New blood cells develop from the transplanted stem cells.
The stem cells may come from your own body or from a donor: :

  • Autologous stem cell transplantation: This type of transplant uses your own stem cells. Your stem cells are removed before high-dose treatment. The cells may be treated to kill lymphoma cells that may be present. The stem cells are frozen and stored. After you receive high-dose treatment, the stored stem cells are thawed and returned to you.
  • Allogeneic stem cell transplantation: Sometimes healthy stem cells from a donor are available. Your brother, sister, or parent may be the donor. Or the stem cells may come from an unrelated donor. Doctors use blood tests to be sure the donor’s cells match your cells.
  • Syngeneic stem cell transplantation: This type of transplant uses stem cells from a patient’s healthy identical twin.

Your doctor needs to know the extent (stage) of non-Hodgkin lymphoma to plan the best treatment. Staging is a careful attempt to find out what parts of the body are affected by the disease.

Lymphoma usually starts in a lymph node. It can spread to nearly any other part of the body. For example, it can spread to the liver, lungs, bone, and bone marrow.

Staging may involve one or more of the following tests:

  • Bone marrow biopsy: The doctor uses a thick needle to remove a small sample of bone and bone marrow from your hipbone or another large bone. Local anesthesia can help control pain. A pathologist looks for lymphoma cells in the sample.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your head, neck, chest, abdomen, or pelvis. You may receive an injection of contrast material. Also, you may be asked to drink another type of contrast material. The contrast material makes it easier for the doctor to see swollen lymph nodes and other abnormal areas on the x-ray.
  • MRI: Your doctor may order MRI pictures of your spinal cord, bone marrow, or brain. MRI uses a powerful magnet linked to a computer. It makes detailed pictures of tissue on a computer screen or film.
  • Ultrasound: An ultrasound device sends out sound waves that you cannot hear. A small hand-held device is held against your body. The waves bounce off nearby tissues, and a computer uses the echoes to create a picture. Tumors may produce echoes that are different from the echoes made by healthy tissues. The picture can show possible tumors.
  • Spinal tap: The doctor uses a long, thin needle to remove fluid from the spinal column. Local anesthesia can help control pain. You must lie flat for a few hours afterward so that you don’t get a headache. The lab checks the fluid for lymphoma cells or other problems.
  • PET scan: You receive an injection of a small amount of radioactive sugar. A machine makes computerized pictures of the sugar being used by cells in your body. Lymphoma cells use sugar faster than normal cells, and areas with lymphoma look brighter on the pictures.

The stage is based on where lymphoma cells are found (in the lymph nodes or in other organs or tissues). The stage also depends on how many areas are affected. The stages of non-Hodgkin lymphoma are as follows:

  • Stage I: The lymphoma cells are in one lymph node group (such as in the neck or underarm). Or, if the abnormal cells are not in the lymph nodes, they are in only one part of a tissue or organ (such as the lung, but not the liver or bone marrow).
  • Stage II: The lymphoma cells are in at least two lymph node groups on the same side of (either above or below) the diaphragm. (See the picture of the diaphragm.) Or, the lymphoma cells are in one part of an organ and the lymph nodes near that organ (on the same side of the diaphragm). There may be lymphoma cells in other lymph node groups on the same side of the diaphragm.
  • Stage III: The lymphoma is in lymph nodes above and below the diaphragm. It also may be found in one part of a tissue or an organ near these lymph node groups.
  • Stage IV: Lymphoma cells are found in several parts of one or more organs or tissues (in addition to the lymph nodes). Or, it is in the liver, blood, or bone marrow.
  • Recurrent: The disease returns after treatment.

In addition to these stage numbers, your doctor may also describe the stage as A or B:

  • A: You have not had weight loss, drenching night sweats, or fevers.
  • B: You have had weight loss, drenching night sweats, or fevers.

This information is about non-Hodgkin lymphoma, a cancer that starts in the immune system. Non-Hodgkin lymphoma is also called NHL.

Non-Hodgkin lymphoma begins when a lymphocyte (usually a B cell) becomes abnormal. The abnormal cell divides to make copies of itself. The new cells divide again and again, making more and more abnormal cells. The abnormal cells don't die when they should. They don't protect the body from infections or other diseases. The buildup of extra cells often forms a mass of tissue called a growth or tumor.

Because lymphatic tissue is in many parts of the body, Hodgkin lymphoma can start almost anywhere. Usually, it's first found in a lymph node.

When lymphoma is found, the pathologist reports the type. There are many types of lymphoma. The most common types are diffuse large B-cell lymphoma and follicular lymphoma.

Lymphomas may be grouped by how quickly they are likely to grow:

  • Indolent (also called low-grade) lymphomas grow slowly. They tend to cause few symptoms.
  • Aggressive (also called intermediate-grade and high-grade) lymphomas grow and spread more quickly. They tend to cause severe symptoms. Over time, many indolent lymphomas become aggressive lymphomas.

It’s a good idea to get a second opinion about the type of lymphoma that you have. The treatment plan varies by the type of lymphoma. A pathologist at a major referral center can review your biopsy. See the Second Opinion section for more information.

Visit the National Cancer Institute where this information and more can be found about Non Hodgkin Lymphoma or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el linfoma no Hodgkin.

People with leukemia have many treatment options. The options are watchful waiting, chemotherapy, targeted therapy, biological therapy, radiation therapy, and stem cell transplant. If your spleen is enlarged, your doctor may suggest surgery to remove it. Sometimes a combination of these treatments is used.

The choice of treatment depends mainly on the following:

  • The type of leukemia (acute or chronic)
  • Your age
  • Whether leukemia cells were found in your cerebrospinal fluid

It also may depend on certain features of the leukemia cells. Your doctor also considers your symptoms and general health.

People with acute leukemia need to be treated right away. The goal of treatment is to destroy signs of leukemia in the body and make symptoms go away. This is called a remission. After people go into remission, more therapy may be given to prevent a relapse. This type of therapy is called consolidation therapy or maintenance therapy. Many people with acute leukemia can be cured.

If you have chronic leukemia without symptoms, you may not need cancer treatment right away. Your doctor will watch your health closely so that treatment can start when you begin to have symptoms. Not getting cancer treatment right away is called watchful waiting.

When treatment for chronic leukemia is needed, it can often control the disease and its symptoms. People may receive maintenance therapy to help keep the cancer in remission, but chronic leukemia can seldom be cured with chemotherapy. However, stem cell transplants offer some people with chronic leukemia the chance for cure.

Your doctor can describe your treatment choices, the expected results, and the possible side effects. You and your doctor can work together to develop a treatment plan that meets your medical and personal needs.

You may want to talk with your doctor about taking part in a clinical trial, a research study of new treatment methods. See the Taking Part in Cancer Research section.

Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat leukemia include hematologists, medical oncologists, and radiation oncologists. Pediatric oncologists and hematologists treat childhood leukemia. Your health care team may also include an oncology nurse and a registered dietitian.

Whenever possible, people should be treated at a medical center that has doctors experienced in treating leukemia. If this isn’t possible, your doctor may discuss the treatment plan with a specialist at such a center.

Before treatment starts, ask your health care team to explain possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.

Watchful Waiting

People with chronic lymphocytic leukemia who do not have symptoms may be able to put off having cancer treatment. By delaying treatment, they can avoid the side effects of treatment until they have symptoms.

If you and your doctor agree that watchful waiting is a good idea, you’ll have regular checkups (such as every 3 months). You can start treatment if symptoms occur.

Although watchful waiting avoids or delays the side effects of cancer treatment, this choice has risks. It may reduce the chance to control leukemia before it gets worse.

You may decide against watchful waiting if you don’t want to live with an untreated leukemia. Some people choose to treat the cancer right away.

If you choose watchful waiting but grow concerned later, you should discuss your feelings with your doctor. A different approach is nearly always available.

Chemotherapy

Many people with leukemia are treated with chemotherapy. Chemotherapy uses drugs to destroy leukemia cells.

Depending on the type of leukemia, you may receive a single drug or a combination of two or more drugs.

You may receive chemotherapy in several different ways:

  • By mouth: Some drugs are pills that you can swallow.
  • Into a vein (IV): The drug is given through a needle or tube inserted into a vein.
  • Through a catheter (a thin, flexible tube): The tube is placed in a large vein, often in the upper chest. A tube that stays in place is useful for patients who need many IV treatments. The health care professional injects drugs into the catheter, rather than directly into a vein. This method avoids the need for many injections, which can cause discomfort and injure the veins and skin.
  • Into the cerebrospinal fluid: If the pathologist finds leukemia cells in the fluid that fills the spaces in and around the brain and spinal cord, the doctor may order intrathecal chemotherapy. The doctor injects drugs directly into the cerebrospinal fluid. Intrathecal chemotherapy is given in two ways:
    • Into the spinal fluid: The doctor injects the drugs into the spinal fluid.
    • Under the scalp: Children and some adult patients receive chemotherapy through a special catheter called an Ommaya reservoir. The doctor places the catheter under the scalp. The doctor injects the drugs into the catheter. This method avoids the pain of injections into the spinal fluid.

Intrathecal chemotherapy is used because many drugs given by IV or taken by mouth can’t pass through the tightly packed blood vessel walls found in the brain and spinal cord. This network of blood vessels is known as the blood-brain barrier.

Chemotherapy is usually given in cycles. Each cycle has a treatment period followed by a rest period.

You may have your treatment in a clinic, at the doctor’s office, or at home. Some people may need to stay in the hospital for treatment.

Targeted Therapy

People with chronic myeloid leukemia and some with acute lymphoblastic leukemia may receive drugs called targeted therapy. Imatinib (Gleevec) tablets were the first targeted therapy approved for chronic myeloid leukemia. Other targeted therapy drugs are now used too.

Targeted therapies use drugs that block the growth of leukemia cells. For example, a targeted therapy may block the action of an abnormal protein that stimulates the growth of leukemia cells.

Biological Therapy

Some people with leukemia receive drugs called biological therapy. Biological therapy for leukemia is treatment that improves the body’s natural defenses against the disease.

One type of biological therapy is a substance called a monoclonal antibody. It’s given by IV infusion. This substance binds to the leukemia cells. One kind of monoclonal antibody carries a toxin that kills the leukemia cells. Another kind helps the immune system destroy leukemia cells.

For some people with chronic myeloid leukemia, the biological therapy is a drug called interferon. It is injected under the skin or into a muscle. It can slow the growth of leukemia cells.

You may have your treatment in a clinic, at the doctor’s office, or in the hospital. Other drugs may be given at the same time to prevent side effects.

Doctors sometimes find leukemia after a routine blood test. If you have symptoms that suggest leukemia, your doctor will try to find out what’s causing the problems. Your doctor may ask about your personal and family medical history.

You may have one or more of the following tests:

  • Physical exam: Your doctor checks for swollen lymph nodes, spleen, or liver.
  • Blood tests: The lab does a complete blood count to check the number of white blood cells, red blood cells, and platelets. Leukemia causes a very high level of white blood cells. It may also cause low levels of platelets and hemoglobin, which is found inside red blood cells.
  • Biopsy: Your doctor removes tissue to look for cancer cells. A biopsy is the only sure way to know whether leukemia cells are in your bone marrow. Before the sample is taken, local anesthesia is used to numb the area. This helps reduce the pain. Your doctor removes some bone marrow from your hipbone or another large bone. A pathologist uses a microscope to check the tissue for leukemia cells.

There are two ways your doctor can obtain bone marrow. Some people will have both procedures during the same visit:

  • Bone marrow aspiration: The doctor uses a thick, hollow needle to remove samples of bone marrow.
  • Bone marrow biopsy: The doctor uses a very thick, hollow needle to remove a small piece of bone and bone marrow.

Other Tests

The tests that your doctor orders for you depend on your symptoms and type of leukemia. You may have other tests:

  • Cytogenetics: The lab looks at the chromosomes of cells from samples of blood, bone marrow, or lymph nodes. If abnormal chromosomes are found, the test can show what type of leukemia you have. For example, people with CML have an abnormal chromosome called the Philadelphia chromosome.
  • Spinal tap: Your doctor may remove some of the cerebrospinal fluid (the fluid that fills the spaces in and around the brain and spinal cord). The doctor uses a long, thin needle to remove fluid from the lower spine. The procedure takes about 30 minutes and is performed with local anesthesia. You must lie flat for several hours afterward to keep from getting a headache. The lab checks the fluid for leukemia cells or other signs of problems.
  • Chest x-ray: An x-ray can show swollen lymph nodes or other signs of disease in your chest.

The types of leukemia also can be grouped based on the type of white blood cell that is affected. Leukemia can start in lymphoid cells or myeloid cells.  Leukemia that affects lymphoid cells is called lymphoid, lymphocytic, or lymphoblastic leukemia.  Leukemia that affects myeloid cells is called myeloid, myelogenous, or myeloblastic leukemia.

There are four common types of leukemia:

  • Chronic lymphocytic leukemia (CLL): CLL affects lymphoid cells and usually grows slowly. It accounts for more than 15,000 new cases of leukemia each year. Most often, people diagnosed with the disease are over age 55. It almost never affects children.
  • Chronic myeloid leukemia (CML): CML affects myeloid cells and usually grows slowly at first. It accounts for nearly 5,000 new cases of leukemia each year. It mainly affects adults.
  • Acute lymphocytic (lymphoblastic) leukemia (ALL): ALL affects lymphoid cells and grows quickly. It accounts for more than 5,000 new cases of leukemia each year. ALL is the most common type of leukemia in young children. It also affects adults.
  • Acute myeloid leukemia (AML): AML affects myeloid cells and grows quickly. It accounts for more than 13,000 new cases of leukemia each year. It occurs in both adults and children.
  • Hairy Cell Leukemia: A rare type of leukemia in which abnormal B-lymphocytes (a type of white blood cell) are present in the bone marrow, spleen, and peripheral blood. When viewed under a microscope, these cells appear to be covered with tiny hair-like projections.

Leukemia is cancer that starts in the tissues that forms blood.

The types of leukemia can be grouped based on how quickly the disease develops and gets worse. Leukemia is either chronic (which usually gets worse slowly) or acute (which usually gets worse quickly):

  • Chronic leukemia: Early in the disease, the leukemia cells can still do some of the work of normal white blood cells. People may not have any symptoms at first. Doctors often find chronic leukemia during a routine checkup – before there are any symptoms. Slowly, chronic leukemia gets worse. As the number of leukemia cells in the blood increases, people get symptoms, such as swollen lymph nodes or infections. When symptoms do appear, they are usually mild at first and get worse gradually.
  • Acute leukemia: The leukemia cells can’t do any of the work of normal white blood cells. The number of leukemia cells increases rapidly. Acute leukemia usually worsens quickly.

Lo que usted necesita saber sobre la leucemia.

Your blood is living tissue made up of liquid and solids. The liquid part, called plasma, is made of water, salts and protein. Over half of your blood is plasma. The solid part of your blood contains red blood cells, white blood cells and platelets.

Red blood cells deliver oxygen from your lungs to your tissues and organs. White blood cells fight infection and are part of your body's defense system. Platelets help blood to clot. Bone marrow, the spongy material inside your bones, makes new blood cells. Blood cells constantly die and your body makes new ones. Red blood cells live about 120 days, platelets six days and white cells less than one day.

There are many types of blood disorders, including: bleeding disorders, platelet disorders, bone marrow disorders, hemophilia and anemia. There are also several cancers of the blood including Hodgkin and non-Hodgkin lymphoma, leukemia and myeloma. 

People with thyroid cancer have many treatment options. Treatment usually begins within a few weeks after the diagnosis, but you will have time to talk with your doctor about treatment choices and get a second opinion.
The choice of treatment depends on:

  • the type of thyroid cancer (papillary, follicular, medullary, or anaplastic)
  • the size of the nodule
  • your age
  • whether the cancer has spread

You and your doctor can work together to develop a treatment plan that meets your needs.

Your doctor can describe your treatment choices and the expected results. Thyroid cancer may be treated with surgery, thyroid hormone treatment, radioactive iodine therapy, external radiation therapy, or chemotherapy. Most patients receive a combination of treatments. For example, the standard treatment for papillary cancer is surgery, thyroid hormone treatment, and radioactive iodine therapy. Although external radiation therapy and chemotherapy are not often used, when they are, the treatments may be combined.

Surgery and external radiation therapy are local therapies. They remove or destroy cancer in the thyroid. When thyroid cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.

Thyroid hormone treatment, radioactive iodine therapy, and chemotherapy are systemic therapies. Systemic therapies enter the bloodstream and destroy or control cancer throughout the body.

Surgery

Most people with thyroid cancer have surgery. The surgeon removes all or part of the thyroid. The type of surgery depends on the type and stage of thyroid cancer, the size of the nodule, and your age.

  • Total thyroidectomy: This surgery can be used for all types of thyroid cancer. The surgeon removes all of the thyroid through an incision in the neck. If the surgeon is not able to remove all of the thyroid tissue, it can be destroyed by radioactive iodine therapy later.

Nearby lymph nodes also may be removed. If cancer has invaded tissue within the neck, the surgeon may remove nearby tissue. If cancer has spread outside the neck, surgery, radioactive iodine therapy, or external radiation therapy may be used to treat those areas.

  • Lobectomy: Some people with follicular or papillary thyroid cancer may have only part of the thyroid removed. The surgeon removes one lobe and the isthmus. Some people who have a lobectomy later have a second surgery to remove the rest of the thyroid. Less often, the remaining thyroid tissue is destroyed by radioactive iodine therapy.

The time it takes to heal after surgery is different for each person. You may be uncomfortable for the first few days. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain relief.

Surgery for thyroid cancer removes the cells that make thyroid hormone. After surgery, nearly all people need to take pills to replace the natural thyroid hormone. You will need thyroid hormone pills for the rest of your life.

If the surgeon removes the parathyroid glands, you may need to take calcium and vitamin D pills for the rest of your life.

Thyroid Hormone Treatment

After surgery to remove part or all of the thyroid, nearly everyone needs to take pills to replace the natural thyroid hormone. However, thyroid hormone pills are also used as part of the treatment for papillary or follicular thyroid cancer. Thyroid hormone slows the growth of thyroid cancer cells left in the body after surgery.

Thyroid hormone pills seldom cause side effects. Your doctor gives you blood tests to make sure you’re getting the right dose of thyroid hormone. Too much thyroid hormone may cause you to lose weight and feel hot and sweaty. It may also cause a fast heart rate, chest pain, cramps, and diarrhea. Too little thyroid hormone may cause you to gain weight, feel cold and tired, and have dry skin and hair. If you have side effects, your doctor can adjust your dose of thyroid hormone.

Radioactive Iodine Therapy

Radioactive iodine (I-131) therapy is a treatment for papillary or follicular thyroid cancer. It kills thyroid cancer cells and normal thyroid cells that remain in the body after surgery.

People with medullary thyroid cancer or anaplastic thyroid cancer usually do not receive I-131 therapy. These types of thyroid cancer rarely respond to I-131 therapy.

Even people who are allergic to iodine can take I-131 therapy safely. The therapy is given as a liquid or capsule that you swallow. I-131 goes into the bloodstream and travels to thyroid cancer cells throughout the body. When thyroid cancer cells take in enough I-131, they die.

Many people get I-131 therapy in a clinic or in the outpatient area of a hospital and can go home afterward. Some people have to stay in the hospital for one day or longer. Ask your health care team to explain how to protect family members and coworkers from being exposed to the radiation.

Most radiation from I-131 is gone in about one week. Within three weeks, only traces of I-131 remain in the body.

During treatment, you can help protect your bladder and other healthy tissues by drinking a lot of fluids. Drinking fluids helps I-131 pass out of the body faster.

Some people have mild nausea the first day of I-131 therapy. A few people have swelling and pain in the neck where thyroid cells remain. If thyroid cancer cells have spread outside the neck, those areas may be painful too.

You may have a dry mouth or lose your sense of taste or smell for a short time after I-131 therapy. Chewing sugar-free gum or sucking on sugar-free hard candy may help.

A rare side effect in men who receive a high dose of I-131 is loss of fertility. In women, I-131 may not cause loss of fertility, but some doctors advise women to avoid getting pregnant for one year after a high dose of I-131.

Researchers have reported that a very small number of patients may develop a second cancer years after treatment with a high dose of I-131. See the “Follow-up Care” section for information about checkups after treatment.

A high dose of I-131 also kills normal thyroid cells, which make thyroid hormone. After radioactive iodine therapy, you need to take thyroid hormone pills to replace the natural hormone.

External Radiation Therapy

External radiation therapy (also called radiotherapy) is a treatment for any type of thyroid cancer that can’t be treated with surgery or I-131 therapy. It’s also used for cancer that returns after treatment or to treat bone pain from cancer that has spread.

External radiation therapy uses high-energy rays to kill cancer cells. A large machine directs radiation at the neck or other tissues where cancer has spread.

Most patients go to the hospital or clinic for their treatment, usually 5 days a week for several weeks. Each treatment takes only a few minutes.

Chemotherapy

Chemotherapy is a treatment for anaplastic thyroid cancer. It’s sometimes used to relieve symptoms of medullary thyroid cancer or other thyroid cancers.

Chemotherapy uses drugs to kill cancer cells. The drugs are usually given by injection into a vein. They enter the bloodstream and can affect cancer cells all over the body.

You may have treatment in a clinic, at the doctor’s office, or at home. Some people may need to stay in the hospital during treatment.

To plan the best treatment, your doctor needs to learn the extent (stage) of the disease. Staging is a careful attempt to find out the size of the nodule, whether the cancer has spread, and if so, to what parts of the body.

Thyroid cancer spreads most often to the lymph nodes, lungs, and bones. When cancer spreads from its original place to another part of the body, the new tumor has the same kind of cancer cells and the same name as the original cancer. For example, if thyroid cancer spreads to the lungs, the cancer cells in the lungs are actually thyroid cancer cells. The disease is metastatic thyroid cancer, not lung cancer. For that reason, it’s treated as thyroid cancer, not lung cancer. Doctors call the new tumor “distant” or metastatic disease.

Staging may involve one or more of these tests:

  • Ultrasound: An ultrasound exam of your neck may show whether cancer has spread to lymph nodes or other tissues near your thyroid.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of areas inside your body. A CT scan may show whether cancer has spread to lymph nodes, other areas in your neck, or your chest.
  • MRI: MRI uses a powerful magnet linked to a computer. It makes detailed pictures of tissue. Your doctor can view these pictures on a screen or print them on film. MRI may show whether cancer has spread to lymph nodes or other areas.
  • Chest x-ray: X-rays of your chest may show whether cancer has spread to the lungs.
  • Whole body scan: You may have a whole body scan to see if cancer has spread from the thyroid to other parts of the body. You get a small amount of a radioactive substance. The substance travels through the bloodstream. Thyroid cancer cells in other organs or the bones take up the substance. Thyroid cancer that has spread may show up on a whole body scan.

If you have symptoms that suggest thyroid cancer, your doctor will help you find out whether they are from cancer or some other cause. Your doctor will ask you about your personal and family medical history. You may have one or more of the following tests:

  • Physical exam: Your doctor feels your thyroid for lumps (nodules). Your doctor also checks your neck and nearby lymph nodes for growths or swelling.
  • Blood tests: Your doctor may 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. If your doctor thinks you may have medullary thyroid cancer, you may be checked for a high level of calcitonin and have other blood tests.
  • Ultrasound: An ultrasound device uses sound waves that people cannot hear. The device aims sound waves at the thyroid, and a computer creates a picture of the waves that bounce off the thyroid. The picture can show thyroid nodules that are too small to be felt. The doctor uses the picture to learn the size and shape of each nodule and whether the nodules are solid or filled with fluid. Nodules that are filled with fluid are usually not cancer. Nodules that are solid may be cancer.
  • Thyroid scan: Your doctor may order a scan of your thyroid. You swallow a small amount of a radioactive substance, 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 tissue for cancer cells with a microscope.

Your doctor may take tissue for a biopsy in one of two ways:

  • Fine-needle aspiration: Most people have this type of biopsy. Your 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.
  • Surgical biopsy: If a diagnosis cannot be made from fine-needle aspiration, a surgeon removes the whole nodule during an operation. If the doctor suspects follicular thyroid cancer, surgical biopsy may be needed for diagnosis.

There are several types of thyroid cancer:

  • Papillary thyroid cancer: In the United States, this type makes up about 80 percent of all thyroid cancers. It begins in follicular cells and grows slowly. If diagnosed early, most people with papillary thyroid cancer can be cured.
  • Follicular thyroid cancer: This type makes up about 15 percent of all thyroid cancers. It begins in follicular cells and grows slowly. If diagnosed early, most people with follicular thyroid cancer can be treated successfully.
  • Medullary thyroid cancer: This type makes up about 3 percent of all thyroid cancers. It begins in the C cells of the thyroid. Cancer that starts in the C cells can make abnormally high levels of calcitonin. Medullary thyroid cancer tends to grow slowly. It can be easier to control if it's found and treated before it spreads to other parts of the body.
  • Anaplastic thyroid cancer: This type makes up about 2 percent of all thyroid cancers. It begins in the follicular cells of the thyroid. The cancer cells tend to grow and spread very quickly. Anaplastic thyroid cancer is very hard to control.

Visit the National Cancer Institute where this information and more can be found about Thyroid Cancer or ask your cancer care team questions about your individual situation.

There are different types of treatment for patients with small cell lung cancer.

Different types of treatment are available for patients with small cell lung cancer. Some treatments are standard (the currently used treatment), 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. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Five types of standard treatment are used:

Surgery

Surgery may be used if the cancer is found in one lung and in nearby lymph nodes only. Because this type of lung cancer is usually found in both lungs, surgery alone is not often used. Occasionally, surgery may be used to help determine the patient’s exact type of lung cancer. During surgery, the doctor will also remove lymph nodes to see if they contain cancer.

Even if the doctor removes all the cancer that can be seen at the time of the operation, 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.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them 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 placed directly into 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 the chemotherapy is given depends on the type and stage of the cancer being treated.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. 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. Prophylactic cranial irradiation (radiation therapy to the brain to reduce the risk that cancer will spread to the brain) may also be given. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Laser therapy

Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells.

Endoscopic stent placement

An endoscope is a thin, tube-like instrument used to look at tissues inside the body. An endoscope has a light and a lens for viewing and may be used to place a stent in a body structure to keep the structure open. Endoscopic stent placement can be used to open an airway blocked by abnormal tissue.

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.

After small cell lung cancer has been diagnosed, tests are done to find out if cancer cells have spread within the chest or to other parts of the body.

The process used to find out if cancer has spread within the chest or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Some of the tests used to diagnose small cell lung cancer are also used to stage the disease. (See the General Information section.) Other tests and procedures that may be used in the staging process include the following:

 

  • Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.
  • Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.
  • MRI (magnetic resonance imaging) of the brain: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography. EUS may be used to guide fine-needle aspiration (FNA) biopsy of the lung, lymph nodes, or other areas.
  • Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the tissue under a microscope to look for cancer cells.
  • Radionuclide bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.

The following stages are used for small cell lung cancer:

  • Limited-Stage Small Cell Lung Cancer:
    • In limited-stage, cancer is found in one lung, the tissues between the lungs, and nearby lymph nodes only.
  • Extensive-Stage Small Cell Lung Cancer:
    • In extensive-stage, cancer has spread outside of the lung in which it began or to other parts of the body.

Tests and procedures that examine the lungs are used to detect (find), diagnose, and stage small cell lung cancer.

The following tests and procedures may be used:

  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • 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.
  • CT scan (CAT scan) of the brain, chest, and abdomen: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
  • Sputum cytology: A microscope is used to check for cancer cells in the sputum (mucus coughed up from the lungs).
  • Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
  • Fine-needle aspiration (FNA) biopsy of the lung: The removal of tissue or fluid from the lung using a thin needle. A CT scan, ultrasound, or other imaging procedure is used to locate the abnormal tissue or fluid in the lung. A small incision may be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid. A sample is removed with the needle and sent to the laboratory. A pathologist then views the sample under a microscope to look for cancer cells. A chest x-ray is done after the procedure to make sure no air is leaking from the lung into the chest.
  • Thoracoscopy: A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the esophagus or lung. If certain tissues, organs, or lymph nodes can’t be reached, a thoracotomy may be done. In this procedure, a larger incision is made between the ribs and the chest is opened.
  • Thoracentesis: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.

There are two types of small cell lung cancer.

These two types include many different types of cells. The cancer cells of each type grow and spread in different ways. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope:

  • Small cell carcinoma (oat cell cancer).
  • Combined small cell carcinoma.

Smoking tobacco is the major risk factor for developing small cell lung cancer.

Visit the National Cancer Institute where this information and more can be found about Small Cell Lung Cancer or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer de pulmón de células pequeñas.

For each stage of soft tissue sarcoma, there are different treatment options available. Some of the options that may be offered by your doctor are as follows:

Stage I Sarcoma:

  • Surgery (wide local excision or Mohs microsurgery).
  • Radiation therapy before and/or after surgery.

If cancer is found in the head, neck, abdomen, or chest, treatment may include the following:

  • Surgery.
  • Radiation therapy before or after surgery.
  • Fast neutron radiation therapy.

Stages II and III adult soft tissue sarcoma treatments include:

  • Surgery (wide local excision).
  • Surgery (wide local excision) with radiation therapy, for large tumors.
  • High-dose radiation therapy for tumors that cannot be removed by surgery.
  • Radiation therapy or chemotherapy before limb-sparing surgery. Radiation therapy may also be given after surgery.
  • A clinical trial of surgery followed by chemotherapy, for large tumors.

Stage IV adult soft tissue sarcoma that involves lymph nodes may include the following treatments:

  • Surgery (wide local excision) with or without lymphadenectomy. Radiation therapy may also be given after surgery.
  • Radiation therapy before and after surgery.
  • A clinical trial of surgery followed by chemotherapy.

Treatment of stage IV adult soft tissue sarcoma that involves internal organs of the body may include the following:

  • Surgery (wide local excision).
  • Surgery to remove as much of the tumor as possible, followed by radiation therapy.
  • High-dose radiation therapy, with or without chemotherapy, for tumors that cannot be removed by surgery.
  • Chemotherapy with 1 or more anticancer drugs, before surgery or as palliative therapy to relieve symptoms and improve the quality of life.
  • A clinical trial of chemotherapy with or without stem cell transplant.
  • A clinical trial of chemotherapy following surgery to remove cancer that has spread to the lungs.

Treatment for recurring sarcoma may be somewhat different and will be guided by your cancer treatment team of physicians and nurses.

Stage I

Divided into Stages IA and IB:

  • Stage IA - the tumor is low-grade (likely to grow and spread slowly) and 5 centimeters or smaller. It may be either superficial (in subcutaneous tissue with no spread into connective tissue or muscle below) or deep (in the muscle and may be in connective or subcutaneous tissue).
  • Stage IB - the tumor is low-grade (likely to grow and spread slowly) and larger than 5 centimeters. It may be either superficial or deep in the tissue.

Stage II

Divided into Stages IIA and IIB:

  • Stage IIA - the tumor is mid-grade (somewhat likely to grow and spread quickly) or high-grade (likely to grow and spread quickly) and 5 centimeters or smaller. It may be either superficial or deep in the tissue.
  • Stage IIB - the tumor is mid-grade (somewhat likely to grow and spread quickly) and larger than 5 centimeters. It may be either superficial or deep in the tissue.

Stage III

The tumor is either:

  • High-grade (likely to grow and spread quickly), larger than 5 centimeters, and either superficial or deep in the tissue; or
  • Any grade, any size, and has spread to nearby lymph nodes.

Stage IV

The tumor is any grade, any size, and may have spread to nearby lymph nodes. Cancer has spread to distant parts of the body, such as the lungs. 

If a soft tissue sarcoma is suspected, a biopsy will be done. The type of biopsy will be based on the size and location of the tumor. There are three types of biopsies commonly used. Your physician will choose the best one for you:

  • Incisional biopsy: The removal of part of a lump or a sample of tissue.
  • Core biopsy: The removal of tissue using a wide needle.
  • Excisional biopsy: The removal of an entire lump or area of tissue that doesn’t look normal.

The following tests may be done on the tissue that was removed:

  • Immunohistochemistry study: is used to tell the difference between different types of cancer.
  • Light and electron microscopy: Used to look for certain changes in the cells.
  • Cytogenetic analysis: Used to look for certain changes in the chromosomes.
  • FISH (fluorescence in situ hybridization): A laboratory test used to look at genes or chromosomes in cells and tissues.
  • Flow cytometry: A laboratory test that measures the number of cells in a sample, the percentage of live cells in a sample, and certain characteristics of cells, such as size, shape, and the presence of tumor markers on the cell surface. 

Sarcoma develops from tissues like muscle or bone tissues. There are two primary types of sarcoma:

  • Soft tissue sarcoma which starts in the soft tissues such as fat, nerves, muscles, fibrous tissues, deep skin tissues or blood vessels.
  • Osteosarcoma, which develops from bone.

We are going to focus on soft tissue sarcoma in this section.

A sarcoma may appear as a painless lump under the skin, often on an arm or a leg. Sarcomas that begin in the abdomen may not cause symptoms until they become very large. As the sarcoma grows larger and presses on nearby organs, nerves, muscles, or blood vessels, symptoms may include pain or trouble breathing.

Visit the National Cancer Institute where you can find more information on bone and soft tissue sarcomas. And be sure to ask your cancer care team questions about your individual situation.

The treatment that’s right for you depends mainly on your age, the grade of the tumor (the Gleason score), the number of biopsy tissue samples that contain cancer cells, the stage of the cancer, your symptoms, and your general health. Your doctor can describe your treatment choices, the expected results of each, and the possible side effects. You and your doctor can work together to develop a treatment plan that meets your medical and personal needs.

Active Surveillance

You may choose active surveillance if the risks and possible side effects of treatment outweigh the possible benefits. Your doctor may suggest active surveillance if you’re diagnosed with early stage prostate cancer that seems to be slowly growing. Your doctor may also offer this option if you are older or have other serious health problems.

Choosing active surveillance doesn’t mean you’re giving up. It means you’re putting off the side effects of surgery or radiation therapy. Having surgery or radiation therapy is no guarantee that a man will live longer than a man who chooses to put off treatment.

If you and your doctor agree that active surveillance is a good idea, your doctor will check you regularly (such as every 3 to 6 months, at first). After about one year, your doctor may order another biopsy to check the Gleason score. You may begin treatment if your Gleason score rises, your PSA level starts to rise, or you develop symptoms. You’ll receive surgery, radiation therapy, or another approach.

Active surveillance avoids or delays the side effects of surgery and radiation therapy, but this choice has risks. For some men, it may reduce the chance to control cancer before it spreads. Also, it may be harder to cope with surgery or radiation therapy when you’re older.

If you choose active surveillance but grow concerned later, you should discuss your feelings with your doctor. Another approach is an option for most men.

Surgery

Surgery is an option for men with early (Stage I or II) prostate cancer. It’s sometimes an option for men with Stage III or IV prostate cancer. The surgeon may remove the whole prostate or only part of it.

Before the surgeon removes the prostate, the lymph nodes in the pelvis may be removed. If prostate cancer cells are found in the lymph nodes, the disease may have spread to other parts of the body. If cancer has spread to the lymph nodes, the surgeon does not always remove the prostate and may suggest other types of treatment.

There are several types of surgery for prostate cancer. Each type has benefits and risks. You and your doctor can talk about the types of surgery and which may be right for you:

  • Open surgery: The surgeon makes a large incision (cut) into your body to remove the tumor. There are two approaches:
    • Through the abdomen: The surgeon removes the entire prostate through a cut in the abdomen. This is called a radical retropubic prostatectomy.
    • Between the scrotum and anus: The surgeon removes the entire prostate through a cut between the scrotum and the anus. This is called a radical perineal prostatectomy.
  • Laparoscopic prostatectomy: The surgeon removes the entire prostate through small cuts, rather than a single long cut in the abdomen. A thin, lighted tube (a laparoscope) helps the surgeon remove the prostate.
  • Robotic laparoscopic surgery: The surgeon removes the entire prostate through small cuts. A laparoscope and a robot are used to help remove the prostate. The surgeon uses handles below a computer display to control the robot’s arms.
  • Cryosurgery: For some men, cryosurgery is an option. The surgeon inserts a tool through a small cut between the scrotum and anus. The tool freezes and kills prostate tissue. Cryosurgery is under study. See the section on Taking Part in Cancer Research.
  • TURP: A man with advanced prostate cancer may choose TURP (transurethral resection of the prostate) to relieve symptoms. The surgeon inserts a long, thin scope through the urethra. A cutting tool at the end of the scope removes tissue from the inside of the prostate. TURP may not remove all of the cancer, but it can remove tissue that blocks the flow of urine.

Surgery can damage the nerves around the prostate. Damaging these nerves can make a man impotent (unable to have an erection). In some cases, your surgeon can protect the nerves that control erection. But if you have a large tumor or a tumor that’s very close to the nerves, surgery may cause impotence. Impotence can be permanent. You can talk with your doctor about medicine and other ways to help manage the sexual side effects of cancer treatment.

If your prostate is removed, you will no longer produce semen. You’ll have dry orgasms. If you wish to father children, you may consider sperm banking or a sperm retrieval procedure before surgery.

Radiation Therapy

Radiation therapy is an option for men with any stage of prostate cancer. Men with early stage prostate cancer may choose radiation therapy instead of surgery. It also may be used after surgery to destroy any cancer cells that remain in the area. In later stages of prostate cancer, radiation treatment may be used to help relieve pain.

Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. It affects cells only in the treated area.

Doctors use two types of radiation therapy to treat prostate cancer. Some men receive both types:

  • External radiation: The radiation comes from a large machine outside the body. You will go to a hospital or clinic for treatment. Treatments are usually 5 days a week for several weeks. Many men receive 3-dimensional conformal radiation therapy or intensity-modulated radiation therapy. These types of treatment use computers to more closely target the cancer to lessen the damage to healthy tissue near the prostate.
  • Internal radiation (implant radiation or brachytherapy): The radiation comes from radioactive material usually contained in very small implants called seeds. Dozens of seeds are placed inside needles, and the needles are inserted into the prostate. The needles are removed, leaving the seeds behind. The seeds give off radiation for months. They don’t need to be removed once the radiation is gone.

Both internal and external radiation can cause impotence. You can talk with your doctor about ways to help cope with this side effect.

Hormone Therapy

A man with prostate cancer may have hormone therapy before, during, or after radiation therapy. Hormone therapy is also used alone for prostate cancer that has returned after treatment.

Male hormones (androgens) can cause prostate cancer to grow. Hormone therapy keeps prostate cancer cells from getting the male hormones they need to grow. The testicles are the body’s main source of the male hormone testosterone. The adrenal gland makes other male hormones and a small amount of testosterone.

Hormone therapy uses drugs or surgery:

  • Drugs: Your doctor may suggest a drug that can block natural hormones:
    • Luteinizing hormone-releasing hormone (LH-RH) agonists: These drugs can prevent the testicles from making testosterone. Examples are leuprolide, goserelin, and triptorelin. The testosterone level falls slowly. Without testosterone, the tumor shrinks, or its growth slows. These drugs are also called gonadotropin-releasing hormone (GnRH) agonists.
    • Antiandrogens: These drugs can block the action of male hormones. Examples are flutamide, bicalutamide, and nilutamide.
    • Other drugs: Some drugs can prevent the adrenal gland from making testosterone. Examples are ketoconazole and aminoglutethimide.
  • Surgery: Surgery to remove the testicles is called orchiectomy.

After orchiectomy or treatment with an LH-RH agonist, your body no longer gets testosterone from the testicles, the major source of male hormones. Because the adrenal gland makes small amounts of male hormones, you may receive an antiandrogen to block the action of the male hormones that remain. This combination of treatments is known as total androgen blockade (also called combined androgen blockade). However, studies have shown that total androgen blockade is no more effective than surgery or an LH-RH agonist alone.

Doctors usually treat prostate cancer that has spread to other parts of the body with hormone therapy. For some men, the cancer will be controlled for two or three years, but others will have a much shorter response to hormone therapy. In time, most prostate cancers can grow with very little or no male hormones, and hormone therapy alone is no longer helpful. At that time, your doctor may suggest chemotherapy or other forms of treatment that are under study. In many cases, the doctor may suggest continuing with hormone therapy because it may still be effective against some of the cancer cells.

Chemotherapy

Chemotherapy may be used for prostate cancer that has spread and no longer responds to hormone therapy.

When prostate cancer spreads, it’s often found in nearby lymph nodes. If cancer has reached these nodes, it also may have spread to other lymph nodes, the bones, or other organs.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if prostate cancer spreads to bones, the cancer cells in the bones are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. For that reason, it’s treated as prostate cancer, not bone cancer. Doctors call the new tumor “distant” or metastatic disease.

These are the stages of prostate cancer:

  • Stage I: The cancer can’t be felt during a digital rectal exam, and it can’t be seen on a sonogram. It’s found by chance when surgery is done for another reason, usually for BPH. The cancer is only in the prostate. The grade is G1, or the Gleason score is no higher than 4.
  • Stage II: The tumor is more advanced or a higher grade than Stage I, but the tumor doesn’t extend beyond the prostate. It may be felt during a digital rectal exam, or it may be seen on a sonogram.
  • Stage III: The tumor extends beyond the prostate. The tumor may have invaded the seminal vesicles, but cancer cells haven’t spread to the lymph nodes.
  • Stage IV: The tumor may have invaded the bladder, rectum, or nearby structures (beyond the seminal vesicles). It may have spread to the lymph nodes, bones, or to other parts of the body.

Your doctor can check for prostate cancer before you have any symptoms. During an office visit, your doctor will ask about your personal and family medical history. You’ll have a physical exam. You may also have one or both of the following tests:

  • Digital rectal exam: Your doctor inserts a lubricated, gloved finger into the rectum and feels your prostate through the rectal wall. Your prostate is checked for hard or lumpy areas.
  • Blood test for prostate-specific antigen (PSA): A lab checks the level of PSA in your blood sample. The prostate makes PSA. A high PSA level is commonly caused by BPH or prostatitis (inflammation of the prostate). Prostate cancer may also cause a high PSA level. See the NCI fact sheet The Prostate-Specific Antigen (PSA) Test: Questions and Answers.

The digital rectal exam and PSA test are being studied in clinical trials to learn whether finding prostate cancer early can lower the number of deaths from this disease.

The digital rectal exam and PSA test can detect a problem in the prostate. However, they can’t show whether the problem is cancer or a less serious condition. If you have abnormal test results, your doctor may suggest other tests to make a diagnosis. For example, your visit may include other lab tests, such as a urine test to check for blood or infection. Your doctor may order other procedures:

  • Transrectal ultrasound: The doctor inserts a probe into the rectum to check your prostate for abnormal areas. The probe sends out sound waves that people cannot hear (ultrasound). The waves bounce off the prostate. A computer uses the echoes to create a picture called a sonogram.
  • Transrectal biopsy: A biopsy is the removal of tissue to look for cancer cells. It’s the only sure way to diagnose prostate cancer. The doctor inserts needles through the rectum into the prostate. The doctor removes small tissue samples (called cores) from many areas of the prostate. Transrectal ultrasound is usually used to guide the insertion of the needles. A pathologist checks the tissue samples for cancer cells.

If Cancer Is Found

If cancer cells are found, the pathologist studies tissue samples from the prostate under a microscope to report the grade of the tumor. The grade tells how much the tumor tissue differs from normal prostate tissue. It suggests how fast the tumor is likely to grow.

Tumors with higher grades tend to grow faster than those with lower grades. They are also more likely to spread. Doctors use tumor grade along with your age and other factors to suggest treatment options.

One system of grading is with the Gleason score. Gleason scores range from 2 to 10. To come up with the Gleason score, the pathologist uses a microscope to look at the patterns of cells in the prostate tissue. The most common pattern is given a grade of 1 (most like normal cells) to 5 (most abnormal). If there is a second most common pattern, the pathologist gives it a grade of 1 to 5, and adds the two most common grades together to make the Gleason score. If only one pattern is seen, the pathologist counts it twice. For example, 5 + 5 = 10. A high Gleason score (such as 10) means a high-grade prostate tumor. High-grade tumors are more likely than low-grade tumors to grow quickly and spread.

Another system of grading prostate cancer uses grades 1 through 4 (G1 to G4). G4 is more likely than G1, G2, or G3 to grow quickly and spread. Read more in the Staging Section.

Each year, more than 241,000 American men learn they have this disease. Prostate cancer is the second most common type of cancer among men in this country. Only skin cancer is more common.

Learning about medical care for prostate cancer can help you take an active part in making choices about your care. This booklet tells about:

  • Diagnosis and staging
  • Treatment options
  • Tests you may have after treatment

Visit the National Cancer Institute where this information and more can be found about Prostate Cancer or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer de próstata en español.

Treatment options for people with cancer of the pancreas are surgery, chemotherapy, targeted therapy, and radiation therapy. You’ll probably receive more than one type of treatment.

The treatment that’s right for you depends mainly on the following:

  • The location of the tumor in your pancreas
  • Whether the disease has spread
  • Your age and general health

At this time, cancer of the pancreas can be cured only when it’s found at an early stage (before it has spread) and only if surgery can completely remove the tumor. For people who can’t have surgery, other treatments may be able to help them live longer and feel better.

You may have a team of specialists to help plan your treatment. Specialists who treat cancer of the pancreas include surgeons, medical oncologists, radiation oncologists, and gastroenterologists.

Your health care team can describe your treatment choices, the expected results of each, and the possible side effects. Because cancer treatments often damage healthy cells and tissues, side effects are common. These side effects depend on many factors, including the type and extent of treatment. Side effects may not be the same for each person, and they may even change from one treatment session to the next. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. You and your health care team can work together to develop a treatment plan that meets your needs.

Surgery

Surgery may be an option for people with an early stage of pancreatic cancer. The surgeon usually removes only the part of the pancreas that has cancer. But, in some cases, the whole pancreas may be removed.

The type of surgery depends on the location of the tumor in the pancreas. Surgery to remove a tumor in the head of the pancreas is called a Whipple procedure. The Whipple procedure is the most common type of surgery for pancreatic cancer. You and your surgeon may talk about the types of surgery and which may be right for you.

In addition to part or all of your pancreas, the surgeon usually removes the following nearby tissues:

  • Duodenum
  • Gallbladder
  • Common bile duct
  • Part of your stomach

Also, the surgeon may remove your spleen and nearby lymph nodes.

Surgery for pancreatic cancer is a major operation. You will need to stay in the hospital for one to two weeks afterward. Your health care team will watch for signs of bleeding, infection, or other problems. It takes time to heal after surgery, and the time needed to recover is different for each person. You may have pain or discomfort for the first few days. It’s common to feel weak or tired for a while. You may need to rest at home for one to three months after leaving the hospital.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. Most people with pancreatic cancer get chemotherapy. For early pancreatic cancer, chemotherapy is usually given after surgery, but in some cases, it’s given before surgery. For advanced cancer, chemotherapy is used alone, with targeted therapy, or with radiation therapy.

Chemotherapy for pancreatic cancer is usually given by vein (intravenous). The drugs enter the bloodstream and travel throughout your body. Chemotherapy is given in cycles. Each treatment period is followed by a rest period. The length of the rest period and the number of cycles depend on the anticancer drugs used.

Some drugs used for pancreatic cancer also may cause tingling or numbness in your hands and feet.

Targeted Therapy

People with cancer of the pancreas who can’t have surgery may receive a type of drug called targeted therapy along with chemotherapy.

Targeted therapy slows the growth of pancreatic cancer. It also helps prevent cancer cells from spreading. The drug is taken by mouth.

Side effects may include diarrhea, nausea, vomiting, a rash, and shortness of breath.

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. It can be given along with other treatments, including chemotherapy.

The radiation comes from a large machine. The machine aims beams of radiation at the cancer in the abdomen. You’ll go to a hospital or clinic 5 days a week for several weeks to receive radiation therapy. Each session takes about 30 minutes.

Although radiation therapy is painless, it may cause other side effects. The side effects include nausea, vomiting, or diarrhea. You may also feel very tired.

Staging is a careful attempt to find out the following:

  • The size of the tumor in the pancreas
  • Whether the tumor has invaded nearby tissues
  • Whether the cancer has spread, and if so, to what parts of the body

When cancer of the pancreas spreads, the cancer cells may be found in nearby lymph nodes or the liver. Cancer cells may also be found in the lungs or in fluid collected from the abdomen.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original (primary) tumor. For example, if pancreatic cancer spreads to the liver, the cancer cells in the liver are actually pancreatic cancer cells. The disease is metastatic pancreatic cancer, not liver cancer. It’s treated as pancreatic cancer, not as liver cancer. Doctors sometimes call the new tumor in the liver “distant” disease.

To learn whether pancreatic cancer has spread, your doctor may order CT scans or EUS.

Also, a surgeon may look inside your abdomen with a laparoscope (a thin, tube-like device that has a light and a lens for seeing inside the body). The surgeon inserts the laparoscope through a small incision in your belly button. The surgeon will look for any signs of cancer inside your abdomen. You’ll need general anesthesia for this exam.

These are the stages of cancer of the pancreas:

  • Stage I: The tumor is found only in the pancreas.
  • Stage II: The tumor has invaded nearby tissue but not nearby blood vessels. The cancer may have spread to the lymph nodes.
  • Stage III: The tumor has invaded nearby blood vessels.
  • Stage IV: The cancer has spread to a distant organ, such as the liver or lungs.

If you have symptoms that suggest cancer of the pancreas, your doctor will try to find out what’s causing the problems. You may have blood or other lab tests. Also, you may have one or more of the following tests:

  • Physical exam: Your doctor feels your abdomen to check for changes in areas near the pancreas, liver, gallbladder, and spleen. Your doctor also checks for an abnormal buildup of fluid in the abdomen. Also, your skin and eyes may be checked for signs of jaundice.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your pancreas, nearby organs, and blood vessels in your abdomen. You may receive an injection of contrast material so your pancreas shows up clearly in the pictures. Also, you may be asked to drink water so your stomach and duodenum show up better. On the CT scan, your doctor may see a tumor in the pancreas or elsewhere in the abdomen.
  • Ultrasound: Your doctor places the ultrasound device on your abdomen and slowly moves it around. The ultrasound device uses sound waves that can’t be heard by humans. The sound waves make a pattern of echoes as they bounce off internal organs. The echoes create a picture of your pancreas and other organs in the abdomen. The picture may show a tumor or blocked ducts.
  • EUS: Your doctor passes a thin, lighted tube (endoscope) down your throat, through your stomach, and into the first part of the small intestine. An ultrasound probe at the end of the tube sends out sound waves that you can’t hear. The waves bounce off tissues in your pancreas and other organs. As your doctor slowly withdraws the probe from the intestine toward the stomach, the computer creates a picture of the pancreas from the echoes. The picture can show a tumor in the pancreas. It can also show how deeply the cancer has invaded the blood vessels.

Some doctors use the following tests also:

  • ERCP: The doctor passes an endoscope through your mouth and stomach, down into the first part of your small intestine. Your doctor slips a smaller tube through the endoscope into the bile ducts and pancreatic ducts. (See picture of ducts.) After injecting dye through the smaller tube into the ducts, the doctor takes x-ray pictures. The x-rays can show whether the ducts are narrowed or blocked by a tumor or other condition.
  • MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of areas inside your body.
  • PET scan: You’ll receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan may show a tumor in the pancreas. It can also show cancer that has spread to other parts of the body.
  • Needle biopsy: The doctor uses a thin needle to remove a small sample of tissue from the pancreas. EUS or CT may be used to guide the needle. A pathologist uses a microscope to look for cancer cells in the tissue.

If cancer of the pancreas is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment.

There are two main types of pancreatic cancer.

Most often, pancreatic cancer starts in the ducts that carry pancreatic juices. This type is called exocrine pancreatic cancer. Information will focus on this type of pancreatic cancer.

Much less often, pancreatic cancer begins in the cells that make hormones. This type may be called endocrine pancreatic cancer or islet cell cancer.

Each year in the United States, more than 43,000 people are diagnosed with cancer of the pancreas. Most are over 65 years old. Visit the National Cancer Institute where this information and more can be found about Pancreatic Cancer or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer de páncreas en español.

Your doctor can describe your treatment choices and the expected results. Most women have surgery and chemotherapy. Rarely, radiation therapy is used.

Cancer treatment can affect cancer cells in the pelvis, in the abdomen, or throughout the body:

  • Local therapy: Surgery and radiation therapy are local therapies. They remove or destroy ovarian cancer in the pelvis. When ovarian cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
  • Intraperitoneal chemotherapy: Chemotherapy can be given directly into the abdomen and pelvis through a thin tube. The drugs destroy or control cancer in the abdomen and pelvis.
  • Systemic chemotherapy: When chemotherapy is taken by mouth or injected into a vein, the drugs enter the bloodstream and destroy or control cancer throughout the body.

You may want to know how treatment may change your normal activities. You and your doctor can work together to develop a treatment plan that meets your medical and personal needs.

Surgery
The surgeon makes a long cut in the wall of the abdomen. This type of surgery is called a laparotomy. If ovarian cancer is found, the surgeon removes:

  • both ovaries and fallopian tubes (salpingo-oophorectomy)
  • the uterus (hysterectomy)
  • the omentum (the thin, fatty pad of tissue that covers the intestines)
  • nearby lymph nodes
  • samples of tissue from the pelvis and abdomen

If the cancer has spread, the surgeon removes as much cancer as possible. This is called “debulking” surgery.

If you have early Stage I ovarian cancer, the extent of surgery may depend on whether you want to get pregnant and have children. Some women with very early ovarian cancer may decide with their doctor to have only one ovary, one fallopian tube, and the omentum removed.

Chemotherapy
Chemotherapy uses anticancer drugs to kill cancer cells. Most women have chemotherapy for ovarian cancer after surgery. Some women have chemotherapy before surgery.

Usually, more than one drug is given. Drugs for ovarian cancer can be given in different ways:

  • By vein (IV): The drugs can be given through a thin tube inserted into a vein.
  • By vein and directly into the abdomen: Some women get IV chemotherapy along with intraperitoneal (IP) chemotherapy. For IP chemotherapy, the drugs are given through a thin tube inserted into the abdomen.
  • By mouth: Some drugs for ovarian cancer can be given by mouth.

Chemotherapy is given in cycles. Each treatment period is followed by a rest period. The length of the rest period and the number of cycles depend on the anticancer drugs used.

You may have your treatment in a clinic, at the doctor’s office, or at home. Some women may need to stay in the hospital during treatment.

Radiation Therapy

Radiation therapy is rarely used in the initial treatment of ovarian cancer, but it may be used to relieve pain and other problems caused by the disease. The treatment is given at a hospital or clinic. Each treatment takes only a few minutes.

To plan the best treatment, your doctor needs to know the grade of the tumor and the extent (stage) of the disease. The stage is based on whether the tumor has invaded nearby tissues, whether the cancer has spread, and if so, to what parts of the body.

Usually, surgery is needed before staging can be complete. The surgeon takes many samples of tissue from the pelvis and abdomen to look for cancer.

Your doctor may order tests to find out whether the cancer has spread:

  • CT scan: Doctors often use CT scans to make pictures of organs and tissues in the pelvis or abdomen. An x-ray machine linked to a computer takes several pictures. You may receive contrast material by mouth and by injection into your arm or hand. The contrast material helps the organs or tissues show up more clearly. Abdominal fluid or a tumor may show up on the CT scan.
  • Chest x-ray: X-rays of the chest can show tumors or fluid.
  • Barium enema x-ray: Your doctor may order a series of x-rays of the lower intestine. You are given an enema with a barium solution. The barium outlines the intestine on the x-rays. Areas blocked by cancer may show up on the x-rays.
  • Colonoscopy: Your doctor inserts a long, lighted tube into the rectum and colon. This exam can help tell if cancer has spread to the colon or rectum.

These are the stages of ovarian cancer:

  • Stage I: Cancer cells are found in one or both ovaries. Cancer cells may be found on the surface of the ovaries or in fluid collected from the abdomen.
  • Stage II: Cancer cells have spread from one or both ovaries to other tissues in the pelvis. Cancer cells are found on the fallopian tubes, the uterus, or other tissues in the pelvis. Cancer cells may be found in fluid collected from the abdomen.
  • Stage III: Cancer cells have spread to tissues outside the pelvis or to the regional lymph nodes. Cancer cells may be found on the outside of the liver.
  • Stage IV: Cancer cells have spread to tissues outside the abdomen and pelvis. Cancer cells may be found inside the liver, in the lungs, or in other organs.

If you have a symptom that suggests ovarian cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor may ask about your personal and family medical history.

You may have one or more of the following tests. Your doctor can explain more about each test:

  • Physical exam: Your doctor checks general signs of health. Your doctor may press on your abdomen to check for tumors or an abnormal buildup of fluid (ascites). A sample of fluid can be taken to look for ovarian cancer cells.
  • Pelvic exam: Your doctor feels the ovaries and nearby organs for lumps or other changes in their shape or size. A Pap test is part of a normal pelvic exam, but it is not used to collect ovarian cells. The Pap test detects cervical cancer. The Pap test is not used to diagnose ovarian cancer.
  • Blood tests: Your doctor may order blood tests. The lab may check the level of several substances, including CA-125. CA-125 is a substance found on the surface of ovarian cancer cells and on some normal tissues. A high CA-125 level could be a sign of cancer or other conditions. The CA-125 test is not used alone to diagnose ovarian cancer. This test is approved by the Food and Drug Administration for monitoring a woman’s response to ovarian cancer treatment and for detecting its return after treatment.
  • Ultrasound: The ultrasound device uses sound waves that people cannot hear. The device aims sound waves at organs inside the pelvis. The waves bounce off the organs. A computer creates a picture from the echoes. The picture may show an ovarian tumor. For a better view of the ovaries, the device may be inserted into the vagina (transvaginal ultrasound).
  • Biopsy: A biopsy is the removal of tissue or fluid to look for cancer cells. Based on the results of the blood tests and ultrasound, your doctor may suggest surgery (a laparotomy) to remove tissue and fluid from the pelvis and abdomen. Surgery is usually needed to diagnose ovarian cancer. To learn more about surgery, see the “Treatment” section.

Although most women have a laparotomy for diagnosis, some women have a procedure known as laparoscopy. The doctor inserts a thin, lighted tube (a laparoscope) through a small incision in the abdomen. Laparoscopy may be used to remove a small, benign cyst or an early ovarian cancer. It may also be used to learn whether cancer has spread.

A pathologist uses a microscope to look for cancer cells in the tissue or fluid. If ovarian cancer cells are found, the pathologist describes the grade of the cells. Grades 1, 2, and 3 describe how abnormal the cancer cells look. Grade 1 cancer cells are not as likely as to grow and spread as Grade 3 cells.

Ovarian epithelial cancer is the most common type of ovarian cancer. It begins in the tissue that covers the ovaries. This information is not about ovarian germ cell tumors or other types of ovarian cancer. To find out more about all types of of ovarian cancer, please visit the National Cancer Institute Web site or ask your cancer care team about your individual situation.

People with early oral cancer may be treated with surgery or radiation therapy. People with advanced oral cancer may have a combination of treatments. For example, radiation therapy and chemotherapy are often given at the same time. Another treatment option is targeted therapy.

The choice of treatment depends mainly on your general health, where in your mouth or throat the cancer began, the size of the tumor, and whether the cancer has spread.

Surgery

Surgery to remove the tumor in the mouth or throat is a common treatment for oral cancer. Sometimes the surgeon also removes lymph nodes in the neck. Other tissues in the mouth and neck may be removed as well. You may have surgery alone or in combination with radiation therapy.

Also, surgery may cause tissues in your face to swell. This swelling usually goes away within a few weeks. However, removing lymph nodes can result in swelling that lasts a long time.

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. It’s an option for small tumors or for people who can’t have surgery. Or, it may be used before surgery to shrink the tumor. It also may be used after surgery to destroy cancer cells that may remain in the area.

Doctors use two types of radiation therapy to treat oral cancer. Some people with oral cancer have both types:

  • External radiation therapy: The radiation comes from a machine. Some treatment centers offer IMRT, which uses a computer to more closely target the oral tumor to lessen the damage to healthy tissue. You may go to the hospital or clinic once or twice a day, generally 5 days a week for several weeks. Each treatment takes only a few minutes.
  • Internal radiation therapy (implant radiation therapy or brachytherapy): Internal radiation therapy isn’t commonly used for oral cancer. The radiation comes from radioactive material in seeds, wires, or tubes put directly in the mouth or throat tissue. You may need to stay in the hospital for several days. Usually the radioactive material is removed before you go home.

 

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. The drugs that treat oral cancer are usually given through a vein (intravenous). The drugs enter the bloodstream and travel throughout your body. Chemotherapy and radiation therapy are often given at the same time.

Targeted Therapy

Some people with oral cancer receive a type of drug known as targeted therapy. It may be given along with radiation therapy or chemotherapy.

Cetuximab (Erbitux) was the first targeted therapy approved for oral cancer. Cetuximab binds to oral cancer cells and interferes with cancer cell growth and the spread of cancer. You may receive cetuximab through a vein once a week for several weeks at the clinic.

If oral cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. When oral cancer spreads, cancer cells may be found in the lymph nodes in the neck or in other tissues of the neck. Cancer cells can also spread to the lungs, liver, bones, and other parts of the body.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells as the primary (original) tumor. For example, if oral cancer spreads to the lungs, the cancer cells in the lungs are actually oral cancer cells. The disease is called metastatic oral cancer, not lung cancer. It’s treated as oral cancer, not lung cancer. Doctors sometimes call the new tumor “distant” or metastatic disease.

Your doctor may order one or more of the following tests:

  • X-rays: An x-ray of your entire mouth can show whether cancer has spread to the jaw. Images of your chest and lungs can show whether cancer has spread to these areas.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your body. You may receive an injection of dye. Tumors in your mouth, throat, neck, lungs, or elsewhere in the body can show up on the CT scan.
  • MRI: A powerful magnet linked to a computer is used to make detailed pictures of your body. An MRI can show whether oral cancer has spread.
  • Endoscopy: The doctor uses a thin, lighted tube (endoscope) to check your throat, windpipe, and lungs. The doctor inserts the endoscope through your nose or mouth. Local anesthesia is used to ease your discomfort and prevent you from gagging. Some people also may be given a mild sedative. Sometimes the doctor uses general anesthesia to put a person to sleep. This exam may be done in a doctor’s office, an outpatient clinic, or a hospital.
  • PET scan: You receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan shows whether oral cancer may have spread.

Doctors describe the stage of oral cancer based on the size of the tumor, whether it has invaded nearby tissues, and whether it has spread to the lymph nodes or other tissues:

  • Early cancer: Stage I or II oral cancer is usually a small tumor (smaller than a walnut), and no cancer cells are found in the lymph nodes.
  • Advanced cancer: Stage III or IV oral cancer is usually a large tumor (as big as a lime). The cancer may have invaded nearby tissues or spread to lymph nodes or other parts of the body.

If you have symptoms that suggest oral cancer, your doctor or dentist will check your mouth and throat for red or white patches, lumps, swelling, or other problems. A physical exam includes looking carefully at the roof of your mouth, back of your throat, and insides of your cheeks and lips. The floor of your mouth and lymph nodes in your neck will also be checked.

An ear, nose, and throat specialist can see the back of your nose, tongue, and throat by using a small, long-handled mirror or a lighted tube. Sometimes pictures need to be made with a CT scan or MRI to find a hidden tumor. (The Staging section describes imaging tests.)

The removal of a small piece of tissue to look for cancer cells is called a biopsy. Usually, a biopsy is done with local anesthesia. Sometimes, it’s done under general anesthesia. A pathologist then looks at the tissue under a microscope to check for cancer cells. A biopsy is the only sure way to know if the abnormal area is cancer.

Cancer that forms in tissues of the oral cavity (the mouth) or the oropharynx (the part of the throat at the back of the mouth).

This includes areas under the tongue:

  • Lips
  • Gums and teeth
  • Tongue
  • Lining of your cheeks
  • Salivary glands (glands that make saliva)
  • Floor of your mouth (area under the tongue

This includes areas of the throat:

  • Roof of your mouth (hard palate)
  • Soft palate
  • Uvula
  • Oropharynx
  • Tonsils

Visit the National Cancer Institute where this information and more can be found about Oral Cancer or ask your cancer care team questions about your individual situation.

Lo que usted necesita saber sobre el cáncer oral en español.