bowang0911/MedQuAD huggingface dataset:
Enlarged and Misshapen Bones Paget's disease of bone causes affected bones to become enlarged and misshapen. Our bones are living tissue, and our bodies are constantly breaking down old bone and replacing it with new bone. In Paget's disease, however, old bone is broken down and replaced at a faster rate than normal. The new bone is larger and weaker than normal bone. Paget's disease can occur in any bone in the body, but it is most common in the pelvis, spine, skull, and leg bones. It may occur in just one bone or in several bones, but it does not affect the entire skeleton or spread from affected bones to normal bones. Common symptoms include pain, misshapen bones, and a greater chance of broken bones. Complications Paget's disease can also lead to complications, such as arthritis, headaches, hearing loss, or nervous system problems, depending on which bones are affected. If not treated, Paget's disease can reduce a person's ability to perform activities of daily living, thereby reducing quality of life. Although it is the second most common bone disease after osteoporosis, Paget's disease is still uncommon. According to Bone Health and Osteoporosis: A Report of the Surgeon General, an estimated 1 million people in the U.S. have Paget's disease, or about 1.3 people per 100 men and women age 45-74. The disease is more common in older people and those of Northern European heritage. Men are more likely than women to have the disease. Cause is Unknown Paget's disease is named after the British surgeon, Sir James Paget, who first identified the disease in 1877. Researchers are not sure what causes it. Heredity may be a factor in some cases. Research suggests that a close relative of someone with Paget's disease is seven times more likely to develop the disease than someone without an affected relative. However, most people with Paget's disease do not have any relatives with the disease. Researchers think the disease also may be caused by other factors, such as a slow-acting virus. A Treatable Disease The good news is that Paget's disease of bone is treatable, especially if it is diagnosed early. In recent years, the Food and Drug Administration has approved several medications that can stop or slow the disease's progression. In some cases, surgery can help patients manage the symptoms and complications of the disease.
Symptoms Many people don't know they have Paget's disease because they have a mild case of the disease and do not have any symptoms. However, people with more advanced cases of the disease will likely have symptoms. Symptoms vary depending on which bone or bones are affected. People with Paget's disease may experience - bone pain  - misshapen bones  - fractures  - osteoarthritis of the joints adjacent to bone affected by the disease.  bone pain misshapen bones fractures osteoarthritis of the joints adjacent to bone affected by the disease. Paget's disease can also cause a variety of neurological complications as a result of compression of nerve tissue by bone affected by the disease. Misshapen bone is most obvious when the leg bones, skull, or bones of the spine are affected. Leg bones may become bowed, the skull may become enlarged, and malformed spinal bones may cause curvature of the spine. Complications People with Paget's disease also are more likely to break bones because bones affected by the disease are more fragile. Enlarged and malformed bones can distort the position of bones and joints. This causes wear and tear on the joints next to bones affected by Paget's disease, resulting in arthritis. On very rare occasions, Paget's disease is linked to the development of osteosarcoma, a type of bone cancer. Less than one percent of patients have this complication.
An Underdiagnosed Disease Experts believe that Paget's disease is underdiagnosed; people with a mild case and no symptoms may never know they have the disease. Or, they may receive a diagnosis by accident when x-rays or other laboratory tests done for another reason reveal Paget's disease. When symptoms do occur, they usually appear gradually and, in the early stages, may be confused with those of arthritis or other medical problems. Sometimes a person may not receive a clear diagnosis until the disease progresses and complications develop. Diagnostic Tests X-rays are almost always used to diagnose Paget's disease, but the disease may be discovered using one of three tests: - x-rays  -  an alkaline phosphatase blood test  -  or a bone scan. x-rays an alkaline phosphatase blood test or a bone scan. Bones affected by Paget's disease have a distinctive appearance on x-rays, which may show increased bone density, an abnormal bone structure, bowing, and enlargement. X-rays of leg bones may show very tiny fractures called microfractures. The enzyme alkaline phosphatase is involved in the normal growth of new bone. Having higher-than-normal levels of this chemical in the blood, however, may be a sign of Paget's disease. The alkaline phosphatase blood test measures the level of this substance. A bone scan provides a picture of the affected bones that doctors can use to see how far the disease has progressed. If a bone scan done for another reason suggests Paget's disease, the doctor can order x-rays to confirm the diagnosis. If the Disease Runs in the Family Early diagnosis and treatment of Paget's disease is important. Because Paget's disease can be hereditary, some experts recommend that the brothers, sisters, and children of anyone with the disease talk to their doctor about having an alkaline phosphatase blood test every 2 to 3 years after about age 40.
Paget's disease is almost always diagnosed by x-ray, although it may be discovered using one of two other tests: an alkaline phosphatase blood test or a bone scan. Paget's disease is often found by accident when a person undergoes one of these tests for another reason. In other cases, a person experiences problems that lead his or her physician to order these tests. If Paget's disease is first suggested by an alkaline phosphatase blood test or bone scan, the physician usually orders an x-ray to verify the diagnosis. A bone scan is typically used to identify all the bones in the skeleton that are affected by the disease.
Early Detection is Important When skin cancer is found early, it is more likely to be treated successfully. Therefore, it is important to know how to recognize the signs of skin cancer in order to improve the chances of early diagnosis. Most non-melanoma skin cancers (basal cell carcinoma and squamous cell carcinoma) can be cured if found and treated early. Skin Changes A change on the skin is the most common sign of skin cancer. This may be a new growth, a sore that doesn't heal, or a change in an old growth. Not all skin cancers look the same. Sometimes skin cancer is painful, but usually it is not. Checking your skin for new growths or other changes is a good idea. Keep in mind that changes are not a sure sign of skin cancer. Still, you should report any changes to your health care provider right away. You may need to see a dermatologist, a doctor who has special training in the diagnosis and treatment of skin problems. A Mole That is Bleeding Also see a doctor if a mole is bleeding or if more moles appear around the first one. Most of the time, these signs are not cancer. Sometimes, it is not even a mole. Still, it is important to check with a doctor so that any problems can be diagnosed and treated as early as possible. Don't ignore your symptoms because you think they are not important or because you believe they are normal for your age. Signs of Melanoma Melanoma skin cancer is more difficult to treat, so it is important to check for signs and seek treatment as soon as possible. Use the following ABCDE rule to remember the symptoms of melanoma. See a doctor if you have a mole, birthmark, or other pigmented area of skin with  A = Asymmetry. One half of the mole looks different than the other half. (top left image)  B = Border. The edges are often ragged, notched, or blurred in outline. The pigment may spread into the surrounding skin. (top right image)  C = Color. The mole is more than one color. Shades of black, brown, and tan may be present. Areas of white, gray, red, pink, or blue may also be seen.(bottom left image)   D = Diameter.There is a change in size, usually an increase. Melanomas can be tiny, but most are larger than the size of a pea (larger than 6 millimeters or about 1/4 inch). (bottom right image)   E = Evolving. The mole has changed over the past few weeks or months.
What Happens During Screening? Checking for cancer in a person who does not have any symptoms is called screening. Screening can help diagnose skin problems before they have a chance to become cancerous. A doctor, usually a dermatologist, screens for skin cancer by performing a total-body skin examination. During a skin exam, the dermatologist or other health care professional looks for changes in the skin that could be skin cancer, and checks moles, birth marks, or pigmentation for the ABCD signs of melanoma. He or she is looking for abnormal size, color, shape, or texture of moles, and irregular patches of skin. Screening examinations are very likely to detect large numbers of benign skin conditions, which are very common in older people. Even experienced doctors have difficulty distinguishing between benign skin irregularities and early carcinomas or melanomas. To reduce the possibility of misdiagnosis, you might want to get a second opinion from another health professional. Self-Examinations You can also perform self-examinations to check for early signs of melanoma. Make sure to have someone else check your back and other hard to see areas. Do not attempt to shave off or cauterize (destroy with heat) any suspicious areas of skin. Risk Tool The National Cancer Institute developed a Melanoma Risk Tool which can help patients and their doctors determine their risk. The tool can be found at http://www.cancer.gov/melanomarisktool/. Performing a Biopsy In order to diagnose whether or not there is skin cancer, a mole or small piece of abnormal skin is usually removed. Then, a doctor will study the suspicious cells under a microscope or perform other tests on the skin sample. This procedure is called a biopsy. It is the only sure way to diagnose skin cancer. You may have the biopsy in a doctor's office or as an outpatient in a clinic or hospital. Where it is done depends on the size and place of the abnormal area on your skin. You may have local anesthesia, which means that you can be awake for the procedure. If Cancer Is Found If the biopsy shows you have cancer, tests might be done to find out if cancer cells have spread within the skin or to other parts of the body. Often the cancer cells spread to nearby tissues and then to the lymph nodes. Has the Cancer Spread? Lymph nodes are an important part of the body's immune system. Lymph nodes are masses of lymphatic tissue surrounded by connective tissue. Lymph nodes play a role in immune defense by filtering lymphatic fluid and storing white blood cells. Often in the case of melanomas, a surgeon performs a lymph node test by injecting either a radioactive substance or a blue dye (or both) near the skin tumor. Next, the surgeon uses a scanner to find the lymph nodes containing the radioactive substance or stained with the dye. The surgeon might then remove the nodes to check for the presence of cancer cells. If the doctor suspects that the tumor may have spread, the doctor might also use computed axial tomography (CAT scan or CT scan), or magnetic resonance imaging (MRI) to try to locate tumors in other parts of the body.
Many Treatment Options There are many treatment options for people with melanoma and non-melanoma skin cancer. The choice of treatment depends on your age and general health, the site of the cancer, the stage of the cancer, whether or not it has spread beyond the original site, and other factors. If tests show that you have cancer, you should talk with your doctor and make treatment decisions as soon as possible. Studies show that early treatment leads to better chances for successful outcomes. In some cases, all of the cancer is removed during the biopsy, and no further treatment is needed. For others, more treatment will be needed, and a doctor can explain all of the treatment options. Working With a Team of Specialists A person with skin cancer, particularly if it is melanoma, is often treated by a team of specialists. The team will keep the primary doctor informed about the patient's progress. The team may include a medical oncologist (a specialist in cancer treatment), a dermatologist (a specialist in skin problems), a surgeon, a radiation oncologist (a specialist in radiation therapy), and others. Before starting treatment, you may want another doctor to review the diagnosis and treatment plan. Some insurance companies require a second opinion. Others may pay for a second opinion if you request it. Plan Ahead for Doctor Visits When planning your skin cancer treatment, you may meet with many different health care providers, get lots of information, and have lots of questions. Plan ahead for doctor appointments by writing down your questions and bringing a paper and pen to take notes. Sometimes it also helps to bring a friend or family member to your doctor appointments so they can help you listen, take notes, ask questions, and give you support. Clinical Trials for Skin Cancer Some skin cancer patients take part in studies of new treatments. These studies, called clinical trials, are designed to find out whether a new treatment is safe, effective, and better than the current standard of care. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Talk to your doctor if you are interested in taking part in a clinical trial. The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. - Click here to see a list of the current clinical trials on melanoma.  - Click here to see a list of the current clinical trials on non-melanoma skin cancer. Click here to see a list of the current clinical trials on melanoma. Click here to see a list of the current clinical trials on non-melanoma skin cancer. A separate window will open. Click the "x" in the upper right hand corner of the "Clinical Trials" window to return here.
Skin cancer occurs when cancer cells form in the tissues of the skin. The skin is mainly made up of two layers: the inner layer, called the dermis, and the outer layer, called the epidermis. Within the epidermis, there are three types of cells; squamous cells, basal cells, and melanocytes. There are three types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. The types of cancer are named after the type of cells that are affected. Basal cell carcinoma and squamous cell carcinoma are very common, especially in older people. However, they are rarely life-threatening. Melanoma is a less common, yet more serious, type of cancer.
Basal cell carcinoma develops in the basal cells of the epidermis, the outer layer of the skin. It is the most common type of skin cancer in the United States, but it spreads slowly and is rarely life-threatening. Basal cell carcinoma occurs most often on parts of the body that have been exposed to the sun, such as the face, ears, neck, hands and legs. However, it can be found on any part of the body.
Skin cancer is caused by DNA damage, which can result from excess exposure to ultraviolet (UV) light. Having a previous occurrence of skin cancer or a close family member with the disease also puts you at risk for skin cancer. Other risk factors include having - a weak immune system  - unusual moles or a large number of moles  - white or light (fair)-colored skin, especially with freckles  - blond or red hair or blue or green eyes  - scars or burns on the skin, or skin diseases that make someone sensitive to the sun. a weak immune system unusual moles or a large number of moles white or light (fair)-colored skin, especially with freckles blond or red hair or blue or green eyes scars or burns on the skin, or skin diseases that make someone sensitive to the sun. In 2008 the National Cancer Institute developed a Melanoma Risk Tool which can help patients and their doctors determine their risk. The tool can be found at  http://www.cancer.gov/melanomarisktool/.
The best way to reduce your skin cancer risk is to reduce your exposure to ultraviolet (UV) rays from the sun. To do this, you can avoid outdoor activities during midday, when the sun's rays are strongest, or wear protective clothing, such as a wide-brimmed hat, long-sleeved shirt, and pants. (Watch the video to learn more about how to protect your skin. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Darker-colored clothing is more protective against the sun. A white t-shirt, for example, provides little resistance to ultraviolet (UV) rays, particularly if it gets wet. In addition, wearing sunglasses that wrap around the face or have large frames is a good way to shield the delicate skin around the eyes. When going outside, you should always wear sunscreen and lipscreen. Your sunscreen should have an SPF of at least 15. UV radiation can also come from sunlamps, tanning beds, or tanning booths. UV radiation is present even in cold weather or on a cloudy day. A person's risk of cancer is related to lifetime exposure to UV radiation.
Skin cancer is usually visible. Changes in your skin, such as lumps, scabs, red spots, rough patches, or new or irregular moles should be reported to your doctor. You should also see a doctor if you have a mole, birthmark, or other pigmented area of skin that can be classified by the ABCDE symptom system. ABCDE stands for Melanoma skin cancer is more difficult to treat, so it is important to check for signs and seek treatment as soon as possible. Use the following ABCDE rule to remember the symptoms of melanoma. See a doctor if you have a mole, birthmark, or other pigmented area of skin with  A = Asymmetry. One half of the mole looks different than the other half. (top left image)  B = Border. The edges are often ragged, notched, or blurred in outline. The pigment may spread into the surrounding skin. (top right image)  C = Color. The mole is more than one color. Shades of black, brown, and tan may be present. Areas of white, gray, red, pink, or blue may also be seen.(bottom left image)   D = Diameter.There is a change in size, usually an increase. Melanomas can be tiny, but most are larger than the size of a pea (larger than 6 millimeters or about 1/4 inch). (bottom right image)   E = Evolving. The mole has changed over the past few weeks or months. Other symptoms of skin cancer include a bleeding mole or the appearance of more moles around the first one.
Once cancer has been found, the doctor will need to determine the extent, or stage, of the cancer. Through staging, the doctor can tell if the cancer has spread and, if so, to what parts of the body. More tests may be performed to help determine the stage. Knowing the stage of the disease helps you and the doctor plan treatment. Staging will let the doctor know - the size of the tumor and exactly where it is  - if the cancer has spread from the original tumor site  - if cancer is present in nearby lymph nodes  - if cancer is present in other parts of the body. the size of the tumor and exactly where it is if the cancer has spread from the original tumor site if cancer is present in nearby lymph nodes if cancer is present in other parts of the body. The choice of treatment is based on many factors, including the size of the tumor, its location in the layers of the skin, and whether it has spread to other parts of the body. For stage 0, I, II or III cancers, the main goals are to treat the cancer and reduce the risk of it returning. For stage IV cancer, the goal is to improve symptoms and prolong survival.
Different types of treatment are available for patients with skin cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Four types of standard treatment are used: surgery, radiation therapy, chemotherapy, photodynamic therapy, and immunotherapy. Another therapy, biologic therapy, is one of many therapies currently being tested in clinical trials. These standard cancer treatments work in different ways. - Surgery removes the cancer.  - Chemotherapy uses anti-cancer drugs to kill cancer cells or stop their growth.  - Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors.  - Photodynamic therapy uses a drug and a type of laser light to kill cancer cells.  - Immunotherapy, which is newer, uses the patient's own immune system to fight the cancer. Surgery removes the cancer. Chemotherapy uses anti-cancer drugs to kill cancer cells or stop their growth. Radiation therapy uses high-energy beams to kill cancer cells and shrink tumors. Photodynamic therapy uses a drug and a type of laser light to kill cancer cells. Immunotherapy, which is newer, uses the patient's own immune system to fight the cancer. In June of 2011, an important advance in treating melanoma was announced at an annual cancer meeting. A drug called ipilimumab was approved for treating the disease, and it works differently than traditional chemotherapy. It uses immunotherapy to help the immune system recognize and reject cancer cells. When its successful, immunotherapy can lead to complete reversal of even advanced disease. Some patients with stage IV metastatic disease who were treated in early immunotherapy trials after other therapies were unsuccessful are still in complete remission more than 20 years later.
Yes. Some skin cancer patients take part in studies of new treatments. These studies, called clinical trials, are designed to find out whether a new treatment is both safe and effective. Clinical trials are research studies with people to find out whether a new drug, therapy, or treatment is both safe and effective. New therapies are tested on people only after laboratory and animal studies show promising results. The Food and Drug Administration sets strict rules to make sure that people who agree to be in the studies are treated as safely as possible. Often, clinical trials compare a new treatment with a standard one so that doctors can learn which is more effective. Talk to your doctor if you are interested in taking part in a clinical trial. The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials at ClinicalTrials.gov. - Click here to see a list of the current clinical trials on melanoma.  - Click here to see a list of the current clinical trials on non-melanoma skin cancer. Click here to see a list of the current clinical trials on melanoma. Click here to see a list of the current clinical trials on non-melanoma skin cancer. A separate window will open. Click the "x" in the upper right hand corner of the "Clinical Trials" window to return here.