In September 2009 actor Patrick Swayze passed away due to pancreatic cancer. This week Steve Jobs has lost the battle to the disease.

You can read about this horrible cancer in our original post.

Here are some updated statistics you should know about -

• Each year, more than 43,000 people are diagnosed with this cancer in the United States alone.
• 37,660 people have died of pancreatic cancer since the beginning of the year.
• Smoking is the most important risk factor for pancreatic cancer. Smokers are more likely to develop this cancer, while heavy smokers are at an even higher risk.
• Jaundice (yellowing of the skin, dark urine and pale stools) may be a sign of pancreatic cancer. Also abdominal pain may be one of the first signs.
• It’s usually discovered too late, which is one of the reasons so many people die of it
• If the cancer can’t be removed by surgery, survival may last for only 4-6 months.

Haiku by Andrew Forgrave

The Lustgarten foundation was established to advance the scientific and medical research related to the diagnosis, treatment, cure and prevention of pancreatic cancer. You can make a donation to help prevent further deaths from this disease.

Related posts:

1. In The News – Pancreatic Cancer – The 4th Leading Cause of Death
2. Swine Flu – 7 New Facts
3. The Most Popular Posts in September

We usually go to the doctor when we don’t feel well or have a symptom that bothers us – and that’s how diseases are discovered most of the time. But – some diseases can be detected before having any symptoms, when they’re on their early stage. Screening tests are meant just for that and  are one of the best ways to protect your health – they are generally simple, performed routinely and can detect serious illnesses. Here ‘s a list of 10 important screening tests that you should know and consider taking.

Photo by Chandra Marsono

1. Colon Cancer Screening: Every person over 50 years old (or younger if a close relative had colon cancer, if they have IBD, or if they have certain genetic syndromes) should have colorectal cancer screening. The screening tests are aimed to find growths inside your colon, called polyps. Polyps have the potential to become cancer – but if detected early, they can be removed, preventing cancer. There are several ways to find polyps:

• Fecal occult blood (recommended once a year) is a simple stool test in which the feces is searched for small amounts of blood (that comes from polyps) which you can’t see on your own.
• During flexible sigmoidoscopy (recommended every 5 years) a short lighted tube is inserted to your rectum and looks for polyps on the lower third of your colon. During this procedure, polyps can also be removed.
• Colonoscopy (recommended every 10 years) is a similar test using a longer tube which can reach the whole length of your colon.

2. Mammography: A mammogram is a used for early detection of breast cancer – which is the most common cancer in women. This is an x-ray of the breasts, which can discover cancer when it’s still too small to feel it on your own. The test is recommended for all women between the ages of 50 to 74, and should be performed every 2 years. Besides that, it’s recommended for all women to have self-exams and clinical exams (by a doctor) of the breasts regularly.

On the left – a normal breast in mammography. On the right – a breast with breast cancer (white). Photo by National Cancer Institute.

3. Mole Exam: In this exam a dermatologist looks at your moles to see if any of them is suspicious to be skin cancer or melanoma. it’s recommended to have this check-up once a year. Besides that, you should try a self check-up every month – look for moles which are asymmetric, don’t have sharp borders, don’t have a constant color or are larger than 6mm (about a quarter of an inch).

4. Pap smear: This is a screening test for cervical cancer – the cervix is lower part of the uterus in women, and can be reached in a vaginal exam. It’s a simple test which is performed in your gynecologist’s office. During the usual gynecologic exam, the doctor will collect some cells from your uterine cervix and the area around it. Later these cells are check under a microscope and pre-cancer cells will be looked for. These cells can be also checked for a virus called HPV which causes cervical cancer. This test is performed once a year after the age of 21 or 3 years after the first time you have sex (whichever comes earlier).

5. Prostate cancer screening: The prostate is an organ that exists only in men. It’s small (about the size of a walnut), located under the bladder and in front of the rectum, and produces part of the semen fluids. Prostate cancer is the most common cancer in men. There are two screening tests for this cancer: a PSA test is a simple blood test to measure the levels of a substance called Prostate specific antigen (PSA) – which will be high in prostate cancer. Another important test is a digital rectal exam – this is done in your doctor’s office – the doctor inserts a finger to your rectum and feels the size and shape of the prostate. Currently there isn’t enough evidence supporting routine testing for prostate cancer, but you can ask your doctor if you should do one of the tests yourself.

6. Bone Density: The purpose of this test is to diagnose osteoporosis – a condition common in older people (mostly women) in which bones become thin and weakened, which makes them susceptible to fractures. This is a special x-ray picture which measures the density of bones in your hips, spine and wrists. Routine screening is recommended for women older than 65 years old.

7. HIV Test: HIV is the virus causing AIDS (Acquired Immunodeficiency Syndrome), which makes your body susceptible to life-threatening infections. It can be transmitted by having unprotected sex or sharing needles with someone who has the disease. The United States Center for Disease Control and Prevention (CDC) recommends that everyone get tested at least once in their life, and afterwards at least once a year if they had new sex partners since the last test (or their partner had sex with someone else), or if they are injecting drugs or steroids with used injection equipment.

8. Abdominal Ultrasound: This test’s purpose is to look for an aortic aneurysm. This is a dilatation of an artery so it looks like a balloon, causing the wall of the artery to become thinner so it might rupture. A common place for such an aneurysm is the abdominal aorta, which is a part of the largest artery in the body – you don’t want this one to rupture. A simple ultrasound test can discover an aneurysm. In the United States, this screening test is recommended for men between ages 65-75 who smoked in the past (or still are) or men above 60 years old with a family history of an aortic aneurysm. This test should be performed only once.

Photo by National Heart, Lung and Blood Institute

8. Abdominal Ultrasound: This test’s purpose is to look for an aortic aneurism. An aneurism is a dilatation of an artery so it looks like a balloon. This causes the wall of the artery to become thinner so it might rupture. A common place for such an aneurism is the abdominal aorta, which is a part of the largest artery in the body – you don’t want this one to rupture. With a simple ultrasound test (which can produce images of your abdomen without any radiation), the doctor can see if there is an aneurism. Sometimes the treatment for that will be surgery. In the United States, this screening test is recommended for men between ages 65-75 who smoked in the past (or still are) or men above 60 years old with a family history of an aortic aneurism. This test should be performed only once.

9. Routine blood tests: You should have a routine blood test once a year. This includes complete blood count (CBC) to check for anemia, fasting glucose levels – which is a screening test for diabetes, and cholesterol levels – high cholesterol raises the risk for heart diseases (and treating it can prevent them).

10. Routine Check-Up with your family doctor: It’s important to visit your family doctor at least once a year when you’re healthy. They will perform a physical exam, measure your blood pressure (high blood pressure doesn’t cause any symptoms but can be dangerous in the long run) and do an EKG (which is a test that checks the activity of your heart) – to look for various heart diseases. This is also a good opportunity to tell the doctor about symptoms or problems that bother you.

Here’s a summary of screening tests mentioned in the article. Find the ones that apply to you and make your appointment today.

Related posts:

1. Common Variable Immunodeficiency (CVID)–When a Cold Can Threaten Your Life (As Seen on House MD)
2. Crohn’s Disease – Inflammation in The Intestines Which Can Influence Your Whole Life

Several days ago the World Health Organization (WHO) cancer research agency (IRAC) announced that the radiation produced by cell phones can possibly cause brain cancer. This was concluded after a group of more than 30 experts met together and went through all the research done in this subject on the last decades.

(Photo by Jose Oller)

What exactly is this radiation?

Cellular phones produce a type of radiation called radiofrequency electromagnetic radiation. Radiation is practically a group of waves which travels through the air, but which you can’t see. Radiation comes in two flavors: ionizing (like UV, X-rays) and non-ionizing (like infra-red, microwave, radio, and yes – cell phone radiation).

Ionizing radiation is proved to be dangerous and cause cancer (which is why, for example, you shouldn’t do too many CT scans, which are just a whole lot of x-rays done together). On the other side, non-ionizing radiation shouldn’t cause any damage to your body. Or at least that was the belief until now.

(Photo by FDA.gov)

How dangerous is it?

The WHO divides all the things that were thought to cause cancer to 5 groups by the “level of evidence” – how much they are sure that something is carcinogenic (causes cancer). The most dangerous stuff belongs to group 1, which includes, for example, asbestos (small particles that cause lung cancer) and some viruses (like Hepatitis B and C, which can cause liver cancer) and ionizing radiation (which we spoke about above). Group 4 is supposed to include agents which are probably not carcinogenic. Naturally there are also groups 2 and 3 in between.

The group of experts classified cellular phones radiation in group 2b. This means that there could be some risk, and more research should be done to understand the risks better. One of the most important studies that the experts based their assumption on was The Interphone Study, which found an increased risk for brain cancer only in the group of heavy users (around 30 minutes per day, every day, for 10 years). People in this group were 40% more likely to get a brain cancer called glioma. There were several problems with this study – and some claimed that the way is was conducted caused results that aren’t reliable.

What types of cancer can I get from cell phones?

The experts found that two diseases were possibly related to cellular phone use:

Glioma: This is the most common type of brain cancer. The tumor is composed of glial cells, which are cells placed between the main cells in the brain (neurons) and support them. Gliomas cause symptoms by growing into healthy areas of the brain and hurting the neurons – either by destroying them or compressing them. This can cause headaches, seizures, problems with language or vision, and even personality changes – depending on the function of the neurons damaged. The treatment can include brain surgery, radiation and chemotherapy.

An MRI of a brain with a glioma – which is the darker round spot on the right of both pictures (photo by Mikhail Kalinin)

Acoustic neuroma: This is a slowly-growing tumor on the acoustic nerve – which is the nerve responsible for hearing. The special location of the tumor causes symptoms like hearing loss or ringing in the ears, and sometimes it can also hurt your balance (which is also a function of the ear and its nerves). Rarely, it grows fast into structures of the brainstem -which is responsible for vital functions like breathing. The treatment depends on the symptoms – in some cases no treatment is needed, but sometimes surgery or radiation treatments will be used.

What the world has to say

On the last couple of days, the internet and the news are full of responses to the WHO announcement. For example, the LA Times health blog “booster shots” claims there is not enough data and refers to former studies dealing with the relation between non-ionizing radiation and cancer; the health blog of Time wonders ‘what took them so long’; the Wall Street Journal reviews the studies conducted on the subject and criticizes the WHO for an immature announcement ; and CNN published an opinion article by physicist Bernard Leikind who claims that cell phones cannot cause cancer from the physics point-of-view. The main conclusion is that there is no reason to panic just yet.

(Photo by Kevin Micalizzi)

What can I do to prevent it?

• Use an earphone: According to earlier data released by the WHO on this subject, cellular phones emit radiation only when turned on, and the radiation exposure of the used depends on the distance from the phone – when the phone is placed 30-40 cm away from the body (like when text-messaging or using an “hands free” device – like an earphone), the exposure is much lower then when its close to the head.
• Limit use as much as possible: Like explained before, one of the largest studies that proved damage from cellular phone use showed an increased risk for glioma only in heavy users.
• Avoid using cell phones when reception is low: In cases of low reception, the phone has to transmit at increased power – which increases the exposure to radiation.
• The International Business Times published yesterday a list of the lowest radiation emitting cell phones.
• According to the WHO, the use of commercial devices for reducing exposure wasn’t proved to be effective.

Related posts:

1. Pancreatic Cancer–6 Facts You Should Know [News]
2. In The News – Pancreatic Cancer – The 4th Leading Cause of Death
3. Lung Cancer – Why You May Be at Risk (As Seen on House MD)

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


On episode 19 of season 7, called “Last Temptation”, a 16 years old patient named Kendall Pierson collapses while embarking on a boat trip. Later her hand turns blue while running on a treadmill and her pineal gland is found to be calcified. Later she collapses due to a hypertensive crisis. An MRI of her arm discovers that she has a tumor called lymphoid sarcoma in the arm. As hard as we tried, we couldn’t really find enough data about lymphoid sarcoma. Seems the writers went a little too rare with the disease, or that a more likely diagnosis is in place here: osteosarcoma.

Photo by NBCUniversal

Danger level: High

What is it?

Osteosarcoma is the most common type of bone cancer is children.

Who gets it?

In the United States, about 400 children  and adolescents (under age 20) are diagnosed with osteosarcoma each year. 

It’s a little more common in black people and in males. It’s also more common as a child ages – quite rare under the age of 5, but becoming more common towards age 20 (it’s more common at the age when a child is growing faster).

What causes it?

The exact reason for the development of osteosarcoma isn’t known. There are, though, some risk factors which increase a child’s risk of developing the tumor:

1. Rapid bone growth: As mentioned above, at times when the child grows faster, their chances of developing an osteosarcoma increase.
2. Exposure to radiation
3. A genetic problem: For example, children with retinoblastoma (more on that in a future post) are more likely to develop osteosarcoma. (other genetic diseases associated with it include Li-Fraumeni syndrome, and Rothmund-Thomson syndrome – more on those in the future).

How does it feel?

Any bone may be involved in the disease, but it’s more common in areas of bone which grow faster, such as the end of the thigh bone, the beginning of the shinbone, or the beginning of the arm bone.

Usually the child will feel pain in the area, and a swelling may also be felt there. Sometimes the child may limp as a result of the pain.

How is it discovered?

Usually an x-ray is performed first on the area. It will show an area of destroyed bone (called in medicine a “lyric lesion”). An example for that can be seen in this x-ray.

Photo by bc the path

In order to diagnose osteosarcoma for sure, a piece of the bone is needed (a process called a biopsy). It is then looked at under a microscope. This is how it looks:

There are many types of cells in this picture, which we can’t explain here. There is also a clear pink area, created by the tumor. Photo by Nephron.

CT and/or MRI are usually also needed, to see if the tumor has spread to other areas in the body (it tends to spread to the lungs and to other bones).

How is it treated?

Osteosarcoma is usually treated with chemotherapy, after which surgery is performed, which either removes the tumor or involves an amputation of the limb in which the tumor exists (like the case on the House episode). After that, more chemotherapy is usually used.

What happens after treatment?

The most important way to answer that depends on whether the tumor has spread to other areas, a fact which worsens the outcome.

About 60-70% of children with a tumor that hasn’t spread are cured thanks to treatment. Those with metastasis have a worse outcome – only 30-35% of them will survive.

There is currently no known way to prevent osteosarcomas.

The following video is about Bianca Bresadola, who died of osteosarcoma. May she rest in peace.

Related posts:

1. Neuroblastoma – The Most Common Cancer in Infants
2. Paget Disease of Bone – Bone Deformity For An Unknown Reason
3. Necrotizing Fasciitis Revisited, Osteosarcoma, and Aneurysms – (As Seen on House MD)

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


On last night’s episode (season 7, episode 15), named “Bombshells”, a mass is found on Cuddy’s kidney. After seeing findings in her lungs on imaging it’s presumed she has a malignant tumor in her kidneys that has metastasized to the lungs. A biopsy from the tumor reveals something different, though: She has a benign tumor, called an oncocytoma.

Danger level: Medium

What is it?

Renal oncocytoma is a type of tumor that can be found in the kidney.

Who gets it?

There are many types of kidney cancers, the most common of which is called a renal cell carcinoma. Renal oncocytomas, on the other hand, aren’t that common. They account for about 3-7% of tumors in the kidney.

They are about 2-2.5 times more common in men than in women. They’re usually discovered around age 62.

What causes it?

Sometimes, renal oncocytomas can run in families. This tends to occur more in families in which a syndrome by the long name of Birt-Hogg-Dube syndrome (BHD) is running, due to a genetic mutation.

In other cases, the tumor just appears. There is currently no theory to explain why.

Our kidneys are made of little units called nephrons. There are about 1.5 million (!) nephrons in one kidney. The nephron itself has many tubules and parts, as can be seen in this drawing:

Renal oncocytomas arise from the collecting ducts of the nephron (called in the drawing “collecting tub.” (short for tubule)).

As in other tumors, it occurs when the cells in the area continue dividing without stopping, creating a mass.

How does it feel?

Most people don’t feel anything, and in most cases the tumor is found accidentally after taking an image of the abdomen for some other reason.

In other cases there may be bloody urine (called hematuria), or flank pain.

It’s important to note that this tumor is benign, meaning that it doesn’t tend to spread throughout the body like a malignant tumor does, and so poses less threat.

How is it discovered?

After such a tumor is found in imaging (such as ultrasound or a CT scan), a biopsy is usually needed to know which type of tumor it is. A biopsy is a procedure in which a piece of tissue (in this case, the kidney) is taken and looked at under a microscope. Each tumor has a distinct appearance which can differentiate it from other types. This is how a renal oncocytoma looks under the microscope:

Photo by Nephron

How is it treated?

Most patients are treated with surgery, in which the tumor (or the whole kidney) is taken out.

What happens after treatment?

Like mentioned above, this tumor is benign. Taking it out by surgery should provide cure.

The bottom line – How do I avoid it?

There is currently no known way to prevent this tumor.

Related posts:

1. Astrocytoma (Butterfly Tumor)–A Brain Tumor That Spreads To Both Sides (As Seen On Grey’s Anatomy)
2. Nesidioblastoma – A Tumor of the Pancreas That Can Secrete Hormones (As Seen on House MD)
3. TTP Explained Again (As Seen on House MD)

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


On episode 4 of season 2, called “TB or Not TB”, a doctor named Sebastian Charles, who works with tuberculosis patients in Africa, collapses and is taken to the hospital. With tuberculosis being his specialty, the doctor is sure he has tuberculosis. Later on, during a press conference, he becomes disoriented and his heart fails. Turns out he has a small tumor called nesidioblastoma causing his symptoms.

Danger level: High

What is it?

Nesidioblastoma (also called “islet cell carcinoma”) is an uncommon cancer of the pancreas.

Who gets it?

Tumors of the endocrine pancreas (more about that word later) are pretty rare. In the US, they happen to 3-10 out of a million people per year.

They are slightly more common in women than in men.

In terms of age, they mostly present at ages 30-50.

What causes it?

The pancreas is a gland in our body. It has two types of cells:

1. Endocrine cells: Make hormones (chemicals that control actions of other cells or organs in the body), like insulin.
2. Exocrine cells: Make enzymes (proteins that have a function, like little machines) that are released into our intestines and help the body digest food.

Islet cell tumors, like nesidioblastoma, arise from the endocrine part of the pancreas. This means that they secrete hormones. They may be functional (causing symptoms) or non-functional.

An example would be a tumor that secretes insulin, like on the House episode. Insulin controls the amount of sugar in the blood. When insulin is high, sugar in the blood enters the cells, and there is less sugar in the blood.

How does it feel?

That depends on what the tumor secretes.

If it secretes insulin, like was shown on the House episode, it will lead to low sugar levels in the blood. This means the brain will not get enough sugar, necessary for it to function properly. This will lead to headaches, blurry vision, changes in thinking and concentration, weakness. Also sweating, changes in the heart rhythm, and body tremors.

Other hormones other than insulin can be secreted, and cause different symptoms.

How is it discovered?

There are different ways to discover different types of tumors arising from the pancreas.

For an insulin secreting tumor, for example, glucose (blood sugar) and insulin in the blood can be measured.

Another way of finding the tumor, which was shown on House, helps locate the tumor in the pancreas. In this method, calcium is injected into an artery that goes to one part of the pancreas. At the same time, a blood sample is taken from a blood vessel that comes out of the pancreas (a vein) to see if it secretes more hormones as a result. If there’s a tumor in the area the calcium reached, there will be an increase in the amount of hormone in the blood sample.

How is it treated?

Depending on the extent of the tumor, it can be removed from the body. Sometimes, other treatment measures are needed, if this is not enough.

What happens after treatment?

That depends on whether the tumor has spread to other areas of the body or not. If it has, chances of survival lower.

The bottom line – How do I avoid it?

There is currently no way to prevent nesidioblastomas or other tumors of the endocrine pancreas.

Related posts:

1. Astrocytoma (Butterfly Tumor)–A Brain Tumor That Spreads To Both Sides (As Seen On Grey’s Anatomy)
2. Pheochromocytoma – A Rare Tumor That Can Cause Hypertension (As Seen on House MD)
3. Renal Oncocytoma–Cuddy’s Kidney Tumor Explained (As Seen on House MD)

This is part of our House MD Project series.

Episode 21 of season 1, named “Three Stories” is not a usual episode. Instead of the usual one patient story (and the occasional clinic patients), this episode tells 3 short stories (as its name implies). Each patient presented with a different disease. Since this episode was presented differently, so will this article digress from the usual presentation. The 3 diseases on that episode will be covered here in brief.

Disease 1 – Necrotizing Fasciitis

This long name means simply an infection by what is known as the “flesh eating bacteria”.

On the House episode, a 40 year-old farmer arrives at the hospital claiming he was bit by a snake. After an anti-venom doesn’t help him and his leg’s muscles begin to rot, it is found out he was actually bitten by a dog, a bite that infected him with a germ called streptococcus.

We already covered necrotizing fasciitis in the past and you can read all about this disease here:

Necrotizing Fasciitis (Flesh Eating Bacteria) – Are You at Risk, and How You Can Avoid It

Disease 2 – Osteosarcoma

update: We now have a complete article about osteosarcoma, if you’re interested to know more details

The 2nd patient is a 16 year-old volleyball player arriving at the hospital after what seems like a strained ankle. After some trial and error it is found she has osteosarcoma, a cancer in the leg of thigh.

Osteosarcomas are the most common malignant bone cancer in children (along with a cancer named Ewing sarcoma). The cause is unknown. In the US, about 400 children and adolescents younger than 20 years old are diagnosed with osteosarcoma each year. It most commonly affects adolescents.

The disease presents with pain in a bony site. A mass may be palpable in the area as well. X-ray image of the area can discover the tumor. A biopsy from the area is needed to make sure it’s osteosarcoma.

An x-ray picture of an osteosarcoma of the arm. Photo by bc the path

Before chemotherapy, osteosarcoma used to be treated with amputation alone. Today chemotherapy is used along with surgery which can cut the tumor. Sometimes amputation is still needed, as was seen on House.

Disease 3 – Aneurysm

The 3rd patient is actually Dr. House himself, telling the story of how he got his leg pain to begin with. Turns out he had an aneurysm in the artery of his leg which wasn’t diagnosed on time, leading to blockage of blood to his leg’s muscles, which led to muscle death.

An aneurysm is a dilatation of an artery. The chances of getting it increase with age (it happens to at least 3% of people older than 50). Most aneurysms don’t cause any symptoms and go unnoticed. As they progressively enlarge, though, they may cause symptoms as a result of compression of the surrounding area, of clogging, sending a blood clot, or rupturing.

In the case of the House episode, his leg aneurysm clogged with a blood clot. This led to blood not arriving to his leg muscles, causing muscle death.

Related posts:

1. Osteosarcoma–The Most Common Bone Cancer in Children (As Seen on House MD)
2. Necrotizing Fasciitis (Flesh Eating Bacteria) – Are You At Risk, and How Can You Avoid It
3. Acute Intermittent Porphyria Revisited (As Seen on House MD)

Michael Douglas told a US television audience on Tuesday night that he has been diagnosed with and is receiving treatment for stage 4 throat cancer. There is more than one type of organ in the throat which can have cancer, and Douglas didn’t go into details.

According to specialists, if the cancer started at the base of his tongue (as Douglas’ press representative described), he probably has a type of cancer called oropharyngeal cancer.

Danger level: High

What is it?

Oropharyngeal cancer is a disease in which malignant cells form in the oropharynx.

Who gets it?

The average age of being diagnosed with oropharyngeal cancer is 60, with men getting it twice as frequently as women. It’s more common in African-Americans men than in white men.

There are certain things that raise your risk of getting oropharyngeal cancer (called risk factors). Such risk factors include:

1. Smoking and chewing tobacco
2. Heavy alcohol use
3. A diet low in fruits and vegetables
4. Drinking a sort of a South American stimulant drink named maté.
5. Chewing an Asian type of stimulant called betel quid.
6. Being infected with human papillomavirus (HPV) – This is a sexually transmitted virus. Unsafe oral sex with multiple partners is a risk factor for getting infected with HPV.

Michael Douglas said in his interview this week that he used to be a drinker and a smoker.

Alcohol and smoking are major risk factors for oropharyngeal cancer. Photo by Darwin Bell

What causes it?

First of all – what is the oropharynx, in which this cancer develops?

The oropharynx is the middle part of the throat (the throat is also called pharynx), behind the mouth. This part includes the back 1/3 of our tongue, the soft palate, the side and back walls of the throat, and the tonsils.

As with other types of cancer, oropharyngeal cancer happens when cells in this area start to grow out of control, for reasons not clearly understood.

How does it feel?

People with oropharyngeal cancer may feel any of those:

1. A sore throat that doesn’t go away – Michael Douglas’ tumor was discovered due to this very complaint.
2. A lump in the back of the mouth, throat, or neck
3. A dull pain behind the breastbone
4. Cough
5. Trouble swallowing
6. Weight loss not caused by a diet
7. Ear pain
8. A voice change

How is it discovered?

Diagnosis is made by taking a sample of the area suspected to be cancerous and looking at it under a microscope. A CT scan or an MRI are also used, and can help to see if the cancer has spread.

During the diagnosis process, tests are done to find out if the cancer has spread from the oropharynx to other places in the body. This is part of the staging process, common in cancers. Staging tells which stage the tumor is at (there are 4 stages), and can help guide the right type of therapy and also tell about the chances of survival.

Stage 1: In this stage, the cancer is 2 centimeters or smaller and is still in the oropharynx.

Stage 2: It’s between 2-4 centimeters, and is still in the oropharynx

Stage 3: It’s larger than 4 centimeters and is still in the oropharynx, or it has spread to a nearby lymph node.

Stage 4: It has spread further.

(This is a summary of stages, and lacks many details)

Michael Douglas’ tumor is at stage 4.

How is it treated?

Depending on the stage, oropharyngeal cancer can be treated by surgery, radiation therapy, and other types of possible treatments which include chemotherapy, among other things.

What happens after treatment?

That depends on the stage and the location of the tumor. The survival after treatment is better in earlier stages.

The bottom line – How do I avoid it?

1. Stop smoking – This is the most important thing you can do.

2. Limit your alcohol consumption

3. Limit the number of your sex partners. Using a condom, unfortunately, can’t fully protect you from HPV during sex.

Here’s the part of the interview with Michael Douglas, as seen on the David Letterman show:

Related posts:

1. In The News – Pancreatic Cancer – The 4th Leading Cause of Death
2. Pancreatic Cancer–6 Facts You Should Know [News]
3. Lung Cancer – Why You May Be at Risk (As Seen on House MD)

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


On episode 18, called “Babies & Bathwater”, a young pregnant woman named Naomi is having brain and kidney dysfunction. An x-ray shows a mass in her lung, which turns out to be a type of lung cancer, called small cell lung cancer. The problems she had with her kidney and brain are related to a phenomenon called paraneoplastic syndrome, which often comes with that type of lung cancer.

Photo by Fox.

Danger level: High

What is it?

Lung cancer is a disease in which malignant cells form in the lung.

Who gets it?

Lung cancer is second most common cancer in the US, second only to prostate cancer in men and breast cancer in women. (Throughout the world it’s number 1 in men, and number 5 in women). It’s the leading cause of cancer death in the US.

Lung cancer is twice as common in men than in women. The chances of having it grow as you age.

People who smoke have the greatest risk of developing lung cancer (at least 4 out of 5 cases are associated with cigarette smoking). The risk of lung cancer increases with the number of cigarettes you smoke per day and the number of years you have smoked. About 10% of all smokers eventually develop lung cancer.

There are other risk factors related to developing lung cancer:

1. Exposure to secondhand smoke: Even if you don’t smoke yourself and only exposed to other people’s smoking your risk is higher.
2. Exposure to radon gas in the home: It hasn’t been completely proven, but some studies suggest there’s a relation between this and lung cancer.
3. Exposure to carcinogens: A carcinogen is a substance that’s involved in cancer formation. Examples include asbestos, radiation, arsenic, chromates, nickel, and others.

Smoking is the most proven risk factor for lung cancer. Photo by Helga Weber

What causes it?

The exact mechanism isn’t known. What is known is that there are several types of lung cancer, broadly divided into 2 categories: Small cell lung cancer (the one featured on the House episode) and Non-small cell lung cancer.

These names have been given because of the way the cancer looks under the microscope. But their separation means more than that: Small cell lung cancer is much more aggressive. It spreads quickly, making it particularly threatening. Up to 75% of people diagnosed with this type have a metastatic disease (cancer that has spread) by the time they are diagnosed.

Large cell lung cancer divides into further 3 types, but this is beyond the scope of this article.

How does it feel?

That depends on the type of lung cancer, where the cancer is, and the way it spreads.

One common symptom is a chronic cough. Some people cough up blood or sputum streaked with blood. Other things which may appear include loss of appetite, weight loss, fatigue, chest pain, and weakness.

Lung cancer can also cause all sorts of complications:

1. It can block the airways: This can lead to anything from wheezing, to a collapse of the lungs, to pneumonia.
2. It can cause a “pleural effusion” – that’s fluid that accumulates around your lungs.
3. It can cause something called Horner’s syndrome: Which is a condition in which you have a droopy eyelid, a small pupil, and reduced respiration on one side of the face. This can happen if the tumor hits a nerve on its surroundings.
4. It can cause paraneoplastic syndromes: This is the phenomenon shown on the House episode. These are things caused by the cancer at places far from the cancer itself
5. It can spread to other parts of the body through the bloodstream: areas it tends to spread to include the liver, brain, adrenal glands, spinal cord, or bones.

That’s a partial list. If not treated, it can also lead to death.

How is it discovered?

The first thing done is usually a chest X-ray. A CT scan will show the tumor with more detail, and also discover tumors that an X-ray may have missed.

A biopsy (a piece of the lung taken for examination under a microscope) is usually needed to confirm the diagnosis.

How is it treated?

There are various ways to treat lung cancers. They depend on the type of cancer, its location, its severity, whether it has spread, and the person’s overall health.

Treatments include surgery, chemotherapy and radiation therapy.

What happens after treatment?

Lung cancer isn’t good news, even when treated. On average, people with non-small cell cancer who aren’t treated survive 6 months. Treated, 70% of them may get well and live after 5 years. With small cell lung cancer, less than 1% will live after 5 years.

• Don’t smoke! Also, quitting smoking can lower your chances of developing lung cancer considerably.
• If you live or work with smokers, encourage them to quit and ask them not to smoke around you.
• If you’re exposed to cancer-causing chemicals at work, take necessary safety measures to limit inhalation.

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2. Blood Clotting Tendency (Thrombosis) – Are You at Risk? (As Seen on House MD)
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Yesterday actor Patrick Swayze, known for his performance in such films as "Dirty Dancing" and "Ghost", died of pancreatic cancer. What is this cancer, and how can you avoid this deadly condition?

Danger level: High

What is it?

Pancreatic cancer is a disease in which malignant cells form in the pancreas. It is the 4th leading cause of cancer-related death.

Who gets it?

In the US, more than 37,000 people are diagnosed with pancreatic cancer each year. It happens to about 8-10 people out of 100,000 each year.

It’s most common in African Americans. It’s also more common in people of Native Hawaiian, Korean, Czech, Latvian, and New Zealand Maori origin. It’s quite rare in India, where there are about 2 cases per 100,000 people.

Pancreatic cancer is related to age – After age 50, the risk for it increases. Most people diagnosed with it are in their 70s and 80s.

There are some risk factors, which increase your risk of having pancreatic cancer:

1. Smoking
2. Being overweight
3. A history of chronic pancreatitis – In you or someone in your close family
4. A history of pancreatic cancer – In you or someone in your close family

Patrick Swayze, in 2006. Photo by MoonSoleil

What causes it?

The pancreas is a large gland in our abdomen. It’s responsible for making two things: insulin, which helps our body control the level of sugar in our blood; and pancreatic juices, which help our body digest the foods we eat.

The pancreas has three parts: The head, the body and the tail. Cancer can develop in any of these parts. Most cancers develop in the head of the pancreas (it is the part that’s leftmost in the drawing above).

Cancer is a condition which develops when cells in our body start dividing more than they should, causing a growth in an organ called a tumor. As with most other cancers, the reason for it is unknown, although it is known that a chronic inflammation in the pancreas increases the risk.

How does it feel?

As mentioned above, the cells in the pancreas grow, creating a tumor. This tumor often spreads further from the pancreas, through the blood, to reach other organs.

Unfortunately, this cancer doesn’t cause any symptoms most of the time, until the disease has spread. When symptoms do appear, they may include:

1. Abdominal pain – Usually in the upper or middle abdomen. It can radiate to the back.
2. Jaundice – This is a yellow color in your skin or the whites of your eyes.
3. Loss of appetite
4. Weight loss
5. Fatigue

How is it discovered?

Usually this cancer is detected late, a fact which is responsible for the high death rate involved with it.

Usually it is discovered by taking images of the body by an ultrasound, CT scan or an MRI, although there are other methods as well.

When the cancer is found, it is important to stage it. This term means deciding which stage the cancer is in, or how much it has spread. The higher the stage, the more advanced the cancer is, and the less likely it is that it can be cured. Staging can be done by surgery to open your abdomen and look at the pancreas and other organs, by imaging the body and by taking a blood test called CA 19-9, which helps the doctor follow the cancer and see if it is spreading.

How is it treated?

There are a few types of treatment for this cancer. The one chosen depends on the stage of the disease, on your age, on your overall health and your personal preferences.

Treatment options include surgery, radiation therapy, chemotherapy and sometimes some drugs.

What happens after treatment?

Unfortunately, the death rates for this cancer are high. If the cancer can’t be removed by surgery, people usually survive for about 4-6 months. If the cancer can be operated on, about 20% of people can live for 5 years after the surgery.

This video from this morning’s CBS News sums it up:

The bottom line – How do I avoid it?

There are a few things you can do to lower your chances of having pancreatic cancer:

1. Quit smoking
2. Maintain a healthy weight
3. Eat a balanced diet – The American Cancer Society recommends eating more fruits, vegetables, and whole grains while eating less red meat, although none of this has been actually proven.

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