“Wear Red this month to help raise awareness of the No. 1 killer of people in the U.S.; cardiovascular disease! American Heart Month, observed in February, is a time to focus on heart health awareness. It aims to educate beginners about preventing heart disease through healthy lifestyle CHOICES! National Wear Red Day is Friday 2/07.”
American Heart Association (American Heart Month | American Heart Association)
The heart is like the engine to a car but for us it’s the “pump” for the human body; without the engine the car won’t run and without the pump we won’t live. The normal size of the heart is about the size of your fist, maybe a little bigger.
It pumps blood continuously through your entire circulatory system. The heart consists of four chambers, 2 on the right and 2 on the left. The right side only pumps high carbon dioxide levels of blood, after all the oxygen was used by the tissues and returns to the heart in the right upper chamber and leaves to the lung from the right lower chamber. From the lungs it than goes to the left side of the heart now, which is a very short distance as opposed to where the left side pumps the blood. The L side of the heart pumps blood to the feet, brain and all tissues in between with high oxygen levels of blood. This is why the L side of the heart does more work than the R side since the blood leaving the L side has a longer distance in distributing oxygen. The heart pumps the blood with high oxygen blood levels to reach all your tissues and cells, going to the feet, brain, and to all other tissues in between returning home again to the right side of the heart (upper chamber) to get sent to the lungs again for more oxygen. This is why the muscle on the L side of the heart is larger than the right, it works harder. Every time your heart beats (the sound we call lub dub) the organ is sending out a cardiac output of blood either to the lungs for more oxygen or to the body tissues through the aorta to give oxygenated blood to your tissues and cells. This is the mechanics of how blood is pumped by the heart. It pumps in our body to deliver oxygenated blood to organs and remove the carbon dioxide from our organs in our body to stay alive.
Let’s see what can occur if the heart is not functioning properly. If your heart is not pumping out a sufficient amount of blood in your cardiac output to either the body (from left side of the heart); or removing carbon dioxide from the tissues (from the right side of the heart) than it tries to work harder where it does ok at first but over time weakens. As this weak heart struggles to pump blood the muscle fibers of the heart stretch out which is particularly from the left lower chamber, the biggest muscle of the heart. As the struggle for this organ progresses over time this stretching leaves the heart with larger, weaker chambers. The heart enlarges (called cardiomegaly). If this continues to go on this could go into R or L sided heart sided failure. When this happens, blood that should be pumped out of the heart backs up in the lungs=L sided failure or backs up into the tissues=R sided failure.
The side the failure is on doesn’t allow proper filling of the chambers on that side and back up happens; so much like pipes work in backing up when problems occur like a blockage. If this condition occurs that is on the L side the fluids back up in the lungs or the R the fluids first back up in the veins which can expand to hold extra blood but at some point dump the extra fluids in your tissues (What can occur over time is edema in feet first due to gravity). This is all due to overloading of the blood not filling up in the chambers of the heart to make a good cardiac output of blood due to poor pumping of the heart and in time the fluid backs up (bad pumping=backup of blood=fluid overload in the lungs (pulmonary congestion) to fluid staying in the skin (In time to the lower extremities due to gravity=feet which we call edema trying to send the blood back to heart for more oxygen at the lungs going back up the legs when the oxygenated blood is used up.).
This condition in time with no treatment will definitely go into congestive heart failure (CHF) to first one side of the heart and if not controlled can go to both sides of the heart. CHF can range from mild to severe.
There is 670,000 cases that are diagnosed with this every year and is the leading cause of hospitalization in people over 65 y/o. Causes of CHF are: heart attack, CAD (coronary artery disease), cardiomyopathy, other conditions that overwork the heart like high blood pressure, diabetes and obesity (These diseases can be completely preventable or at least well controlled).
There is many of us in this world with knowing how our activity/exercise, eating, and habits could be better for health but do little action or do nothing on their own to change it, which is a large part for certain diseases being so high in America (diabetes, stroke, cardiac diseases=high blood pressure, atherosclerosis, arteriosclerosis to CHF and more).
If people just were more healthy and more active regarding these diseases alone it would decrease in population creating a positive impact on how our health system with insurance presently (a disaster) with our economy (another disaster) for many which could get better with healthy people in the USA.
A healthy heart can pump to all parts of the body in a few seconds which is good cardiac output from the organ but when it gets hard for the heart to keep up with its regular routine it first compensates when healthy but if going into CHF, a unhealthy heart pump it will decompensate causing ischemia (lack of oxygen to the heart tissue). It’s like any tissue in the body, lack of oxygen=lack of nutrients to the body tissue=STARVATION and with lack of oxygen will come PAIN eventually to death if not treated. Take the heart, if it isn’t getting enough oxygen it can go into angina. That is reversible since it is heart pain due to not enough oxygen to the heart tissue=no damage but if left untreated what will occur is a heart attack=myocardial infarction (MI) and is permanent damage because scarring to the heart tissue takes place that is permanent damage to that area of the heart tissue where the MI occurred for life.
Learn more tomorrow about a what happens to a diseased heart.
“February is National Cancer Prevention Awareness Month, a time to reflect on the steps we can take to reduce our risk of cancer. Know this 40% of cancer cases and 44% of cancer-related deaths are linked to preventable lifestyle choices. By making informed decisions about what we eat, drink, and expose ourselves to, we can significantly lower our cancer risk.
5 things you should know about cancer prevention month:
1-Everyone knows, smoking remains the #1 most significant preventable cause of cancer, accounting for about 19.3% of cancer cases and 28.5% of cancer deaths.
2-Alcohol, in any amount, is detrimental to our health. Alcohol consumption contributes to 5.4% of cancer cases. It increases the risk of cancers in the oral cavity, pharynx, esophagus, colorectum, liver, larynx, and breast. CRI Clinical Innovator Marina Baretti, MD (Johns Hopkins University School of Medicine), recently highlighted the importance of controlling alcohol intake. “The recommendation is really to either stay away or (have) no more than two drinks per day for a man (and) no more than one drink per day for a woman,” she advised.
3-Our dietary habits can make a real difference towards our cancer risk. Consumption of red meat (beef, pork, veal, lamb, etc) and processed meats (smoked and cured meats, cold cuts, sausages, etc) have been shown to increase a person’s risk for colorectal cancer. In addition, excess body weight is also a significant and preventable risk factor for cancer. Research has shown that high BMI is associated with an increased risk of developing 13 to 18 types of cancer.
4-Ultra Violet (UV) radiation from the sun and tanning beds contributes to 4.6% of cancer cases. In fact, it’s the primary cause of melanoma, the deadliest form of skin cancer. Over five million annual global cases of skin cancer due to direct exposure of UV rays.
5-It may come as a surprise, but infections caused by viruses and certain bacteria play a significant role in cancer development. In fact, they account for approximately 13% of cancer cases globally.”
CRI – Cancer Research Institute (Five Things You Need to Know for National Cancer Prevention Month – Cancer Research Institute)
Smoking has been linked to many types of cancer, including cancer of the lung, mouth, throat, voice box, pancreas, bladder, cervix and kidney. Even being around secondhand smoke might increase the risk of lung cancer.
But it’s not only smoking that’s harmful. Chewing tobacco has been linked to cancer of the mouth, throat and pancreas.
Staying away from tobacco — or deciding to stop using it — is an important way to help prevent cancer. For help quitting tobacco, ask a health care provider about stop-smoking products and other ways of quitting.
Although eating healthy foods can’t ensure cancer prevention, it might reduce the risk. Consider the following:
People who eat a Mediterranean diet that includes extra-virgin olive oil and mixed nuts might have a reduced risk of breast cancer. The Mediterranean diet focuses mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts. People who follow the Mediterranean diet choose healthy fats, such as olive oil, over butter. They eat fish instead of red meat.
Being at a healthy weight might lower the risk of some types of cancer. These include cancer of the breast, prostate, lung, colon and kidney.
Physical activity counts too. Besides helping control weight, physical activity on its own might lower the risk of breast cancer and colon cancer.
Doing any amount of physical activity benefits health. But for the most benefit, strive for at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of hard aerobic activity.
You can combine moderate and hard activity. As a general goal, include at least 30 minutes of physical activity in your daily routine. More is better.
Skin cancer is one of the most common kinds of cancer and one of the most preventable. Try these tips:
Protecting against certain viral infections can help protect against cancer. Talk to a health care provider about getting vaccinated against:
Another effective cancer prevention tactic is to avoid risky behaviors that can lead to infections that, in turn, might increase the risk of cancer. For example:
Doing regular self-exams and having screenings for cancers — such as cancer of the skin, colon, cervix and breast — can raise the chances of finding cancer early. That’s when treatment is most likely to succeed. Ask a health care provider about the best cancer screening schedule for you.
“As we age, we are more likely to develop systemic health problems like high blood pressure, heart disease or diabetes. It’s important to remember that these diseases can seriously damage your eyes as well. One warning sign of both high blood pressure and diabetes: frequent changes in vision (such as blurriness).
Always tell your ophthalmologist about your health conditions and what medications and nutritional supplements you take. They will also want to know about your eating, sleeping, exercise and other lifestyle choices. Remember: you and your ophthalmologist are partners in caring for your vision.”
American Academy of Ophthalmology (Tips for Eye Health in Adults Over 65 – American Academy of Ophthalmology)
Women are more likely than men to have glaucoma and women are also more likely to be visually impaired or blind due to glaucoma. Also, women are 24 percent less likely to be treated for glaucoma. Cataract is somewhat more common in women, as well. Women should be sure to follow the Academy’s screening guidelines and adhere to their Eye M.D.’s follow-up appointment recommendations and treatment plans.
The term low vision describes vision loss that makes daily tasks difficult. Normal aging of the eye does not lead to low vision; it is a result of eye diseases, injuries or both. Low vision symptoms nclude loss of central and/or peripheral (side) vision, blurred or hazy vision or night blindness. A person may have trouble recognizing faces, reading, driving and shopping. If you experience any of these problems, it is important to see your Eye M.D., who will check for and treat any underlying conditions and advise on low vision resources and low vision aids and devices to help with reading and other daily tasks. Most people with low vision need brighter lighting in their living areas.
About half of all eye injuries occur in or around the home, most often during improvement projects (44 percent). The good news is that nearly all eye injuries can be prevented by using protective eyewear, so every household needs to have at least one pair of certified safety glasses on hand.
It’s also important to reduce the risk of falls, which become more likely as we age, due to changes in vision and balance. Consider taking these safety steps around the home to diminish the risks of injuring your eyes:
Systemic health problems like high blood pressure and diabetes that may be diagnosed or become more problematic in midlife can also affect eye health. One warning sign of both high blood pressure and diabetes is when the ability to see clearly changes frequently. Be sure to keep your Eye M.D. informed about your health conditions and use of medications and nutritional supplements, as well as your exercise, eating, sleeping and other lifestyle choices.
Our eyes need good blood circulation and oxygen intake, and both are stimulated by regular exercise. Regular exercise also helps keep our weight in the normal range, which reduces the risk of diabetes and of diabetic retinopathy. Gentler exercise, including walking, yoga, tai chi, or stretching and breathing, can also be effective ways to keep healthy. Remember to use sun safety and protective eyewear when enjoying sports and recreation.
As we sleep, our eyes enjoy continuous lubrication. Also during sleep the eyes clear out irritants such as dust, allergens, or smoke that may have accumulated during the day.
Some research suggests that light-sensitive cells in the eye are important to our ability to regulate our wake-sleep cycles. This becomes more crucial as we age, when more people have problems with insomnia. While it’s important that we protect our eyes from over-exposure to UV light, our eyes also need exposure to some natural light every day to help maintain normal sleep-wake cycles.
Prevent Blindness has declared February as Age-related Macular Degeneration (AMD) and Low Vision Awareness Month. According to the American Academy of Ophthalmology, AMD is a leading cause of vision loss in people 50 years or older, and more than 2.9 million Americans age 40 and older have low vision. Low vision is defined as a visual impairment that is not correctable through surgery, medicine, eye glasses or contact lenses.
According to the National Eye Institute, currently 4.2 million Americans ages 40 and older are visually impaired. Of these, 3 million have low vision. By 2030, when the last baby boomers turn 65, the number of Americans who have visual impairments is projected to reach 7.2 million, with 5 million having low vision.
But first, what is low vision? Low vision is when even with regular glasses, contact lenses, medicine, or surgery, people have difficulty seeing, which makes everyday tasks difficult to do. Activities that used to be simple like reading the mail, shopping, cooking, and writing can become challenging.
Most people with low vision are age 65 or older. The leading causes of vision loss in older adults are age-related macular degeneration, diabetic retinopathy, cataract, and glaucoma. Among younger people, vision loss is most often caused by inherited eye conditions, infectious and autoimmune eye diseases, or trauma. For people with low vision, maximizing their remaining sight is key to helping them continue to live safe, productive, and rewarding lives.
What is a low vision specialist? A low vision specialist is an ophthalmologist or optometrist who works with people who have low vision. A low vision specialist can develop a vision rehabilitation plan that identifies strategies and assistive devices appropriate for the person’s particular needs.
A low vision examination is quite different from the basic examination routinely performed by primary care optometrists and ophthalmologists.
A low vision examination includes a review of your visual and medical history, and places an emphasis on the vision needed to read, cook, work, study, travel, and perform and enjoy other common activities. The goals of a low vision exam include assessing the functional needs, capabilities, and limitations of your vision, assessing ocular and systemic diseases, and evaluating and prescribing low vision therapies.
Education and counseling of family and other care providers; providing an understanding of your visual functioning to aid educators, vocational counselors, employers and care givers; directing further evaluations and treatments by other vision rehabilitation professionals; and making appropriate referrals for medical intervention are all a part of a low vision evaluation.
The good news is that vision rehabilitation services can help people with vision impairment learn how to stay independent and make the most of their sight. Low Vision Awareness Month is a great time to spread the word about vision rehabilitation — and make sure that people with vision impairment know about the services available to them.
Magnification devices, electronic devices, computer-access software, and other access and mainstream technologies are used to help people with low vision maximize their remaining vision or learn alternative ways to do things, such as using their sense of touch or their sense of hearing.
“Sometimes, Waldenstrom macroglobulinemia (WM) isn’t causing any symptoms when it’s first found. Instead, it’s found when the person has blood tests done for some other reason. WM found this way is sometimes called asymptomatic or smoldering WM.
When WM does cause symptoms, some of them can be like those seen with other types of non-Hodgkin lymphoma (NHL). For example, weight loss, fever, night sweats, and swollen lymph nodes can be seen in many types of NHL.”
American Cancer Society/www.cancer.org (Signs and Symptoms of Waldenstrom Macroglobulinemia | American Cancer Society)
Waldenstrom’s macroglobulinemia is named for the Swedish physician Jan Gosta Waldenström (1906-1996), who in 1944 identified a rare condition in which two patients experienced a thickening of their blood serum, bleeding of the mouth, nose, and blood vessels of the retina, low red blood cell and platelet counts, high erythrocyte sedimentation rates, and lymph node involvement. Bone marrow biopsies showed an excess of lymphoid cells and bone X-rays were normal, excluding a diagnosis of multiple myeloma. Both patients also had a large amount of a single unknown blood protein with an extremely high molecular weight, a “macro” globulin. We now know this globulin as IgM.
The over-production of IgM may also cause many of the symptoms associated with the disease. IgM is a large antibody and tends to make the blood thicker than normal, a condition called hyperviscosity. Unlike normal antibodies that fight infection, the IgM produced by WM cells has no useful function. Sometimes the IgM may incorrectly recognize the body’s tissues as “foreign” and attach to them, causing inflammation and injury.
What are the symptoms of this condition?
People with Waldenstrom’s macroglobulinemia may experience the following symptoms or signs. Sometimes, people with Waldenstrom’s macroglobulinemia do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not cancer.
May signal a more aggressive cancer:
WM might be suspected if your doctor finds you have low blood cell counts or unusual protein levels on blood tests. If so, your doctor may order a blood test called serum protein electrophoresis to find out what the abnormal proteins are. It is usually only after these tests are done that a biopsy of either the bone marrow or a lymph node is considered.
Simply a CBC Complete blood count, that measures the levels of red blood cells, white blood cells, and platelets. If lymphoma cells occupy too much of the bone marrow, these levels will be low.
Quantitative Immunoglobulins – This test measures the levels of the different antibodies (immunoglobulins) in the blood – IgA, IgE, IgG, and IgM – to see if any are abnormally high or low. In WM the level of IgM is high but the IgG level is often low.
Finding a monoclonal IgM antibody in the blood is needed to diagnose WM. This abnormal protein in WM is known by many different names, including monoclonal immunoglobulin M, IgM protein, IgM spike, IgM paraprotein, M protein, and M-spike. High levels of other types of monoclonal immunoglobulins, like IgA or IgG, are seen in different disorders (like multiple myeloma and some other lymphomas).
Sometimes pieces of the IgM protein are excreted by the kidneys into the urine. These proteins can be detected with a test called urine protein electrophoresis (or UPEP).
Viscosity is a measure of how thick the blood is. If the IgM level is too high, the blood will become thick (viscous) and can’t flow freely (think about pouring honey compared to pouring water).
This test measures the blood levels of cryoglobulins (proteins that clump together in cool temperatures and can block blood vessels).
Cold agglutinins are antibodies that attack and kill red blood cells, especially at cooler temperatures. These dead cells can then build up and block blood vessels. A blood test can be used to detect these antibodies.
This test measures another protein made by the cancer cells in WM. This protein itself doesn’t cause any problems, but it’s a useful indicator of a patient’s prognosis (outlook). High levels of β2M are linked with a worse outlook.
The symptoms of WM and NHL are not distinctive enough for a doctor to know for certain if person has one of them, based on symptoms alone. Most symptoms can also be caused by non-cancerous problems like infections or by other kinds of cancers. Blood tests can help point to the correct diagnosis, but a biopsy (removing samples of affected tissue to look at under a microscope) is the only way to be sure. Several types of biopsies might be used.
This is the most important type of biopsy for WM, and is needed to confirm the diagnosis. It can be done at the doctor’s office or at the hospital.
The bone marrow aspiration and biopsy are usually done at the same time. The samples are taken from the back of the pelvic (hip) bone, although in some cases they may be taken from the sternum (breast bone) or other bones.
In bone marrow aspiration, you lie on a table (either on your side or on your belly). The doctor cleans the skin over the hip and then numbs the area and the surface of the bone by injecting a local anesthetic. This may briefly sting or burn. A thin, hollow needle is then inserted into the bone, and a syringe is used to suck out a small amount of liquid bone marrow. Even with the anesthetic, most patients still have some brief pain when the marrow is removed.
A bone marrow biopsy is usually done just after the aspiration. A small piece of bone and marrow is removed with a slightly larger needle that is pushed down into the bone. This may also cause some brief pain.
Once the biopsy is done, pressure is applied to the site to help stop any bleeding. There will be some soreness in the biopsy area when the numbing medicine wears off. Most patients can go home right after the procedure.
The bone marrow samples are then sent to a lab, where they are tested to see if they have lymphoma cells (see below). For a diagnosis of WM, at least 10% of the cells in the bone marrow must be lymphoplasmacytoid lymphoma cells.
In an FNA biopsy, the doctor uses a very thin, hollow needle with a syringe to withdraw a small amount of tissue from a tumor or lymph node. This type of biopsy is useful for sampling lymph nodes to see if they are enlarged because of cancer or another cause such as infection. FNA can help diagnose some lymphomas, but WM is usually diagnosed with a bone marrow biopsy instead.
For an FNA on an enlarged node near the surface of the body, the doctor can aim the needle while feeling the node. If the enlarged node (or tumor) is deep inside the body, the needle can be guided while it is seen on a computed tomography (CT) scan or ultrasound (see the descriptions of imaging tests later in this section).
The main advantage of FNA is that it does not require surgery and can often be done in a doctor’s office. The main drawback is that in some cases it might not get enough tissue to make a definite diagnosis of lymphoma. However, advances in lab tests (discussed later in this section) and the growing experience of many doctors with FNA have improved the accuracy of this procedure.
For these types of biopsies, a surgeon cuts through the skin to remove an entire lymph node or tumor (excisional biopsy) or a just a small part of a large tumor or lymph node (incisional biopsy). These biopsies are rarely needed in people with WM because the diagnosis is usually made with a bone marrow biopsy. They are used more often for other types of lymphoma.
If the area to be biopsied is near the skin surface, this can be done using local anesthesia (numbing medicine). If the area is inside the chest or abdomen, general anesthesia or deep sedation is used (where the patient is asleep). These types of biopsies almost always provide enough tissue to diagnose the exact type of lymphoma.
This type of biopsy may be used in some people with WM to check for amyloid. In this procedure, a thin, hollow needle with a syringe attached is inserted into an area of fat (usually under the skin of the abdomen/belly). A small amount of fat is removed and sent to the lab for testing.
All biopsy specimens are looked at under a microscope by a pathologist – a doctor with special training in using lab tests to diagnose diseases. In some cases, a hematopathologist, a doctor with further training in diagnosing blood and lymph node diseases, might also look at the biopsy. The doctors look at the size and shape of the cells and how the cells are arranged. Sometimes just looking at the cells doesn’t provide a clear answer, so other lab tests are needed.
In this test, a part of the biopsy sample is treated with special man-made antibodies that attach to cells only if they contain specific molecules. These antibodies cause color changes, which can be seen under a microscope. This test may help tell different types of lymphoma from one another and from other diseases.
In this test, cells are treated with special man-made antibodies. Each antibody sticks only to certain types of cells. The cells are then passed in front of a laser beam. If the cells now have antibodies attached to them, the laser will make them give off light, which is measured and analyzed by a computer.
This is the most common test for immunophenotyping – classifying lymphoma cells according to the substances (antigens) on their surfaces. Different types of lymphocytes have different antigens on their surface. These antigens also change as each cell matures.
This test can help show whether a lymph node is swollen because of lymphoma, some other cancer, or a non-cancerous disease. It has become very important in helping doctors determine the exact type of lymphoma so they can select the best treatment.
Doctors use this technique to look at the chromosomes (long strands of DNA) inside lymphoma cells. Cells (usually from the bone marrow) are first grown in the lab. Then the chromosomes are stained and looked at under a microscope. Because it takes time for the cells to start dividing, this test can take weeks.
In some lymphomas, the cells may have too many chromosomes, too few chromosomes, missing parts of chromosomes (called deletions), or other abnormalities. These changes can help identify the type of lymphoma. In WM, deletions are the most common type of chromosome change.
Molecular tests such as fluorescent in situ hybridization (FISH) and polymerase chain reaction (PCR) are not usually needed to diagnose WM, but they are sometimes used to diagnose other types of NHL. These tests look at the cells’ DNA without having to grow the cells in the lab first. The tests can give results in less time than cytogenetics and can be done on cells from different sources (like lymph nodes, blood, and bone marrow). They are generally used to look for specific chromosome or gene changes, not just any change.
Imaging tests use x-rays, magnetic fields, sound waves, or radioactive particles to produce pictures of the inside of the body. These tests are not needed to diagnose WM, but one or more of them might be done to help show the extent of the disease in the body.
An x-ray might be done to look at the chest for enlarged lymph nodes.
The CT scan uses x-rays to make detailed cross-sectional images of your body. Unlike a regular x-ray, CT scans can show the detail in soft tissues (such as internal organs). This scan can help show if any lymph nodes or organs in your body are enlarged. CT scans are useful for looking for signs of lymphoma in the chest, abdomen, and pelvis.
Before the test, you may be asked to drink a contrast solution and/or get an intravenous (IV) injection of a contrast dye to better outline abnormal areas in the body. You might need an IV line through which the contrast dye is injected. The injection can cause some flushing (a feeling of warmth, especially in the face). Some people are allergic to the dye and get hives or a flushed feeling or, rarely, have more serious reactions like trouble breathing and low blood pressure. Be sure to tell the doctor if you have any allergies (especially iodine or shellfish) or have ever had a reaction to any contrast material used for x-rays. Medication can be given to help prevent and treat allergic reactions.
A CT scanner has been described as a large donut, with a narrow table that slides in and out of the middle opening. You need to lie still on the table while the scan is being done. CT scans take longer than regular x-rays, and some people might feel a bit confined by the ring while the pictures are being taken.
CT-guided needle biopsy: CT scans can also be used to guide a biopsy needle into a suspicious area. For this procedure, the patient lies on the CT scanning table while the doctor moves a biopsy needle through the skin and toward the area. CT scans are repeated until the needle is in the right place. A biopsy sample is then removed and sent to the lab to be looked at under a microscope.
Like CT scans, MRI scans make detailed images of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays. This test is rarely used in WM, but if your doctor is concerned about the brain or spinal cord, MRI is very useful for looking at these areas.
Sometimes a contrast material is injected into a vein to make some structures clearer. This contrast is not the same as the contrast used for CT scans, but allergic reactions can still occur. Again, medicine can be given to prevent and treat allergic reactions.
MRI scans take longer than CT scans – often up to an hour. You may have to lie inside a narrow tube, which is confining and can upset some people. Newer, more open MRI machines might be another option. The machine makes loud buzzing and clicking noises that some people find disturbing. Some places provide headphones or earplugs to help block this noise out.
Ultrasound uses sound waves and their echoes to make pictures of internal organs or masses.
Ultrasound can be used to look at lymph nodes near the surface of the body or to look inside your abdomen for enlarged lymph nodes or organs such as the liver, spleen, and kidneys. (It can’t be used to look at organs or lymph nodes in the chest because the ribs block the sound waves.) It is sometimes used to help guide a biopsy needle into an enlarged lymph node.
For this test, a small, microphone-like instrument called a transducer is placed on the skin (which is first lubricated with a gel). It gives off sound waves and picks up the echoes as they bounce off the organs. A computer then converts the echoes into a black and white image on a screen.
This is an easy test to have, and it uses no radiation. For most ultrasounds, you simply lie on a table, and a technician moves the transducer over the part of your body being looked at.
For a PET scan, a radioactive sugar (known as FDG) is injected into the blood. (The amount of radioactivity used is very low and will pass out of the body in a day or so.) Because cancer cells in the body grow quickly, they absorb large amounts of the sugar. You then lie on a table in the PET scanner for about 30 minutes while a special camera creates a picture of areas of radioactivity. The picture is not detailed like a CT or MRI scan, but it can provide helpful informa- tion about your whole body.
PET scans can help tell if an enlarged lymph node contains lymphoma or not. It can also help spot small areas that might be lymphoma, even if the area looks normal on a CT scan. These tests can be used to tell if a lymphoma is responding to treatment. They can also be used after treatment to help decide whether an enlarged lymph node still contains lymphoma or is merely scar tissue.
Many medical centers now use a machine that combines the PET scan with a CT scan (PET/CT scan). This lets the doctor compare areas of higher radioactivity on the PET scan with the more detailed appearance of that area on the CT scan.
Should I get a second opinion? If so when?
What treatments are approved for WM?