Center for disease prevention and control recommends the following:

Should you get screened for prostate cancer?

The answer is different for each man. If you are thinking about being screened, learn about the possible benefits and harms of screening, diagnosis, and treatment, and talk to your doctor about your personal risk factors.

What Is Prostate Cancer Screening?

Cancer screening means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancer early that may spread if not treated.

There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are—

• A blood test called a prostate specific antigen (PSA) test. PSA is a substance your prostate makes. This test measures the level of PSA in your blood. Your PSA level may be high if you have prostate cancer and for many other reasons, such as having an enlarged prostate, a prostate infection, or taking certain medicines.
• Digital rectal examination, when a health care provider inserts a gloved, lubricated finger into a man’s rectum to feel the prostate for anything abnormal, such as cancer.

Screening may find cancer that is likely to spread to other places in the body, so it can be treated before it spreads. This may lower the chance of death from prostate cancer in some men.

But most prostate cancers grow slowly and don’t cause any health problems. If a screening test finds a slow-growing cancer, it may cause you to worry, and lead to unneeded tests and treatments that can have serious side effects.

Also, a PSA test can be abnormal, but you don’t have prostate cancer. This is called a false positive result. A false positive PSA test result often leads to more unnecessary tests.

The only way to know if an abnormal test is due to cancer is to do a biopsy. A biopsy is when a small piece of tissue is removed from the prostate and looked at under a microscope to check for cancer. A prostate biopsy can cause pain, blood in the semen or ejaculate, and infection.

The most common treatments for localized (early-stage) prostate cancer are surgery to remove the prostate, radiation therapy, and active surveillance (getting tested regularly, and treating the cancer only if it grows or causes symptoms). Side effects from radiation therapy or surgery may include—

• Impotence.
• Loss of bladder control.
• Bowel problems.

Talk to Your Doctor

If you are thinking about being screened, you and your doctor should consider—

• If you have an increased risk of getting prostate cancer.
• If you have any health problems that may make it harder for you to be treated for prostate cancer if it is found, or that may make you less likely to benefit from screening.
• How you feel about the possible benefits and harms of screening, diagnosis, and treatment.

“The eye is like a tiny camera. Central Serous Retinopathy usually causes typical symptoms. It may be associated with either physical or emotional stress, and can occur at any age, although it is more commonly diagnosed in young adults (under 50 years old). Fluid can be detected in the macula with a dilated eye examination.”.

Retina Group

“New Cases

• Approximately every 3 minutes one person in the United States (US) is diagnosed with a blood cancer.
• An estimated combined total of 176,200 people in the US are expected to be diagnosed with leukemia, lymphoma or myeloma in 2019.
• New cases of leukemia, lymphoma and myeloma are expected to account for 10 percent of the estimated 1,762,450 new cancer cases diagnosed in the US in 2019.”

Leukemia and Lymphoma Society

Today’s topics will be covering on leukemia and lymphoma than what is the difference between them actually.  It will also include the factors proning you to these cancers, the tests that the M.D. might do and the different treatments for all 3 cancers Leukemia, Lymphoma and Myeloma (discussed in Part II).

Leukemia

Leukemia and Lymphoma Society states leukemia begins in a cell in the bone marrow and in the blood.  Remember the bone marrow creates our cells releasing them into the blood stream.   The cell undergoes a change and becomes a type of leukemia cell. Once the marrow cell undergoes a leukemic change, the leukemia cells may grow and survive better than normal cells. Over time, the leukemia cells crowd out or suppress the development of normal cells. The rate at which leukemia progresses and how the cells replace the normal blood and marrow cells are different with each type of leukemia.

After diagnosis and treatment, many people with leukemia live many good, quality years.

Leukemia is a cancer of the early blood-forming cells, meaning just coming formed from the bone marrow. Most often, leukemia is a cancer of the white blood cells, but some leukemia (s) start in other blood cell types or effect the count of other cells in our bloodstream. Leukemia is often described as being either acute (fast growing) or chronic (slow growing). Different types of leukemia have different treatment options and outlooks.

The National Cancer Institute also says leukemia is a broad term for cancers of the blood cells. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. Leukemia occurs most often in adults older than 55, but it is also the most common cancer in children younger than 15.

Leukemia may affect red blood cells, white blood cells, and platelets.

In a healthy child, the bone marrow makes blood stem cells (immature cells) that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell.

A myeloid stem cell becomes one of three types of mature blood cells:

A lymphoid stem cell becomes a lymphoblast cell and then one of three types of lymphocytes (white blood cells):

The major types of leukemia are:

• Acute lymphocytic leukemia (ALL). This is the most common type of leukemia in young children. ALL can also occur in adults.
• Acute myelogenous leukemia (AML). AML is a common type of leukemia. It occurs in children and adults. AML is the most common type of acute leukemia in adults.
• Chronic lymphocytic leukemia (CLL). With CLL, the most common chronic adult leukemia, you may feel well for years without needing treatment.
• Chronic myelogenous leukemia (CML). This type of leukemia mainly affects adults. A person with CML may have few or no symptoms for months or years before entering a phase in which the leukemia cells grow more quickly.
• Other types. Other, rarer types of leukemia exist, including hairy cell leukemia, myelodysplastic syndromes and myeloproliferative disorders.

Statistics by the American Cancer Society:  Leukemia is the most common type of cancer in children and teens, accounting for 1 out of 3 cancers.   Most childhood leukemias are ALL Acute Lymphocytic Leukemia.  Most of the remaining cases for childhood are AML Acute Myeloid Leukemia.  Chronic Leukemia is rare in children.   However, because other types of leukemia become more common with age, most leukemia is found in among adults.

Decades of research have led to vastly improved outcomes for children diagnosed with ALL.

Lymphoma

Lymphoma starts in the immune system and affects the lymph nodes and lymphocytes, which are a type of white blood cell. There are two main types of lymphocyte, B cells and T cells.  Whereas Leukemia starts in the bone marrow affecting the white blood cells.  Doctors categorize leukemia based on which type of white blood— lymphocytes or myeloid cells — and whether the illness is developing very quickly (acute disease) or slowly over time (chronic disease).

Cancer can affect any part of the body, including the blood. Leukemia and lymphoma are both forms of blood cancer. The main difference is that leukemia affects the blood and bone marrow, while lymphomas tend to affect the lymph nodes.  BUT remember leukemia can go into the lymph nodes since its in the blood stream the cancer cells and can effect the lymph nodes.  BOTH effect white blood cells. Myeloma is similar in that it effects plasma a white blood cell.

The origin of where Myeloma, Leukemia or Lymphoma.  Lets look at all 3 All start in the Bone Marrow but the effect is similar in general but the type with the stage of cancer the individual has is a major factor of ending results.

All 3 types of cancers this article in Part I to Part II are bad cancer cells that derive in all in the bone marrow and they all effect some type of White Blood Cell (WBC).  All White Blood Cells are to fight infection and prevent it.  

Myeloma effects the normal plasma cells originating in the bone marrow and are an important part of the immune system.  Lymphocytes (lymph cells) are one of the main types of white blood cells in the immune system and include T cells and B cells. Lymphocytes are in many areas of the body, such as lymph nodes, the bone marrow, the intestines, and the bloodstream.  These are the cells involved in this cancer being the problem.

Lymphoma is cancer that begins in infection-fighting cells of the immune system, called lymphocytes. Leukocytes are WBCs also that are affected in this cancer like Myeloma.  In Lymphoma the leukocytes become an abnormal amount (of WBCs) in the body.  Lymphocytes are a form of small leukocyte (white blood cell) with a single round nucleus (remember this is the brain for the cell), occurring especially in the lymphatic system.  Abnormal lymphocytes, a type of white blood cell that fights infection, become lymphoma cells, which multiply and collect in your lymph nodes. Over time, these cancerous cells impair your immune system. Lymphomas are divided into two categories: Hodgkin lymphoma and non-Hodgkin lymphoma (this is another topic in itself).  These cells are in the lymph nodes, spleen, thymus, bone marrow, and other parts of the body.

Leukemia is a cancer of the body’s blood-forming tissues, including the bone marrow and the lymphatic system.  In Leukemia many of the white blood cells produced in the bone marrow do not mature normally. These abnormal cells, called leukemic cells, are unable to fight infection the way healthy white cells can. As they grow in number, the leukemic cells also interfere with the production of other blood cells. Obviously the WBCs start in the bone marrow just like every cell does.

So these 3 cancers are similar in many ways with the ending results but where they effect initially or their primary area effected might be slightly different, as discussed already in this topic. 

Factors that may increase your risk of developing some types of any 3 cancers include:

• Previous cancer treatment. People who’ve had certain types of chemotherapy and radiation therapy for other cancers have an increased risk of developing certain types of leukemia.
• Genetic disorders. Genetic abnormalities seem to play a role in the development of leukemia. Certain genetic disorders, such as Down syndrome, are associated with an increased risk of leukemia.
• Exposure to certain chemicals. Exposure to certain chemicals, such as benzene — which is found in gasoline and is used by the chemical industry — is linked to an increased risk of some kinds of leukemia.
• Smoking. Smoking cigarettes increases the risk of acute myelogenous leukemia.
• Family history of leukemia. If members of your family have been diagnosed with leukemia, your risk of the disease may be increased.

However, most people with known risk factors don’t get leukemia. And many people with leukemia have none of these risk factors.

Regarding Myeloma, Leukemia or Lymphoma:

Doctors may find in a routine blood test, before symptoms begin. If this happens, or if you have signs or symptoms that suggest any 3 of the cancers, you may undergo the following diagnostic exams:

• Physical exam. Your doctor will look for physical signs of Myeloma or Leukemia or Lymphoma, such as pale skin from anemia, swelling of your lymph nodes, and enlargement of your liver and spleen.
• Blood tests. By looking at a sample of your blood, your doctor can determine if you have abnormal levels of red or white blood cells or platelets — which may suggest leukemia.
• Bone marrow test. Your doctor may recommend a procedure to remove a sample of bone marrow from your hipbone. The bone marrow is removed using a long, thin needle. The sample is sent to a laboratory to look for leukemia cells. Specialized tests of your cancer cells that may reveal certain characteristics that are used to determine your treatment options.

Treatment

Treatment for your Myeloma, Leukemia or Lymphoma depends on many factors. Your doctor determines your treatment options based on your age and overall health, the type of cancer of the 3 you have, and whether it has spread to other parts of your body, including the central nervous system.

Common treatments used to fight these 3 blood cancers include:

• Chemotherapy. Chemotherapy is the major form of treatment for all 3. This drug treatment uses chemicals to kill cancer cells.Depending on the type of cancer you have, you may receive a single drug or a combination of drugs. These drugs may come in a pill form, or they may be injected directly into a vein.
• Biological therapy. Biological therapy works by using treatments that help your immune system recognize and attack cancer cells.
• Targeted therapy. Targeted therapy uses drugs that attack specific vulnerabilities within your cancer cells.For example, the drug imatinib (Gleevec) stops the action of a protein within the leukemia cells of people with chronic myelogenous leukemia. This can help control the disease.
• Radiation therapy. Radiation therapy uses X-rays or other high-energy beams to damage cancer cells and stop their growth. During radiation therapy, you lie on a table while a large machine moves around you, directing the radiation to precise points on your body.You may receive radiation in one specific area of your body where there is a collection of cancer cells, or you may receive radiation over your whole body. Radiation therapy may be used to prepare for a stem cell transplant.
• Stem cell transplant. A stem cell transplant is a procedure to replace your diseased bone marrow with healthy bone marrow.Before a stem cell transplant, you receive high doses of chemotherapy or radiation therapy to destroy your diseased bone marrow. Then you receive an infusion of blood-forming stem cells that help to rebuild your bone marrow.You may receive stem cells from a donor, or in some cases you may be able to use your own stem cells. A stem cell transplant is very similar to a bone marrow transplant.

Blood cancer is a very broad term that describes multiple types of cancer. The common factor is that the cancer originates in blood cells and can spread throughout the body via the bloodstream or through the lymphatic system. White blood cells are the immune cells in our bodies that fight disease. Red blood cells carry oxygen throughout the body and remove carbon dioxide.  Platelets are for clotting.  Remember most importantly what was stated in Part I all cells are created by the bone marrow and then after created released out in the bloodstream (a free flowing unit system in the body that cells move along in going from tissues  in the toes to the brain).  When cancer cells created by marrow also go in the bloodstream allowing the cancer cells to free float through -out the bloodstream.

The different types of blood cancer are classified by the cell type that has become cancerous, where the cancer is located in the body, and how fast the cancer is progressing.

The three most common major types of blood cancer are myeloma, leukemia, lymphoma.

What is leukemia?

Leukemia usually involves the white blood cells. Your white blood cells are potent infection fighters — they normally grow and divide in an orderly way, as your body needs them. But in people with leukemia, the bone marrow produces abnormal white blood cells, which don’t function properly.  There are many types of leukemia, which are classified by the specific type of white blood cell involved. White blood cells include the neutrophils and monocytes, which ingest (eat) bacteria and other germs; eosinophils and basophils, which are involved in allergic reactions; and lymphocytes, which play a key role in our body’s immune system.

Leukemia begins within the bone marrow, which is the soft spongy tissue inside our bones. In adults, remember we said yesterday bone marrow is found mainly in the flat bones, like the pelvis, skull, breastbone, ribs, shoulders, and vertebrae.

The bone marrow is where blood cells are made in a complex biological process called “hematopoiesis.” When a blood cell in the bone marrow changes to become cancerous, it can crowd out other cells and spread to the rest of the body via its primary channel the bloodstream.

What are the major types of leukemia?

There are four major sub-types of leukemia. Your specific diagnosis depends on how quickly the cancer grows and in which blood cell type it originates.  Acute types of leukemia affect very young white blood cells and can progress rapidly. Chronic leukemias affect slightly more mature cells and progress more slowly. Lymphocytic leukemias affect white blood cells called lymphocytes, whereas myeloid leukemias affect cells that are destined to become any other type of blood cell.

• Acute lymphocytic leukemia (ALL)
• Chronic lymphocytic leukemia (CLL)
• Acute myeloid leukemia (AML)
• Chronic myeloid leukemia (CML)

What is lymphoma?

Lymphoma is a cancer that begins in the lymphatic system, which is part of the immune system. The lymphatic system is made up mainly of immune cells.  We said yesterday they are called lymphocytes. B-cells and T-cells are the main lymphocytes, and each has a specific function in protecting our bodies from disease.

Lymphoma originates in lymph tissues, which can be found in many parts of the body, including in the lymph nodes, thymus, tonsils, adenoids, spleen, lymphatic vessels, and parts of the digestive system.  If you have been diagnosed with lymphoma, your specific symptoms will depend on where your tumor began.

What are the major types of lymphoma?

There are two major sub-types of lymphoma. Your diagnosis depends on the type of cell where the cancer originated plus other characteristics of the tumor. Hodgkin lymphoma is characterized by the presence of Reed-Sternberg cells, which are named after the researchers who discovered them. Non-Hodgkin lymphoma does not have Reed-Sternberg cells.

• Hodgkin lymphoma
• Non-Hodgkin lymphoma

What is Multiple Myeloma?

Multiple myeloma is a cancer of plasma cells (B and T cells).  Multiple myeloma is a cancer of plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system.The immune system is made up of several types of cells that work together to fight infections and other diseases.

We stated yesterday myeloma is most often found in bone marrow. Remember normal plasma cells are found in the bone marrow & an important part of the immune system.

The immune system is made up of several types of cells that work together to fight infections and other diseases. Lymphocytes (lymph cells) are one of the main types of white blood cells in the immune system and include T cells and B cells. Lymphocytes are in many areas of the body, such as lymph nodes, the bone marrow, the intestines, and the bloodstream.

When B cells respond to an infection, they mature and change into plasma cells. Plasma cells make the antibodies (also called immunoglobulins) that help the body attack and kill germs.

When plasma cells become cancerous=cancer cells (intially made in the bone marrow than released in the blood), they multiply and begin to crowd out healthy cells and produce abnormal antibodies called M proteins.  This continues to to replicate till the body dies or some treatment takes over decreasing them by destroying them (Ex. Chemo) or possibly putting the patient in remission.

What are the major types of myeloma?

There are four major sub-types of myeloma. Diagnosis depends on how localized or spread out the cancer has become and where it originated. The most common form of myeloma is multiple myeloma. Over 90% of people with myeloma have multiple myeloma.

• Multiple myeloma -This is the one we will be discussing in this topic.
• Plasmacytoma
• Localized myeloma
• Extramedullary myelom

Multiple Myeloma Complications:

In multiple myeloma, the overgrowth of plasma cells in the bone marrow can crowd out normal blood-forming cells:

1-Leading to low cell counts=RBCs-low in iron/anemia, level of platelets in the become low (called thrombocytopenia)=increased bleeding and bruising & WBCs low called leukopenia=problems fighting infections.

2-Myeloma cells make a substance that tells the osteoclasts to speed up dissolving the bone. So old bone is broken down without new bone to replace it, making the bones painful, weak, thinning the bones and easy to break.

3-Abnormal plasma cells cannot protect the body from infections. As mentioned before, normal plasma cells produce antibodies that attack germs. In multiple myeloma, the myeloma cells crowd out the normal plasma cells, so that antibodies to fight the infection can’t be made. The antibody made by the myeloma cells does not help fight infections. That’s because the myeloma cells are just many copies of the same plasma cell – all making copies of the same exact (or monoclonal) antibody.

A monoclonal gammopathy is when plasma cells make too many copies of the same antibody. It is usually found on a routine blood test when looking for other conditions.In monoclonal gammopathy of undetermined significance (MGUS), abnormal plasma cells make many copies of the same antibody (called a monoclonal protein). However, these plasma cells do not form an actual tumor or mass and do not cause any of the problems seen in multiple myeloma. MGUS usually does not affect a person’s health. It doesn’t cause weak bones, high calcium levels, kidney problems, or low blood counts.

4-Myeloma cells make an antibody that can harm the kidneys, leading to kidney damage and even kidney failure.

Factors that may increase your risk of multiple myeloma include:

• Increasing age. Your risk of multiple myeloma increases as you age, with most people diagnosed in their mid-60s.
• Male sex. Men are more likely to develop the disease than are women.
• Black race. Black people are about twice as likely to develop multiple myeloma as are white people.
• Family history of multiple myeloma. If a brother, sister or parent has multiple myeloma, you have an increased risk of the disease.
• Personal history of a monoclonal gammopathy of undetermined significance (MGUS). Every year 1 percent of the people with MGUS in the United States develop multiple myeloma.

Diagnosing Multiple Myeloma:

• Blood tests. Laboratory analysis of your blood may reveal the M proteins produced by myeloma cells. Another abnormal protein produced by myeloma cells — called beta-2-microglobulin — may be detected in your blood and give your doctor clues about the aggressiveness of your myeloma.Additionally, blood tests to examine your kidney function, blood cell counts, calcium levels and uric acid levels can give your doctor clues about your diagnosis.
• Urine tests. Analysis of your urine may show M proteins, which are referred to as Bence Jones proteins when they’re detected in urine.
• Examination of your bone marrow. Your doctor may remove a sample of bone marrow for laboratory testing. The sample is collected with a long needle inserted into a bone (bone marrow aspiration and biopsy).In the lab, the sample is examined for myeloma cells. Specialized tests, such as fluorescence in situ hybridization (FISH) can analyze myeloma cells to understand their genetic abnormalities. Tests are also done to measure the rate at which the myeloma cells are dividing.
• Imaging tests. Imaging tests may be recommended to detect bone problems associated with multiple myeloma. Tests may include an X-ray, MRI, CT or positron emission tomography (PET).

After someone is diagnosed with cancer, doctors will try to figure out if it has spread, and if so, how far. This process is called staging (I,II,III,IV). The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it.

Treatment:

1-Targeted therapy. Targeted drug treatment focuses on specific abnormalities within cancer cells that allow them to survive. Bortezomib (Velcade), carfilzomib (Kyprolis) and ixazomib (Ninlaro) are targeted drugs that block the action of a substance in myeloma cells that breaks down proteins. This action causes myeloma cells to die. Targeted-therapy drugs may be administered through a vein in your arm or in pill form.

Other targeted-therapy treatments include monoclonal antibody drugs that bind to the specific proteins present on myeloma cells, causing them to die.

2-Biological therapy. Biological therapy drugs use your body’s immune system to fight myeloma cells. The drugs thalidomide (Thalomid), lenalidomide (Revlimid) and pomalidomide (Pomalyst) enhance the immune system cells that identify and attack cancer cells. These medications are commonly taken in pill form.

3-Chemotherapy. Chemotherapy drugs kill fast-growing cells, including myeloma cells. Chemotherapy drugs can be given through a vein in your arm or taken in pill form. High doses of chemotherapy drugs are used before a bone marrow transplant.

4-Corticosteroids. Corticosteroids, such as prednisone and dexamethasone, regulate the immune system to control inflammation in the body. They are also active against myeloma cells. Corticosteroids can be taken in pill form or administered through a vein in your arm.

5-Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, is a procedure to replace your diseased bone marrow with healthy bone marrow.

Before a bone marrow transplant, blood-forming stem cells are collected from your blood. You then receive high doses of chemotherapy to destroy your diseased bone marrow. Then your stem cells are infused into your body, where they travel to your bones and begin rebuilding your bone marrow.

6-Radiation therapy. This treatment uses beams of energy, such as X-rays and protons, to damage myeloma cells and stop their growth. Radiation therapy may be used to quickly shrink myeloma cells in a specific area — for instance, when a collection of abnormal plasma cells form a tumor (plasmacytoma) that’s causing pain or destroying a bone.

“On September 11, 2001, 19 militants associated with the Islamic extremist group al-Qaida hijacked four airplanes carring out suicide attacks against targets in the United States. Two of the planes flew into the twin towers of the World Trade Center in New York City, a third plane hit the Pentagon, & the fourth plane crashed in a field in Shanksville, Pennsylvania. Almost 3,000 people were killed during the 9/11 terrorist attacks, which triggered major U.S. initiatives to combat terrorism and defined the presidency of George W. Bush.”

History.com

HEALTH EFFECTS FROM SEPTEMBER 11 DISASTER

The world trade center (WTC) terrorist attact and its aftermath exposed hundreds of thousands of people to dust, debris, smoke and fumes.  I was one that went down that day as a volunteer RN to help out my country.  It was a sight I will never forget and thank God nothing like it has happened since including developing anything from being exposed to the environment of this disaster.  September 11, 2001, among rescue and clean up workers, office workers, building evacuees, and residents of lower Manhattan living down their have shown increased respiratory and other physical health problems, like developing cancers after this terrible terrorist tragedy.  Following is a outline of the most common conditions experienced by individuals exposed to the WTC attacks and their aftermath.  The types of conditions are:

Upper Airway Cough Syndrome:  Formerly named postnasal drip syndrome which is commonly caused by continuous irritation or infection of the sinuses and the nose either due to allergies or from environmental irritants.  The signs or symptoms that arise from this are cough, nasal congestion, postnasal drip and frequent need to clear the throat.

Asthma/Reactive Airways Dysfunction Syndrome:  Some people exposed to the WTC disaster area have developed asthma related to exposure to irritants (also called reactive airways dysfunction syndrome [RADS]).  Signs and symptoms include:  Shortness of Breath (SOB); chest tightness, wheezing, coughing, phlegm, possible triggering of symptoms by colds or seasonal allergies or exercise or fragrances or extremes of temperature or humidity, recurrent episodes of respiratory infections requiring antibiotic treatment.

GASTROESOPHAGEAL REFLUX DISEASE OR LARYNGOPHARYNGEAL REFLUX DISEASE:  Some people exposed to the WTC disaster developed this condition.  GERD results from the flow back or return (reflux) of stomach contents into the esophagus. LPRD results from the reflux of stomach contents into the voice box or throat.

Symptoms of GERD: Heartburn, acid regurgitation, upset stomach, cough made worse with meals or at night

Symptoms of LPRD: Hoarseness or other vocal changes, sore throat, cough, sensation of having a lump in the throat

Long-Term Physical Health Concerns

There has been increased concern about sarcoidosis and cancer among individuals who were highly exposed during the WTC disaster. The NYC Department of Health and Mental Hygiene, in conjunction with other programs, is closely monitoring these conditions in order to detect any increases in these diseases.

At this time, there is no evidence of an increased rate of cancer among individuals highly exposed to the WTC disaster. Increased rates of sarcoidosis have been documented among fire department personnel ( Izbicki G, Chavko R, Banauch, GI, et al. World Trade Center “Sarcoid-Like” Granulomatous Pulmonary Disease in New York City Fire Department Workers. Chest. 2007;3:131;1414-1423). Rates of sarcoidosis among other groups are currently under investigation.

Sarcoidosis is difficult to verify because NYC providers are not required by law to report sarcoidosis cases to the Health Department.  Based on New York City death certificate records over the   past 10 years, there have been an average of 32 sarcoidosis deaths per year, with the annual number remaining the same since the WTC attacks. During the   same period, there have been between 362 and 439 sarcoidosis-related hospitalizations per year in NYC (five per 100,000 people), with the annual   rate remaining the same since the disaster.

* Breathing in beryllium, other metal dust or fumes or moldy materials can cause lung disease, which may resemble sarcoidosis.

.Sarcoidosis

Sarcoidosis* is an auto-immune disease that can attack any organ   of the body, although it often starts in the lungs or lymph nodes. It mainly   affects people between 20 and 40 years of age, with African-Americans three  times more likely to develop the condition than Caucasians and women twice as   likely to develop it as men. While most sarcoidosis patients recover without treatment, less than one-third develop chronic debilitating sarcoidosis and  fewer than 5% die from the disease. The exact cause of sarcoidosis is unknown.

Sarcoidosis and World Trade Center (WTC) Dust Exposure

While studies have not definitively linked dust exposure from   the WTC disaster to new-onset sarcoidosis among exposed workers, the data   does suggest elevated levels of sarcoidosis among firefighters.

There have been a few reported sarcoidosis cases among rescue   workers that may be related to Ground Zero dust exposure. In May 2007, the New York City Chief Medical Examiner determined that dust exposure from the disaster contributed to a sarcoidosis death, based on published epidemiologic findings among exposed firefighters.

Cancers

The collapse and burning of the WTC and neighboring buildings   released a complex mixture of irritant dust, smoke and gases. The dust cloud   also contained heavy metals, as well as asbestos and other carcinogens. In   addition, smoke released from the fires contained hazardous and potentially   cancer-causing substances.

Because of these exposures, there has been concern about the   possibility of increased cancer rates among WTC-exposed people. The NYC   Department of Health and Mental Hygiene, the Fire Department of New York and   other researchers are carefully monitoring cancer rates among highly exposed   people.

In 2007, the NYC Department of Health and Mental Hygiene brought together a panel of experts, including representatives from FDNY, the Mount Sinai School of Medicine, the New York State Department of Health and the National Institute for Occupational Safety and Health, to discuss the potential impact of the WTC disaster on cancer rates and mortality.

In 2010, after beginning the process of confirming cancer   diagnoses within their cohorts, the NYC Department of Health and Mental   Hygiene and FDNY co-chaired another conference of outside experts, including biostatisticians, environmental health scientists and cancer epidemiologists,   to help address the complex methodological questions associated with their   preliminary cancer investigations. The conference produced several   recommendations which are described in the 2010 WTC Medical Working group annual report.

Although cancer associated with specific exposures takes a long   time to develop, three early cancer studies based on verified diagnoses   within their cohorts through 2008 (the latest year for which data was   available when these analyses began) have been published:

• FDNY found that nearly 9,000 firefighters with WTC exposure may be at greater risk for cancer than firefighters  who weren’t exposed.
• The WTC Health Registry found small increases in rates of prostate cancer, thyroid cancer and multiple myeloma, a blood cancer, among nearly 34,000 WTC rescue and recovery workers in comparison to rates among New York State residents after adjusting for age, race/ethnicity and sex.
• Prostate and thyroid cancer rates were higher than expected among nearly 21,000 rescue and recovery workers enrolled in the WTC Health Program in comparison to rates in New York, New Jersey, Connecticut and Pennsylvania where the majority  of workers lived.

Cancer analyses continue at FDNY, the WTC Health Registry and at   the Mount Sinai School of Medicine.

In 2012, the National Institute for Occupational Safety and Health  added many different types of cancers to the list of conditions that can be treated at the World Trade Center Health Program.

What the New York City  Health Department Is Doing:

Through the World Trade Center (WTC) Health Registry, the Health Department is conducting a cancer study that will help determine if cancer rates are higher among those exposed to the WTC disaster. Results of   the study will appear on this Web site and will be submitted to peer-reviewed scientific journals.

The Department is also conducting a broader public awareness campaign about cancer testing, and is working with its clinical partners to offer free cancer screenings. Identifying cancer early in the course of the disease reduces the risk of developing disability from cancer. Department efforts to reduce the rates of smoking among WTC disaster-exposed people also help reduce their risk for developing cancer and other diseases.

What You Can Do

Seek medical care.

If you were exposed to the WTC disaster and have developed symptoms or conditions you feel are related to this exposure, tell your doctor and bring the Clinical Guidelines for Physicians Treating Adults   Exposed to the WTC Disaster to   help your doctor diagnose and treat your symptoms. The Health Department also   released clinical guidelines  for   health care providers on how to treat children and adolescents exposed to the WTC disaster.

If you or your doctor believe that you require more specialized   care, you may be eligible for free treatment at a WTC   Center of Excellence or affiliated facility.

Practice preventive   health.

Whether or not you are currently experiencing symptoms, there   are things you can do to maintain your current health status, prevent   worsening of your health, and detect any new conditions. Suggested measures   include:

1. 1. If you smoke, quit! Tobacco is known to cause   cancer and make existing respiratory conditions worse. If you currently   smoke, there are programs in place to help you quit.
   2. Lead a healthy lifestyle by drinking alcohol   in moderation and avoiding more than moderate sun exposure. Increase physical   activity, keep your weight down and eat a healthful and nutritious diet.
   3. Have a physical exam every year that includes a   complete blood count (CBC). Be sure your exam includes all tests appropriate   for your sex and age, including cancer screenings.
   4. Avoid   risks at work and during leisure time. If you have any respiratory conditions  try to reduce your exposure to irritants such as dust, pollen, grass and   smoke both at home and at work. Consider giving up activities that expose you to irritants, and if activities cannot be avoided, wear personal protective   equipment to minimize exposure.

“Gynecologic cancer is any cancer that starts in a woman’s reproductive organs. Cancer is always named for the part of the body where it starts. Gynecologic cancers begin in different places within a woman’s pelvis, which is the area below the stomach and in between the hip bones.  The areas included uterine, cervical, ovary (s), vaginal and vulvar.”

Centers for Disease Control and Prevention