QUOTE FOR WEDNESDAY:

“The causes of fibromyalgia are not known. But certain things can increase someone’s risk of developing it.

Risk factors or triggers

Risk factors or triggers may include:

  • Stressful or traumatic events, accidents, or injuries.
  • Repeat injuries, such as repeated joint stress from sports or physical jobs.
  • Illness, including viral infections.

Some people may be more likely to develop fibromyalgia

These include:

Center for Disease Control – CDC (facts about fibromyalgia – Search)

Part III Fibromyalgia – the treatment!

How is Fibromyalgia treated?

There is no cure for fibromyalgia. However, symptoms can be treated with both non-drug and medication based treatments. Many times the best outcomes are achieved by using multiple types of treatments.

Non-Drug Therapies: People with fibromyalgia should use non-drug treatments as well as any medicines their doctors suggest. Research shows that the most effective treatment for fibromyalgia is physical exercise. Physical exercise should be used in addition to any drug treatment. Patients benefit most from regular aerobic exercises. Other body-based therapies, including Tai Chi and yoga, can ease fibromyalgia symptoms. Although you may be in pain, low impact physical exercise will not be harmful.

Cognitive behavioral therapy is a type of therapy focused on understanding how thoughts and behaviors affect pain and other symptoms. CBT and related treatments, such as mindfulness, can help patients learn symptom reduction skills that lessen pain. Mindfulness is a non-spiritual meditation practice that cultivates present moment awareness. Mindfulness based stress reduction has been shown to significantly improve symptoms of fibromyalgia.

You can also try other complementary therapies such as:

  • Massage therapy.
  • Movement therapy.
  • Chiropractic therapy.
  • Acupuncture.
  • Diet supplements.

Other complementary and alternative therapies (sometimes called CAM or integrative medicine), such as acupuncture, chiropractic and massage therapy, can be useful to manage fibromyalgia symptoms. Many of these treatments, though, have not been well tested in patients with fibromyalgia.

It is important to address risk factors and triggers for fibromyalgia including sleep disorders, such as sleep apnea, and mood problems such as stress, anxiety, panic disorder, and depression. This may require involvement of other specialists such as a Sleep Medicine doctor, Psychiatrist, and therapist.

Medications: The U.S. Food and Drug Administration has approved three drugs for the treatment of fibromyalgia. They include two drugs that change some of the brain chemicals (serotonin and norepinephrine) that help control pain levels: duloxetine (Cymbalta) and milnacipran (Savella). Older drugs that affect these same brain chemicals also may be used to treat fibromyalgia. These include amitriptyline (Elavil) and cyclobenzaprine (Flexeril). Other antidepressant drugs can be helpful in some patients. Side effects vary by the drug. Ask your doctor about the risks and benefits of your medicine.

The other drug approved for fibromyalgia is pregabalin (Lyrica). Pregabalin and another drug, gabapentin (Neurontin), work by blocking the over activity of nerve cells involved in pain transmission. These medicines may cause dizziness, sleepiness, swelling and weight gain.

It is strongly recommended to avoid opioid narcotic medications for treating fibromyalgia. The reason for this is that research evidence shows these drugs are not of helpful to most people with fibromyalgia, and will cause greater pain sensitivity or make pain persist. Tramadol (Ultram) may be used to treat fibromyalgia pain if short-term use of an opioid narcotic is needed. Over-the-counter medicines such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (commonly called NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve, Anaprox) are not effective for fibromyalgia pain. Yet, these drugs may be useful to treat the pain triggers of fibromyalgia. Thus, they are most useful in people who have other causes for pain such as arthritis in addition to fibromyalgia.

For sleep problems, some of the medicines that treat pain also improve sleep. These include cyclobenzaprine (Flexeril), amitriptyline (Elavil), gabapentin (Neurontin) or pregabalin (Lyrica). It is not recommended that patients with fibromyalgia take sleeping medicines like zolpidem (Ambien) or benzodiazepine medications.

Always confirm with your doctor which RX is best and not contraindicated for you, for your safety!

QUOTE FOR TUESDAY:

“Fibromyalgia affects an estimated 3.4% of women and 0.5% of men in the United States, or 3 million to 6 million Americans. It most commonly affects women of childbearing age or older. In fact, some estimates suggest that more than 7% of women in their 70s have fibromyalgia. Many people with fibromyalgia also have psychiatric problems such as depression, anxiety, or eating disorders, although the relationship between fibromyalgia and mental health disorders remains unclear.

While not a deadly disease, fibromyalgia can significantly impact one’s emotional well-being and overall quality of life. It strikes people of all ages, but it’s more common in women than men. It also runs in families. The risk of developing fibromyalgia is much higher if a first-degree relative, such as a parent or sibling, also has the condition.”

Harvard Health Publishing (Fibromyalgia – Harvard Health)

Part II Fibromyalgia – The symptoms and how its diagnosed!

 

Signs and Symptoms of Fibromyalgia:

Fibromyalgia is a physical disorder, not a psychological condition. The most common constellation of Fibromyalgia symptoms (widespread chronic muscle pain, sleeplessness, relentless fatigue, cognitive dysfunction, and a host of other overlapping conditions like TMJD, IBS, migraine, interstitial cystitis, metabolic syndrome, endometriosis, and vulvodynia) can wax and wane over time.

Symptoms include:

  • Tenderness to touch or pressure affecting muscles and sometimes joints or even the skin
  • Severe fatigue
  • Sleep problems (waking up unrefreshed)
  • Problems with memory or thinking clearly

Some patients also may have:

  • Depression or anxiety
  • Migraine or tension headaches
  • Digestive problems: irritable bowel syndrome (commonly called IBS) or gastroesophageal reflux disease (often referred to as GERD)
  • Irritable or overactive bladder
  • Pelvic pain
  • Temporomandibular disorder – often called TMJ (a set of symptoms including face or jaw pain, jaw clicking, and ringing in the ears)

How Fibromyalgia is diagnosed:

A doctor will suspect fibromyalgia based on your symptoms. Doctors may require that you have tenderness to pressure or tender points at a specific number of certain spots before saying you have fibromyalgia, but they are not required to make the diagnosis (see the Box). A physical exam can be helpful to detect tenderness and to exclude other causes of muscle pain. There are no diagnostic tests (such as X-rays or blood tests) for this problem. Yet, you may need tests to rule out another health problem that can be confused with fibromyalgia.

Because widespread body pain is the main feature of fibromyalgia, health care providers will ask you to describe your pain. This may help tell the difference between fibromyalgia and other diseases with similar symptoms. Other conditions such as hypothyroidism (underactive thyroid gland) and polymyalgia rheumatica sometimes mimic fibromyalgia. Blood tests can tell if you have either of these problems. Sometimes, fibromyalgia is confused with rheumatoid arthritis or lupus. But, again, there is a difference in the symptoms, physical findings and blood tests that will help your health care provider detect these health problems. Unlike fibromyalgia, these rheumatic diseases cause inflammation in the joints and tissues.

 

Part I Fibromyalgia

 

What is this disorder?

Fibromyalgia is a common neurologic health problem that causes widespread pain and tenderness (sensitivity to touch).  This invisible, life-altering condition causes 2-4% of women, men and children of all backgrounds worldwide to suffer. (That’s 10 million Americans alone.) The disorder can strike suddenly or occur as a gradual increase in symptoms, indicating changes in the central nervous system (neuroplasticity). Sensory information (such as light, sound, and touch) becomes amplified by the CNS, causing the brain to respond with increasing pain and symptoms. FM severity often increases over time and may become disabling.

The pain and tenderness tend to come and go, and move about the body. Most often, people with this chronic (long-term) illness are fatigued (very tired) and have sleep problems. The diagnosis can be made with a careful examination.

Fibromyalgia is most common in women, though it can occur in men. It most often starts in middle adulthood, but can occur in the teen years and in old age. You are at higher risk for fibromyalgia if you have a rheumatic disease (health problem that affects the joints, muscles and bones). These include osteoarthritis, lupus, rheumatoid arthritis, or ankylosing spondylitis.

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.

 Women are more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.

Causes:

The causes of fibromyalgia are unclear. They may be different in different people. Current research suggests involvement of the nervous system, particularly the central nervous system (brain and spinal cord). Fibromyalgia is not from an autoimmune, inflammation, joint, or muscle disorder. Fibromyalgia may run in families. There likely are certain genes that can make people more prone to getting fibromyalgia and the other health problems that can occur with it. Genes alone, though, do not cause fibromyalgia.

There is most often some triggering factor that sets off fibromyalgia. It may be spine problems, arthritis, injury, or other type of physical stress. Emotional stress also may trigger this illness. The result is a change in the way the body “talks” with the spinal cord and brain. Levels of brain chemicals and proteins may change. More recently, Fibromyalgia has been described as Central Pain Amplification disorder, meaning the volume of pain sensation in the brain is turned up too high.

Although Fibromyalgia can affect quality of life, it is still considered medically benign. It does not cause any heart attacks, stroke, cancer, physical deformities, or loss of life.

While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.

Stay tune for Part II Monday on Signs, Symptoms and more!

QUOTE FOR MONDAY:

“Soft tissue sarcomas form in cartilage, fat, muscle, blood vessels, tendons, nerves, and around joints. Osteosarcomas develop in bone; liposarcomas form in fat cells. Rhabdomyosarcomas form in muscle, and Ewing sarcomas form in bone and soft tissue.

About 22% of bone and joint cancer cases are diagnosed in those under age 20, while soft tissue cancers are more often diagnosed in those 55 years or older.”

American Association for Cancer Research – AACR (https://www.aacr.org/patients-caregivers/awareness-months/sarcoma-and-bone-cancer-awareness-month/)

QUOTE FOR MONDAY:

“Fibromyalgia is a long-term condition that causes widespread muscle pain, fatigue and brain fog. It happens when your nervous system becomes more sensitive to pain signals. There isn’t a cure. But lifestyle changes, therapy and medication may help you manage flare-ups and improve daily life.

Research shows it involves changes in how your central nervous system processes pain. This system becomes more sensitive and amplifies pain signals. This means your body feels pain more strongly.

Symptoms often come and go in periods called flare-ups. There isn’t a cure, but treatment could help manage symptoms.”

Cleveland Clinic (Fibromyalgia: What It Is, Symptoms & Treatment)

 

Part II Sarcoma Awareness Month – Learn the symptoms, how its diagnosed, and the treatment!!

Soft tissue sarcoma symptoms:

Like many forms of cancer, soft tissue sarcoma symptoms may appear at a more advanced stage of the disease, or you might not notice any symptoms at all. Symptoms, if they are present, will also vary depending on the type of sarcoma and its location.

Signs of soft tissue sarcoma include:

A lump or mass is the most common soft tissue sarcoma sign. The lump will form in the area in which the tumor is growing, and it may be accompanied by some pain if it is pressing on a nerve or muscle. Even if the lump isn’t painful, if it continues to grow, or if it is located deep within an extremity or body cavity, consult your doctor.

Uncomfortable swelling is another sign of soft tissue sarcoma, especially when it is located in the arms and legs.

Limited mobility may be a symptom of soft tissue sarcoma. Some tumors can restrict motion, such as those found in the hip, knee, shoulder or hands.

Skin lesions can occur when a sarcoma tumor breaks through the skin.

Other symptoms may be signs of soft tissue sarcoma, because a sarcoma tumor can form almost anywhere in the body and can therefore affect a variety of organs. For example, sarcomas in the abdomen may cause abdominal pain, vomiting or constipation, while sarcomas in the uterus may cause vaginal bleeding and/or abdominal pain. With gastrointestinal stromal tumors (GISTs), you may feel full after eating only very small meals, or you may vomit blood or have dark bowel movements.

Diagnosing Sarcoma:

If your doctor thinks you may have a sarcoma, you’ll probably need a full exam and tests, including: A sample of cells from the tumor, called a biopsy. A plain x-ray to imaging tests, such as a CT scan, an ultrasound, an MRI, a PET (Positron Emission Tomography) to help see inside your body. A bone scan, if you might have osteosarcoma.  Also a biopsy-several types of biopsies are used to diagnose sarcomas..

Treatment of Soft Tissue Sarcoma:

Surgery is typically the primary treatment for soft-tissue sarcoma, used to remove tumors. Chemotherapy, radiation therapy and/or targeted therapy may also be recommended, either alone or in combination with surgery, depending on the stage and extent of the disease, along with other factors.

Surgery

The goal of surgery is to locate and completely remove the soft tissue sarcoma tumor. Our pathologists then examine the tumor to determine whether or not additional treatment is necessary, and to reduce the risk of recurrence.

Chemotherapy

Chemotherapy may be used in combination with surgery and radiation therapy to treat advanced-stage soft tissue sarcoma. Chemotherapy drugs work to either destroy cancer cells or impede their ability to grow and reproduce.

At our hospitals, we are developing innovative therapies personalized to the care of each soft tissue sarcoma patient. Our medical oncologists work closely with soft tissue sarcoma patients to determine if chemotherapy is an appropriate treatment option. Throughout your soft tissue sarcoma treatment, your care team continually monitors the effect of chemotherapy on the disease, with physical exams, blood tests, CT scans, MRI scans and chest X-rays and imaging.

Radiation therapy

Depending on the type of soft tissue sarcoma you have and the extent of the disease, your soft tissue sarcoma treatment plan may include radiation therapy. Though surgery is usually the main treatment approach for soft tissue sarcoma, radiation treatments may also be used before (neoadjuvant therapy) or following surgery (adjuvant therapy).

Targeted therapy

Unlike standard chemotherapy drugs, which may affect all cells in the body, targeted therapy drugs are designed to seek out and kill specific cancer cells while sparing surrounding healthy cells. Targeted cancer therapies may be used alone, in combination with other targeted therapy treatments or with other soft tissue sarcoma treatments, such as chemotherapy, radiation therapy and surgery. Among the drugs used in targeted therapy are so-called kinase inhibitors, which target specific protein receptors that help regulate cell growth.

 

QUOTE FOR THE WEEKEND:

“Sarcomas are a rare group of cancers in which malignant cells form in the bones or soft tissues of the body.

Soft tissue sarcomas form in cartilage, fat, muscle, blood vessels, tendons, nerves, and around joints. Osteosarcomas develop in bone; liposarcomas form in fat cells. Rhabdomyosarcomas form in muscle, and Ewing sarcomas form in bone and soft tissue.”

American Association For Cancer Research – AACR (Sarcoma and Bone Cancer Awareness Month | AACR)

Part I Sarcoma Awareness Month-What sarcoma is and the causes!

What is Sarcoma?

Sarcoma is a rare but deadly form of cancer affecting connective tissues such as fat, muscle, blood vessels, nerve, bone, deep skin and cartilage. There are roughly 15,000 new cases in the United States each year, with a very low median age of 36 (for bone sarcomas). Survival rates are low, even in comparison to other rare cancers. Rhabdomyosarcoma, a relatively common sarcoma, has a five-year survival rate of 65%, even if caught before metastasis. If caught after metastasis, the five-year survival rate lowers to approximately 30%. This is all to say that while sarcomas are rare, they are extremely devastating.

Sarcomas are a diverse and sporadic group of tumors that have minimal hereditary influence. They are generally classified into two major groups; the group of tumor-specific reoccurring genetic mutations via specific and aberrant chromosome translocation, and the group of non-reoccurring mutations which are based on severe genetic and chromosomal instability. Both groups have altered cell growth-factor signaling pathways. As a result, the introduction of drugs which can normalize growth-factor receptors and proteins are of great interest and the primary treatment given. With improvements in these drugs, it is believed that sarcoma can move from a deadly disease to a chronic but non-life-threatening disease.

Unfortunately, the specificity of the first group of sarcomas, where specific chromosomes are improperly translocated, can often permit the sarcoma to prevail after standard treatment. This is obviously problematic but, if overcome, could spark the development of a whole new field of cancer treatment. In other words, if scientists can discover how to isolate and guide specific chromosomal arrangement, they will able to address many of the hard to treat cancers of today.

With genetic engineering it is theoretically possible to prevent cancer before it begins. However, even without moving this far into the future, the improper chromosomal translocation can provide a sort of name-tagging of the cancer cell. With the cancer cells identified, it can guide modalities aimed at destroying diseased tissue while sparing healthy tissue.

Sarcoma is an under-researched cancer whose research can help to elevate cancer treatment, as a whole. Not only would breakthroughs save the lives of countless children, it could also advance medicine, as a whole. By bringing awareness to sarcoma and the potential development its research can spark, this potential can become a reality.

Soft tissue sarcomas may develop in any tissue that connects, supports or surrounds other structures and organs in the body. Some examples of where soft tissues sarcomas can develop are muscles, fascia (the tough membrane that surrounds muscles), tendons, fat, blood vessels, nerves and synovial tissues (connective tissue that makes up the membranes surrounding joints).

Soft tissue sarcomas are rare in adults, accounting for less than 1 percent of all new cases of cancer. The American Cancer Society reports that about 12,750 new cases of soft tissue sarcoma will be diagnosed in 2019 (7,240 cases in males and 5,510 cases in females). Sarcomas can be found almost anywhere in the body.

According to the National Cancer Institute, about 50 percent of soft tissue sarcoma cases occur in the extremities (arms and legs), 40 percent occur in the trunk (back and chest), and 10 percent occur in the head and neck.

Causes of Sarcoma:

The American Cancer Society states the following on causes of Sarcoma:

“Scientists don’t know exactly what causes most soft tissue sarcomas , but they have found some risk factors that can make a person more likely to develop these cancers. And research has shown that some of these risk factors affect the genes in cells in the soft tissues.

Researchers have made great progress in understanding how certain changes in DNA (pieces of genes) can cause normal cells to become cancer. DNA carries the instructions for nearly everything our cells do. We usually look like our parents because they are the source of our DNA. But DNA affects more than just the way we look.

The DNA is made of genes. Genes carry the recipes for making proteins, the molecules that control all cell functions. Some genes contain instructions for proteins that control when our cells grow and divide.

  • Certain genes that promote cell division are called oncogenes.
  • Others that slow down cell division or cause cells to die at the right time are called tumor suppressor genes.

Cancers can be caused by DNA mutations (defects) that turn on oncogenes or turn off tumor suppressor genes.

Many family cancer syndromes have been found in which inherited DNA mutations cause a very high risk of developing breast, colon, kidney, eye, or other cancers. Some of these syndromes are also linked to an increased risk of developing soft tissue sarcomas.

DNA mutations in soft tissue sarcoma are common. But they’re usually acquired during life rather than having been inherited before birth. Acquired mutations may result from exposure to radiation or cancer-causing chemicals. In most sarcomas, they occur for no apparent reason.

Researchers still don’t know why most soft tissue sarcomas develop in people who have no apparent risk factors.”