Diagnosis of Osteoporosis

Women who have had a fracture due to fragility are diagnosed with severe osteoporosis and have a high risk for another fracture. Early diagnosis can prevent fractures and slow deterioration of bone tissue.
If the doctor suspects osteoporosis, a bone scan would be suggested. – A common test that measures bone density is called a dual energy X-ray absorptiometry (DEXA). This test measures the density of the bones in your hips, spine and wrist, which are all places likely to be affected by osteoporosis.
- Quantitative computed tomography (QCT) measures bone density in the hip and spine and produces a three-dimensional image that shows true volume density. QCT has the capacity to isolate an area for testing. The radiation level in QCT is 10 times higher than in DEXA.
- Peripheral bone density testing uses ultrasound to identify bone loss in a localized area such as the heel or hand.
Doctor may also order an ultrasound or a computerized tomography (CT) scan to help check the density of your bones.

A prognosis is a medical opinion as to the likely course and outcome of a disease. In other words, the prognosis is the chance that a patient will recover or have a recurrence (return of the cancer). There are many factors that can affect a person’s prognosis, which include:
- The type and location of the cancer.
- The stage of the disease (the extent to which the cancer has metastasized, or spread).
- Its grade (how abnormal the cancer cells look, and how quickly the cancer is likely to grow and spread).
- The person’s age, general health, and response to treatment.

Most thyroid cancers are very curable. In fact, the most common types of thyroid cancer, papillary and follicular, are the most curable. In younger patients, both papillary and follicular cancers have a more than 97% cure rate if treated appropriately. Both papillary and follicular cancers are typically treated with complete removal of the lobe of the thyroid that harbors the cancer, in addition to the removal of most or all of the other side.
The bottom line is that most thyroid cancers are papillary thyroid cancer, and this is one of the most curable cancers of all cancers that humans get. Treated correctly, the cure rate is extremely high.
Medullary cancer of the thyroid is significantly less common, but has a worse prognosis. Medullary cancers tend to spread to large numbers of lymph nodes very early on, and therefore require a much more aggressive operation than the more localized thyroid cancers, such as papillary and follicular. This cancer requires complete thyroid removal plus a dissection to remove the lymph nodes of the front and sides of the neck.
The least common type of thyroid cancer is anaplastic which has a very poor prognosis. Anaplastic thyroid cancer tends to be found after it has spread and is incurable in most cases.

T stages of bone cancer :
TX: Primary tumor can’t be measured.
T0: No evidence of the tumor.
T1: Tumor is 8 cm (around 3 inches) or less.
T2: Tumor is larger than 8 cm.
T3: Tumor is in more than one place on the same bone.

N Stages :
N0: No spread to nearby (regional) lymph nodes.
N1: Cancer detected in nearby lymph nodes.

M Stages :
M0: No distant metastasis.
M1: Distant metastasis (cancer has spread to other tissues or organs).
M1a: Cancer has spread only to the lung.
M1b: Cancer has spread to other sites.

Grades :
G1–G2: Low grade
G3–G4: High grade

Once all of these stages have been determined in a particular case of cancer, the data are combined, and an overall stage is given to the disease.
- Stage IA: T1, N0, M0, G1-G2: Tumor is confined to the bone, less than 8 cm in size, and is low grade.
- Stage IB: T2, N0, M0, G1-G2: Tumor is confined to the bone, larger than 8 cm, and is low grade.
- Stage IIA: T1, N0, M0, G3-G4: Tumor is confined to the bone, less than 8 cm, and is high grade.
- Stage IIB: T2, N0, M0, G3-G4: Tumor is confined to the bone, larger than 8 cm, and is high grade.
- Stage III: T3, N0, M0, Any G: Tumor is confined to the bone but tumor cells are detected at other sites on the bone.
- Stage IVA: Any T, N0, M1a, Any G: Tumor has spread to the lung.
- Stage IVB: Any T, N1, Any M, Any G: Tumor has spread to lymph nodes and distant sites, or Any T, Any N, M1b, Any G: Tumor has spread to distant sites other than the lung.

Local treatment

It is used to treat a tumor without affecting the rest of the body. Surgery and radiation are examples of local treatment.

1. Surgery

The main mode of treatment for breast cancer is surgery, especially so when the tumor is localized.
- Breast conserving surgery: An operation to remove the cancer but not the breast is called breast-sparing surgery.
- Lumpectomy: The surgeon removes the breast cancer and some normal tissue around it.
- Segmental mastectomy: The surgeon removes the cancer and a larger area of normal breast tissue around it. Occasionally, some of the lining over the chest muscles below the tumor is removed as well. Some lymph nodes under the arm may also be removed.
- Total mastectomy: The surgeon removes the whole breast. Some lymph nodes under the arm may also be removed.
- Radical mastectomy: The surgeon removes the breast, both chest muscles, all of the lymph nodes under the arm, and some additional fat and skin.
- Axillary Lymph node dissection: Removing some or all of the lymph nodes in the arm pit. Usually 10 to 20 lymph nodes in the arm pit are removed.

2. Radiation Therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

Systemic treatment

This treatment is given into the bloodstream or by mouth and goes throughout the body to reach cancer cells that may have spread beyond the breast. Chemotherapy, hormone therapy, and targeted therapy are systemic treatments.

1. Chemotherapy

Chemotherapy uses anticancer drugs to kill cancer cells. There are many different kinds of chemotherapy drugs. Often they are used in combination called regimens. The prime target for such medicines is cancer cells that are actively growing and dividing. Unfortunately, anticancer medicines are not able to recognize cancer cells specifically and they also kill normally dividing cells such as the blood and hair cells.

2.Hormone therapy

Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow.
- Hormone therapy with tamoxifen is often given to patients with early stages of breast cancer and those with metastatic breast cancer.
- Hormone therapy with tamoxifen or estrogens can act on cells all over the body and may increase the chance of developing endometrial cancer.
- Hormone therapy with an aromatase inhibitor is given to some postmenopausal women who have hormone-dependent breast cancer.

Targeted therapy

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
- Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory, from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow.
- Tyrosine kinase inhibitors are targeted therapy drugs that block signals needed for tumors to grow. Tyrosine kinase inhibitors may be used in combination with other anticancer drugs as adjuvant therapy.