Most people have had a minor knee problem at one time or another. Most of the time our body movements do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear, overuse, or injury. Knee problems and injuries most often occur during sports or recreational activities, work-related tasks, or home projects.
The knee is the largest joint in the body. The upper and lower bones of the knee are separated by two discs (menisci). The upper leg bone (femur) and the lower leg bones (tibia and fibula) are connected by ligaments, tendons, and muscles. The surface of the bones inside the knee joint is covered by articular cartilage, which absorbs shock and provides a smooth, gliding surface for joint movement. See an illustration of the structures of the knee.
Although a knee problem is often caused by an injury to one or more of these structures, it may have another cause. Some people are more likely to develop knee problems than others. Many jobs, sports and recreation activities, getting older, or having a disease such as osteoporosis or arthritis increase your chances of having problems with your knees.
Sudden (acute) injuries
Injuries are the most common cause of knee problems. Sudden (acute) injuries may be caused by a direct blow to the knee or from abnormal twisting, bending the knee, or falling on the knee. Pain, bruising, or swelling may be severe and develop within minutes of the injury. Nerves or blood vessels may be pinched or damaged during the injury. The knee or lower leg may feel numb, weak, or cold; tingle; or look pale or blue. Acute injuries include:
Sprains, strains, or other injuries to the ligaments and tendons that connect and support the kneecap.
A tear in the rubbery cushions of the knee joint (meniscus).
Ligament tears. The medial collateral ligament (MCL) is the most commonly injured ligament of the knee.
Breaks (fracture) of the kneecap, lower portion of the femur, or upper part of the tibia or fibula. Knee fractures are most commonly caused by abnormal force, such as a falling on the knee, a severe twisting motion, severe force that bends the knee, or when the knee forcefully hits an object.
Kneecap dislocation. This type of dislocation occurs more frequently in 13- to 18-year-old girls. Pieces of bone or tissue (loose bodies) from a fracture or dislocation may get caught in the joint and interfere with movement.
Knee joint dislocation. This is a rare injury that requires great force. It is a serious injury and requires immediate medical care.
Overuse injuries
Overuse injuries occur with repetitive activities or repeated or prolonged pressure on the knee. Activities such as stair climbing, bicycle riding, jogging, or jumping stress joints and other tissues and can lead to irritation and inflammation. Overuse injuries include:
Inflammation of the small sacs of fluid that cushion and lubricate the knee (bursitis).
Inflammation of the tendons (tendinitis) or small tears in the tendons (tendinosis).
Thickening or folding of the knee ligaments (Plica syndrome).
Pain in the front of the knee from overuse, injury, excess weight, or problems in the kneecap (patellofemoral pain syndrome).
Irritation and inflammation of the band of fibrous tissue that runs down the outside of the thigh (iliotibial band syndrome).
Conditions that may cause knee problems
Problems not directly related to an injury or overuse may occur in or around the knee.
Osteoarthritis (degenerative joint disease) may cause knee pain that is worse in the morning and improves during the day. It often develops at the site of a previous injury. Other types of arthritis, such as rheumatoid arthritis, gout, and lupus, also can cause knee pain, swelling, and stiffness.
Osgood-Schlatter disease causes pain, swelling, and tenderness in the front of the knee below the kneecap. It is especially common in boys ages 11 to 15.
A popliteal (or Baker's) cyst causes swelling in the back of the knee.
Infection in the skin (cellulitis), joint (infectious arthritis), bone (osteomyelitis), or bursa (septic bursitis) can cause pain and decreased knee movement.
A problem elsewhere in the body, such as a pinched nerve or a problem in the hip, can sometimes cause knee pain.
Osteochondritis dissecans causes pain and decreased movement when a piece of bone or cartilage or both inside the knee joint loses blood supply and dies.
Treatment
Treatment for a knee problem or injury may include first aid measures, rest, bracing, physical therapy, medicine, and in some cases surgery. Treatment depends on the location, type, and severity of the injury as well as your age, health condition, and activity level (such as work, sports, or hobbies).
Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.
Monday, August 25, 2008
Prostate Cancer
What is prostate cancer?
Prostate cancer is the abnormal growth of cells in a man's prostate gland. The prostate sits just below the bladder. It makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. It usually grows larger as you grow older.
Prostate cancer is common in men older than 65. It usually grows slowly and can take years to grow large enough to cause any problems. Most cases are treatable, because they are found with screening tests before the cancer has spread to other parts of the body.1 Although most men may die with prostate cancer, most men do not die from it.
Experts don't know what causes prostate cancer, but they believe that your age, family history (genetics), and race affect your chances of getting it. Eating a high-fat diet may also play a part.2
What are the symptoms?
Prostate cancer usually does not cause symptoms in its early stages. Most men don't know they have it until it is found during a regular medical exam.
When problems are noticed, they are most often problems with urinating. But these same symptoms can also be caused by an enlarged prostate (benign prostatic hyperplasia). An enlarged prostate is common in older men.
See your doctor for a checkup if:
You have trouble starting your urine stream.
You have a weaker-than-normal urine stream.
You cannot urinate at all.
You have to urinate often.
You feel like your bladder is not emptying completely when you urinate.
You have to get up at night to urinate.
You have pain or burning when you urinate.
You have blood in your urine.
You have a deep pain in your lower back, belly, hip, or pelvis.
How is prostate cancer diagnosed?
The most common way to check for prostate cancer is to have a digital rectal exam, in which the doctor puts a gloved, lubricated finger in your rectum to feel your prostate, and a prostate-specific antigen (PSA) blood test. A higher level of PSA may mean that you have prostate cancer, but it could also mean that you have an enlargement or infection of the prostate.
If your PSA is high, or if your doctor finds anything in the rectal exam, he or she may do a biopsy to figure out the cause. A biopsy means your doctor takes a sample of tissue from your prostate gland and sends it to a lab for testing.
Because many men have regular checkups, about 9 out of 10 prostate cancers are found in the early stages. The 5-year survival rate is almost 100%.1 The 5-year survival rate shows the percentage of men still alive 5 years or longer after diagnosis. It’s important to remember that everyone’s case is different, and these numbers may not show what will happen in your case.
Should you have regular tests for prostate cancer?
It is important to have regular health checkups, including a digital rectal exam. But experts disagree on whether regular PSA testing is right for all men. Testing could lead you to have cancer treatment that can cause other health problems, especially loss of bladder control and not being able to have an erection.
Talk with your doctor about the reasons for and against having a PSA test for prostate cancer. The decision to have a PSA test depends on your doctor's opinion and your preferences.
How is prostate cancer treated?
Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences.
You and your doctor may decide to treat your cancer with surgery, radiation, hormone therapy, or a combination. Or, if the cancer has not spread and you are around age 70 or older, you may be able to wait and watch to see what happens. During watchful waiting, you will have regular checkups with your doctor to see if your cancer has changed.
Choosing treatment for prostate cancer can be confusing. Talk with your doctor to choose the treatment that is best for you.
How can treatment affect your quality of life?
Both surgery and radiation can cause urinary incontinence (not being able to control urination) or impotence (not being able to have an erection).
Nerves that help a man have an erection are right next to the prostate. Surgery to remove the cancer may damage them. Many times a special form of surgery, called nerve-sparing surgery, can be used to try to avoid damaging the nerves. But if the cancer has spread to the nerves, they may have to be removed during surgery.
These same nerves can also be damaged by the X-rays that are used in radiation therapy.
Drugs and mechanical aids may help men who are impotent because of treatment. Many men recover their ability to have an erection several months or years after surgery.
Prostate cancer is the abnormal growth of cells in a man's prostate gland. The prostate sits just below the bladder. It makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. It usually grows larger as you grow older.
Prostate cancer is common in men older than 65. It usually grows slowly and can take years to grow large enough to cause any problems. Most cases are treatable, because they are found with screening tests before the cancer has spread to other parts of the body.1 Although most men may die with prostate cancer, most men do not die from it.
Experts don't know what causes prostate cancer, but they believe that your age, family history (genetics), and race affect your chances of getting it. Eating a high-fat diet may also play a part.2
What are the symptoms?
Prostate cancer usually does not cause symptoms in its early stages. Most men don't know they have it until it is found during a regular medical exam.
When problems are noticed, they are most often problems with urinating. But these same symptoms can also be caused by an enlarged prostate (benign prostatic hyperplasia). An enlarged prostate is common in older men.
See your doctor for a checkup if:
You have trouble starting your urine stream.
You have a weaker-than-normal urine stream.
You cannot urinate at all.
You have to urinate often.
You feel like your bladder is not emptying completely when you urinate.
You have to get up at night to urinate.
You have pain or burning when you urinate.
You have blood in your urine.
You have a deep pain in your lower back, belly, hip, or pelvis.
How is prostate cancer diagnosed?
The most common way to check for prostate cancer is to have a digital rectal exam, in which the doctor puts a gloved, lubricated finger in your rectum to feel your prostate, and a prostate-specific antigen (PSA) blood test. A higher level of PSA may mean that you have prostate cancer, but it could also mean that you have an enlargement or infection of the prostate.
If your PSA is high, or if your doctor finds anything in the rectal exam, he or she may do a biopsy to figure out the cause. A biopsy means your doctor takes a sample of tissue from your prostate gland and sends it to a lab for testing.
Because many men have regular checkups, about 9 out of 10 prostate cancers are found in the early stages. The 5-year survival rate is almost 100%.1 The 5-year survival rate shows the percentage of men still alive 5 years or longer after diagnosis. It’s important to remember that everyone’s case is different, and these numbers may not show what will happen in your case.
Should you have regular tests for prostate cancer?
It is important to have regular health checkups, including a digital rectal exam. But experts disagree on whether regular PSA testing is right for all men. Testing could lead you to have cancer treatment that can cause other health problems, especially loss of bladder control and not being able to have an erection.
Talk with your doctor about the reasons for and against having a PSA test for prostate cancer. The decision to have a PSA test depends on your doctor's opinion and your preferences.
How is prostate cancer treated?
Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences.
You and your doctor may decide to treat your cancer with surgery, radiation, hormone therapy, or a combination. Or, if the cancer has not spread and you are around age 70 or older, you may be able to wait and watch to see what happens. During watchful waiting, you will have regular checkups with your doctor to see if your cancer has changed.
Choosing treatment for prostate cancer can be confusing. Talk with your doctor to choose the treatment that is best for you.
How can treatment affect your quality of life?
Both surgery and radiation can cause urinary incontinence (not being able to control urination) or impotence (not being able to have an erection).
Nerves that help a man have an erection are right next to the prostate. Surgery to remove the cancer may damage them. Many times a special form of surgery, called nerve-sparing surgery, can be used to try to avoid damaging the nerves. But if the cancer has spread to the nerves, they may have to be removed during surgery.
These same nerves can also be damaged by the X-rays that are used in radiation therapy.
Drugs and mechanical aids may help men who are impotent because of treatment. Many men recover their ability to have an erection several months or years after surgery.
Colorectal Cancer
What is colorectal cancer?
Colorectal cancer happens when cells that are not normal grow in your colon or rectum. These cells grow together and form tumors.
This cancer is also called colon cancer or rectal cancer. It is the third most common cancer in the United States. And it occurs most often in people older than 50.
When it is found early, it is easily treated and often cured. But because it usually is not found early, it is the second leading cause of cancer deaths in the United States.1 Fairly simple screening tests can prevent this cancer, but fewer than half of people older than 50 are screened. According to the American Cancer Society, if everyone were tested, tens of thousands of lives could be saved each year.
What causes colorectal cancer?
Most cases begin as polyps, which are small growths inside the colon or rectum. Colon polyps are very common, and most of them do not turn into cancer. But doctors cannot tell ahead of time which polyps will turn into cancer. This is why people older than 50 need regular tests to find out if they have any polyps and then have them removed.
What are the symptoms?
Colorectal cancer usually does not cause symptoms until after it has begun to spread. See your doctor if you have any of these symptoms:
Pain in the belly
Blood in your stool or very dark stools
A change in your bowel habits, such as more frequent stools or a feeling that your bowels are not emptying completely
How is colorectal cancer diagnosed?
If your doctor thinks that you may have this cancer, you will need a test, called a colonoscopy, that lets the doctor see the inside of your entire colon and rectum. During this test, your doctor will remove polyps or take tissue samples from any areas that don't look normal. The tissue will be looked at under a microscope to see if it contains cancer.
Sometimes other tests, such as a barium enema or a sigmoidoscopy, are used to diagnose colorectal cancer.
How is it treated?
Surgery is almost always used to treat colon and rectal cancer. The cancer is easily removed and often cured when it is found early.
If the cancer has spread into the wall of the colon or farther, you may also need radiation or chemotherapy. These treatments have side effects, but most people can manage the side effects with medicines or home care.
Learning that you have cancer can be upsetting. It may help to talk with your doctor or with other people who have had cancer. Your local American Cancer Society chapter can help you find a support group.
How can you prevent colorectal cancer?
Screening tests can prevent many cases of colon and rectal cancer. They look for a certain disease or condition before any symptoms appear. Regular screening is advised for most people age 50 and older. If you have a family history of this cancer, you may need to begin screening earlier than that.
These are the most common screening tests:
Fecal occult blood test. You smear a small sample of your stool on a special card and send it to your doctor or to a lab. Drops of a special solution are placed on the card. If the solution changes color, there is blood in the stool.
Sigmoidoscopy. A doctor puts a flexible viewing tube into your rectum and into the first part of your colon. This lets the doctor see the lower portion of the intestine, which is where most colon cancers grow.
Barium enema. Barium, a whitish liquid, is put into your rectum and colon. The white liquid outlines the inside of the colon so that it can be more clearly seen on an X-ray.
Colonoscopy. A doctor puts a long, flexible viewing tube into your rectum and colon. The tube is usually linked to a video monitor similar to a TV screen. With this test, the doctor can see the entire large intestine.
Colorectal cancer happens when cells that are not normal grow in your colon or rectum. These cells grow together and form tumors.
This cancer is also called colon cancer or rectal cancer. It is the third most common cancer in the United States. And it occurs most often in people older than 50.
When it is found early, it is easily treated and often cured. But because it usually is not found early, it is the second leading cause of cancer deaths in the United States.1 Fairly simple screening tests can prevent this cancer, but fewer than half of people older than 50 are screened. According to the American Cancer Society, if everyone were tested, tens of thousands of lives could be saved each year.
What causes colorectal cancer?
Most cases begin as polyps, which are small growths inside the colon or rectum. Colon polyps are very common, and most of them do not turn into cancer. But doctors cannot tell ahead of time which polyps will turn into cancer. This is why people older than 50 need regular tests to find out if they have any polyps and then have them removed.
What are the symptoms?
Colorectal cancer usually does not cause symptoms until after it has begun to spread. See your doctor if you have any of these symptoms:
Pain in the belly
Blood in your stool or very dark stools
A change in your bowel habits, such as more frequent stools or a feeling that your bowels are not emptying completely
How is colorectal cancer diagnosed?
If your doctor thinks that you may have this cancer, you will need a test, called a colonoscopy, that lets the doctor see the inside of your entire colon and rectum. During this test, your doctor will remove polyps or take tissue samples from any areas that don't look normal. The tissue will be looked at under a microscope to see if it contains cancer.
Sometimes other tests, such as a barium enema or a sigmoidoscopy, are used to diagnose colorectal cancer.
How is it treated?
Surgery is almost always used to treat colon and rectal cancer. The cancer is easily removed and often cured when it is found early.
If the cancer has spread into the wall of the colon or farther, you may also need radiation or chemotherapy. These treatments have side effects, but most people can manage the side effects with medicines or home care.
Learning that you have cancer can be upsetting. It may help to talk with your doctor or with other people who have had cancer. Your local American Cancer Society chapter can help you find a support group.
How can you prevent colorectal cancer?
Screening tests can prevent many cases of colon and rectal cancer. They look for a certain disease or condition before any symptoms appear. Regular screening is advised for most people age 50 and older. If you have a family history of this cancer, you may need to begin screening earlier than that.
These are the most common screening tests:
Fecal occult blood test. You smear a small sample of your stool on a special card and send it to your doctor or to a lab. Drops of a special solution are placed on the card. If the solution changes color, there is blood in the stool.
Sigmoidoscopy. A doctor puts a flexible viewing tube into your rectum and into the first part of your colon. This lets the doctor see the lower portion of the intestine, which is where most colon cancers grow.
Barium enema. Barium, a whitish liquid, is put into your rectum and colon. The white liquid outlines the inside of the colon so that it can be more clearly seen on an X-ray.
Colonoscopy. A doctor puts a long, flexible viewing tube into your rectum and colon. The tube is usually linked to a video monitor similar to a TV screen. With this test, the doctor can see the entire large intestine.
There's Good News About Treatment and Survival of Breast Cancer
Few things are as terrifying as thinking you might have breast cancer: Surveys show it's women's number one health worry. However, 80% of biopsies are benign. And thanks to advances in testing and treatment, breast cancer is less deadly than ever, and curing it is not the toxic, disfiguring ordeal it once was.
The importance of regular breast screening cannot be overstated—nor, for those who have been diagnosed, the importance of understanding the treatment options and finding good medical care. That's what this breast cancer Health Journey is here for: to explain the risks and tests and to guide you through the full range of choices you have on your road to cure. Along the way, we dive deeply into the emotional aspects of this disease, talk to women who have beaten breast cancer, and introduce you to the doctors and experts who have helped them do it.
Our Breast Cancer Health Journey team includes editorial adviser Julia A. Smith, MD, PhD; editor Sally Chew; research editor Michael Gollust; lead writer Lorie Parch; and many contributing journalists.
The importance of regular breast screening cannot be overstated—nor, for those who have been diagnosed, the importance of understanding the treatment options and finding good medical care. That's what this breast cancer Health Journey is here for: to explain the risks and tests and to guide you through the full range of choices you have on your road to cure. Along the way, we dive deeply into the emotional aspects of this disease, talk to women who have beaten breast cancer, and introduce you to the doctors and experts who have helped them do it.
Our Breast Cancer Health Journey team includes editorial adviser Julia A. Smith, MD, PhD; editor Sally Chew; research editor Michael Gollust; lead writer Lorie Parch; and many contributing journalists.
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