New York

http://www.nycvisit.com Welcome to New York City
http://www.ny.gov/ Locate New York State Government
http://www.newyork.com New York's Home Page
http://www.nyc.gov The Official New York City Site
http://www.nyu.edu New York University
http://www.nytimes.com/The New York Times - Breaking News, World News & Multimedia
http://www.nyse.com New York Stock Exchange
http://www.nypl.org¨The New York Public Library
http://www.nylottery.orgNew YOrk Lottery
http://www.nysed.govNew York State Education Department
http://www.iloveny.comI Love New York
http://www.cnewyork.netNew York photos - photos de New York

Los Angeles

http://www.losangeles.com Los Angeles City of Los Angeles
http://www.ci.la.ca.us
http://www.ucla.edu University of California, Los Angeles
http://www.calstatela.edu California State University, Los Angeles
http://www.latimes.com Los Angeles news, - Los Angeles Times
http://www.nba.com/lakers LOS ANGELES LAKERS

http://en.wikipedia.org/wiki/Health_care Healthcarehttp://www.healthcare.comHealthcare
http://hotjobs.yahoo.com/jobs-HealthcareHealthCare
http://www.forbes.com/healthcareHealthcare
http://www.whitehouse.gov/infocus/healthcare/Health care
http://health-care.careerbuilder.comHEalth-care
http://www.thomson.com/solutions/healthcareHealt hcare
http://www.uhc.comHealth care
http://www.healthcareitnews.comHealth care
http://www.gehealthcare.comHealth care
http://www.healthcarecommission.org.ukhealthcare
http://www.healthcare-informatics.comHealthcare
http://www.himss.org/Healthcare
http://www.acibadem.com.tr/English/Health care
http://www.ahrq.gov/Health care
http://www.boston.com/jobs/healthcareHealth care
http://www.ahca.orghealth care
http://www.ameinfo.com/news/HealthcareHealthcare
http://www.bayerhealthcare.comhealth care
http://www.modernhealthcare.comHealthcare
http://www.va.gov/healthHealth Care
http://www.healthcareguy.comHealthCare
http://www.axappphealthcare.co.ukhealth care
http://www.canadian-healthcare.orgCanadian healthcare
http://www.healthcare.orgHealthcare
http://www.healthcareinternational.com/Healthcare
http://www.greatwesthealthcare.comHealthcare
http://www.cancer.orgCancer
http://www.cancer.govCancer
http://cancer.about.comCancer
http://www.webmd.com/cancer/default.htm Cancer
http://www.nature.com/cancerCancer
http://www.cancer.ca/Cancer
http://www.cancer.comCancer
http://www.oncolink.comCancer
http://www.cancerresearchuk.orgCancer
http://www.who.int/cancer/Cancer
http://www.cdc.gov/cancer/azCancer
http://www.cancercare.orgCancer
http://www.cancerhelp.org.ukCancer Help
http://www.cancerbackup.org.ukCancer
http://www.cancer.org.au/Cancer
http://cancerres.aacrjournals.orgCancer
http://www.topix.com/health/cancerCancer
http://www.cancer.dkCancer
http://www.newstarget.com/cancer.htmlCancer
http://www.library.nhs.uk/cancercancer
http://www.insidecancer.orgcancer
http://www.cancermonthly.comCancer
http://www.atcancer.comCancer
http://www.diabetes.orgdiabetes
http://diabetes.diabetesjournals.orgdiabetes
http://en.wikipedia.org/wiki/Diabetes diabetes
http://www.diabetes.comdiabetes
http://diabetes.webmd.comdiabetes
http://diabetes.niddk.nih.gov/diabetes
http://diabetes.about.comdiabetes
http://www.cdc.gov/diabetesdiabetes
http://www.diabetes.org.ukdiabetes
http://de.wikipedia.org/wiki/Diabetesdiabetes
http://www.diabetesaustralia.com.audiabetes
http://www.ndep.nih.govdiabetes
http://www.diabetes.cadiabetes
http://diabetesinformationhub.comdiabetes
http://www.fda.gov/diabetes/diabetes
http://www.diabetes.dk/diabetes
http://www.childrenwithdiabetes.comdiabetes
http://es.wikipedia.org/wiki/Diabetesdiabetes
http://www.library.nhs.uk/diabetes/diabetes
http://www.diabetes-austria.com/ -diabetes
http://www.topix.com/health/diabetesdiabetes
http://www.diabetes.sediabetes
http://www.jdrf.orgdiabetes
http://diabetes.startpagina.nldiabetes
http://nihseniorhealth.gov/diabetes/toc.html diabetes
http://en.wikipedia.org/wiki/HIVHiv
http://www.hiv.lanl.govHiv
http://www.cdc.gov/hiv/Hiv
http://www.hiv-info.deHiv
http://www.hiv.comHiv
http://www.hiv.netHiv
http://nl.wikipedia.org/wiki/HivHiv
http://www.thebody.com/Hiv
http://www.hivmedicine.comHiv
http://www.avert.org/aids.htmHiv
http://www.hivnet.orgHiv
http://www.medicinenet.com/human_immunodeficiency_virus_hiv_aids/article.htm Hiv
http://www.who.int/topics/hiv_infections/enHiv
http://www.myhivstory.blogspot.comHiv
http://aidsinfo.nih.govHiv
http://www.hiv.ch/Hiv
http://de.wikipedia.org/wiki/Aids Hiv
http://aids.about.comHiv
http://www.cdc.gov/fluinfluenza
http://en.wikipedia.org/wiki/Influenza influenza
http://www.who.int/topics/influenza/eninfluenza
http://www.influenza.chinfluenza
http://de.wikipedia.org/wiki/Influenza influenza
http://www.influenza.cominfluenza
http://www.phac-aspc.gc.ca/influenzainfluenza
http://flu01.com/influenza
http://www.influenza.beinfluenza
http://www.medicinenet.com/influenza/article.htminfluenza
http://www.topix.com/health/influenzainfluenza
http://www.medinfo.co.uk/conditions/influenza.html influenza
http://www.influenza.itinfluenza
http://www.abc.net.au/health/library/influenza_ff.htminfluenza
http://www.influenza.deinfluenza

Waldenstrım's Macroglobulinemia Cancer

This disease is due to overproduction of cells that are like Plasma cells from the bone marrow. Under normal circumstances, these cells are in charge of producing immune globulins, the immune proteins that our body needs to fight infections. In case of Waldenström's Disease, the abnormal plasma cells produce abnormal and dysfunctional immune globulins. The kind of immune globulin that is produced in this disease can cause thickening of the blood and lead to a Hyperviscosity syndrome. This disease is basically diagnosed by detecting these abnormal immune globulins in the blood, or alternatively, by observing the abnormal cells in the bone marrow. This is a very rare and low grade cancer and is more commonly seen after age of 65.


--------------------------------------------------------------------------------

Causes:

The cause of this illness is unknown. The disease is named after Professor Jan Waldenström, a Swedish physician who described this illness.




--------------------------------------------------------------------------------

Signs and Symptoms

Patients may not show any signs for quite sometime. This illness can present itself in many different fashions. Most patients, however, present with Hyperviscosity syndrome. As the disease progresses, it can cause any of the following problems:

Anemia

Low platelet count

Frequent infections

Fever

Weight loss

Enlargement of lymph glands

Enlargement of Liver and spleen.


--------------------------------------------------------------------------------

Diagnosis

The diagnosis is established by certain blood tests and also taking a biopsy of the bone marrow.


--------------------------------------------------------------------------------

Treatment

Waldenström's Disease involves almost all of the bone marrow space in the body. As a result, the disease can only be treated with chemotherapy. Any patient who is under the age of 60, and otherwise in good health, should be considered for a bone marrow transplantation. For individuals who are older or can not tolerate the transplant, chemotherapy is most appropriate. If the disease causes a local problem in bones, like bone pain, or fractures, etc., radiation can be used to alleviate that problem.

The most commonly used chemotherapy regimens for treatment of Waldenström's Disease is Cladribine (Leustatin). This drug can induce a very good remission in great majority of patients.

Other drugs that might be used are : Melphalan , Prednisone, Cytoxan, Interferon


--------------------------------------------------------------------------------

Remission:

Refers to the response of any cancer to the treatment.

Complete remission refers to the situation where the disease disappears completely with the treatment

Partial remission refers to the situation where the disease shrinks but does not disappears completely with the treatment

The remission status is determined by measuring the immune globulin levels in the blood, as well as repeating the bone marrow tests.


--------------------------------------------------------------------------------

Prognosis:

Waldenström's Disease may remain silent for years. It may, however, gradually transition into more aggressive stage, or even transform into a Lymphoma. Prognosis of Waldenström's Disease depends on the response to chemotherapy.


--------------------------------------------------------------------------------

Follow up

After completion of treatment, and in any combination that might have taken place, patients need to remain under surveillance for possibility of recurrence of cancer. Follow up shall be scheduled on a regular basis and initially every 1-3 months for 1-2 years. The frequency of follow up will depend on the condition of the patient and their disease. In each follow up visits, patients are examined and normally a blood test and evaluation of immune globulins should be done.

Treatment of recurrent disease will depend on the stage and extent of the reoccurred disease. Most patients are then treated with chemotherapy with same agents as mentioned above. Radiation therapy may be helpful in managing painful or symptomatic areas, where the cancer has spread to.

Multiple Myeloma

Roughly 16,000 Americans develop this illness each year. It is more frequent in men than in women and is more commonly seen after age 60. This disease is due to an overproduction of plasma cells from the bone marrow. Under normal circumstances, these cells are in charge of producing immune globulins, the immune proteins that our body needs to fight infection. In the case of multiple Myeloma, the abnormal plasma cells produce abnormal and dysfunctional immune globulins.

One indicator of the disease is a blood test known as Beta 2 microglobulin. This disease is basically diagnosed by detecting these abnormal immune globulins in the blood or, alternatively, by observing the abnormal plasma cells in the bone marrow.


--------------------------------------------------------------------------------

Causes:

The cause of this illness is unknown.


--------------------------------------------------------------------------------

Signs and Symptoms

Patients may not show any signs for quite sometime and Myeloma can present itself in many different ways. Approximately 20 percent of patients are diagnosed incidentally and during workup on an unrelated problem. As the disease progresses, it can cause any of the following problems:

Bone pain

High calcium levels

Kidney failure

Anemia

Low platelet count

Hyperviscosity Syndrome

Frequent infections

Fever

Weight loss


--------------------------------------------------------------------------------

Diagnosis

The diagnosis is established by certain blood tests and also taking a biopsy of the bone marrow.


--------------------------------------------------------------------------------

Staging

Staging refers to determination of the extent of the disease and is a very good guideline as to the treatment plans and outcome of Multiple Myeloma. The extent of the disease depends on the presence or absence of any of the following:

Bone Disease

High calcium levels

Kidney failure

Anemia

Low platelet count

Lower stages of the illness are indicated by very minimal problems, and higher stages with the presence of most of the above problems.


--------------------------------------------------------------------------------

Treatment

Multiple Myeloma involves almost all of the bone marrow space in the body. As a result, the disease can only be treated with systemic therapies. Any patient, who is under the age of 70, and in otherwise good health, should be considered and offered a bone marrow transplantation.

Following are the two of the most commonly used regimens for treatment of multiple Myeloma:

Thalidomide, Dexamethasone known as ThalDex regimen which is treatment of choice for previously untreated patients.

Velcade

Melphalan, Prednisone, known as MP regimen: The two drugs are given orally for 4-7 days and are repeated every month

Vincristine, Adriamycin, Decadron, known as VAD regimen. This is an intravenous treatment, whereby Vincristine and Adriamycin are given intravenously by way of continuous infusion over a period of four days. The infusion is repeated every month. Decadron is given orally. This is a more aggressive regimen with more side effects, as opposed to MP.

If the disease causes a local problem in the bones, like bone pain or fractures, etc., radiation can be used to alleviate the problem. Other drugs that can also be used are: Cytoxan, VP-16, Interferon, BiCNU


--------------------------------------------------------------------------------

Remission:

Refers to the response of any cancer to treatment.

Complete remission refers to the situation where the disease disappears completely with the treatment.

Partial remission refers to the situation where the disease shrinks but does not disappear completely with the treatment

Measuring the immune globulin levels in the blood, as well as repeating the bone marrow tests determine the remission status. When and if patients enter a remission, they are best maintained on a treatment regimen with Interferon.


--------------------------------------------------------------------------------

Prognosis:

Patients with lower stages have a better prognosis. Low Stage Multiple Myeloma may remain silent for years. It may, however, gradually progress into higher stages. Prognosis of High Stage Multiple Myeloma depends on the response to chemotherapy.


--------------------------------------------------------------------------------

Special Situations

Patients with advanced Multiple Myeloma may develop any of the following complications.

Spinal cord compression

Bone destruction and metastasis

High Calcium level

Pain

High Uric acid


--------------------------------------------------------------------------------

Survival

Survival of patients with Multiple Myeloma, in whom a cure is not possible, may vary from months to years, depending on the extent of the cancer, overall condition of the patient, as well as his/her response to treatment and the duration of the response. Those treated with bone marrow transplant have a 30% chance of cure.


--------------------------------------------------------------------------------

Follow-up

After completion of treatment, in any combination that might have taken place, patients need to remain under surveillance for the possibility of a recurrence of cancer. Follow-up should be scheduled on a regular basis, initially every one to three months for one to two years. The frequency of follow-up will depend on the condition of the patient and his/her disease. In each follow-up visit, patients are examined and normally a blood test and evaluation of immune globulins and Beta 2 microglobulin is done.

Treatment of recurrent disease will depend on the stage and extent of the reoccurred disease. Most patients are then treated with chemotherapy using the same agents mentioned above. Radiation therapy may be helpful in managing painful or symptomatic areas to which the cancer has spread. If patients experience pain, various pain medications can be used to alleviate pain. For patients with advanced disease,

Lymphomas

Lymphomas are cancers of the organs and cells of the body's immune (lymphoid) system. They are categorized into two primary groups:

Hodgkin's Lymphoma or Hodgkin's Disease

Non-Hodgkin's Lymphoma

The signs and symptoms, as well as the treatment of these diseases, may vary.

Leukemias

Leukemia is a cancerous disorder of the blood cells. There are a variety of Leukemias, each with its own peculiar signs, symptoms, prognosis and behavior. roughly 30,000 Americans develop some sort of leukemia every year.

There are four major types of leukemia:

Acute Myeloid Leukemia

Acute Lymphoid Leukemia

Chronic Myeloid Leukemia

Chronic Lymphoid Leukemia

Acute Leukemia refers to Leukemia which, if left untreated, can cause fatal complications in a very short period of time.

Chronic Leukemias, on the other hand, if left untreated in some cases may not cause any problems at all even for years.

Hairy Cell Leukemia is an entity of its own that will be discussed separately.

When Leukemias progress, they can cause a rise or decline in the number of blood cells. Even though the total number of blood cells may be elevated, in most instances, the count of normal blood cells is reduced. This is due to overproduction of the leukemic cells that result in overpopulation of the bone marrow and suppression of normal blood cell production.

In most instances, the underlying problem is an abnormality in maturation and growth of normal blood cells which leads to accumulation of abnormal, immature and dysfunctional cells in the blood, the leukemia cells.