Pam Curry

1. Normal bone marrow produces new blood cells

, which include red blood cells, white blood cells (neutrophils, plasma cells and monocytes) and platelets.

2. Monoclonal gammopathy of undetermined significance:

 Elevated levels of M protein due to an increased number of plasma cells. Bone lesions are absent. No treatment is necessary. Disease should be monitored every six to 12 months.

 Elevated levels of M protein due to an increased number of plasma cells. Bone lesions are absent. Standard of care is to monitor disease without treatment. Enrollment in a clinical trial comparing treatment to observation might be an option.

4. Solitary or intramedullary plasmacytoma:

 Elevated levels of M protein, increased number of plasma cells and a single tumor in the bone or soft tissue. Treatment typically consists of radiation therapy.

 High levels of M protein and elevated levels of plasma cells accompanied by multiple painful bone lesions and anemia. Kidney damage might also be present. Treatment options include chemotherapy, targeted agents and immune modulators with or without bone marrow transplantation.

Articles

Multiple myeloma begins with a single precancerous plasma cell that multiplies uncontrollably and can eventually cause bone lesions and anemia.

Medical Illustration: Multiple Myeloma

Certain drugs target estrogen receptor-positive or HER2-positive breast cancers. Research is examining whether better drugs or combinations can improve outcomes.

ILLUSTRATION BY PAM CURRY, ORIGINALLY PUBLISHED IN “A NEW ERA,” CURE SPECIAL ISSUE: ADVANCES IN BREAST CANCER 2007

 are also commonly used to treat different types of breast cancer. Chemotherapy kills cells that are in the process of dividing; in adults, that most often means cancer cells. Chemotherapy drugs work by inhibiting the creation of nucleotides that are needed for DNA formation, by damaging the DNA itself, or by halting mitosis, the process by which the chromosomes containing DNA physically divide. These drugs as not as specific as hormonal or HER2-targeted therapies and can injure normal cells to a greater extent, and therefore tend to cause more side effects.

Medical Illustration: Breast Cancer

 The cancer is located on one side of the prostate. At this stage, the tumor is very small or found incidentally, possibly during surgery or by an elevated prostate-specific antigen (PSA) level. The Gleason score is low.

 The cancer is located only in the prostate but can be seen on imaging scans or felt during a digital rectal exam. The Gleason score may range from 2 to 10.

 The cancer has extended through the outer layer of the prostate and into surrounding tissues and may be found in the seminal vesicle but not in the lymph nodes. The Gleason score may range from 2 to 10.

 The cancer has spread to the lymph nodes near or far from the prostate or has spread to distant tissues or organs, such as the liver or bones. The Gleason score may range from 2 to 10.

 defines prostate cancer by grade based on the pathologist’s review of a biopsy or surgical specimen, with 1 being the least aggressive and 5 being the most aggressive. The grade of the most common tumor pattern is added to the grade of the second most common tumor pattern in the tissue examined to create the Gleason score. A Gleason score of 2 to 4 is considered low grade, 5 to 7 is intermediate grade and 8 to 10 is high grade.

When diagnosing prostate cancer, doctors consider staging and grading. In grading, a score is assigned based on the Gleason grading system.

Pam Curry

Medical Illustration: Multiple Myeloma

Medical Illustration: Breast Cancer

Medical Illustration: Prostate Cancer

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