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The Cancer Center of Huntsville, P.C.

TCC News


Ovarian Cancer: Signs and Symptoms

Bone Cancer: Overview and Signs

Sarcoma: Symptoms and Causes

Skin Cancer: Signs and Prevention

Esophageal Cancer: Overview and Symptoms

Colorectal Cancer: Signs and Symptoms

Advanced Stage Lung Cancer

Cancer Among African-Americans

Robin Erwin - Survivorship Care

What is Cervical Cancer?

Male Breast Cancer

Diagnosis Strengthens Dedication

Real Men Wear Pink

Belles and Beaus Ball


Ovarian Cancer: Signs and Symptoms

Ovarian cancer is a cancer that begins in the ovaries, the reproduction system of a woman. There are two ovaries, one on each side of the uterus and about the size of an almond. The ovaries produce eggs as well as the hormones estrogen and progesterone.

Ovarian is one of the deadliest types of cancer because it is very difficult to detect until it is in the late stages. At this point, the cancer may already have spread to the abdomen and pelvis.

In its early stages, ovarian cancer rarely causes any symptoms, which is why it is so difficult to detect. Signs and symptoms of ovarian cancer may include the following:

  • A frequent need to urinate
  • Discomfort in the pelvic area
  • Abdominal bloating or swelling
  • Quickly feeling full when eating
  • Weight loss
  • Changes in bowel habits, such as constipation

There are also risk factors linked to ovarian cancer, which include:

  • Older age. Ovarian cancer is more common in women in their 50s and 60s.
  • Family history. People with two or more close relatives with ovarian cancer have an increased risk of developing the disease.
  • Estrogen hormone replacement therapy. This is especially true with long-term use and in large doses.
  • Age when menstruation started and ended. Beginning menstruation at an early age, or starting menopause at a later age may increase the risk of developing ovarian cancer.

There is no known way to prevent ovarian cancer. But there may be ways to reduce your risk.

Ask your doctor about birth control pills. Women who use oral contraceptives may have a reduced risk of developing ovarian cancer. Oral contraceptives do have risks, but your doctor will discuss those with you.

If you have a family history of breast and ovarian cancers, tell your doctor. If you are found to have a gene mutation that increases your risk of ovarian cancer, you may consider surgery to remove your ovaries to prevent ovarian cancer.


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Bone Cancer: Overview and Signs

Bone cancer is a mass of unusual cells growing in a bone. Most bone tumors are not cancerous. Bone cancer can begin in any bone in the body, but is most commonly found in the pelvis, or long bones such as the arms and legs.

Non-cancerous bone tumors are much more common than cancerous ones, which make up less than one-percent of all cancers.

While researchers say the onset of bone cancer could relate to hereditary factors, the actual cause is unknown. In many cases, when bone cancer is found, it is a secondary cancer having spread from another source.

Signs of bone cancer include:

  • Pain: It may be mild and intermittent, often occurring at night or after vigorous exercise. Over time, the sensation will increase developing into a persistent ache.
  • Tingling, Numbness, Burning Sensation: Nerve pain may be difficult to describe to a physician. Bone cancer disrupts the normal activity of bone cells, injuring nerve fibers and increasing nerve sensitivity.
  • Joint Stiffness and Swelling: Bone cancers often develop in or near a joint in the upper arms and legs. The joint becomes tender, but the tumor causes stiffness.
  • Weakened Bones and Fractures: Cancer weakens the bones and may cause unexplained fractures.
  • Low Back Pain: Bone cancer developing in the pelvis may cause low back pain and even sciatica. This cancer may cause back pain that does not respond to physical therapy.

Diagnosis of bone cancer is done using various methods including scans and imaging and needle or surgical biopsies.

The treatment options for bone cancer will depend on the type of cancer, the stage of the cancer, and your overall health. You and your cancer team will make these decisions together. Treatments may include surgery, chemotherapy, radiation therapy, or a combination of such treatments.


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Sarcoma: Symptoms and Causes

Sarcoma is a general term for cancers that begin in the bones and soft tissues and can occur in various locations in your body.

The uncommon group of cancers usually arise in the bones and connectivity tissue such as muscle and fat. There are many types of soft tissue tumors and not all of them will develop into cancer. Soft tissue sarcomas can also develop in nerves and blood vessels and can be found in any part of the body.

There are at least 70 types of sarcoma. Treatment will vary depending upon the type and severity of the cancer.

Signs and symptoms include:

  • Bone pain
  • A lump that can be felt through skin that may, or may not be painful
  • A broken bone that happens unexpectedly or without an obvious injury
  • Abdominal pain
  • Unexplained weight loss

It is unclear what causes most sarcomas, however there are certain factors that may increase your risk of developing this type of cancer:

  • Radiation therapy may increase your risk of developing sarcoma later
  • Exposure to chemicals such as industrial chemicals and herbicides
  • Inherited syndromes, which can be passed from parents to children, such as familial retinoblastoma and neurofibromatosis
  • Chronic swelling, or lymphedema, caused by a backup of lymph fluid
  • Exposure to viruses such as the herpesvirus 8 can increase the risk of a type of sarcoma called Kaposi's in people with weakened immune systems

Sarcoma is usually treated with surgery to remove the cancer. Other treatments may be used before or after surgery to improve your chances of recovery. Which treatments are best for you will depend on the type of sarcoma, its location, how aggressive the cells are, and whether the cancer has spread to other parts of your body. Your doctor will help determine the best course of treatment.


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Skin Cancer: Signs and Prevention

It is that time of year again where we are all happy to get out into the fresh air and enjoy the sunshine. However, enjoying a day in the sun without protecting your skin can result in skin cancer, which is deadly if not discovered at an early stage.

There are three major types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma. And while sun exposure is a big risk factor, skin cancer can develop on parts of the skin that have not been exposed to the sun.

Melanoma is the most dangerous form of skin cancer and occurs when pigment-producing cells that give color to the skin become cancerous. Melanoma is more dangerous because of its ability to spread to other organs more rapidly if not detected early.

Basal cell carcinoma signs and symptoms include:

  • A pearly or waxy bump
  • A flat, flesh-colored or brown scar-like lesion
  • A bleeding or scabbing sore that heals, and then returns

Squamous cell carcinoma signs and symptoms include:

  • A firm, red nodule
  • A flat lesion, with a scaly, crusted surface

Melanoma signs and symptoms include:

  • A painful lesion that itches or burns
  • A mole that changes in color or size, and bleeds
  • A large brownish spot with scattered speckles
  • A painful lesion that itches or burns
  • Dark lesions on your palm, soles, fingertips or toes, or on the mucous membranes lining your mouth, nose, vagina or anus

Risk factors for all skin cancer include:

  • Fair skin
  • A history of sunburns
  • Excessive sun exposure
  • Abnormal moles
  • A family history of skin cancer

Much of the damage caused to skin cells is due to exposure to UVA light, whether through the sun, or tanning beds. You can reduce your risk of skin cancer by limiting your exposure to UVA light, and by using sunscreen protection and a hat and other protective clothing.

Also, checking your skin on a regular basis and seeing a doctor if you notice any abnormality in freckles, moles, or other parts of your skin.


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April is Esophageal Cancer Awareness Month


Esophageal Cancer: Overview and Symptoms

Esophageal cancer is cancer that develops in the esophagus, the tube that runs from your throat to your stomach. The esophagus helps move the food you eat from the back of your throat to your stomach to be digested.

This type of cancer usually begins in the cells that line the inside of the esophagus. It is the sixth most common cause of cancer deaths worldwide, and it is more commonly detected in men.

Early onset esophageal cancer typically causes no signs or symptoms. You should make an appointment with your doctor if you have any of these signs or symptoms.

Symptoms of esophageal cancer include:

  • Difficulty swallowing
  • Unexplained weight loss
  • Worsening indigestion or heartburn
  • Chest pain, pressure or burning
  • Coughing or hoarseness

If you have been diagnosed with Barrett's esophagus, a precancerous condition caused by chronic acid reflux, you have a greater chance of developing esophageal cancer. Your doctor can talk with you about screening tests if you have this disorder.

While it is not known what causes esophageal cancer, there are some risk factors:

  • Smoking
  • Obesity
  • Overconsumption of alcohol
  • Gastroesophageal reflux disease
  • Having bile reflux
  • Not eating enough nuts and vegetables
  • A steady habit of drinking very hot beverages

There are steps you can take to reduce your risk of developing esophageal cancer, and these include:

  • Maintaining a healthy weight
  • Eating more fruits and vegetables
  • Drinking alcohol in moderation. For healthy men, this means two drinks per day; for healthy women, one drink per day.
  • Quitting smoking

The type of treatment you receive will depend upon the type of cells involved in your cancer, your cancer's stage, and your overall health at the time of diagnosis. Treatments can include surgery, chemotherapy, radiation and targeted drug therapy.

Esophageal cancer is an aggressive form of cancer and often is not detected until late in the disease process. This is why it is important that if you have any of the symptoms, you should make an appointment with your doctor as soon as possible.


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Colorectal Cancer: Signs and Symptoms

Colorectal cancer is a cancer that starts in the colon or rectum. When detected at an early stage or before it can become cancerous, it is highly curable. This makes screening tests vitally important in your yearly health routine.

Colon cancer is now the third most common type of cancer in the United States. This cancer develops when tumorous growths develop in the large intestine, which is where the body draws out water and salt from solid waste. The waste then moves through the rectum and is disposed of through the anus.

Though it can happen at any age, colon cancer typically affects older adults. It usually begins as small non-cancerous tumors known as polyps that form inside the colon. Left undetected, and therefore not removed, these polyps often grow into cancers.

Polyps may be small and produce few symptoms, which is why doctors may recommend regular colon cancer screening tests. Colonoscopies will not be recommended as often if you are an otherwise healthy adult with no family history of the disease.

Symptoms of colon cancer include:

  • Rectal bleeding, or blood in your stool
  • Persistent abdominal discomfort, such as cramps and unexplained diarrhea
  • A persistent change in your bowel habits
  • A feeling that your bowel doesn't empty completely
  • Weakness and fatigue
  • Unexplained weight loss

Many people with colon cancer experience no symptoms in the early stages. But when symptoms appear, the likelihood that you have cancer is much greater.

Because some gene mutations pass through generations, it is believed that colon cancer may be hereditary. This is why if someone in your family has suffered colon cancer, your doctor may recommend screening at a younger age and more often than every ten years.

Changing your diet to one high in fiber with plenty of fruits and vegetables may lower your risk of developing colon cancer. Quitting smoking and consuming fewer alcoholic beverages may also lower your risk.

If you have any of the above-listed symptoms, you should contact your doctor immediately.


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Advanced Stage Lung Cancer

Last week, millions of Americans were shocked to hear that conservative radio host, Rush Limbaugh, has advanced stage lung cancer. Limbaugh made the announcement on his radio show as stunned listeners took it all in.

Because the symptoms of lung cancer are often vague in its early stages, many times the cancer is already advanced by the time it is diagnosed, as is the case with Limbaugh.

Rush has often talked about his love for a good cigar but, and perhaps more importantly, he is very open about having smoked cigarettes for many years. And although he says he quit the cigarettes years ago, it is not uncommon for a former smoker to develop lung cancer.

Advanced stage lung cancer is cancer that has spread to both lungs, the fluid surrounding the lungs, or to another part of the body such as the liver or other organs. Although there is no cure for lung cancer at this stage, there are treatments that can make symptoms easier to handle.

The symptoms for advanced stage lung cancer are the same as those for lung cancer that may be diagnosed at an earlier stage:

  • A cough that doesn't go away
  • Shortness of breath
  • Chest pain
  • Coughing up blood, even a small amount
  • Hoarseness
  • Weight loss without explanation
  • Bone pain
  • Unrelenting headaches

Dr. Rachel Kruspe, medical oncologist with The Cancer Center of Huntsville, said If you've smoked for at least 30 years and are at least 55 years old, then talk with your doctor about a chest CT to screen for lung cancer. These scans can save lives by detecting lung cancer early.

Surgery may be the first choice of treatment for patients with non-small-cell lung cancer, but few patients can be treated surgically because the cancer is usually advanced when discovered. Complete remission of non-small-cell lung cancer has been achieved through the use of chemotherapy and other treatments.

If you suffer any of the above-listed symptoms, make an appointment with your doctor as quickly as you can. Survival rates are higher when lung cancer is discovered at an early stage.


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Cancer Among African-Americans

February is Black History Month, a time to celebrate the accomplishments of African-Americans. It is also an opportunity to explore the high incidence of cancer among blacks in the African-American community.

According to research, black people tend to develop cancer at earlier ages than do other ethnicities. The cancers tend to be more aggressive with worse outcomes than with other groups.

The experts also believe that one-half of black men, and one-third of black women will be diagnosed with cancer at some point in their lives. The reasons for these trends are not well-understood, however screening and early detection are just as important in lowering mortality rates.

The five most common types of cancer are: breast cancer, cervical cancer, lung cancer, colon cancer, and prostate cancer. The American Cancer Society lists early screening methods for each of these cancers, as follows:

  • Breast Cancer: Mammogram
  • Cervical Cancer: Pap Smears
  • Lung Cancer: low-dose CT scanning for those at high risk
  • Colon Cancer: Colonoscopies
  • Prostate Cancer: PSA testing (a blood test)

There are recommendations for lifestyle changes to ensure a healthier life, and knowing your family history may help where early detection is a concern. Here are some things for you to consider:

  • Exercise regularly (30 minutes a day is recommended)
  • Consume a diet high in fruits and vegetables, and low in fats and red meats
  • Avoid the use of tobacco products
  • Consume alcoholic beverages in moderation (1 to 2 drinks per week)

It is also recommended that you discuss family medical histories and genetic tendencies with your family. Some cancers are believed to be carried genetically.

If you have concerns, talk with your family doctor. Cancer screening and early detection can mean the difference between life and death for many people.


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Introducing Robin Erwin - Survivorship Care

We are excited to welcome Robin Erwin, CRNP to the TCC family. Robin is going to be managing Survivorship Care. Survivorship focuses on the health and life of a person with cancer post treatment until the end of life. This includes issues related to the ability to get health care and follow-up treatment, late effects of treatment, second cancers, and quality of life.

During your course of treatment, you will have an appointment with Robin. At this appointment, you may discuss any side effects that you are experiencing from your treatment and when to call the office. Robin will help manage these symptoms. She will assess emotional distress caused by your illness. If needed, referrals to other medical professionals or medications may be started to help lessen this distress. Robin will assist with life or work concerns and complete forms for employment disruptions. If you have FMLA or short/long term disability forms that need to be completed, please bring these to your appointment. Our team can also provide financial resources or counseling if needed.

Robin is a Huntsville native. She received her Bachelor of Science in Nursing in 1999 from UAH. She then worked in the Surgical Trauma ICU as an RN. In 2012 she graduated with a masters in nursing and began her career as a Family Nurse Practitioner. She worked in Primary Care until 2019. She is Board certified by the American Academy of Nurse Practitioners.

In her free time Robin enjoys cooking, reading and traveling with her husband and daughter.


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January is Cervical Cancer Awareness Month


What is Cervical Cancer?

Cervical cancer is a type of cancer that occurs in the cervix at the lower part of the uterus in a woman. It can be contracted through the human papillomavirus (HPV), which is a sexually transmitted infection. Various strains of HPV play a role in causing most cervical cancer.

In its early stages, cervical cancer presents no signs or symptoms. However, HPV can survive for years in the body and may contribute to the process that causes some cervical cells to become cancerous.

HPV is so common that most people contract it at some time in their lives. The virus usually causes no symptoms, which is why it is difficult to know whether or not you have it. For most women, HPV will go away on its own, however, if it does not, there is the chance that cervical cancer will develop.

Dr. Rosa Michel Ortega with The Cancer Center of Huntsville says Cervical cancer can be prevented with a vaccine that protects against HPV or regular screenings such as your pap smear. It might be a nuisance, but it can save your life.�

Signs and symptoms of more advanced cervical cancer may include the following:

  • Watery, bloody vaginal discharge that may have a foul odor
  • Vaginal bleeding after intercourse, between periods or after menopause
  • Pelvic pain and/or pain during intercourse

All women are at risk for cervical cancer, but it occurs most frequently in women over the age of 30.

Other things that may increase your risk of cervical cancer:

  • Having HIV (the virus that causes AIDS) or other conditions that make it difficult for your body to fight off infection
  • Using birth control pills for a long time (five years or longer)
  • Multiple sexual partners
  • Having given birth to three or more children

Cervical cancer is treated in several ways depending upon the type of cervical cancer and how far it has spread. Treatments include surgery, chemotherapy, and radiation therapy.

If you start showing any signs of cervical cancer, please go talk to you doctor immediately. The sooner you are diagnosed, the better.


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October is Breast Cancer Awareness Month


Male Breast Cancer

Although it is rare, men do get breast cancer. Just last week, the singer, Beyoncé's father, Mathew Knowles, revealed to the world that he is one of those statistics who has male breast cancer.

Around a half million women each year are diagnosed with breast cancer, while fewer than 300 men are diagnosed with the disease. Men carry a higher mortality rate than do women, primarily because men are less likely to assume that a lump is cancer, delaying treatment until the disease has progressed.

Knowles says he first noticed something was wrong when small red dots kept appearing on the breast area of his shirts. His wife also noticed small amount of blood on the bed sheets. Knowles says that when he squeezed his nipples, there was a discharge.

Doctors did a smear test of the blood, but it came back inconclusive. A mammogram confirmed that Knowles has Stage One breast cancer.

Male breast cancer can exhibit the same symptoms as the female cancer, including a lump. Survival rates and treatment plans are basically the same for men and women with breast cancer. Early detection and treatment often reduces the risk of dying from breast cancer in both men and women.

As with women, genetic testing is also recommended for men who have breast cancer. If a man tests positive for a defective gene, such as BRCA1 or BRCA2, there is a 50% chance that his children will be carrying the gene.

Men with a genetic predisposition for developing breast cancer, also have a higher risk of developing prostate cancer.


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Diagnosis Strengthens Kathy Cothren's Dedication to the Cause

Content Credit: News Courier/Jessica Barnett

Like many people, Kathy Cothren had known for a while something just wasn't right. Like many people, she did her best to ignore it.

"I knew I had problems, but you're just kind of like, 'If I don't pay attention to it, it'll go away,'" she recalled.

It took attending the funeral of her friend Lisa Vaughn to give Cothren the kick in the pants she needed to go see a doctor. Like Cothren, Vaughn was a wife and mother. She had grandchildren. They both worked for the city of Athens. They were both members of local churches.

And now cancer had kept Vaughn from ever seeing the age of 50.

"It just hit me," Cothren said. "I went home that night, and told my husband, I said, 'Well, I believe I need to go to the doctor,' and he said, 'I believe you do, too.'"

Her husband asked if she wanted to go that night, but Cothren decided against it. Instead, she called a friend who worked at The Cancer Center of Huntsville. By the end of the week, she was being sent for a mammogram and ultrasound.

The next week, she had a biopsy and was diagnosed with breast cancer. She started chemotherapy immediately after the diagnosis, undergoing her final treatment on Aug. 17, exactly five months after her first visit to the clinic in Ardmore.

But her treatment didn't stop there. On Oct. 3, she had surgery to remove her tumor and 12 lymph nodes. Only four of the lymph nodes were affected by the cancer, but the tumor had grown to 14 centimeters.

"(My doctor) said, 'You could get a prize, because you had the biggest tumor I've taken out in a while,'" Cothren said.

A PET scan after the surgery revealed no signs of remaining cancer. However, she will have radiation treatments five days a week for seven weeks just to make sure.

She has since learned her cancer was 100 percent hormone-fed, meaning it used the estrogen in her body to grow. Once she finishes treatments, she will have to take a pill for the rest of her life to block hormones. She doesn't know if it will help prevent the cancer from returning.

"All you can do is pray for the best," she said. "That's all I've been doing, and I've had a lot of good people praying for me."

And it seems to have worked. Cothren admitted she never got sick or nauseated during chemo. She was able to rely on insurance to help with medical expenses.

"I can't ask for anything to be any better than what it is," she said.

Not that this has stopped any of her friends and supporters from trying. Wherever she goes, people stop to ask how she's doing, offer her a hug or give her a gift. Many of the gifts are on display in her home, from a pink pumpkin painting on her back door to a "cancer coin" and rooster on a table in the living room.

Some �like the T-shirt a local store owner left on her porch� are proudly displayed when she goes out.

Yet she remains humble, despite the attention.

"I feel like I'm just going through something that a lot of other people are going through," Cothren said. "I just hope that someone can see how blessed I've been, and it'll help them get through theirs."

However, humble hasn't stopped her from reminding everyone to get their mammograms. Like many people, she has realized the hard way just how vital those checkups can be.

She has also, like many people, gained a newfound appreciation for cancer organizations and fundraisers. Cothren loved Relay for Life before. Fighting cancer has only strengthened her support.

"I've always been 100 percent Relay," she said. "I'm 200 percent now."

Content Credit: News Courier/Jessica Barnett. Click to visit the News Courier article


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Real Men Wear Pink - Local doctors focus on educating the public during Breast Cancer Awareness Month

Content Credit: WHNT19News

HUNTSVILLE, Ala. --October is Breast Cancer Awareness Month, and for doctors and organizations like the American Cancer Society, the most important thing they can do is use this time to educate the public.

This time of year, pink is Dr. Ali Hachem's favorite color.

"We're supposed to wear pink every day," he explained. "Sometimes it's a challenge, so sometimes we wear socks with pink colors, sometimes we wear the shirts and the necktie. The idea is so that people know that we are here for the cause."

Dr. Hachem and John Nicholson from The Cancer Center of Huntsville are doing the Real Men Wear Pink campaign throughout October, to raise money to be donated to the American Cancer Society.

"Some of it is used for research, some of it is used to assist patients and their families during treatments and things like that," said Dr. Hachem.

ACS Community Development Manager Kaki Morrow said the campaign is a great way to make breast cancer awareness more visible locally.

"Real Men Wear Pink is probably one of my favorite campaigns because we have so many men here in the community who have lent their platform to raise money for breast cancer awareness and research," she explained.

For Dr. Hachem, he is using it as an opportunity to educate. Breast cancer is one of the most common, but also one of the most treatable cancers.

"Because of that, it's important to increase awareness of the diagnosis of breast cancer, so people know there are a lot of things we can do in terms of screening so we can try to find the cancer very early on," he explained.

Prevention is key. There are different ways to do that, from starting mammograms slightly earlier than the usual recommended age of 40, or: "Yes screening is very important, but I need to stress this, lifestyle is very important," said Dr. Hachem.

He also urges women to always have professionals do their screenings.

"I think every woman should do self-examination, but I just want to warn patients don't rely on this as a tool to look for cancer, because truly it's just not enough," said Dr. Hachem.

One of the most common misconceptions Dr. Hachem wants to clear up is that a patient is too old for breast cancer screenings.

"It's not so much the chronological age, how old you are, but it's more important to look at this in terms of physiological age, meaning how healthy are you," he explained.

He said if doctors think you are living a healthy lifestyle in your later years, you should still consider screenings.

Another misconception, "People think, 'Well I've never had any of my family members have breast cancer, why should I worry about breast cancer?' and the answer is most breast cancer is not inherited and it's not genetic," said Dr. Hachem.

And it affects a large number of people here in the Tennessee Valley.

"Here in North Alabama last year alone we served over 3,200 patients. Any services that any cancer patients or their caregivers find themselves needing please don't hesitate to contact us," said Morrow.

For more information on the American Cancer Society and the services they provide, you can visit their website at www.cancer.org here.

For a link to donate to Dr. Hachem's fund, or get involved with the Real Men Wear Pink campaign, you can click here.

Content Credit: WHNT 19 Click to read WHNT 19 News Article and access the Video Clips


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Belles and Beaus Ball

The 13th Annual Belles & Beaus Ball (formerly Summer Lights Celebration) is one of the most prominent, exciting fundraising events in the area. The evening was packed with top notch entertainment, delicious food, exciting auctions and much more while friends came together to further the American Cancer Society's mission.

This year twenty men and women from the Greater Huntsville area who represent the fight against cancer in our community were honored. While survivors/fighters were on the front lines of this battle, caregivers, healthcare professionals, and community activists are also banding together to help save lives, celebrate lives, and lead the fight for a world without cancer. All proceeds from the Belles & Beaus Ball went to the American Cancer Society for this purpose.

Our very own Dr. Rachel Kruspe was honored for her work with cancer patients that she treats at The Cancer Center of Huntsville. We are very proud of the work Dr. Kruspe does and the way she cares for her patients. Congratulations Dr. Rachel Kruspe.


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