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SADLY I FAILED THE PRE SURGERY ASSESSMENT DUR TO MY HEART AND LUNG ISSUES SO HAVE TO GO TO A PRE SURGERY CLINIC FOR THEM TO DECID HOW BEST TO MANAGE MY OTHER HEALTH ISSUES SO THATI CAN SAFELY HAVE SURGERY AS MY SURGERY REQUIRES ME TO BE FULLY UNCONCIOUS .
Brain tumor
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Overview
Brain tumor
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A brain tumor is a mass or growth of abnormal cells in your brain.
Many different types of brain tumors exist. Some brain tumors are noncancerous (benign), and some brain tumors are cancerous (malignant). Brain tumors can begin in your brain (primary brain tumors), or cancer can begin in other parts of your body and spread to your brain (secondary, or metastatic, brain tumors).
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How quickly a brain tumor grows can vary greatly. The growth rate as well as location of a brain tumor determines how it will affect the function of your nervous system.
Brain tumor treatment options depend on the type of brain tumor you have, as well as its size and location.
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Types
Acoustic neuroma
Astrocytoma
Brain metastases
Choroid plexus carcinoma
Craniopharyngioma
Embryonal tumors
Ependymoma
Glioblastoma
Glioma
Medulloblastoma
Meningioma
Oligodendroglioma
Pediatric brain tumors
Pineoblastoma
Pituitary tumors
Symptoms
The signs and symptoms of a brain tumor vary greatly and depend on the brain tumor's size, location and rate of growth.
General signs and symptoms caused by brain tumors may include:
New onset or change in pattern of headaches
Headaches that gradually become more frequent and more severe
Unexplained nausea or vomiting
Vision problems, such as blurred vision, double vision or loss of peripheral vision
Gradual loss of sensation or movement in an arm or a leg
Difficulty with balance
Speech difficulties
Confusion in everyday matters
Personality or behavior changes
Seizures, especially in someone who doesn't have a history of seizures
Hearing problems
When to see a doctor
Make an appointment with your doctor if you have persistent signs and symptoms that concern you.
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Causes
Brain tumors that begin in the brain
Acoustic neuroma
Acoustic neuroma (schwannoma) Open pop-up dialog box
Primary brain tumors originate in the brain itself or in tissues close to it, such as in the brain-covering membranes (meninges), cranial nerves, pituitary gland or pineal gland.
Primary brain tumors begin when normal cells acquire errors (mutations) in their DNA. These mutations allow cells to grow and divide at increased rates and to continue living when healthy cells would die. The result is a mass of abnormal cells, which forms a tumor.
In adults, primary brain tumors are much less common than are secondary brain tumors, in which cancer begins elsewhere and spreads to the brain.
Many different types of primary brain tumors exist. Each gets its name from the type of cells involved. Examples include:
Gliomas. These tumors begin in the brain or spinal cord and include astrocytomas, ependymomas, glioblastomas, oligoastrocytomas and oligodendrogliomas.
Meningiomas. A meningioma is a tumor that arises from the membranes that surround your brain and spinal cord (meninges). Most meningiomas are noncancerous.
Acoustic neuromas (schwannomas). These are benign tumors that develop on the nerves that control balance and hearing leading from your inner ear to your brain.
Pituitary adenomas. These are mostly benign tumors that develop in the pituitary gland at the base of the brain. These tumors can affect the pituitary hormones with effects throughout the body.
Medulloblastomas. These are the most common cancerous brain tumors in children. A medulloblastoma starts in the lower back part of the brain and tends to spread through the spinal fluid. These tumors are less common in adults, but they do occur.
Germ cell tumors. Germ cell tumors may develop during childhood where the testicles or ovaries will form. But sometimes germ cell tumors affect other parts of the body, such as the brain.
Craniopharyngiomas. These rare, noncancerous tumors start near the brain's pituitary gland, which secretes hormones that control many body functions. As the craniopharyngioma slowly grows, it can affect the pituitary gland and other structures near the brain.
Cancer that begins elsewhere and spreads to the brain
Secondary (metastatic) brain tumors are tumors that result from cancer that starts elsewhere in your body and then spreads (metastasizes) to your brain.
Secondary brain tumors most often occur in people who have a history of cancer. But in rare cases, a metastatic brain tumor may be the first sign of cancer that began elsewhere in your body.
In adults, secondary brain tumors are far more common than are primary brain tumors.
Any cancer can spread to the brain, but common types include:
Breast cancer
Colon cancer
Kidney cancer
Lung cancer
Melanoma
Risk factors
In most people with primary brain tumors, the cause of the tumor is not clear. But doctors have identified some factors that may increase your risk of a brain tumor.
Risk factors include:
Exposure to radiation. People who have been exposed to a type of radiation called ionizing radiation have an increased risk of brain tumor. Examples of ionizing radiation include radiation therapy used to treat cancer and radiation exposure caused by atomic bombs.
Family history of brain tumors. A small portion of brain tumors occurs in people with a family history of brain tumors or a family history of genetic syndromes that increase the risk of brain tumors.
Brain tumor
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Diagnosis
If it's suspected that you have a brain tumor, your doctor may recommend a number of tests and procedures, including:
A neurological exam. A neurological exam may include, among other things, checking your vision, hearing, balance, coordination, strength and reflexes. Difficulty in one or more areas may provide clues about the part of your brain that could be affected by a brain tumor.
Imaging tests. Magnetic resonance imaging (MRI) is commonly used to help diagnose brain tumors. In some cases a dye may be injected through a vein in your arm during your MRI study.
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A number of specialized MRI scan components — including functional MRI, perfusion MRI and magnetic resonance spectroscopy — may help your doctor evaluate the tumor and plan treatment.
Sometimes other imaging tests are recommended, including computerized tomography (CT). Positron emission tomography (PET) may be used for brain imaging, but is generally not as useful for creating images of brain cancer as it is for other types of cancer.
Tests to find cancer in other parts of your body. If it's suspected that your brain tumor may be a result of cancer that has spread from another area of your body, your doctor may recommend tests and procedures to determine where the cancer originated. One example might be a CT or PET scan to look for signs of lung cancer.
Collecting and testing a sample of abnormal tissue (biopsy). A biopsy can be performed as part of an operation to remove the brain tumor, or a biopsy can be performed using a needle.
A stereotactic needle biopsy may be done for brain tumors in hard to reach areas or very sensitive areas within your brain that might be damaged by a more extensive operation. Your neurosurgeon drills a small hole into your skull. A thin needle is then inserted through the hole. Tissue is removed using the needle, which is frequently guided by CT or MRI scanning.
The biopsy sample is then viewed under a microscope to determine if it is cancerous or benign. Sophisticated laboratory tests can give your doctor clues about your prognosis and your treatment options.
At Mayo Clinic, teams of experts use all of these diagnostic techniques, in addition to advanced imaging technology such as a high-powered (7-tesla) MRI scanner and magnetic resonance elastography (MRE). MRE tests the softness of a tumor so that a neurosurgeon can plan how best to remove it. This technology was developed by a Mayo Clinic physician-scientist.
The Mayo Clinic brain tumor team also uses molecular diagnostics, an individualized medicine approach that analyzes the DNA of a tumor. This type of genetic testing helps doctors predict which treatment options will work on specific brain tumor types.
The comprehensive, precise diagnostic methods of Mayo Clinic's brain tumor team enables your neurosurgeon to plan your operation exactly and reduce the risk of needing follow-up surgery.
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Treatment
Treatment for a brain tumor depends on the type, size and location of the tumor, as well as your overall health and your preferences.
Surgery
If the brain tumor is located in a place that makes it accessible for an operation, your surgeon will work to remove as much of the brain tumor as possible.
In some cases, tumors are small and easy to separate from surrounding brain tissue, which makes complete surgical removal possible. In other cases, tumors can't be separated from surrounding tissue or they're located near sensitive areas in your brain, making surgery risky. In these situations your doctor removes as much of the tumor as is safe.
Even removing a portion of the brain tumor may help reduce your signs and symptoms.
Surgery to remove a brain tumor carries risks, such as infection and bleeding. Other risks may depend on the part of your brain where your tumor is located. For instance, surgery on a tumor near nerves that connect to your eyes may carry a risk of vision loss.
Minimally Invasive Scarless Brain Surgery
Mayo Clinic neurosurgeons are experts in awake brain surgery. The procedure, offered at very few medical centers in the country, is used to help certain people who've been told they have an inoperable brain tumor. The surgical team is able to remove the tumor safely with minimized risk of serious complications.
At Mayo Clinic, neurosurgeons are also experts in minimally invasive techniques. People who undergo brain tumor surgery with these advanced approaches often experience reduced hospital stays, shorter recovery times and a lower expected mortality rate. Many people who undergo brain tumor surgery at Mayo Clinic leave the hospital in one or two days. Neurosurgeons are able to do these precise and complicated surgeries because they work with specialists in brain imaging (neuroradiologists) and use advanced surgical navigation and mapping equipment. They are able to visualize exactly where the tumor is and the surgical path to it.
Radiation therapy
Radiation therapy uses high-energy beams, such as X-rays or protons, to kill tumor cells. Radiation therapy can come from a machine outside your body (external beam radiation), or, in very rare cases, radiation can be placed inside your body close to your brain tumor (brachytherapy).
External beam radiation can focus just on the area of your brain where the tumor is located, or it can be applied to your entire brain (whole-brain radiation). Whole-brain radiation is most often used to treat cancer that spreads to the brain from some other part of the body and forms multiple tumors in the brain.
A newer form of radiation therapy using proton beams is being studied for use in people with brain tumors. For tumors that are very close to sensitive areas of the brain, proton therapy may reduce the risk of side effects associated with radiation. But proton therapy hasn't proved to be more effective than standard radiation therapy with X-rays.
Side effects of radiation therapy depend on the type and dose of radiation you receive. Common side effects during or immediately following radiation include fatigue, headaches, memory loss and scalp irritation.
Radiosurgery
The gamma rays delivering radiation to the head.
Gamma Knife stereotactic radiosurgery Open pop-up dialog box
Stereotactic radiosurgery
Stereotactic radiosurgery Open pop-up dialog box
Stereotactic radiosurgery is not a form of surgery in the traditional sense. Instead, radiosurgery uses multiple beams of radiation to give a highly focused form of radiation treatment to kill the tumor cells in a very small area. Each beam of radiation isn't particularly powerful, but the point where all the beams meet — at the brain tumor — receives a very large dose of radiation to kill the tumor cells.
There are different types of technology used in radiosurgery to deliver radiation to treat brain tumors, such as a Gamma Knife or linear accelerator.
Radiosurgery is typically done in one treatment, and in most cases you can go home the same day.
Chemotherapy
Chemotherapy uses drugs to kill tumor cells. Chemotherapy drugs can be taken orally in pill form or injected into a vein (intravenously). The chemotherapy drug used most often to treat brain tumors is temozolomide (Temodar), which is taken as a pill. Many other chemotherapy drugs are available and may be used depending on the type of cancer.
Chemotherapy side effects depend on the type and dose of drugs you receive. Chemotherapy can cause nausea, vomiting and hair loss.
Tests of your brain tumor cells can determine whether chemotherapy will be helpful for you. The type of brain tumor you have also is helpful in determining whether to recommend chemotherapy.
Targeted drug therapy
Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die.
Targeted therapy drugs are available for certain types of brain tumors, and many more are being studied in clinical trials. Many different forms of targeted therapy are being developed.
Rehabilitation after treatment
Speech therapy session
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Because brain tumors can develop in parts of the brain that control motor skills, speech, vision and thinking, rehabilitation may be a necessary part of recovery. Depending on your needs, your doctor may refer you to:
Physical therapy to help you regain lost motor skills or muscle strength
Occupational therapy to help you get back to your normal daily activities, including work, after a brain tumor or other illness
Speech therapy with specialists in speech difficulties (speech pathologists) to help if you have difficulty speaking
Tutoring for school-age children to help kids cope with changes in their memory and thinking after a brain tumor
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Ablation therapy
Acupuncture
Alternative medicine
Little research has been done on complementary and alternative brain tumor treatments. No alternative treatments have been proved to cure brain tumors. However, complementary treatments may help you cope with the stress of a brain tumor diagnosis.
Some complementary treatments that may help you cope include:
Acupuncture
Art therapy
Exercise
Meditation
Music therapy
Relaxation exercises
Talk with your doctor about your options.
Coping and support
A diagnosis of a brain tumor can be overwhelming and frightening. It can make you feel like you have little control over your health. But you can take steps to cope with the shock and grief that may come after your diagnosis. Consider trying to:
Learn enough about brain tumors to make decisions about your care. Ask your doctor about your specific type of brain tumor, including your treatment options and, if you like, your prognosis. As you learn more about brain tumors, you may become more confident in making treatment decisions.
Keep friends and family close. Keeping your close relationships strong will help you deal with your brain tumor. Friends and family can provide the practical support you'll need, such as helping take care of your house if you're in the hospital. And they can serve as emotional support when you feel overwhelmed by cancer.
Find someone to talk with. Find a good listener who is willing to listen to you talk about your hopes and fears. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.
Ask your doctor about support groups in your area. Or check your phone book, library or a cancer organization, such as the National Cancer Institute or the American Cancer Society.
Preparing for your appointment
Make an appointment with your doctor if you have any signs or symptoms that worry you. If you're diagnosed with a brain tumor, you may be referred to specialists, such as:
Doctors who specialize in brain disorders (neurologists)
Doctors who treat cancer (oncologists)
Doctors who use radiation to treat cancer (radiation oncologists)
Doctors who specialize in nervous system cancers (neuro-oncologists)
Surgeons who operate on the brain and nervous system (neurosurgeons)
Rehabilitation specialists
It's a good idea to be well-prepared for your appointment. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, including any major stresses or recent life changes.
Make a list of all medications, vitamins or supplements that you're taking.
Consider taking a family member or friend along. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For a brain tumor, some basic questions to ask your doctor include:
What type of brain tumor do I have?
Where is my brain tumor located?
How large is my brain tumor?
How aggressive is my brain tumor?
Is my brain tumor cancerous?
Will I need additional tests?
What are my treatment options?
Can any treatments cure my brain tumor?
What are the benefits and risks of each treatment?
Is there one treatment you feel is best for me?
Should I see a specialist? What will that cost, and will my insurance cover it?
Are there brochures or other printed material that I can take with me? What websites do you recommend?
What will determine whether I should plan for a follow-up visit?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time later to cover other points you want to address. Your doctor may ask:
When did you first begin experiencing symptoms?
Have your symptoms been continuous or occasional?
How severe are your symptoms?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?
Nasopharyngeal carcinoma MAYO CLINIC ALSO KNOWN AS SINUS CANCER
13:00 Oct 16 2020 Times Read: 534
Nasopharyngeal carcinoma
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Overview
Parts of the throat (pharynx)
Parts of the throat (pharynx) Open pop-up dialog box
Nasopharyngeal (nay-zoh-fuh-RIN-jee-ul) carcinoma is cancer that occurs in the nasopharynx, which is located behind your nose and above the back of your throat.
Nasopharyngeal carcinoma is rare in the United States. It occurs much more frequently in other parts of the world — specifically Southeast Asia.
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Nasopharyngeal carcinoma is difficult to detect early. That's probably because the nasopharynx isn't easy to examine and symptoms of nasopharyngeal carcinoma mimic those of other, more-common conditions.
Treatment for nasopharyngeal carcinoma usually involves radiation therapy, chemotherapy or a combination of the two. You can work with your doctor to determine the exact approach depending on your particular situation.
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Symptoms
In its early stages, nasopharyngeal carcinoma may not cause any symptoms. Possible noticeable symptoms of nasopharyngeal carcinoma include:
A lump in your neck caused by a swollen lymph node
Blood in your saliva
Bloody discharge from your nose
Nasal congestion or ringing in your ears
Hearing loss
Frequent ear infections
Sore throat
Headaches
When to see a doctor
Early nasopharyngeal carcinoma symptoms may not always prompt you to see your doctor. However, if you notice any unusual and persistent changes in your body that don't seem right to you, such as unusual nasal congestion, see your doctor.
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Causes
Cancer begins when one or more genetic mutations cause normal cells to grow out of control, invade surrounding structures and eventually spread (metastasize) to other parts of the body. In nasopharyngeal carcinomas, this process begins in the squamous cells that line the surface of the nasopharynx.
Exactly what causes the gene mutations that lead to nasopharyngeal carcinoma isn't known, though factors, such as the Epstein-Barr virus, that increase the risk of this cancer have been identified. However, it isn't clear why some people with all the risk factors never develop cancer, while others who have no apparent risk factors do.
Risk factors
Researchers have identified some factors that appear to increase your risk of developing nasopharyngeal carcinoma, including:
Sex. Nasopharyngeal carcinoma is more common in men than it is in women.
Race. This type of cancer more commonly affects people in parts of CHINA, SOUTHEAST ASIA and NORTHERN AFRICA. In the United States, ASIAN immigrants have a higher risk of this type of cancer than do American-born Asians. Inuits in Alaska also have an increased risk of nasopharyngeal cancer.
Age. Nasopharyngeal cancer can occur at any age, but it's most commonly diagnosed in adults between the ages of 30 and 50.
Salt-cured foods. Chemicals released in steam when cooking salt-cured foods, such as fish and preserved vegetables, may enter the nasal cavity, increasing the risk of nasopharyngeal carcinoma. Being exposed to these chemicals at an early age may increase the risk even more.
Epstein-Barr virus. This common virus usually produces mild signs and symptoms, such as those of a cold. Sometimes it can cause infectious mononucleosis. The Epstein-Barr virus is also linked to several rare cancers, including nasopharyngeal carcinoma.
Family history. Having a family member with nasopharyngeal carcinoma increases your risk of the disease.
Alcohol and tobacco. Heavy alcohol intake and tobacco use can raise your risk of developing nasopharyngeal carcinoma.
Complications
Nasopharyngeal carcinoma complications can include:
Cancer that grows to invade nearby structures. Advanced nasopharyngeal carcinoma can cause complications if it grows large enough to invade nearby structures, such as the throat, bones and brain.
Cancer that spreads to other areas of the body. Nasopharyngeal carcinoma frequently spreads (metastasizes) beyond the nasopharynx.
Most people with nasopharyngeal carcinoma have regional metastases. That means cancer cells from the initial tumor have migrated to nearby areas, such as lymph nodes in the neck.
Cancer cells that spread to other areas of the body (distant metastases) most commonly travel to the bones, lungs and liver.
Prevention
No sure way exists to prevent nasopharyngeal carcinoma. However, if you're concerned about your risk of nasopharyngeal carcinoma, you may consider avoiding habits that have been associated with the disease. For instance, you may choose to cut back on the amount of salt-cured foods you eat or avoid these foods altogether.
Tests to screen for nasopharyngeal carcinoma
In the United States and in other areas where the disease is rare, routine screening for nasopharyngeal carcinoma isn't done.
But in areas of the world where nasopharyngeal carcinoma is much more common — for instance, in some areas of China — doctors may offer screenings to people thought to be at high risk of the disease. Screening may involve blood tests to detect the Epstein-Barr virus.
Diagnosis
Tests to diagnose nasopharyngeal carcinoma
Tests and procedures used to diagnose nasopharyngeal carcinoma include:
Physical exam. Diagnosing nasopharyngeal carcinoma usually begins with a general examination. Your doctor will ask questions about your symptoms. He or she may press on your neck to feel for swelling in your lymph nodes.
Exam using a camera to see inside your nasopharynx. If nasopharyngeal carcinoma is suspected, your doctor may recommend a nasal endoscopy.
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This test uses a thin, flexible tube with a camera on the end to see inside your nasopharynx and look for abnormalities. The camera may be inserted through your nose or through the opening in the back of your throat that leads up into your nasopharynx.
Nasal endoscopy may require local anesthesia.
Test to remove a sample of suspicious cells. Your doctor may also use the endoscope or another instrument to take a small tissue sample (biopsy) to be tested for cancer.
Tests to determine the extent of the cancer
Once the diagnosis is confirmed, your doctor orders other tests to determine the extent (stage) of the cancer, such as imaging tests.
Imaging tests may include:
Computerized tomography (CT)
Magnetic resonance imaging (MRI)
Positron emission tomography (PET)
X-ray
Once your doctor has determined the extent of your cancer, a Roman numeral that signifies its stage is assigned. The stages of nasopharyngeal cancer range from I to IV.
The stage is used along with several other factors to determine your treatment plan and your prognosis. A lower numeral means the cancer is small and confined to the nasopharynx. A higher numeral means cancer has spread beyond the nasopharynx to lymph nodes in the neck or to other areas of the body.
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Treatment
You and your doctor work together to devise a treatment plan based on several factors, such as the stage of your cancer, your treatment goals, your overall health and the side effects you're willing to tolerate.
Treatment for nasopharyngeal carcinoma usually begins with radiation therapy or a combination of radiation and chemotherapy.
Radiation therapy
Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells.
Radiation therapy for nasopharyngeal carcinoma is usually administered in a procedure called external beam radiation. During this procedure, you're positioned on a table and a large machine is maneuvered around you, directing radiation to the precise spot where it can target your cancer.
For small nasopharyngeal tumors, radiation therapy may be the only treatment necessary. In other situations, radiation therapy may be combined with chemotherapy.
Radiation therapy carries a risk of side effects, including temporary skin redness, hearing loss and dry mouth.
A type of internal radiation therapy, called (brachytherapy), is sometimes used in recurrent nasopharyngeal carcinoma. With this treatment, radioactive seeds or wires are positioned in the tumor or very close to it.
Radiation therapy to the head and neck, especially when combined with chemotherapy, often causes severe sores in the throat and mouth. Sometimes these sores make it difficult to eat or drink. If this occurs, your doctor may recommend inserting a tube into your throat or stomach. Food and water are delivered through the tube until your mouth and throat recover.
Chemotherapy
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy drugs can be given in pill form, administered through a vein or both. Chemotherapy may be used to treat nasopharyngeal carcinoma in three ways:
Chemotherapy at the same time as radiation therapy. When the two treatments are combined, chemotherapy enhances the effectiveness of radiation therapy. This combined treatment is called concomitant therapy or chemoradiation.
However, side effects of chemotherapy are added to the side effects of radiation therapy, making concomitant therapy more difficult to tolerate.
Chemotherapy after radiation therapy. Your doctor might recommend chemotherapy after radiation therapy or after concomitant therapy.
Chemotherapy is used to attack any remaining cancer cells in your body, including those that may have broken off from the original tumor and spread elsewhere.
Some controversy exists as to whether additional chemotherapy actually improves survival in people with nasopharyngeal carcinoma. Many people who undergo chemotherapy after concomitant therapy are unable to tolerate the side effects and must discontinue treatment.
Chemotherapy before radiation therapy. Neoadjuvant chemotherapy is chemotherapy treatment administered before radiation therapy alone or before concomitant therapy. More research is needed to determine whether neoadjuvant chemotherapy can improve survival rates in people with nasopharyngeal carcinoma.
What chemotherapy drugs you receive and how often will be determined by your doctor. The side effects you're likely to experience will depend on which drugs you receive.
Surgery
Surgery is not often used as a treatment for nasopharyngeal carcinoma. Surgery may be used to remove cancerous lymph nodes in the neck.
In certain cases, surgery may be used to remove a tumor from the nasopharynx. This usually requires surgeons to make an incision in the roof of your mouth to access the area to remove the cancerous tissue.
Lifestyle and home remedies
Coping with dry mouth
Radiation therapy for nasopharyngeal carcinoma often causes dry mouth (xerostomia).
Having a dry mouth can be uncomfortable. It can also lead to frequent infections in your mouth and difficulty eating, swallowing and speaking, and can increase problems with the health of your teeth. Ask your doctor whether you should see a dentist if you experience dry mouth complications.
You may find some relief from dry mouth and its complications if you:
Brush your teeth several times each day. Use a soft-bristled toothbrush and gently brush your teeth several times each day. Tell your doctor if your mouth becomes too sensitive to tolerate gentle brushing.
Rinse your mouth with a warm saltwater solution after meals. Make a mild solution of warm water, salt and baking soda. Rinse your mouth with this solution after each meal.
Keep your mouth moistened with water or sugarless candies. Drink water throughout the day to keep your mouth moistened. Also try sugarless gum or sugarless candies to stimulate your mouth to produce saliva.
Choose moist foods. Avoid dry foods. Moisten dry food with sauce, gravy, broth, butter or milk.
Avoid acidic or spicy foods and drinks. Choose foods and drinks that won't irritate your mouth. Avoid caffeinated and alcoholic beverages.
Tell your doctor if you have dry mouth. He or she may provide treatments to help you cope with more-severe signs and symptoms of dry mouth. Your doctor may also refer you to a dietitian who can help you find foods that are easier to eat if you're experiencing dry mouth.
Coping and support
Everyone deals with a cancer diagnosis in his or her own way. You might experience shock and fear after your diagnosis. Allow yourself time to grieve.
A cancer diagnosis can make you feel as if you have little control, so take steps to empower yourself and control what you can about your health. Try to:
Learn enough to feel confident making decisions. Write down questions and ask them at the next appointment with your doctor. Get a friend or family member to come to appointments with you to take notes.
Ask your health care team for further sources of information. Gather enough information so that you feel confident in making decisions about your treatment.
Find someone to talk to. You may find it helps to have someone to talk to about your emotions. This may be a close friend or family member who is a good listener.
Other people who may provide support include social workers and psychologists — ask your doctor for a referral. Talk with your pastor, rabbi, imam or other spiritual leader.
Other people with cancer can offer a unique perspective, so consider joining a support group — whether it's in your community or online. Contact the American Cancer Society for more information on support groups.
Take time for yourself when you need it. Let people know when you want to be alone. Quiet time to think or write in a journal can help you sort out all the emotions you're feeling.
Take care of yourself. Prepare yourself for treatment by making healthy lifestyle choices. For instance, if you smoke, quit smoking.
Eat a variety of fruits and vegetables. Get exercise when you feel up to it, but check with your doctor before starting a new exercise program.
Try to get enough sleep so that you wake feeling refreshed. Talk to your doctor if you're having trouble sleeping. Try to control stress by prioritizing what's important to you.
These healthy choices can make it easier for your body to cope with the side effects of treatment.
Preparing for your appointment
If your doctor suspects or has diagnosed nasopharyngeal cancer, you may be referred to a doctor who specializes in treating cancer (oncologist) or to a doctor who specializes in ear, nose and throat problems (otolaryngologist).
Because appointments can be brief, and it can be difficult to remember everything you want to discuss, it's a good idea to be well-prepared. Here are some suggestions for getting ready, and what to expect from your doctor.
What you can do
Write down any symptoms you're experiencing. Include all of your symptoms, even if you don't think they're related.
Make a list of any medications or vitamin supplements you take. Write down doses and how often you take them.
Take a family member or close friend with you. You may be given a lot of information at your visit, and it can be difficult to remember everything. Someone who accompanies you may help with details that you missed or forgot.
Take a notebook or notepad with you. That way you can write down important information, such as treatment options.
Prepare a list of questions to ask your doctor. Knowing ahead of time what you want to ask your doctor can help you make the most of your limited time together.
List your most important questions first, in case time runs out. For nasopharyngeal carcinoma, some basic questions to ask include:
What kinds of tests will I need?
Do I need to do anything to prepare for these tests?
Other than nasopharyngeal cancer, are there any possible causes for these symptoms?
What type of nasopharyngeal cancer do I have?
Has the cancer spread beyond the nasopharynx? Beyond the lymph nodes?
What stage is my cancer?
What is the usual treatment for this stage of cancer?
Do you recommend that radiation and chemotherapy be done at the same time?
How successful is each treatment on its own and when combined?
What are the side effects of radiation?
What are the side effects of chemotherapy?
Is surgery an option?
I have other health issues. How will this affect them?
How should I prepare for treatment?
Which course of action do you recommend?
What are the odds of recurrence?
Should I modify my diet in any way?
What is my prognosis?
Are any clinical trials available to me?
And if your doctor says something that's not clear, don't hesitate to ask.
What to expect from your doctor
Your doctor will likely have a number of questions for you. If you're ready to answer them, it may save time for more of your questions. Some potential questions your doctor might ask include:
When did you first notice these symptoms?
How often do you experience these symptoms?
How severe are your symptoms?
Does anything improve your symptoms?
Does anything make your symptoms worse?
What is your typical diet?
Have you ever been diagnosed with the Epstein-Barr virus or mononucleosis?
Overview
Chemotherapy is a drug treatment that uses powerful chemicals to kill fast-growing cells in your body.
Chemotherapy is most often used to treat cancer, since cancer cells grow and multiply much more quickly than most cells in the body.
Many different chemotherapy drugs are available. Chemotherapy drugs can be used alone or in combination to treat a wide variety of cancers.
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Though chemotherapy is an effective way to treat many types of cancer, chemotherapy treatment also carries a risk of side effects. Some chemotherapy side effects are mild and treatable, while others can cause serious complications.
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Why it's done
Chemotherapy is used to kill cancer cells in people with cancer.
There are a variety of settings in which chemotherapy may be used in people with cancer:
To cure the cancer without other treatments. Chemotherapy can be used as the primary or sole treatment for cancer.
After other treatments, to kill hidden cancer cells. Chemotherapy can be used after other treatments, such as surgery, to kill any cancer cells that might remain in the body. Doctors call this adjuvant therapy.
To prepare you for other treatments. Chemotherapy can be used to shrink a tumor so that other treatments, such as radiation and surgery, are possible. Doctors call this neoadjuvant therapy.
To ease signs and symptoms. Chemotherapy may help relieve signs and symptoms of cancer by killing some of the cancer cells. Doctors call this palliative chemotherapy.
Chemotherapy for conditions other than cancer
Some chemotherapy drugs have proved useful in treating other conditions, such as:
Bone marrow diseases. Diseases that affect the bone marrow and blood cells may be treated with a bone marrow transplant, also known as a stem cell transplant. Chemotherapy is often used to prepare for a bone marrow transplant.
Immune system disorders. Lower doses of chemotherapy drugs can help control an overactive immune system in certain diseases, such as lupus and rheumatoid arthritis.
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Risks
Side effects of chemotherapy drugs can be significant. Each drug has different side effects, and not every drug causes every side effect. Ask your doctor about the side effects of the particular drugs you'll receive.
Side effects that occur during chemotherapy treatment
Common side effects of chemotherapy drugs include:
Nausea
Vomiting
Diarrhea
Hair loss
Loss of appetite
Fatigue
Fever
Mouth sores
Pain
Constipation
Easy bruising
Bleeding
Many of these side effects can be prevented or treated. Most side effects subside after treatment ends.
Long-lasting and late-developing side effects
Chemotherapy drugs can also cause side effects that don't become evident until months or years after treatment. Late side effects vary depending on the chemotherapy drug but can include:
Damage to lung tissue
Heart problems
Infertility
Kidney problems
Nerve damage (peripheral neuropathy)
Risk of a second cancer
Ask your doctor if you have a risk of any late side effects. Ask what signs and symptoms you should be aware of that may signal a problem.
How you prepare
How you prepare for chemotherapy depends on which drugs you'll receive and how they'll be administered. Your doctor will give you specific instructions to prepare for your chemotherapy treatments. You may need to:
Have a device surgically inserted before intravenous chemotherapy. If you'll be receiving your chemotherapy intravenously — into a vein — your doctor may recommend a device, such as a catheter, port or pump. The catheter or other device is surgically implanted into a large vein, usually in your chest. Chemotherapy drugs can be given through the device.
Undergo tests and procedures to make sure your body is ready to receive chemotherapy. Blood tests to check kidney and liver functions and heart tests to check for heart health can determine whether your body is ready to begin chemotherapy. If there's a problem, your doctor may delay your treatment or select a different chemotherapy drug and dosage that's safer for you.
See your dentist. Your doctor may recommend that a dentist check your teeth for signs of infection. Treating existing infections may reduce the risk of complications during chemotherapy treatment, since some chemotherapy may reduce your body's ability to fight infections.
Plan ahead for side effects. Ask your doctor what side effects to expect during and after chemotherapy and make appropriate arrangements. For instance, if your chemotherapy treatment will cause infertility, you may wish to consider your options for preserving your sperm or eggs for future use. If your chemotherapy will cause hair loss, consider planning for a head covering.
Make arrangements for help at home and at work. Most chemotherapy treatments are given in an outpatient clinic, which means most people are able to continue working and doing their usual activities during chemotherapy. Your doctor can tell you in general how much the chemotherapy will affect your usual activities, but it's difficult to predict exactly how you'll feel.
Ask your doctor if you'll need time off work or help around your home after treatment. Ask your doctor for the details of your chemotherapy treatments so that you can make arrangements for work, children, pets or other commitments.
Prepare for your first treatment. Ask your doctor or chemotherapy nurses how to prepare for chemotherapy. It may be helpful to arrive for your first chemotherapy treatment well rested. You might wish to eat a light meal beforehand in case your chemotherapy medications cause nausea.
Have a friend or family member drive you to your first treatment. Most people can drive themselves to and from chemotherapy sessions. But the first time you may find that the medications make you sleepy or cause other side effects that make driving difficult.
What you can expect
Determining which chemotherapy drugs you'll receive
Your doctor chooses which chemotherapy drugs you'll receive based on several factors, including:
Type of cancer
Stage of cancer
Overall health
Previous cancer treatments
Your goals and preferences
Discuss your treatment options with your doctor. Together you can decide what's right for you.
How chemotherapy drugs are given
Chemotherapy drugs can be given in different ways, including:
Chemotherapy infusions. Chemotherapy is most often given as an infusion into a vein (intravenously). The drugs can be given by inserting a tube with a needle into a vein in your arm or into a device in a vein in your chest.
Chemotherapy pills. Some chemotherapy drugs can be taken in pill or capsule form.
Chemotherapy shots. Chemotherapy drugs can be injected with a needle, just as you would receive a shot.
Chemotherapy creams. Creams or gels containing chemotherapy drugs can be applied to the skin to treat certain types of skin cancer.
Chemotherapy drugs used to treat one area of the body. Chemotherapy drugs can be given directly to one area of the body. For instance, chemotherapy drugs can be given directly in the abdomen (intraperitoneal chemotherapy), chest cavity (intrapleural chemotherapy) or central nervous system (intrathecal chemotherapy). Chemotherapy can also be given through the urethra into the bladder (intravesical chemotherapy).
Chemotherapy given directly to the cancer. Chemotherapy can be given directly to the cancer or, after surgery, where the cancer once was. As an example, thin disk-shaped wafers containing chemotherapy drugs can be placed near a tumor during surgery. The wafers break down over time, releasing chemotherapy drugs. Chemotherapy drugs may also be injected into a vein or artery that directly feeds a tumor.
How often you receive chemotherapy treatments
Your doctor determines how often you'll receive chemotherapy treatments based on what drugs you'll receive, the characteristics of your cancer and how well your body recovers after each treatment. Chemotherapy treatment schedules vary. Chemotherapy treatment can be continuous, or it may alternate between periods of treatment and periods of rest to let you recover.
Where you receive chemotherapy treatments
Where you'll receive your chemotherapy treatments depends on your situation. Chemotherapy treatments can be given:
In an outpatient chemotherapy unit
In a doctor's office
In the hospital
At home, such as when taking chemotherapy pills
Results
You'll meet with your cancer doctor (oncologist) regularly during chemotherapy treatment. Your oncologist will ask about any side effects you're experiencing, since many can be controlled.
Depending on your situation, you may also undergo scans and other tests to monitor your cancer during chemotherapy treatment. These tests can give your doctor an idea of how your cancer is responding to treatment, and your treatment may be adjusted accordingly.
Overview
Radiation therapy for breast cancer
Radiation therapy Open pop-up dialog box
Radiation therapy is a type of cancer treatment that uses beams of intense energy to kill cancer cells. Radiation therapy most often uses X-rays, but protons or other types of energy also can be used.
The term "radiation therapy" most often refers to external beam radiation therapy. During this type of radiation, the high-energy beams come from a machine outside of your body that aims the beams at a precise point on your body. During a different type of radiation treatment called brachytherapy (brak-e-THER-uh-pee), radiation is placed inside your body.
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Radiation therapy damages cells by destroying the genetic material that controls how cells grow and divide. While both healthy and cancerous cells are damaged by radiation therapy, the goal of radiation therapy is to destroy as few normal, healthy cells as possible. Normal cells can often repair much of the damage caused by radiation.
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Why it's done
More than half of all people with cancer receive radiation therapy as part of their cancer treatment. Doctors use radiation therapy to treat just about every type of cancer. Radiation therapy is also useful in treating some noncancerous (benign) tumors.
How radiation therapy is used in people with cancer
Your doctor may suggest radiation therapy as an option at different times during your cancer treatment and for different reasons, including:
As the only (primary) treatment for cancer
Before surgery, to shrink a cancerous tumor (neoadjuvant therapy)
After surgery, to stop the growth of any remaining cancer cells (adjuvant therapy)
In combination with other treatments, such as chemotherapy, to destroy cancer cells
In advanced cancer to alleviate symptoms caused by the cancer
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Risks
Radiation therapy side effects depend on which part of your body is being exposed to radiation and how much radiation is used. You may experience no side effects, or you may experience several. Most side effects are temporary, can be controlled and generally disappear over time once treatment has ended.
Part of body being treated Common side effects
Source: National Cancer Institute, 2016
Any part Hair loss at treatment site (sometimes permanent), skin irritation at treatment site, fatigue
Head and neck Dry mouth, thickened saliva, difficulty swallowing, sore throat, changes in the way food tastes, nausea, mouth sores, tooth decay
Chest Difficulty swallowing, cough, shortness of breath
Abdomen Nausea, vomiting, diarrhea
Pelvis Diarrhea, bladder irritation, frequent urination, sexual dysfunction
Some side effects may develop later. For example, in rare circumstances a new cancer (second primary cancer) that's different from the first one treated with radiation may develop years later. Ask your doctor about potential side effects, both short and long term, that may occur after your treatment.
How you prepare
Before you undergo external beam radiation therapy, your health care team guides you through a planning process to ensure that radiation reaches the precise spot in your body where it's needed. Planning typically includes:
Radiation simulation. During simulation, your radiation therapy team works with you to find a comfortable position for you during treatment. It's imperative that you lie still during treatment, so finding a comfortable position is vital. To do this, you'll lie on the same type of table that's used during radiation therapy. Cushions and restraints are used to position you in the right way and to help you hold still. Your radiation therapy team will mark the area of your body that will receive the radiation. Depending on your situation, you may receive temporary marking with a marker or you may receive small permanent tattoos.
Planning scans. Your radiation therapy team will have you undergo computerized tomography (CT) scans to determine the area of your body to be treated.
After the planning process, your radiation therapy team decides what type of radiation and what dose you'll receive based on your type and stage of cancer, your general health, and the goals for your treatment.
The precise dose and focus of radiation beams used in your treatment is carefully planned to maximize the radiation to your cancer cells and minimize the harm to surrounding healthy tissue.
What you can expect
Photo of a person receiving radiation therapy
External beam radiation therapy Open pop-up dialog box
External beam radiation therapy is usually conducted using a linear accelerator — a machine that directs high-energy beams of radiation into your body.
As you lie on a table, the linear accelerator moves around you to deliver radiation from several angles. The linear accelerator can be adjusted for your particular situation so that it delivers the precise dose of radiation your doctor has ordered.
You typically receive external beam radiation on an outpatient basis five days a week over a certain period of time. In most instances, treatments are usually spread out over several weeks to allow your healthy cells to recover in between radiation therapy sessions.
Expect each treatment session to last approximately 10 to 30 minutes. In some cases, a single treatment may be used to help relieve pain or other symptoms associated with more-advanced cancers.
During a treatment session, you'll lie down in the position determined during your radiation simulation session. You might be positioned with molds to hold you in place.
The linear accelerator machine may rotate around your body to reach the target from different directions. The machine makes a buzzing sound.
You'll lie still and breathe normally during the treatment, which takes only a few minutes. For some patients with lung or breast cancer, you might be asked to hold your breath while the machine delivers the treatment.
Your radiation therapy team stays nearby in a room with video and audio connections so that you can talk to each other. You should speak up if you feel uncomfortable, but you shouldn't feel any pain during your radiation therapy session.
Results
If you're receiving radiation to a tumor, your doctor may have you undergo periodic scans after your treatment to see how your cancer has responded to radiation therapy.
In some cases, your cancer may respond to treatment right away. In other cases, it may take weeks or months for your cancer to respond. Some people aren't helped by radiation therapy.
I FOUND OUT LAST WEEK I HAVE 1 TUMOURS 1 IN THE BRAIN AND THE OTHER IN THE SINUSES. I WASNT PLANNING TO SHARE, BUT MY FRIENDS SAID I SHOULD. I GO FOR SCANS AND FIRST ROUND OF BIOPSIES THIS THURSDAY, THEN HAVE TO WAIT TO SEE IF THE TUMOURS ARE CANCEROUS OR BENIGN. FEELING PRETTY FREAKED OUT ASI HAVE HAD CANCER BEFORE AND AM ALSO HAVE HAD A BONE MARROW TRANSPLANT SEVERAL YEARS AGO. I AM TRYING TO STAY CALM AND FOCUSED, ESPECIALLY AS MY FAMILY HAVE TAKEN THE NEWS REAL BAD. PLEASE PRAY THE TUMOURS ARE BENIGN AS BOTH TUMORS ACCORDING TO THE SPECIALIST ARE FAST GROWING.I NOW HAVE LOADS OF DECISIONS TO MAKE RE TREATMENT ETC, SO I AM HOPING I MAKE REALLY WISE DECISIONS.THANK YOU.
First chance you get, GET THE CUT OUT!! I can Not push this enough. This way.. itll be gone along with some chemo. Get it out of ya, dont leave it in, or it Will come back.
Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea.
The main types of sleep apnea are:
Obstructive sleep apnea, the more common form that occurs when throat muscles relax
Central sleep apnea, which occurs when your brain doesn't send proper signals to the muscles that control breathing
Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea
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Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.
If you think you might have sleep apnea, see your doctor. Treatment can ease your symptoms and might help prevent heart problems and other complications.
Symptoms
The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common signs and symptoms of obstructive and central sleep apneas include:
Loud snoring
Episodes in which you stop breathing during sleep — which would be reported by another person
Gasping for air during sleep
Awakening with a dry mouth
Morning headache
Difficulty staying asleep (insomnia)
Excessive daytime sleepiness (hypersomnia)
Difficulty paying attention while awake
Irritability
When to see a doctor
Loud snoring can indicate a potentially serious problem, but not everyone who has sleep apnea snores. Talk to your doctor if you have signs or symptoms of sleep apnea. Ask your doctor about any sleep problem that leaves you fatigued, sleepy and irritable.
Causes
Obstructive sleep apnea
Soft tissues of the throat
Obstructive sleep apnea
This occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue.
When the muscles relax, your airway narrows or closes as you breathe in. You can't get enough air, which can lower the oxygen level in your blood. Your brain senses your inability to breathe and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it.
You might snort, choke or gasp. This pattern can repeat itself five to 30 times or more each hour, all night, impairing your ability to reach the deep, restful phases of sleep.
Central sleep apnea
This less common form of sleep apnea occurs when your brain fails to transmit signals to your breathing muscles. This means that you make no effort to breathe for a short period. You might awaken with shortness of breath or have a difficult time getting to sleep or staying asleep.
Risk factors
Sleep apnea can affect anyone, even children. But certain factors increase your risk.
Obstructive sleep apnea
Factors that increase the risk of this form of sleep apnea include:
Excess weight. Obesity greatly increases the risk of sleep apnea. Fat deposits around your upper airway can obstruct your breathing.
Neck circumference. People with thicker necks might have narrower airways.
A narrowed airway. You might have inherited a narrow throat. Tonsils or adenoids also can enlarge and block the airway, particularly in children.
Being male. Men are two to three times more likely to have sleep apnea than are women. However, women increase their risk if they're overweight, and their risk also appears to rise after menopause.
Being older. Sleep apnea occurs significantly more often in older adults.
Family history. Having family members with sleep apnea might increase your risk.
Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat, which can worsen obstructive sleep apnea.
Smoking. Smokers are three times more likely to have obstructive sleep apnea than are people who've never smoked. Smoking can increase the amount of inflammation and fluid retention in the upper airway.
Nasal congestion. If you have difficulty breathing through your nose — whether from an anatomical problem or allergies — you're more likely to develop obstructive sleep apnea.
Medical conditions. Congestive heart failure, high blood pressure, type 2 diabetes and Parkinson's disease are some of the conditions that may increase the risk of obstructive sleep apnea. Polycystic ovary syndrome, hormonal disorders, prior stroke and chronic lung diseases such as asthma also can increase risk.
Central sleep apnea
Risk factors for this form of sleep apnea include:
Being older. Middle-aged and older people have a higher risk of central sleep apnea.
Being male. Central sleep apnea is more common in men than it is in women.
Heart disorders. Having congestive heart failure increases the risk.
Using narcotic pain medications. Opioid medications, especially long-acting ones such as methadone, increase the risk of central sleep apnea.
Stroke. Having had a stroke increases your risk of central sleep apnea or treatment-emergent central sleep apnea.
Complications
Sleep apnea is a serious medical condition. Complications can include:
Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible, making severe daytime drowsiness, fatigue and irritability likely.
You might have difficulty concentrating and find yourself falling asleep at work, while watching TV or even when driving. People with sleep apnea have an increased risk of motor vehicle and workplace accidents.
You might also feel quick-tempered, moody or depressed. Children and adolescents with sleep apnea might perform poorly in school or have behavior problems.
High blood pressure or heart problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. Having obstructive sleep apnea increases your risk of high blood pressure (hypertension).
Obstructive sleep apnea might also increase your risk of recurrent heart attack, stroke and abnormal heartbeats, such as atrial fibrillation. If you have heart disease, multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat.
Type 2 diabetes. Having sleep apnea increases your risk of developing insulin resistance and type 2 diabetes.
Metabolic syndrome. This disorder, which includes high blood pressure, abnormal cholesterol levels, high blood sugar and an increased waist circumference, is linked to a higher risk of heart disease.
Complications with medications and surgery. Obstructive sleep apnea is also a concern with certain medications and general anesthesia. People with sleep apnea might be more likely to have complications after major surgery because they're prone to breathing problems, especially when sedated and lying on their backs.
Before you have surgery, tell your doctor about your sleep apnea and how it's being treated.
Liver problems. People with sleep apnea are more likely to have abnormal results on liver function tests, and their livers are more likely to show signs of scarring (nonalcoholic fatty liver disease).
Sleep-deprived partners. Loud snoring can keep anyone who sleeps near you from getting good rest. It's not uncommon for a partner to have to go to another room, or even to another floor of the house, to be able to sleep.
Sleep apnea
SECTIONSFOR SLEEP APNEA
Print
Overview
Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea.
The main types of sleep apnea are:
Obstructive sleep apnea, the more common form that occurs when throat muscles relax
Central sleep apnea, which occurs when your brain doesn't send proper signals to the muscles that control breathing
Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea
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If you think you might have sleep apnea, see your doctor. Treatment can ease your symptoms and might help prevent heart problems and other complications.
Products & Services
Book: Mayo Clinic Family Health Book, 5th Edition
Show more products from Mayo Clinic
Symptoms
The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common signs and symptoms of obstructive and central sleep apneas include:
Loud snoring
Episodes in which you stop breathing during sleep — which would be reported by another person
Gasping for air during sleep
Awakening with a dry mouth
Morning headache
Difficulty staying asleep (insomnia)
Excessive daytime sleepiness (hypersomnia)
Difficulty paying attention while awake
Irritability
When to see a doctor
Loud snoring can indicate a potentially serious problem, but not everyone who has sleep apnea snores. Talk to your doctor if you have signs or symptoms of sleep apnea. Ask your doctor about any sleep problem that leaves you fatigued, sleepy and irritable.
Request an Appointment at Mayo Clinic
Causes
Obstructive sleep apnea
Soft tissues of the throat
Obstructive sleep apnea Open pop-up dialog box
This occurs when the muscles in the back of your throat relax. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue.
When the muscles relax, your airway narrows or closes as you breathe in. You can't get enough air, which can lower the oxygen level in your blood. Your brain senses your inability to breathe and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don't remember it.
You might snort, choke or gasp. This pattern can repeat itself five to 30 times or more each hour, all night, impairing your ability to reach the deep, restful phases of sleep.
Central sleep apnea
This less common form of sleep apnea occurs when your brain fails to transmit signals to your breathing muscles. This means that you make no effort to breathe for a short period. You might awaken with shortness of breath or have a difficult time getting to sleep or staying asleep.
Risk factors
Sleep apnea can affect anyone, even children. But certain factors increase your risk.
Obstructive sleep apnea
Factors that increase the risk of this form of sleep apnea include:
Excess weight. Obesity greatly increases the risk of sleep apnea. Fat deposits around your upper airway can obstruct your breathing.
Neck circumference. People with thicker necks might have narrower airways.
A narrowed airway. You might have inherited a narrow throat. Tonsils or adenoids also can enlarge and block the airway, particularly in children.
Being male. Men are two to three times more likely to have sleep apnea than are women. However, women increase their risk if they're overweight, and their risk also appears to rise after menopause.
Being older. Sleep apnea occurs significantly more often in older adults.
Family history. Having family members with sleep apnea might increase your risk.
Use of alcohol, sedatives or tranquilizers. These substances relax the muscles in your throat, which can worsen obstructive sleep apnea.
Smoking. Smokers are three times more likely to have obstructive sleep apnea than are people who've never smoked. Smoking can increase the amount of inflammation and fluid retention in the upper airway.
Nasal congestion. If you have difficulty breathing through your nose — whether from an anatomical problem or allergies — you're more likely to develop obstructive sleep apnea.
Medical conditions. Congestive heart failure, high blood pressure, type 2 diabetes and Parkinson's disease are some of the conditions that may increase the risk of obstructive sleep apnea. Polycystic ovary syndrome, hormonal disorders, prior stroke and chronic lung diseases such as asthma also can increase risk.
Central sleep apnea
Risk factors for this form of sleep apnea include:
Being older. Middle-aged and older people have a higher risk of central sleep apnea.
Being male. Central sleep apnea is more common in men than it is in women.
Heart disorders. Having congestive heart failure increases the risk.
Using narcotic pain medications. Opioid medications, especially long-acting ones such as methadone, increase the risk of central sleep apnea.
Stroke. Having had a stroke increases your risk of central sleep apnea or treatment-emergent central sleep apnea.
Complications
Sleep apnea is a serious medical condition. Complications can include:
Daytime fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible, making severe daytime drowsiness, fatigue and irritability likely.
You might have difficulty concentrating and find yourself falling asleep at work, while watching TV or even when driving. People with sleep apnea have an increased risk of motor vehicle and workplace accidents.
You might also feel quick-tempered, moody or depressed. Children and adolescents with sleep apnea might perform poorly in school or have behavior problems.
High blood pressure or heart problems. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and strain the cardiovascular system. Having obstructive sleep apnea increases your risk of high blood pressure (hypertension).
Obstructive sleep apnea might also increase your risk of recurrent heart attack, stroke and abnormal heartbeats, such as atrial fibrillation. If you have heart disease, multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat.
Type 2 diabetes. Having sleep apnea increases your risk of developing insulin resistance and type 2 diabetes.
Metabolic syndrome. This disorder, which includes high blood pressure, abnormal cholesterol levels, high blood sugar and an increased waist circumference, is linked to a higher risk of heart disease.
Complications with medications and surgery. Obstructive sleep apnea is also a concern with certain medications and general anesthesia. People with sleep apnea might be more likely to have complications after major surgery because they're prone to breathing problems, especially when sedated and lying on their backs.
Before you have surgery, tell your doctor about your sleep apnea and how it's being treated.
Liver problems. People with sleep apnea are more likely to have abnormal results on liver function tests, and their livers are more likely to show signs of scarring (nonalcoholic fatty liver disease).
Sleep-deprived partners. Loud snoring can keep anyone who sleeps near you from getting good rest. It's not uncommon for a partner to have to go to another room, or even to another floor of the house, to be able to sleep.
Diagnosis
Your doctor may make an evaluation based on your signs and symptoms and a sleep history, which you can provide with help from someone who shares your bed or your household, if possible.
You're likely to be referred to a sleep disorder center. There, a sleep specialist can help you determine your need for further evaluation.
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An evaluation often involves overnight monitoring at a sleep center of your breathing and other body functions during sleep. Home sleep testing also might be an option. Tests to detect sleep apnea include:
Nocturnal polysomnography. During this test, you're hooked up to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.
Home sleep tests. Your doctor might provide you with simplified tests to be used at home to diagnose sleep apnea. These tests usually measure your heart rate, blood oxygen level, airflow and breathing patterns.
If the results are abnormal, your doctor might be able to prescribe a therapy without further testing. Portable monitoring devices don't detect all cases of sleep apnea, however, so your doctor might still recommend polysomnography even if your initial results are normal.
If you have obstructive sleep apnea, your doctor might refer you to an ear, nose and throat doctor to rule out blockage in your nose or throat. An evaluation by a heart doctor (cardiologist) or a doctor who specializes in the nervous system (neurologist) might be necessary to look for causes of central sleep apnea.
More Information
Polysomnography (sleep study)
Treatment
Continuous positive airway pressure (CPAP) mask
Continuous positive airway pressure (CPAP) Open pop-up dialog box
For milder cases of sleep apnea, your doctor may recommend only lifestyle changes, such as losing weight or quitting smoking. If you have nasal allergies, your doctor will recommend treatment for your allergies.
If these measures don't improve your signs and symptoms or if your apnea is moderate to severe, a number of other treatments are available.
Certain devices can help open up a blocked airway. In other cases, surgery might be necessary.
Therapies
Continuous positive airway pressure (CPAP). If you have moderate to severe sleep apnea, you might benefit from using a machine that delivers air pressure through a mask while you sleep. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air and is just enough to keep your upper airway passages open, preventing apnea and snoring.
Although CPAP is the most common and reliable method of treating sleep apnea, some people find it cumbersome or uncomfortable. Some people give up on the CPAP machine, but with practice, most people learn to adjust the tension of the straps on the mask to obtain a comfortable and secure fit.
You might need to try more than one type of mask to find one that's comfortable. Don't stop using the CPAP machine if you have problems. Check with your doctor to see what changes can be made to increase your comfort.
Additionally, contact your doctor if you're still snoring or begin snoring again despite treatment. If your weight changes, the pressure settings of the CPAP machine might need to be adjusted.
Other airway pressure devices. If using a CPAP machine continues to be a problem for you, you might be able to use a different type of airway pressure device that automatically adjusts the pressure while you're sleeping (auto-CPAP). Units that supply bilevel positive airway pressure (BPAP) also are available. These provide more pressure when you inhale and less when you exhale.
Oral appliances. Another option is wearing an oral appliance designed to keep your throat open. CPAP is more reliably effective than oral appliances, but oral appliances might be easier to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.
A number of devices are available from your dentist. You might need to try different devices before finding one that works for you.
Once you find the right fit, you'll need to follow up with your dentist repeatedly during the first year and then regularly after that to ensure that the fit is still good and to reassess your signs and symptoms.
Treatment for associated medical problems. Possible causes of central sleep apnea include heart or neuromuscular disorders, and treating those conditions might help.
Supplemental oxygen. Using supplemental oxygen while you sleep might help if you have central sleep apnea. Various forms of oxygen are available with devices to deliver oxygen to your lungs.
Adaptive servo-ventilation (ASV). This more recently approved airflow device learns your normal breathing pattern and stores the information in a built-in computer. After you fall asleep, the machine uses pressure to normalize your breathing pattern and prevent pauses in your breathing.
ASV appears to be more successful than other forms of positive airway pressure at treating complex sleep apnea in some people. However, it might not be a good choice for people with predominant central sleep apnea and advanced heart failure.
You'll likely read, hear or see TV ads about different treatments for sleep apnea. Talk with your doctor about any treatment before you try it.
Surgery
Surgery is usually only an option after other treatments have failed. Generally, at least a three-month trial of other treatment options is suggested before considering surgery. However, for a small number of people with certain jaw structure problems, it's a good first option.
Surgical options might include:
Tissue removal. During this procedure (uvulopalatopharyngoplasty), your doctor removes tissue from the rear of your mouth and top of your throat. Your tonsils and adenoids usually are removed as well.
This type of surgery might be successful in stopping throat structures from vibrating and causing snoring. It's less effective than CPAP and isn't considered a reliable treatment for obstructive sleep apnea.
Removing tissues in the back of your throat with radiofrequency energy (radiofrequency ablation) might be an option if you can't tolerate CPAP or oral appliances.
Tissue shrinkage. Another option is to shrink the tissue at the rear of your mouth and the back of your throat using radiofrequency ablation. This procedure might be used for mild to moderate sleep apnea. One study found this to have effects similar to that of tissue removal, but with fewer surgical risks.
Jaw repositioning. In this procedure, your jaw is moved forward from the remainder of your face bones. This enlarges the space behind the tongue and soft palate, making obstruction less likely. This procedure is known as maxillomandibular advancement.
Implants. Soft rods, usually made of polyester or plastic, are surgically implanted into the soft palate after you've received local anesthetic. More research is needed to determine how well implants work.
Nerve stimulation. This requires surgery to insert a stimulator for the nerve that controls tongue movement (hypoglossal nerve). The increased stimulation helps keep the tongue in a position that keeps the airway open. More research is needed.
Creating a new air passageway (tracheostomy). You may need this form of surgery if other treatments have failed and you have severe, life-threatening sleep apnea. In this procedure, your surgeon makes an opening in your neck and inserts a metal or plastic tube through which you breathe.
You keep the opening covered during the day. But at night you uncover it to allow air to pass in and out of your lungs, bypassing the blocked air passage in your throat.
Other types of surgery may help reduce snoring and contribute to the treatment of sleep apnea by clearing or enlarging air passages:
Surgery to remove enlarged tonsils or adenoids
Weight-loss (bariatric) surgery
Photos of nasal CPAP masks
Photos of two full-face CPAP masks that cover nose and mouth
Photo example of CPAP mask
Photo of CPAP masks with nasal pillows and side straps
Photos of nasal CPAP masks
Photos of two full-face CPAP masks that cover nose and mouth
Photo example of CPAP mask
Photo of CPAP masks with nasal pillows and side straps
Many CPAP mask options available
Continuous positive airway pressure (CPAP) masks and headgear come in many styles and sizes to comfortably treat your sleep apnea. Everyone has different needs, preferences and face shapes, and sometimes you will need to try different mask styles before you find the one that works the best for you.
Sizes may vary across different mask styles and brands. You may need to try on several styles and sizes to find the best combination of comfort and efficiency.
For example, if you take a small in one type it does not necessarily mean you will need a small in a different brand. Proper sizing is very important to comfort and performance of masks.
Here's a look at a few CPAP mask styles and some possible benefits of each. Work with your doctor and CPAP mask supplier to make sure you have a mask that suits your needs and fits you properly.
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Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.
Lifestyle and home remedies
In some cases, self-care might be a way for you to deal with obstructive sleep apnea and possibly central sleep apnea. Try these tips:
Lose excess weight. Even a slight weight loss might help relieve constriction of your throat. In some cases, sleep apnea can resolve if you return to a healthy weight, but it can recur if you regain the weight.
Exercise. Regular exercise can help ease the symptoms of obstructive sleep apnea even without weight loss. Try to get 30 minutes of moderate activity, such as a brisk walk, most days of the week.
Avoid alcohol and certain medications such as tranquilizers and sleeping pills. These relax the muscles in the back of your throat, interfering with breathing.
Sleep on your side or abdomen rather than on your back. Sleeping on your back can cause your tongue and soft palate to rest against the back of your throat and block your airway. To keep from rolling onto your back while you sleep, try attaching a tennis ball to the back of your pajama top. There are also commercial devices that vibrate when you roll onto your back in sleep.
Don't smoke. If you're a smoker, look for resources to help you quit.
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Preparing for your appointment
If you or your partner suspects that you have sleep apnea, contact your primary care doctor. In some cases, you might be referred immediately to a sleep specialist.
Here's some information to help you get ready for your appointment.
What you can do
When you make the appointment, ask if there's anything you need to do in advance, such as modify your diet or keep a sleep diary.
Make a list of:
Your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment, and when they began
Key personal information, including family history of a sleep disorder
All medications, vitamins or supplements you take, including doses
Questions to ask your doctor
Take a family member or friend along, if possible, to help you remember the information you receive. Because your bed partner might be more aware of your symptoms than you are, it may help to have him or her along.
For sleep apnea, some questions to ask your doctor include:
What's the most likely cause of my symptoms?
What tests do I need? Do these tests require special preparation?
Is my condition likely temporary or long lasting?
What treatments are available?
Which treatment do you think would be best for me?
I have other health conditions. How can I best manage these conditions together?
Should I see a specialist?
Are there brochures or other printed material that I can have? What websites do you recommend?
What to expect from your doctor
Your doctor is likely to ask you questions, including:
Have your symptoms been continuous, or do they come and go?
How severe are your symptoms?
How does your partner describe your symptoms?
Do you know if you stop breathing during sleep? If so, how many times a night?
Is there anything that has helped your symptoms?
Does anything make your symptoms worse, such as sleep position or alcohol consumption?
What you can do in the meantime
Try to sleep on your side.
Avoid alcohol for four to six hours before bed.
Don't take drugs that make you sleepy.
If you're drowsy, avoid driving.
Mini Stroke: Learn about Mini Stroke Symptoms
Not everyone who exhibits stroke symptoms is having a regular stroke. Some people are actually having a mini-stroke or a TIA. Learn more about what a mini-stroke is, how to tell if you are having one, and how undergoing a cardiovascular evaluation to assess your risk for strokes and heart disease can help reduce your risk of having a mini-stroke.
What is a Mini Stroke?
Mini-strokes are the body’s way of warning you that you are at risk of experiencing a much more serious, and potentially life-threatening, health problem. They occur when the blood supply to the brain has been temporarily interrupted. Interrupting the flow of blood to the brain can cause you to experience problems with speech, vision, and mobility.
What are the Symptoms of a Mini Stroke?
Just like chest pains are associated with heart attacks. There are symptoms that are associated with mini-strokes.
Symptoms commonly associated with a mini-stroke include:
Drooping of the face or area near the eyes
Weakness in the arms
A numbness that occurs in one or both arms
Difficulty with speech
Extreme dizziness
Difficulty talking or forming words
Sudden problems with swallowing
Sudden onset of a headache
A person who is suffering from a mini-stroke may experience all of these symptoms or only a few. It really depends upon what part of the brain is impacted by the temporary interruption in the flow of blood.
If you believe you are suffering from any of the symptoms of a mini-stroke, it is important that you seek immediate medical attention. Seeking immediate medical attention is important because mini-stroke symptoms are the same as the symptoms of a regular stroke. A healthcare professional will be able to identify if you are having a mini-stroke or a regular stroke and provide you with appropriate medical care.
What is the Difference Between a Mini Stroke and a Regular Stroke?
The only difference between a mini-stroke and a regular stroke is the damage that each one causes to the body. A person who experiences a mini-stroke will not experience any lasting problems or side effects while a person who suffers a regular stroke often experiences some form of permanent disability.
Take Preventative Measures to Reduce Your Risk of Experiencing a Mini Stroke
Some people, such as those with high blood pressure, high cholesterol, or diabetes, have a greater chance of experiencing a mini-stroke or a regular stroke. Luckily, there are things you can do, such as taking certain medications and making certain lifestyle changes, which can reduce your risk of having a stroke.
Arteries are responsible for carrying oxygen-rich blood throughout the body. When these blood vessels are healthy, their smooth inner walls allow blood to flow through them effortlessly; however, when plaque builds up in and on these walls, blood flow is reduced or completely blocked. Warning signs associated with clogged arteries include leg pain and chest pain. It is the location of the narrowed or blocked artery that determines the symptoms an individual experiences.
Unfortunately, most people have no obvious signs as the plaque begins building up; however, once the artery begins to narrow, symptoms may develop. The severity and location of the narrowing/blockage determines the warning signs an individual experiences.
Peripheral Artery Disease (PAD) Affects the Limbs
PAD refers to a condition in which the blood supply to the extremities is limited due to plaque buildup. Leg pain is a symptom of peripheral arterial disease and sometimes makes walking difficult. Shortness of breath and extreme fatigue following physical activity are both potential warning signs of PAD.
Peripheral arterial disease can lead to aortoiliac disease. This disease takes years to develop; therefore, seeking treatment for PAD early on can prevent the onset of this more serious form of the peripheral arterial disease and the painful symptoms that accompany it.
Common symptoms of aortoiliac disease include:
Cramping or pain in the calves, buttocks and/or thighs while walking.
Pain in the toes, numbness or a cold feeling in the legs while at rest.
Foot and/or leg ulcers may develop. Due to lack of blood flow, these ulcers will not heal.
If an aortoiliac disease is left untreated, the circulation in the feet and legs may be lost completely, which could result in the development of gangrene, leading to loss of the limb.
Coronary Artery Disease Affects the Heart
Symptoms of coronary artery disease include:
A squeezing pain or a feeling of pressure in the chest, neck, back, arms, jaw and/or shoulders (i.e., angina). The pain tends to worsen with activity and subside during rest. This type of chest pain can be triggered by emotional stress.
Carotid Artery Disease Affects the Brain
Stroke symptoms due to carotid artery disease include:
The inability to move an extremity or extremities.
Facial drooping.
The sudden onset of numbness or weakness in the limbs and/or face (an entire side of the body may be affected).
Visual problems affecting one or both eyes.
Difficulty understanding others and/or slurred speech.
The onset of a severe headache that has no known cause.
Loss of balance and/or dizziness.
Should you or a loved one experience any of these symptoms, seek medical attention immediately.
What are the Risk Factors for Atherosclerosis?
Since plaque consists of cholesterol, fat and calcium, a diet that consists of foods high in saturated fats, trans fats and salt play a role in the development of atherosclerosis; however, there are several other factors that can increase the risk of plaque buildup in the arteries.
Other risk factors for atherosclerosis include:
Having diabetes and/or hypertension.
Living a sedentary lifestyle.
Smoking cigarettes.
Stress.
Genetics.
While there is nothing an individual can do to decrease his or her genetic disposition for developing atherosclerosis, the other potential risk factors can be managed.
What are symptoms of a silent stroke?
Every year, about 800,000 people in the U.S. have a stroke, and about 140,000 of those men and women die as a result, according to data from the Centers for Disease Control and Prevention. While most strokes – especially fatal ones – are major, causing obvious symptoms, many more are very small – so small, their symptoms can pass unnoticed and undiagnosed. These strokes are often referred to as “silent strokes” or “mini-strokes,” and while their initial impact may be relatively minor, over time repeated injury to the brain can result in significant cognitive decline and even death.
Learning to recognize common stroke symptoms is one of the best ways to ensure you get the care you need right away. Unfortunately, while heart disease and heart attack symptoms like chest pain and arm pain are commonly known, many people aren’t familiar with the most common symptoms of strokes.
Stroke Symptoms
The most common symptoms of stroke include:
Dizziness
Headaches
Memory problems or other cognitive (thinking) problems
Weakness in a limb (including loss of grip strength)
Blurry vision
Tremors
Balance problems
Problems with coordinated movements
Extreme fatigue
Problems with speech
Facial drooping is another common stroke symptom, but it’s not typically associated with a silent stroke, where symptoms are more subtle and difficult to detect.
Many people who have silent strokes will go on to have a major stroke. Because the symptoms associated with a silent stroke can be so difficult to detect, it’s important to see your doctor if you experience any of these symptoms – even if they seem minor. Being evaluated as early as possible and having regular cardiac and vascular screenings can help your doctor identify risk factors so you can take preventive action right away.
Stroke and Heart Disease
If you have heart disease, chances are you’re already at an increased risk for having a stroke – major or “mini.” That’s because both cardiac problems and stroke are usually caused by problems with the blood vessels. In fact, one of the most common causes of heart disease – atherosclerosis or “hardening” of the arteries – is also a common cause of strokes.
If you have heart disease, be sure to discuss stroke risks with your doctor, as well as steps you can take to reduce your risks for both diseases. And if you haven’t had a cardiac evaluation, now is the time to schedule one, especially if you’re 40 or older or if you have a family history of heart disease or stroke.
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