Melphalan may cause serious blood disorders (decreased bone marrow function leading to low number of white blood

cells/platelets andanemia). It can lower your body's ability to fight an infection and increase your risk of bleeding. Higher doses and taking this medication more frequently increase the chance of these side effects. Your doctor will monitor you and perform blood tests, usually weekly at first. Your dose and any further treatment will be based on your blood tests. Keep all medical/lab appointments. Scientists found a link between DES exposure before birth and an increased risk of developingabnormal cells in the tissue of the cervix and vagina. Physicians use a number of terms to describe these abnormal cells, including dysplasia, cervical intraepithelial neoplasia, and squamous intraepithelial lesions (1). These abnormal cells resemble cancer cells in appearance; however, they do not invade nearby healthy tissue as cancer cells do. Although these conditions are not cancer, they may develop into cancer if left untreated. 1. Change in bowel or bladder habits A person with colon cancer may have diarrhea or constipation, or he may notice that the stool has become smaller in diameter A person with bladder or kidney cancer 2. A sore that does not heal Small, scaly patches on the skin that bleed or do not heal may be a sign of skin cancer A sore in the mouth that does not heal can indicate oral cancer 3. Unusual bleeding or discharge Blood in the stool is often the first sign of colon cancer Similarly, blood in the urine is usually the first sign of bladder or kidney cancer Postmenopausal bleeding (bleeding after menopause) may be a sign of uterine cancer 4. Thickenings or lumps Enlargement of the lymph nodes or glands (such as the thyroid gland) can be an early sign of cancer Breast and testicular cancers may also present as a lump 5. Indigestion or difficulty in swallowing Cancers of the digestive system, including those of the esophagus, stomach, and pancreas, may cause indigestion, heartburn, or difficulty swallowing 6. Obvious change in a wart or mole Moles or other skin lesions that change in shape, size, or color should be reported 7. Nagging or persistent cough or hoarseness Cancers of the respiratory tract, including lung cancer and laryngeal cancer, may cause a cough that does not go away or a hoarse (rough) voice 8. Unexplained anemia Sudden unexplained weight loss The lymphatic system works in close cooperation with other body systems to perform these important functions:

The lymphatic system aids the immune system in destroying pathogens and filtering waste so that the lymph can be safely returned to the circulatory system. To remove excess fluid, waste, debris, dead blood cells, pathogens, cancer cells, and toxins from these cells and the tissue spaces between them. The lymphatic system also works with the circulatory system to deliver nutrients, oxygen, and hormones from the blood to the cells that make up the tissues of the body. The Origin of Lymph Lymph originates as plasma, which is the fluid portion of blood. The arterial blood that flows out of the heart slows as it moves through a capillary bed (see figure above). This slowing allows some plasma to leave the arterioles and flow into the tissues where it becomes tissue fluid. Also known as extracellular fluid, this is fluid that flows between the cells but is not found within the cells. This fluid delivers nutrients, oxygen, and hormones to the cells. As this fluid leaves the cells, it takes with it cellular waste products and protein cells. Approximately 90 percent of this tissue fluid flows into the venules. Here it enters the venous circulation as plasma and continues in the circulatory system. The remaining 10 percent of the fluid that is left behind is now known as lymph. Blood Flow Compared with Lymphatic Flow Lymph returning to the subclavian veins. Lymph Notes The bloodstream is pumped by the heart. It circulates throughout the body and is cleansed by being filtered by the kidneys. The lymphatic system does not have a pump to aid in its flow, instead this system is designed so that lymph only flows upward through the body traveling from the extremities (feet and hands) and upward through the body toward the neck. As it travels through the body, lymph passes through lymph nodes where it is filtered. At the base of the neck, the lymph enters the subclavian veins and once again becomes plasma in the bloodstream. Cancers are capable of spreading throughout the body by two mechanisms: invasion and metastasis. Invasion refers to the direct migration and penetration by cancer cells into neighboring tissues. Metastasis refers to the ability of cancer cells to penetrate into lymphatic and blood vessels, circulate through the bloodstream, and then invade normal tissues elsewhere in the body.

Depending on whether or not they can spread by invasion and metastasis, tumors are classified as being either benign or malignant. Benign tumors are tumors that cannot spread by invasion or metastasis; hence, they only grow locally. Malignant tumors are tumors that are capable of spreading by invasion and metastasis. By definition, the term cancer applies only to malignant tumors.