What does Cancer mean?

What does Cancer mean?
What does Cancer mean?

What does Cancer mean? A comprehensive guide for type, causes, diagnosis, treatment of cancer. If we try to understand what Cancer means to a common person, we can refer it to the growth of our cells out-of-control invading other tissues. Our cells become cancerous due to the accumulation of defects, or mutations, in their DNA.

Certain inherited genetic defects (for example, BRCA1 and BRCA2 mutations) and infections may increase the risk of cancer. Environmental factors (for example, air pollution) and poor lifestyle choices—such as smoking and heavy alcohol use—can also damage DNA and lead to cancer. It is good for us that most of the time, our cells are able to detect and repair DNA damage. If a cell is severely damaged and cannot repair itself, it usually undergoes so-called programmed cell death or apoptosis.

But when damaged cells grow, divide, and spread abnormally instead of self-destructing as they should, we call it Cancer is growing. These damaged cells form tumors within the body.

In other words, we can say that a tumor is an abnormal mass of cells. They can either be malignant (cancerous) or benign (non-cancerous).

What is cancer?

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Cancer can occur anywhere in the body. Broadly, cancers are classified as either solid (for example breast, lung, or prostate cancers) or liquid (blood cancers). It is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. They can form a subset of neoplasms.

Cancer is further classified according to the tissue in which it arises. It can take shape in form of tumors.

Tumors are mostly of two types:

  1. Malignant Tumors
  2. Benign Tumors

 

What Is A Tumor?

What type of tumor do I have?

Malignant Tumors

Malignant tumors spread and invade other tissues. There are many different types of malignancy based on where a cancer tumor originates. All tumor cells show the six characteristics of cancer. These are required to produce a malignant tumor:

  1. Cell growth and division absent the proper signals
  2. Continuous growth and division even given contrary signals
  3. Avoidance of programmed cell death
  4. Limitless number of cell divisions
  5. Promoting blood vessel construction
  6. Invasion of tissue and formation of metastases

The progression from normal cells to cells that can form a detectable mass to become cancerous involves multiple steps known as malignant progression.

Different treatment options for benign vs malignant tumors

What are the differences between benign & malignant tumours?

 

Benign Tumors

Benign tumors grow locally and do not spread to other parts of the body. They are not considered cancer but can still be dangerous, especially when they press against vital organs like the brain or nervous system within the brain or somewhere else.

Cancer Metastasis

Metastasis is the process under which damaged cells break free from a malignant tumor and travel to invade other tissues in the body. Damaged cells metastasize to other sites via the lymphatic system and the bloodstream.

From the original or primary tumor, they can travel to other sites such as the lungs, bones, liver, brain, and other areas. These metastatic tumors are called as “secondary cancers” because they arise from the primary tumor.

Metastasized Cancer

Metastatic cancer keeps its name intact as primary cancer. Bladder cancer that metastasizes to the liver is not called as liver cancer. We address it as metastatic bladder cancer. We can not ignore Metastasis as it helps us in determination of stages and treatment of cancer. Some types of metastatic cancer are curable, but not all.

 

Benign Tumors – Causes, Symptoms, Treatments & More…

What Causes Cancer?

Generally, we can not prove what caused a particular cancer to a particular person, because the various causes do not have specific fingerprints. For example, if a person who uses tobacco heavily develops lung cancer, then it was probably caused by the tobacco use, but since everyone has a small chance of developing lung cancer as a result of air pollution or radiation, the cancer may have develop for one of those reasons.

Excepting the rare transmissions that occur with pregnancies and occasional organ donors, cancer is generally not a transmissible disease.

We find that 22% cancer deaths are caused through the use of tobacco whereas another 10% deaths take place due to obesity, poor diet, lack of physical activity and drinking alcohol. Among other factors we include certain infections, exposure to ionizing radiation and environmental pollutants. In the developing world nearly 20% of cancers are due to infections such as hepatitis B, hepatitis C and human papillomavirus (HPV).

These factors act, at least partly, by changing the genes of a cell. Typically many genetic changes are required before cancer develops. Approximately 5–10% of cancers are due to inherited genetic defects from a person’s parents.

Certain genes control the life cycle of the cell. Its growth, function, division, and death is controlled. If anyhow these genes are damaged, the balance between normal cell growth and death is lost. Cancer is caused by DNA damage and out-of-control cell growth. Cancer can be caused in any of the following situations.

1. Environment

The majority of cancers, we can say, some 90–95% of cases, are due to environmental factors. Yes, Cancer is caused by environmental exposure. Sunlight through ultraviolet radiation, air pollutants like soot, wood dust, asbestos and arsenic can cause cancer. Environmental factors mean any cause that is not inherited genetically, such as lifestyle, economic and behavioral factors and not merely pollution.

Common environmental factors that contribute to cancer death include tobacco (25–30%), diet and obesity (30–35%), infections (15–20%), radiation (both ionizing and non-ionizing, up to 10%), stress, lack of physical activity and environmental pollutants.

 

Environmental Causes of Cancer

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2. Mutations

Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat. Cancer can take place through Genetic mutations. For example, mutations of genes BRCA1 and BRCA2 (linked to 75% risk of breast and ovarian cancers) can inhibit the body’s ability to safe-guard and repair DNA. These mutated genes go down genetically to future generations, leading to a genetically-inherited increased risk of cancer.

The 5–10% of the cancer cases are due to inherited genetics. Less than 0.3% of the population are carriers of a genetic mutation that has a large effect on cancer risk and these cause less than 3–10% of cancer. Some of these syndromes may include hereditary non-polyposis colorectal cancer (HNPCC or Lynch syndrome), which is present in about 3% of people with colorectal cancer, among others.

Fundamentally, Cancer is a disease of tissue growth regulation. In order for a normal cell to transform into a cancer cell, the genes that regulate cell growth and differentiation must be altered. The affected genes are divided into two broad categories. Oncogenes are genes that promote cell growth and reproduction.

Tumor suppressor genes are genes that inhibit cell division and survival. Malignant transformation can occur through the formation of novel oncogenes, the inappropriate over-expression of normal oncogenes, or by the under-expression or disabling of tumor suppressor genes.

Typically, changes in multiple genes are required to transform a normal cell into a cancer cell. Genetic changes can occur at different levels and by different mechanisms. The gain or loss of an entire chromosome can occur through errors in mitosis. More common are mutations, which are changes in the nucleotide sequence of genomic DNA.

Large-scale mutations involve the deletion or gain of a portion of a chromosome. Genomic amplification occurs when a cell gains copies (often 20 or more) of a small chromosomal locus, usually containing one or more oncogenes and adjacent genetic material. Translocation occurs when two separate chromosomal regions become abnormally fused, often at a characteristic location.

A well-known example of this is the Philadelphia chromosome, or translocation of chromosomes 9 and 22, which occurs in chronic myelogenous leukemia and results in production of the BCR-abl fusion protein, an oncogenic tyrosine kinase. Small-scale mutations include point mutations, deletions and insertions, which may occur in the promoter region of a gene and affect its expression, or may occur in the gene’s coding sequence and alter the function or stability of its protein product.

Disruption of a single gene may also result from integration of genomic material from a DNA virus or retrovirus, leading to the expression of viral oncogenes in the affected cell and its descendants.

Replication of the data contained within the DNA of living cells will probabilistically result in some errors (mutations). Complex error correction and prevention is built into the process and safeguards the cell against cancer. If significant error occurs, the damaged cell can self-destruct through programmed cell death, termed apoptosis. If the error control processes fail, then the mutations will survive and be passed along to daughter cells.

 

Cancer: rogue cells and DNA mutations

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Mutation in tumor suppressor gene leads to cancer

3. Microbes

Some substances cause cancer primarily through their physical effects. Prolonged exposure to asbestos, naturally occurring mineral fibers that are a major cause of mesothelioma (cancer of the serous membrane) usually the serous membrane surrounding the lungs can cause cancer.

Other substances in this category, including both naturally occurring and synthetic asbestos-like fibers, such as wollastonite, attapulgite, glass wool and rock wool, are believed to have similar effects. Non-fibrous particulate materials that cause cancer include powdered metallic cobalt and nickel and crystalline silica (quartz, cristobalite and tridymite). Usually, physical carcinogens must get inside the body (such as through inhalation) and require years of exposure to produce cancer.

Frequent, long-term application of hot objects to the body causing repeated burns on the same part of the body, such as those produced by kanger and kairo heaters (charcoal hand warmers), can produce skin cancer, especially if carcinogenic chemicals are also present. Frequent consumption of scalding hot tea may produce esophageal cancer. Generally, it is believed that the cancer arises, or a pre-existing cancer is encouraged, during the process of healing, rather than directly by the trauma.

However, repeated injuries to the same tissues might promote excessive cell proliferation, which could then increase the odds of a cancerous mutation. Chronic inflammation has been hypothesized to directly cause mutation. Inflammation can contribute to proliferation, survival, angiogenesis and migration of cancer cells by influencing the tumor microenvironment. Oncogenes build up an inflammatory pro-tumorigenic microenvironment. Some microbes like bacteria like H. pylori, which causes stomach ulcers, Viral infections (including Epstein-Barr, HPV, and hepatitis B and C) have also been linked to cancer.

4. Lifestyle

Our modern life styles also invite a number of cancers. Our diet, physical inactivity and obesity are related to up to 30–35% of cancer deaths. In the United States excess body weight is associated with the development of many types of cancer and is a factor in 14–20% of cancer deaths.

A UK study including data on over 5 million people showed higher body mass index to be related to at least 10 types of cancer and responsible for around 12,000 cases each year in that country.

Physical inactivity is believed to contribute to cancer risk, not only through its effect on body weight but also through negative effects on the immune system and endocrine system. More than half of the effect from diet is due to excessive eating, rather than from eating too few vegetables or other healthful foods.

Some specific foods are linked to specific cancers. A high-salt diet is linked to gastric cancer. Aflatoxin B1, a frequent food contaminant, causes liver cancer. Betel nut chewing can cause oral cancer. National differences in dietary practices may partly explain differences in cancer incidence.

For example, gastric cancer is more common in Japan due to its high-salt diet while colon cancer is more common in the United States.

Immigrant cancer profiles develop mirror that of their new country, often within one generation.

In other words, our lifestyle choices can lead to cancer. If we eat a poor diet, or we have inactivity, obesity, heavy alcohol use, tobacco use including smoking, and exposure to chemicals and toxins, we invite greater cancer risk.

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5. Treatment

Some time medical treatment against one disease can cause other disease. Up to 10% of invasive cancers are related to radiation exposure, including both ionizing radiation and non-ionizing ultraviolet radiation.

Additionally, the majority of non-invasive cancers are non-melanoma skin cancers caused by non-ionizing ultraviolet radiation, mostly from sunlight. Sources of ionizing radiation include medical imaging and radon gas. Ionizing radiation is not a particularly strong mutagen. Residential exposure to radon gas, for example, has similar cancer risks as passive smoking. Radiation is a more potent source of cancer when combined with other cancer-causing agents, such as radon plus tobacco smoke. Radiation can cause cancer in most parts of the body, in all animals and at any age.

Children and adolescents are twice as likely to develop radiation-induced leukemia as adults; radiation exposure before birth has ten times the effect. Medical use of ionizing radiation is a small but growing source of radiation-induced cancers. Ionizing radiation may be used to treat other cancers, but this may, in some cases, induce a second form of cancer. It is also used in some kinds of medical imaging. Prolonged exposure to ultraviolet radiation from the sun can lead to melanoma and other skin malignancies.

Clear evidence establishes ultraviolet radiation, especially the non-ionizing medium wave UVB, as the cause of most non-melanoma skin cancers, which are the most common forms of cancer in the world. Non-ionizing radio frequency radiation from mobile phones, electric power transmission and other similar sources have been described as a possible carcinogen by the World Health Organization’s International Agency for Research on Cancer. However, studies have not found a consistent link between mobile phone radiation and cancer risk. Similarly, treatment with chemotherapy, targeted treatments (drugs designed to target a specific type of cancer cell) or immunosuppressive drugs used to decrease the spread of cancer throughout the body can also cause damage to healthy cells.

Some “second cancers”, completely separate from the initial cancer, have been known to occur following aggressive cancer treatments; however, now some drugs that cause less damage to healthy cells (for example, targeted therapy) are available.

6. Chemicals

Lung cancer is highly correlated with smoking. Exposure to particular substances in tobacco has been linked to specific types of cancer. These substances are called carcinogens. Tobacco smoking, for example, causes 90% of lung cancer. It also causes cancer in the larynx, head, neck, stomach, bladder, kidney, esophagus and pancreas.

Tobacco smoke contains over fifty known carcinogens, including nitrosamines and polycyclic aromatic hydrocarbons. It is responsible about one in five cancer deaths worldwide and about one in three in the developed world Lung cancer death rates in the United States have mirrored smoking patterns, with increases in smoking followed by dramatic increases in lung cancer death rates and, more recently, decreases in smoking rates since the 1950s followed by decreases in lung cancer death rates in men since 1990.

In Western Europe, 10% of cancers in males and 3% of cancers in females are caused by alcohol exposure, especially liver and digestive tract cancers. Cancer from work-related substance exposures may cause between 2–20% of cases, causing at least 200,000 deaths.

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7. Infection

Worldwide approximately 18% of cancer deaths are related to infectious diseases. This proportion ranges from a high of 25% in Africa to less than 10% in the developed world.

Viruses are the usual infectious agents that cause cancer but cancer bacteria and parasites may also play a role.

Onco-viruses which cause cancer include human papillomavirus (cervical cancer), Epstein–Barr virus (B-cell lymphoproliferative disease and nasopharyngeal carcinoma), Kaposi’s sarcoma herpesvirus (Kaposi’s sarcoma and primary effusion lymphomas), hepatitis B and hepatitis C viruses (hepatocellular carcinoma) and human T-cell leukemia virus-1 (T-cell leukemias). Bacterial infection may also increase the risk of cancer.

8. Hormones

Some hormones play a role in the development of cancer by promoting cell proliferation. Insulin-like growth factors and their binding proteins play a key role in cancer cell proliferation, differentiation and apoptosis, suggesting possible involvement in carcinogenesis.

Hormones are important agents in sex-related cancers, such as cancer of the breast, endometrium, prostate, ovary and testis and also of thyroid cancer and bone cancer. For example, the daughters of women who have breast cancer have significantly higher levels of estrogen and progesterone than the daughters of women without breast cancer. These higher hormone levels may explain their higher risk of breast cancer, even in the absence of a breast-cancer gene.

Similarly, men of African ancestry have significantly higher levels of testosterone than men of European ancestry and have a correspondingly higher level of prostate cancer. Men of Asian ancestry, with the lowest levels of testosterone-activating androstanediol glucuronide, have the lowest levels of prostate cancer.

Other factors are relevant: obese people have higher levels of some hormones associated with cancer and a higher rate of those cancers. Women who take hormone replacement therapy have a higher risk of developing cancers associated with those hormones.

On the other hand, people who exercise far more than average have lower levels of these hormones and lower risk of cancer. Osteosarcoma may be promoted by growth hormones. Some treatments and prevention approaches leverage this cause by artificially reducing hormone levels and thus discouraging hormone-sensitive cancers.

 

Can Women’s Hormones Cause Cancer?

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9. Autoimmune diseases

There is an association between celiac disease and an increased risk of all cancers. People with untreated celiac disease have a higher risk, but this risk decreases with time after diagnosis and strict treatment, probably due to the adoption of a gluten-free diet, which seems to have a protective role against development of malignancy in people with celiac disease.

However, the delay in diagnosis and initiation of a gluten-free diet seems to increase the risk of malignancies. Rates of gastrointestinal cancers are increased in people with Crohn’s disease and ulcerative colitis, due to chronic inflammation.

Also, immunomodulators and biologic agents used to treat these diseases may promote developing extra-intestinal malignancies.

 

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Symptoms of Cancer and Signs

Symptoms of cancer depend on the location of the tumor. When it begins, it indicates no symptoms. Signs and symptoms appear as the mass grows or ulcerates. Few symptoms can be specific.

Many frequently occur in individuals who have other conditions. Cancer is a “great imitator”.

Thus, it is common for people diagnosed with cancer to have been treated for other diseases, which were hypothesized to be causing their symptoms.

 

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Local symptoms

Local symptoms may occur due to the mass of the tumor or its ulceration. For example, mass effects from lung cancer can block the bronchus resulting in cough or pneumonia; esophageal cancer can cause narrowing of the esophagus, making it difficult or painful to swallow; and colorectal cancer may lead to narrowing or blockages in the bowel, affecting bowel habits.

Masses in breasts or testicles may produce observable lumps. Ulceration can cause bleeding that, if it occurs in the lung, will lead to coughing up blood, in the bowels to anemia or rectal bleeding, in the bladder to blood in the urine and in the uterus to vaginal bleeding.

Although localized pain may occur in advanced cancer, the initial swelling is usually painless. Some cancers can cause a buildup of fluid within the chest or abdomen.

Systemic symptoms

Systemic symptoms occur due to effects which are not related to direct or metastatic spread. They include: unintentional weight loss, fever, excessive fatigue and changes to the skin. Hodgkin disease, leukemias and cancers of the liver or kidney can cause a persistent fever.

Some cancers may cause specific groups of systemic symptoms, termed paraneoplastic phenomena. Examples include the appearance of myasthenia gravis in thymoma and clubbing in lung cancer.

Metastasis

Cancer can spread from its original site by local spread, lymphatic spread to regional lymph nodes or by haematogenous spread via the blood to distant sites, known as metastasis. When cancer spreads by a haematogenous route, it usually spreads all over the body. However, cancer ‘seeds’ grow in certain selected site only (‘soil’) as hypothesized in the soil and seed hypothesis of cancer metastasis.

The symptoms of metastatic cancers depend on the tumor location and can include enlarged lymph nodes (which can be felt or sometimes seen under the skin and are typically hard), enlarged liver or enlarged spleen, which can be felt in the abdomen, pain or fracture of affected bones and neurological symptoms.

Usually, for the existence of cancer we observe possible signs and symptoms like a lump, abnormal bleeding, prolonged cough, unexplained weight loss and a change in bowel movements.

While these symptoms may indicate cancer, they can have other causes too. So far more than 100 different types of cancer have been diagnosed. Every cancer and every individual is unique. Cancer symptoms and signs depend on the size and location of the cancer as well as the presence or absence of metastasis.

Common Cancer Symptoms

Symptoms and signs of cancer may include:

  • Fever
  • Pain
  • Fatigue
  • Skin changes (redness, sores that won’t heal, jaundice, darkening)
  • Unintended weight loss or weight gain
  • Lumps or tumors (mass)
  • Difficulty swallowing
  • Changes or difficulties with bowel or bladder function
  • Persistent cough or hoarseness
  • Short of breath
  • Chest pain
  • Unexplained bleeding or discharge.

 

Types of Cancer

a) Carcinoma

Occupying the position of 80% to 90% of all cancers, this type of cancers occurs in epithelial tissues in the body. They affect mostly breast, lung, colon, skin, and prostate including the two most common skin cancers, basal cell carcinoma and squamous cell carcinoma. Also in this class is the glandular cancer adenocarcinoma.

b) Sarcoma Cancer

Sarcomas occur in connective tissue like the bones, cartilage, fat, blood vessels, and muscles. They include bone cancers osteosarcoma and Ewing sarcoma, Kaposi sarcoma (which causes skin lesions), and the muscle cancers rhabdomyosarcoma and leiomyosarcoma.

c) Myeloma Cancer

These cancers take place in plasma cells in the bone marrow. This type of cancer includes multiple myeloma, also known as Kahler disease.

d) Leukemia

It is a group of different blood cancers of the bone marrow. They cause large numbers of abnormal blood cells to enter the bloodstream.

e) Lymphoma Cancer

This affects the immune system cells and includes the rare but serious Hodgkin lymphoma (Hodgkin’s lymphoma, also Hodgkin’s disease) and a large group of white blood cell cancers known collectively as non-Hodgkin lymphoma (non-Hodgkin’s lymphoma).

f) Mixed Cancer

They occur from more than one type of tissue

g) Common Cancers

The most common cancers diagnosed are those of the breast, prostate, lung, colon and rectum, and bladder. Cancers of the lung, colon and rectum, breast, and pancreas are responsible for the most deaths. The diagnosis of different cancers is highly variable. Many cancers are curable with early detection and treatment.

Cancers which are aggressive or diagnosed at a later stage may be more difficult to treat, and can even be life threatening.

h) Breast Cancer

Breast cancer is the most common cancer and one of the deadliest. About one in eight women will develop invasive breast cancer at some point in her life. More than 40,000 U.S. women are said to have died from breast cancer in 2015 alone.

i) Lung Cancer

Lung cancer is the second-most-common cancer and the deadliest for both men and women. In 2012, more than 210,000 Americans were diagnosed with lung cancer, and in the same year more than 150,000 Americans died from lung cancer. Worldwide too, lung cancers are the most common cancers.

j) Prostate Cancer

Prostate cancer is the most common cancer found in men. In 2013, more than 177,000 Americans were diagnosed with prostate cancer, and more than 27,000 American men died from prostate cancer.

k) Colorectal Cancer

Colorectal cancer can impact both men and women and is the second-greatest killer in the United States.

l) Liver Cancer

Liver cancer occurs in about 20,000 men and 8,000 women each year. Hepatitis B/C and habit of heavy drinking increase risk of developing liver cancer.

m) Ovarian Cancer

About 20,000 American women are diagnosed with ovarian cancer each year. For American women, ovarian cancer is the eighth most common cancer and the fifth leading cause of cancer death.

n) Pancreatic Cancer

Pancreatic cancer has the highest mortality rate of all major cancers. Of the roughly 53,000 Americans diagnosed with pancreatic cancer each year, only 8 percent will survive more than five years.

o) Cancer during Pregnancy

During pregnancy, cancer detection is some difficult. Cancer affects approximately 1 in 1,000 pregnant women. The most common cancers found during pregnancy are the same as the most common cancers found in non-pregnant women during childbearing ages: breast cancer, cervical cancer, leukemia, lymphoma, melanoma, ovarian cancer and colorectal cancer.

 

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How are Stages of Cancer Determined?

Whenever a patient is diagnosed to be affected with cancer, doctors proceed to determine the stage and classify cancer according to its size, location, and extent of spread. Staging helps them to determine how to treat the patient. Staging process which can be called as TNM system, classifies cancers according to:

  • Tumor (T): Primary tumor size and extent
  • Nodes (N): Spread of cancer to lymph nodes in the regional area of the primary tumor
  • Metastasis (M): Spread of cancer to distant sites away from the primary tumor

Cancers affecting brain, spinal cord, bone marrow (lymphoma), blood (leukemia), and female reproductive system do not attract a TNM classification. Instead, they are classified according to a different staging system.

What are the Stages of Cancer?

Under the TNM classification, cancer usually correlates to one of the following five stages.

Stage 0:

Cancer is “in situ,” meaning that cancerous cells are confined to their site of origin. This has not spread and is not invading other tissues.

Stage I – Stage III:

These higher stages of cancer refer to larger tumors and greater extent of disease. Cancers in these stages may have spread beyond the site of origin to invade regional lymph nodes, tissues, or organs.

Stage IV:

This type of cancer has spread to distant lymph nodes, tissues, or organs in the body far away from the site of origin.

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How to diagnose Cancer?

Cancer can be detected by certain signs and symptoms or screening tests. It is then typically further investigated by medical imaging and confirmed by biopsy. For diagnosing the presence of a cancer, various tests are performed. Positron Emission Tomography and Computed Tomography (PET-CT) Scans and other similar tests can highlight the location of cancer cells with high metabolic rates. The most common test and procedures used to diagnose cancer include:

  • Mammogram
  • Pap Test
  • Tumor Marker Test
  • Bone Scan
  • MRI
  • Tissue Biopsy
  • PET-CT Scan

Diagnosing a new cancer in a pregnant woman is difficult, in part because any symptoms are commonly assumed to be a normal discomfort associated with pregnancy. As a result, cancer is typically discovered at a somewhat later stage than average.

Some imaging procedures, such as MRIs (magnetic resonance imaging), CT scans, ultrasounds and mammograms with fetal shielding are considered safe during pregnancy; some others, such as PET scans, are not.

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What is The Role of Lymph Nodes in Cancer Diagnosis?

Cancer which originates in the lymph nodes or other area of the lymphatic system is called lymphoma. Cancer that originates elsewhere in the body can spread to lymph nodes. The presence of metastasized cancer in the lymph nodes may mean that the cancer is growing quickly and is more likely to spread to other sites. The presence of cancer in lymph nodes often affects projection and treatment decisions. Many diagnostic tests look at the lymph nodes as an indicator.

What are Cancer Treatment Options?

Cancer treatment is highly variable depending on the type and stage of a cancer as well as the overall health of the patient. The most common treatments for cancer are surgery, radiation, and chemotherapy.

Other treatments include targeted/biological therapies, hematopoietic stem cell transplants, angiogenesis inhibitors, cryosurgery, and photodynamic therapy. Since every cancer treatment has potential risks, benefits, and side effects, the care team of a patient may include a specialist, surgeon, oncologist, radiation oncologist and others to decide about the best and appropriate course of treatment.

Treatment of cancer for pregnant women is generally the same as for non-pregnant women. However, radiation and radioactive drugs are normally avoided during pregnancy, especially if the fetal dose might exceed 100 cGy. In some cases, some or all treatments are postponed until after birth if the cancer is diagnosed late in the pregnancy. Early deliveries are often used to advance the start of treatment.

Surgery is generally safe, but pelvic surgeries during the first trimester may cause miscarriage. Some treatments, especially certain chemotherapy drugs given during the first trimester, increase the risk of birth defects and pregnancy loss (spontaneous abortions and stillbirths). Elective abortions are not required and, for the most common forms and stages of cancer, do not improve the mother’s survival.

In a few instances, such as advanced uterine cancer, the pregnancy cannot be continued and in others, the patient may end the pregnancy so that she can begin aggressive chemotherapy. Some treatments can interfere with the mother’s ability to give birth vaginally or to breastfeed. Cervical cancer may require birth by Caesarean section. Radiation to the breast reduces the ability of that breast to produce milk and increases the risk of mastitis. Also, when chemotherapy is given after birth, many of the drugs appear in breast milk, which could harm the baby.

Is There a Cure for Cancer?

Some types of cancers can be cured but not all. It depends upon the stages also. But it has to be admitted that despite enormous effort and funding, no single cure has been found yet to eliminate it altogether. Until a cure can be found, prevention through a healthy lifestyle is the best way to stop cancer.

Some ways to help protect ourselves from cancer can be amongst developing our habits for eating plenty of fruits and vegetables, maintaining a healthy weight, abstaining from tobacco, drinking only in moderation, exercising, avoiding sun damage, getting immunizations and getting regular health screenings from time to time.

In other words, many cancers can be prevented by not smoking, maintaining a healthy weight, not drinking too much alcohol, eating plenty of vegetables, fruits and whole grains, vaccination against certain infectious diseases, not eating too much processed and red meat, and avoiding too much sunlight exposure. Coffee is associated with a reduced risk of liver cancer. Cancer prevention is defined as active measures to decrease cancer risk. The vast majority of cancer cases are due to environmental risk factors. Many of these environmental factors are controllable lifestyle choices.

Thus, cancer is generally preventable. Between 70% and 90% of common cancers are due to environmental factors and therefore potentially preventable. Greater than 30% of cancer deaths could be prevented by avoiding risk factors including: tobacco, excess weight/obesity, insufficient diet, physical inactivity, alcohol, sexually transmitted infections and air pollution.

Not all environmental causes are controllable, such as naturally occurring background radiation and cancers caused through hereditary genetic disorders and thus are not preventable via personal behavior. The presence of carcinogens in meats cooked at high temperatures with excessive consumption of red or processed meat (like bacon, ham, hot dogs, sausages) can lead to an increased risk of breast cancer, colon cancer and pancreatic cancer.

Dietary recommendations for cancer prevention typically include an emphasis on vegetables, fruit, whole grains and fish and an avoidance of processed and red meat (beef, pork, lamb), animal fats and refined carbohydrates. For curing against cancer, medications can be used in a few circumstances.

In the general population, NSAIDs reduce the risk of colorectal cancer; however, due to cardiovascular and gastrointestinal side effects, they cause overall harm when used for prevention. Aspirin has been found to reduce the risk of death from cancer by about 7%. COX-2 inhibitors may decrease the rate of polyp formation in people with familial adenomatous polyposis; however, it is associated with the same adverse effects as NSAIDs. Daily use of tamoxifen or raloxifene reduce the risk of breast cancer in high-risk women. Vitamins are not effective at preventing cancer, although low blood levels of vitamin D are correlated with increased cancer risk.

Whether this relationship is causal and vitamin D supplementation is protective is not determined. Beta-carotene supplementation increases lung cancer rates in those who are high risk. Folic acid supplementation is not effective in preventing colon cancer and may increase colon polyps. It is unclear if selenium supplementation has an effect.

Vaccines have been developed that prevent infection by some carcinogenic viruses. Human papillomavirus vaccine (Gardasil and Cervarix) decrease the risk of developing cervical cancer. The hepatitis B vaccine prevents infection with hepatitis B virus and thus decreases the risk of liver cancer. The administration of human papillomavirus and hepatitis B vaccinations is recommended when resources allow.

 

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How can Cancer be treated?

There are a number of methods to cure cancers. It depends upon the stages and sometime affordability of the costs by the patient. The pattern of treatment changes as per the recovery pattern to be shown by the patient. Amongst the methods, we can include the following:

a) Cancer Surgery

Mostly surgery is performed to remove malignant tumors. It allows for the determination of the exact size of the tumor as well as the extent of spread and invasion into other nearby structures or lymph nodes – all-important factors in prognosis and treatment. Surgery is often combined with other cancer treatments, such as chemotherapy and/or radiation. Surgery can be of three types:

Debulking Surgery

We find sometimes that cancer cannot be entirely surgically removed from the affected part of the body as doing so may damage critical organs or tissues. In that case, debulking surgery is performed to remove as much of the tumor as is safely possible.

Palliative Surgery

Palliative Surgery is performed in the cases of advanced cancer to reduce the effects (for example, pain or discomfort) of a cancerous tumor.

Debulking and palliative surgeries are not curative, but they seek to minimize the effects of the cancer.

Reconstructive Surgery

Doctors carry out reconstructive surgery to restore the look or function of part of the body after cancer surgery. Breast reconstruction after a mastectomy is an example of this kind of surgery.

b) Radiation Therapy

It is a very common cancer treatment. About 50% of all cancer patients are recommended to have radiation treatment. It can be delivered before, during, or after surgery and/or chemotherapy.

Under this therapy, radiation is delivered externally to the patient. But where the patient requires, X-rays, gamma rays, or other high-energy particles are delivered to the affected area from outside the body. It can be delivered internally.

Internal radiation therapy involves the placement of radioactive material inside the body near cancer cells. This is called brachytherapy.

Systemic radiation involves the administration of radioactive medication by mouth or intravenously. The radioactive material travels directly to the cancerous tissue. Radioactive iodine (I-131 for thyroid cancer) and strontium-89 (for bone cancer) are two examples of systemic radiation treatments.

Typically, external radiation is delivered 5 days a week over the course of 5 to 8 weeks. Other treatment regimens are sometimes used.

 

Cancer Treatment: IMRT (Radiation Therapy)

 

 

c) Chemotherapy

Chemotherapy, or “chemo,” refers to more than 100 different medications used to treat cancer and other conditions. If eliminating all cancer cells is not possible, the goals of treatment may be to slow the growth of the cancer, keep the cancer from spreading, and/or relieve cancer-associated symptoms (such as pain).

Depending on the type of chemotherapy prescribed, the medications may be given by mouth, injection, intravenously (IV), or topically. IV chemotherapy may be delivered via a catheter or port, which is usually implanted in a blood vessel of the chest for the duration of the therapy.

Sometimes chemotherapy is delivered regionally, directly to the area that needs treatment. For example, intravesical therapy is used to infuse chemotherapy directly into the bladder for the treatment of bladder cancer.

The chemotherapy is decided upon the type and stage of the cancer, any prior cancer treatment, and the overall health of the patient. Chemotherapy is usually administered in cycles over the course of days, weeks, or months, with rest periods in between.

 

Cancer Treatment: Chemotherapy

 

d) Other Cancer Treatments

In addition to above, doctors can use other therapies to treat cancer like:

1. Targeted or Biological Therapies

Under Targeted or Biological therapies the doctors treat cancer and boost the body’s immune system while minimizing damage to normal, healthy cells. Monoclonal antibodies, immunomodulating drugs, vaccines, and cytokines are examples of targeted or biological therapies.

2. Hematopoietic Stem Cell Transplants

Hematopoietic stem cell transplants involve the infusion of stem cells into a cancer patient after the bone marrow has been destroyed by high-dose chemo and/or radiation.

3. Angiogenesis Inhibitors

Angiogenesis inhibitors are medications that inhibit the growth of new blood vessels that cancerous tumors need in order to grow.

4. Cryosurgery

Cryosurgery involves the application of extreme cold to kill precancerous and cancerous cells.

5. Photodynamic Therapy

In this therapy, laser energy of a specific wavelength is used to tissue that has been treated with a photosensitizing agent, a medication that makes cancerous tissue susceptible to destruction with laser treatment. Photodynamic therapy selectively destroys cancer cells while minimizing the damage to normal, healthy tissues nearby.

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Conclusion

Because cancer is a class of diseases, it is unlikely that there will ever be a single “cure for cancer” any more than there will be a single treatment for all infectious diseases. Diagnostic tests are under development to better target the right therapies to the right patients, based on their individual biology. Presently, Cancer research focuses on the following issues:

  • Agents (e.g. viruses) and events (e.g. mutations) that cause or facilitate genetic changes in cells destined to become cancer.
  • The precise nature of the genetic damage and the genes that are affected by it.
  • The consequences of those genetic changes on the biology of the cell, both in generating the defining properties of a cancer cell and in facilitating additional genetic events that lead to further progression of the cancer.

The improved understanding of molecular biology and cellular biology due to cancer research has led to new treatments for cancer since US President Richard Nixon declared the “War on Cancer” in 1971. Since then, the country has spent over $200 billion on cancer research, including resources from public and private sectors.

The cancer death rate (adjusting for size and age of the population) declined by five percent between 1950 and 2005. In 2016, Barack Obama, President of the United States announced a $1 billion investment into creating such a cure, named the “National Cancer Moonshot”. Competition for financial resources appears to have suppressed the creativity, cooperation, risk-taking and original thinking required to make fundamental discoveries, unduly favoring low-risk research into small incremental advancements over riskier, more innovative research.

Other consequences of competition appear to be many studies with dramatic claims whose results cannot be replicated and perverse incentives that encourage grantee institutions to grow without making sufficient investments in their own faculty and facilities. While cancer’s roots are ancient, it is in many ways a disease of development. It is a disease of both an aging society and an industrial economy.

Only with a requisite level of development can the population reach an age to be more likely to contract cancer. Only with a society that is able to eradicate many acute diseases and control epidemics can populations survive to develop cancer. Medical care has to be at a level that can recognize and diagnose cancer. Industrialized societies also provide the diets, habits, and exposures to carcinogenic chemicals and pollutants that increase the risk and rates of cancer.

Throughout the 20th century, there has been considerable progress on cancer. In that time, the nature of cancer has been better understood, and there have been significant successes in treatment and prevention. This century promises even more. The human genome project may improve the understanding of cancer.

 

 

Returning to Real Life after Cancer

 

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Newer therapeutic approaches—including targeted therapies, adjuvant therapy, and strategies designed to enhance immune systems—offer promise of continued advances in treatment.

While one aspect of the history of cancer has been progress in detecting and treating the disease, another facet of cancer’s history has been the great fear that cancer generates. Cancer had been one of a number of diseases that have been dreaded throughout history. To some degree, the stigma of cancer has lessened.

Yet some forms of cancer still retain a sense of blame and stigma. While men can be diagnosed with breast cancer, most share the diagnosis with only a few friends. Colon cancer, still a major killer, provokes questions of whether the victim regularly had colonoscopies. If not, the victim may be perceived as self-negligent.

Lung cancer remains highly stigmatizing, often carrying a sense of blame that lifestyle habits such as smoking caused the disease.

In fact, recent restrictions on second-hand smoke further confer that sense of blame, affirming that the smoker is not only endangering self but others as well. Perhaps one of the next great advances in the struggle against cancer will be that even as one becomes aware of the complex interplay of biological, environmental, and behavioral factors that influence the incidence, treatment, and mortality rates of cancer, there is an affirmation that the focus of efforts remains to treat cancer patients humanely and argue for taking preventive measures for next generation.

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