BASIC CANCER FACTS


What is Cancer?

Cancer refers to a group of diseases in which abnormal cells divide without control (1). The human body is made up of normal cells which grow and divide to form new cells as the body needs them. When cells grow old, they die and new cells take their place.  Also, when we sustain injuries, new cells are formed to replace the damaged ones. This process keeps us healthy.  If cells continue to divide when there is no need for them, they accumulate to form a mass or tumor.  Tumors may be benign or malignant.  Benign tumors are typically not life threatening.   They do not invade tissues around them and do not spread to distant portions of the body.  Malignant tumors are also referred to as cancer. These malignant tumors are generally more serious than benign ones and may be life threatening.  They tend to invade and damage nearby tissues and organs and the cells from these malignant tumors can spread to other parts of the body.  This is called metastasis. Common types of cancer include breast cancer in women, prostate cancer in men, and lung and colon cancer in both genders.  Cancers can arise from virtually every part of the human body.

What causes cancer?

Most cancers are caused by a combination of factors.  These can be inherited factors passed down from a parent, external factors such as cigarette smoking or a combination of both.  There are certain risk factors that increase the likelihood that a person will develop cancer.  The most recognized factors include increasing age, tobacco use, persistent sunlight exposure, ionizing radiation, toxic chemicals, some viruses and bacteria, certain hormones, family history of cancer, alcohol consumption, poor dietary habits, and lack of physical activity or being overweight.

What are some warning signs of cancer?

A lot of cancers do not have any symptoms or signs early in their course.  In such cancers, the symptoms might arise only after the tumor has reached a critical size or when it interferes with the proper function of surrounding tissues.  However, if a tumor is located in a delicate or critical site, early manifestations of its presence may be observed. Findings which may warrant further investigation include a lump in any part of the body, nagging cough or hoarseness, change in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, indigestion or difficulty swallowing, obvious change in a wart or a mole, etc.  It is important to note that these findings may be due to causes other than cancer. However, it is appropriate to visit your doctor if you have any of these symptoms or signs.

Cancer Screening

This describes the process of checking for cancer in people who have no symptoms or signs.  Some types of cancer such as breast and prostate cancer can be found before they cause any symptoms. If a cancer is at an early stage, treatment is more likely to be effective.  Research has shown that certain people in the population have a higher risk for developing cancer.  Screening is directed at people that fall into such categories.  Not all screening tests are appropriate for everyone.  It is recommended that you speak to your primary care physician about what type of cancer screening may be most suitable for you.

Cancer Prevention

Some types of cancer such as cervical or colorectal cancer can be prevented by detecting abnormalities which are precursors of cancer.  This can be done with screening tests such as a pap smear for cervical cancer or colonoscopy for colon cancer. These abnormalities can then be treated before they have an opportunity to become cancerous.  In addition to such preventive treatment, certain healthy habits can reduce your risk for cancer.  These include avoidance of cigarette smoking, eating healthy foods, maintaining an ideal body weight and getting an adequate amount of exercise.

Diagnosis

There are multiple tests that are used to investigate symptoms or signs that may be suggestive of a cancer.  These include some laboratory tests that might provide important clues such as the PSA test which might be elevated in patients with prostate cancer.  Other tests include x-rays, CT scans and other imaging modalities that might provide information about the state of an individual’s internal organs.  Physicians can also use different types of endoscopes to inspect various organs within the body.  A biopsy might be obtained with one of these endoscopes or by other means, to provide actual tissue to be examined under the microscope by a pathologist.  This is the most definite way to obtain a diagnosis of cancer.

Treatment

The treatment of a cancer depends on many factors including the overall health and well being of the patient, the stage of the cancer, and multiple other factors.  The commonest modalities available for treatment of cancer are surgery, chemotherapy and radiation therapy.  However, there are unique treatment options that may be applicable to certain specific cancers.  It is generally beneficial to obtain an expert opinion once a diagnosis of cancer is made or seriously suspected.  Cancer centers generally have a multi-disciplinary approach to the treatment of most cancers.  It may be necessary to obtain a second opinion when an individual is considering options for treatment.  The prognosis or expected outcome from the treatment of any cancer is dependant on multiple factors.  These include some of the things that have been mentioned already, including the age of the patient, the presence of other serious illnesses, the stage of the cancer, its location and the locally available expertise.
Overall, the treatment of cancer has improved significantly over the last decade or two. This is more so for some cancers rather than others.  It is beneficial for every individual to adopt the general cancer prevention measures mentioned earlier.  There are specific screening tests for men and women that are recommended at a certain age.  This may include screening for breast, cervical and colon cancer. There is considerable controversy about prostate cancer screening. Your primary care physician would be in the best position to guide you about what screening tests are most appropriate for you.  If there is a suspicion of cancer, it is advisable to obtain an expert opinion and seek therapy from a cancer center.  Additional information may be obtained from the following websites:

http://www.cancer.gov/cancertopics/what-is-cancer
http://www.cancer.org/docroot/home/index.asp
http://www.who.int/topics/cancer/en/

 

Spiritual Insights
A diagnosis of cancer often elicits an intense array of emotions – despair, hopelessness, depression, fear, panic, anger, denial, etc. This is quite understandable and even expected. As I have interacted with a large spectrum of patients that have exhibited these responses, I have come to the conclusion that a faithful approach to the challenges which this disease presents, is extremely beneficial. Some Bible passages that I find most pertinent include:

“but those who hope in the LORD
will renew their strength.
They will soar on wings like eagles;
they will run and not grow weary,
they will walk and not be faint”. – Isaiah 40:31 (New International Version)

“Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus”. – Philippians 4:6-7 (New International Version)
“And we know that in all things God works for the good of those who love him, who have been called according to his purpose”. – Romans 8:28 (New International Version)

The physiologic state associated with a mind at peace, is definitely more conducive to the effectiveness of the assigned cancer therapy. Logical decision-making is also facilitated. Prayer, meditation, reading of uplifting material and the support of family, friends and a spiritual community provide immeasurable emotional benefit. Cancer survivors often rely on their religious and spiritual beliefs as a way of deriving meaning during their illness experience and survivorship (2).

Chumy Nwogu, MD, FACS
Associate Professor of Oncology and Surgery
Roswell Park Cancer Institute
University at Buffalo (SUNY), NY
References

1. Understanding Cancer | Roswell Park Cancer Institute . Available at:http://www.roswellpark.org/cancer. Accessed 5/10/2010, 2010.
2. Vachon MLS. Meaning, spirituality, and wellness in cancer survivors. Semin Oncol Nurs 2008;24:218-25.

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