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Cancer : Detailed Guide
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Cancer : Detailed Guide
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Cancer : Detailed Guide
***1***
Cancer develops when cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because of out-of-control growth of abnormal cells.
Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person's life, normal cells divide more rapidly until the person becomes an adult. After that, cells in most parts of the body divide only to replace worn-out or dying cells and to repair injuries.
Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to form new abnormal cells.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 2 ***
Cancer cells develop because of damage to DNA. This substance is in every cell and directs all activities. Most of the time when DNA becomes damaged the body is able to repair it. In cancer cells, the damaged DNA is not repaired. People can inherit damaged DNA, which accounts for inherited cancers. More often, though, a person's DNA becomes damaged by exposure to something in the environment, like smoking.
Cancer usually forms as a tumor. Some cancers, like leukemia, do not form tumors. Instead, these cancer cells involve the blood and blood-forming organs and circulate through other tissues where they grow.
Often, cancer cells travel to other parts of the body where they begin to grow and replace normal tissue. This process is called metastasis. Regardless of where a cancer may spread, however, it is always named for the place it began. For instance, breast cancer that spreads to the liver is still called breast cancer, not liver cancer.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 3 ***
Not all tumors are cancerous. Benign (noncancerous) tumors do not spread (metastasize) to other parts of the body and, with very rare exceptions, are not life threatening.
Different types of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. That is why people with cancer need treatment that is aimed at their particular kind of cancer.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 4 ***
The risk of developing most types of cancer can be reduced by changes in a person's lifestyle, for example, by quitting smoking and eating a better diet. The sooner a cancer is found and treatment begins, the better are the chances for living for many years.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 5 ***
Over one million people get cancer each year. Anyone can get cancer at any age; however, about 77% of all cancers are diagnosed in people age of 55 and older. Although cancer occurs in all racial and ethnic groups, the rate of cancer occurrence (called the incidence rate) varies from group to group.
Millions of people are living with cancer or have been cured of the disease. The sooner a cancer is found and the sooner treatment begins, the better a patient's chances are of a cure. That's why early detection of cancer is such an important weapon in the fight against cancer.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 6 ***
Risk Factors for Cancer
A risk factor is anything that increases a person's chance of getting a disease. Some risk factors can be changed, and others cannot. Risk factors for cancer can include a person's age, , and family medical history. Others are linked to cancer-causing factors in the environment. Still others are related to lifestyle choices such as tobacco and alcohol use, diet, and sun exposure.
Having a risk factor for cancer means that a person is more likely to develop the disease at some point in their lives. However, having one or more risk factors does not necessarily mean that a person will get cancer. Some people with one or more risk factors never develop the disease, while other people who do develop cancer have no apparent risk factors. Even when a person who has a risk factor is diagnosed with cancer, there is no way to prove that the risk factor actually caused the cancer.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 7 ***
Risk Factors for Cancer
Different kinds of cancer have different risk factors. Some of the major risk factors include the following:
*Cancers of the lung, mouth, larynx, bladder, kidney, cervix esophagus, and pancreas are related to tobacco use, including cigarettes, cigars, chewing tobacco, and snuff. Smoking alone causes one-third of all cancer deaths.
*Skin cancer is related to unprotected exposure to strong sunlight.
*Breast cancer risk factors include several factors: age; changes in hormone levels throughout life, such as age at first menstruation, number of pregnancies, and age at menopause; obesity; and physical activity. Some studies have also shown a connection between alcohol consumption and an increased risk of breast cancer. Also, women with a mother or sister who have had breast cancer are more likely to develop the disease themselves.
*While all men are at risk for prostate cancer, several factors can increase the chances of developing the disease, such as age, race, and diet. The chance of getting prostate cancer goes up with age. Prostate cancer is more common among black men than among white men. (We do not yet know why this is so.) A high-fat diet may play a part in causing prostate cancer. Also, men with a father or brother who have had prostate cancer are more likely to get prostate cancer themselves.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 8 ***
Risk Factors for Cancer
Environmental factors, defined broadly to include tobacco use, diet, and infectious diseases, as well as chemicals and radiation cause an estimated 75% of all cancer cases. Among these factors, tobacco use, unhealthy diet, and physical activity are more likely to affect personal cancer risk. Research shows that about one-third of all cancer deaths are related to dietary factors and lack of physical activity in adulthood.
Certain cancers are related to viral infections and could be prevented by behavior changes or vaccines. Skin cancers could be prevented by protection from the sun's rays.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 9 ***
Cancer Prevention
Smoking and drinking alcohol cause some people to get certain types of cancer. These cancers might be prevented by avoiding tobacco and alcohol. The best idea is to never use tobacco at all. Cigarettes, cigars, pipes and smokeless tobacco cause cancer and should not be used. People who already smoke should try to quit. Former smokers have less risk of cancer than do people who continue to smoke.
The chances of getting skin cancer can be lowered by staying in the shade as much as you can, wearing a hat and shirt when you are in the sun, and using sunscreen.
We know that our diet, (what we eat) is linked to some types of cancer, although the exact reasons are not yet clear. The best advice is to eat a lot of fresh fruits and vegetables and whole grains like pasta and bread, and to cut down on high fat foods.
There are tests, called screening examinations, that adults should have in order to find cancer early. If cancer is found early it can often be cured.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 10 ***
Causes of Cancer
Some kinds of cancer are caused by things people do. Smoking can cause cancers of the lungs, mouth, throat, bladder, kidneys and several other organs, as well as heart disease and stroke. While not everyone who smokes will get cancer, smoking increases a person's chance of getting the disease. Drinking a lot of alcohol has also been shown to increase a person's chance of getting cancer of the mouth, throat, and some other organs. This is especially true if the person drinks and smokes.
Radiation (x-rays) can cause cancer. But the x-rays used by the doctor or dentist are safe. Too much exposure to sunlight without any protection can cause skin cancer.
In many cases, the exact cause of cancer remains a mystery. We know that certain changes in our cells can cause cancer to start, but we don't yet know exactly how this happens. Many scientists are studying this problem.
(Edited by Dr. Faisal Mohamed on 10-14-2007, 08:35 PM)
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 11 ***
Signs and Symptoms of Cancer
A symptom is an indication of disease, illness, injury, or that something is not right in the body. Symptoms are felt or noticed by a person, but may not easily be noticed by anyone else. For example, chills, weakness, achiness, shortness of breath, and a cough are possible symptoms of pneumonia.
A sign is also an indication that something is not right in the body. But signs are defined as observations made by a doctor, nurse, or other health care professional. Fever, rapid breathing rate, and abnormal breathing sounds heard through a stethoscope are possible signs of pneumonia.
The presence of one symptom or sign may not give enough information to suggest a cause. For example, a rash in a child could be a symptom of a number of things including poison ivy, an infectious disease like measles, an infection limited to the skin, or a food allergy. But if the rash is seen along with other signs and symptoms like a high fever, chills, achiness, and a sore throat, then a doctor can get a better picture of the illness. In many cases, a patient's signs and symptoms do not provide enough clues by themselves to determine the cause of an illness, and medical tests such as x-rays, blood tests, or a biopsy may be needed.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 12 ***
How Does Cancer Produce Signs and Symptoms?
Cancer is a group of diseases that may cause almost any sign or symptom. The signs and symptoms will depend on where the cancer is, the size of the cancer, and how much it affects the surrounding organs or structures. If a cancer spreads (metastasizes), then symptoms may appear in different parts of the body.
As a cancer grows, it begins to push on nearby organs, blood vessels, and nerves. This pressure creates some of the signs and symptoms of cancer. If the cancer is in a critical area, such as certain parts of the brain, even the smallest tumor can produce early symptoms.
Sometimes, however, cancers form in places where there may be no symptoms until the cancer has grown quite large. Pancreas cancers, for example, do not usually grow large enough to be felt from the outside of the body. Some pancreatic cancers do not produce symptoms until they begin to grow around nearby nerves, causing a backache. Others grow around the bile duct, which blocks the flow of bile and leads to a yellowing of the skin known as jaundice. By the time a pancreatic cancer causes these signs or symptoms, it has usually reached an advanced stage.
A cancer may also cause symptoms such as fever, fatigue, or weight loss. This may be caused by cancer cells using up much of the body’s energy supply or releasing substances that change the body’s metabolism. Or the cancer may cause the immune system to react in ways that produce these symptoms.
Sometimes, cancer cells release substances into the bloodstream that cause symptoms not usually thought to result from cancers. For example, some cancers of the pancreas can release substances which cause blood clots to develop in veins of the legs. Some lung cancers make hormone-like substances that affect blood calcium levels, affecting nerves and muscles and causing weakness and dizziness.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 13 ***
How Are Signs and Symptoms Helpful?
Treatment is most successful when cancer is found as early as possible. Finding cancer early usually means it can be treated while it is still small and is less likely to have spread to other parts of the body. This often means a better chance for a cure, especially if initial treatment is to be surgery.
A good example of the importance of detecting cancer early is melanoma skin cancer. It is easily removed if it has not yet grown deeply into the skin, and the 5-year survival rate (percentage of people living at least 5 years after diagnosis) at this stage is nearly 100%. But once melanoma has spread to other parts of the body the survival rate drops dramatically.
Sometimes people ignore symptoms either because they do not recognize the symptoms as being significant or because they are frightened by what they might mean and don’t want to seek medical help. General symptoms, such as fatigue, are more likely to have a cause other than cancer and can seem unimportant, especially if they have an obvious cause or are only temporary. In a similar way, a person may reason that a more specific symptom like a breast mass is probably a cyst that will go away by itself. But neither of these symptoms should be discounted or overlooked, especially if they have been present for a long period of time or are getting worse.
Most likely, any symptoms you may have will not be caused by cancer, but it’s important to have them checked out by your doctor, just in case. If cancer is not the cause, your doctor can help figure out what is and treat it, if needed.
In some cases it is possible to detect some cancers before symptoms occur. The American Cancer Society and other health groups encourage the early detection of certain cancers before symptoms occur by recommending a cancer-related checkup and specific tests for people who do not have any symptoms. Keep in mind, however, that these recommended tests do not diminish the importance of reporting any symptoms to your doctor.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 14 ***
General Cancer Signs and Symptoms
It is important to know what some of the general (non-specific) signs and symptoms of cancer are. They include unexplained weight loss, fever, fatigue, pain, and changes in the skin. Of course, it’s important to remember that having any of these does not necessarily mean that cancer is present -- there are many other conditions that can cause these signs and symptoms as well.
Unexplained weight loss: Most people with cancer will lose weight at some time with their disease. An unexplained (unintentional) weight loss of 10 pounds or more may be the first sign of cancer, particularly cancers of the pancreas, stomach, esophagus, or lung.
Fever: Fever is very common with cancer, but is more often seen in advanced disease. Almost all patients with cancer will have fever at some time, particularly if the cancer or its treatment affects the immune system and reduces resistance to infection. Less often, fever may be an early sign of cancer, such as with leukemia or lymphoma.
Fatigue: Fatigue may be a significant symptom as cancer progresses. It may occur early, however, in cancers such as with leukemia or if the cancer is causing a chronic loss of
blood, as in some colon or stomach cancers.
Pain: Pain may be an early symptom with some cancers, such as bone cancers or testicular cancer. Most often, however, pain is a symptom of advanced disease.
Skin changes: In addition to cancers of the skin, some internal cancers can produce visible skin signs such as darkening (hyperpigmentation), yellowing (jaundice), reddening (erythema), itching, or excessive hair growth.
(Edited by Dr. Faisal Mohamed on 10-14-2007, 09:20 PM)
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 15 ***
Specific Cancer Signs and Symptoms
In addition to the above general symptoms, you should be watchful for the following common symptoms, which could be an indication of cancer. Again, there may be other causes for each of these, but it is important to bring them to your doctor’s attention as soon as possible so that they can be investigated.
Change in bowel habits or bladder function: Chronic constipation, diarrhea, or a change in the size of the stool may indicate colon cancer. Pain with urination, blood in the urine, or a change in bladder function (such as more frequent or less frequent urination) could be related to bladder or prostate cancer. Any changes in bladder or bowel function should be reported to your doctor.
Sores that do not heal: Skin cancers may bleed and resemble sores that do not heal. A persistent sore in the mouth could be an oral cancer and should be dealt with promptly, especially in patients who smoke, chew tobacco, or frequently drink alcohol. Sores on the penis or vagina may either be signs of infection or an early cancer, and should not be overlooked in either case.
Unusual bleeding or discharge: Unusual bleeding can occur in either early or advanced cancer. Blood in the sputum (phlegm) may be a sign of lung cancer. Blood in the stool (or a dark or black stool) could be a sign of colon or rectal cancer. Cancer of the cervix or the endometrium (lining of the uterus) can cause vaginal bleeding. Blood in the urine is a sign of possible bladder or kidney cancer. A bloody discharge from the nipple may be a sign of breast cancer.
Thickening or lump in breast or other parts of the body: Many cancers can be felt through the skin, particularly in the breast, testicle, lymph nodes (glands), and the soft tissues of the body. A lump or thickening may be an early or late sign of cancer. Any lump or thickening should be reported to your doctor, especially if you’ve just discovered it or noticed it has grown in size. You may be feeling a lump that is an early cancer that could be treated successfully.
Indigestion or trouble swallowing: While they commonly have other causes, these symptoms may indicate cancer of the esophagus, stomach, or pharynx (throat).
Recent change in a wart or mole: Any change in color or shape, loss of definite borders, or an increase in size should be reported to your doctor without delay. The skin lesion may be a melanoma which, if diagnosed early, can be treated successfully.
Nagging cough or hoarseness: A cough that does not go away may be a sign of lung cancer. Hoarseness can be a sign of cancer of the larynx (voice box) or thyroid.
While the signs and symptoms listed above are the more common ones seen with cancer, there are many others that are less common and are not listed here. If you notice any major changes in the way your body functions or the way you feel, especially if it lasts for a long time or gets worse, let your doctor know. If it has nothing to do with cancer, your doctor can investigate it and treat it, if needed. If it is cancer, you’ll give yourself the best chance to have it treated early, when treatment is most likely to be effective.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 16 ***
Cancer Staging
Staging is the process of finding out how far the cancer has spread. Staging the cancer is a vital step in determining your treatment choices, and it will also give your health care team a clearer idea of the outlook for recovery.
Staging can take time, and people are usually anxious to begin treatment soon. Do not worry that the staging process is taking up treatment time. Keep in mind that by staging the cancer, you and your health care team will know which treatments are likely to be the most effective before beginning the treatment.
There is more than one system for staging. The TNM system is the one used most often. It gives three key pieces of information:
T describes the size of the tumor, and whether the cancer has spread to nearby tissues and organs.
N describes how far the cancer has spread to nearby lymph nodes.
M shows whether the cancer has spread (metastasized) to other organs of the body.
Letters or numbers after the T, N, and M give more details about each of these factors. For example, a tumor classified as T1, N0, M0 is a tumor that is very small, has not spread to the lymph nodes, and has not spread to distant organs of the body. Once the TNM descriptions have been established, they can be grouped together into a simpler set of stages, stages 0 through stage IV (0-4).
In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more serious, widespread cancer.
After looking at your test results, your doctor will tell you the stage of your cancer. Be sure to ask your doctor any questions you might have about what the stage of your cancer means and how it will impact your treatment options.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 17 ***
Types of Staging
There are different types of staging:
Clinical staging is an estimate how much cancer there is based on the results of the physical exam, imaging tests (x-rays, CT scans, etc.) and sometimes biopsies of affected areas. For certain cancers the results of other tests, such as blood tests, are also used in staging.
Pathologic staging can only be done on patients who have had surgery to remove or explore the extent of the cancer. It combines the results of clinical staging (physical exam, imaging tests, etc.) with the results from the surgery. In some cases, the pathologic stage may be different from the clinical stage (for example, if the surgery shows the cancer has spread more than it was thought to have spread before surgery.)
Restaging is sometimes used to determine the extent of the disease if a cancer recurs (comes back) after treatment. This is done to help decide what the best treatment option would be at this time. This type of staging is not common.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 18 ***
The TNM Staging System
At one time there were many different systems used to stage cancers, and sometimes different systems were used to stage the same type of cancer. Although some of the better ones are still used, many of these systems did not give doctors very useful information.
The American Joint Committee on Cancer (AJCC) developed the TNM classification system as a tool for doctors to stage different types of cancer based on certain standard criteria. It has replaced many of the older staging systems. In the TNM system, each cancer is assigned a T, N, and M category.
The Tcategory describes the original (primary) tumor. The tumor size is usually measured in centimeters (2 and 1/2 centimeters is about 1 inch) or millimeters (10 millimeters = 1 centimeter.)
* TX means the tumor can't be measured or evaluated.
* T0 means there is no evidence of primary tumor (the primary tumor cannot be found).
* Tis means the cancer is in situ (the tumor has not started growing into the structures around it).
* The numbers T1–T4 describe the tumor size and/or level of invasion into nearby structures. The higher the T number, the larger the tumor and/or the further it has grown into nearby structures.
The N category describes whether or not the cancer has reached nearby lymph nodes.
* NX means the nearby lymph nodes can't be measured or evaluated.
* N0 means nearby lymph nodes do not contain cancer.
*The numbers N1–N3 describe the size, location, and/or the number of lymph nodes involved. The higher the N number, the more lymph nodes are involved.
The M category tells whether there are distant metastases (spread of cancer to other parts of body).
* MX means metastasis can't be measured or evaluated.
* M0 means that no distant metastases were found.
* M1 means that distant metastases were found (the cancer had spread to distant organs or tissues.)
Each cancer type has its own version of this classification system, so letters and numbers don't always mean the same thing for every kind of cancer. For example, for some cancers, classifications may have subcategories, such as T3a and T3b, while others may not have an N3 category.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 19 ***
Stage Grouping
Once the T, N, and M have been learned, they are combined, and an overall "stage" of I, II, III, or IV is assigned. (Sometimes these stages are subdivided as well, using letters such as IIIA and IIIB.)
For example, a T1, N0, M0 breast cancer would mean that the primary breast tumor is less than 2 cm across (T1), does not have lymph node involvement (N0), and has not spread to distant parts of the body (M0). This would make it a stage I cancer.
A T2, N1, M0 breast cancer would mean that the cancer is more than 2 cm but less than 5 cm across (T2), has reached only the lymph nodes in the underarm area (N1), and has not spread to distant parts of the body. This would make it a stage IIB cancer.
Stage I cancers are the least advanced and often have a better prognosis (outlook for survival). Higher stage cancers are often more advanced but in many cases can still be treated successfully.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 20 ***
Other Staging Systems
Staging systems other than the TNM system are often used for Hodgkin disease and other lymphomas, and some childhood cancers. The International Federation of Gynecologists and Obstetricians (FIGO) has a staging system for cancers of the female reproductive organs. The TNM stages closely match the FIGO stages, which makes it fairly easy to convert stages between these 2 systems.
Other, older staging systems (such as the Dukes system for colorectal cancer) may still be used by some doctors. If your doctor uses another staging system, you may want to find out if the stage can be converted into the TNM system. This will often help if you want to read more about your cancer and its treatment, since TNM is more widely used.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 21 ***
Tumor grade
Your prognosis is affected by the type of cancer you have, but it is also strongly influenced by the cancer's stage. For some cancers, another important factor that is considered along with clinical stage is tumor grade. The grade is assigned after a biopsy of the cancerous tissue has been examined. Tumor grade describes how different the cancer cells look compared to normal ones.
Tumor grade is considered when making treatment decisions and is another factor that affects prognosis for some kinds of cancer. The grade of the cancer reflects how abnormal the cancer cells look under the microscope. Grading is done by a pathologist who compares the cancer cells from the biopsy to normal cells. (A pathologist is a doctor who is specially trained in diagnosis and classification of diseases by lab tests, such as looking cells under a microscope.) Grade is important because cancers with more abnormal-looking cells tend to grow and spread more quickly. Higher grade cancers (meaning that the cancer cells look very abnormal) usually have a worse prognosis, and sometimes need different treatments.
The American Joint Committee on Cancer (AJCC) recommends the following cancer grading classifications:
* GX: Grade cannot be determined
* G1: Well-differentiated (the cancer cells look a lot like normal cells)
* G2: Moderately well-differentiated (cancer cells look somewhat like normal cells)
* G3: Poorly differentiated (cancer cells don't look much like normal cells)
* G4: Undifferentiated (the cancer cells don’t look anything like normal cells)
The lower the cancer grade the better the prognosis. G1 cancers are linked to the best outcomes. G4 is associated with the worst outcomes and the others fall in between.
There are problems with grading, though. For example, several different grade levels may be found in one tumor or the tumor grade may change with time.
There are also several grading systems for different types of cancer, such as the Gleason grades for prostate cancer or the Kernohan grades for brain tumors. Each grading system divides cancer cells into those with the most abnormal cells, the least abnormal cells, and those in between. Generally, whatever grading system is used, the lower numbers indicate less aggressive cancers while the higher numbers suggest more rapid cancer cell growth and spread.
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Re: Cancer : Detailed Guide (Re: Dr. Faisal Mohamed)
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*** 22 ***
Cancer Treatment
The number of treatment choices depend on the type of cancer, the stage of the cancer, and other individual factors such as your age, health status, and personal preferences.
The four major types of treatment for cancer are surgery, radiation, chemotherapy, and biologic therapies. You might also have heard about hormone therapies such as tamoxifen and transplant options such as those done with bone marrow.
Certain types of cancer respond very differently to different types of treatment, so determining the type of cancer is a vital step toward knowing which treatments will be most effective. The cancer's stage (how widespread it is) will also determine the best course of treatment, since early-stage cancers respond to different therapies than later-stage ones.
Your overall health, your lifestyle, and your personal preferences will also play a part in deciding which treatment options will be best for you. Not all types of treatment will be effective in your situation, so be sure that you understand your options. Don't be afraid to ask questions; it is your right to know what treatments are most likely to help you and what their side effects may be.
Palliative versus Curative Goals: Before starting treatment, ask about the goal of treatment. Is the purpose of the treatment to cure the cancer, control it, or treat symptoms? Sometimes the goal of treatment can change.
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