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 What is it?
Cancer is a group of diseases characterized by uncontrolled growth or
spread of abnormal cells. The abnormal cells can form a mass, or a
tumor. Tumors can either be "benign" (not harmful) or "malignant"
(cancerous). If the cells grow out of control but are not able to invade
other tissues, the tumor is benign. Cells that grow out of control and
that can also invade other tissues and spread to other parts of the body
represent malignant tumors (cancer). Malignant tumors can spread to
other parts of the body by shedding cells into the blood or lymph
system.
Cancers are classified according to their origin and the type of
tissue involved. Types of cancers include:
- Carcinomas, which begin in tissues like the skin, mucous
membranes, stomach, or intestines.
- Sarcomas, which originate in muscle or connective tissues such
as bone, cartilage, and fat.
- Leukemias, which involve blood cells.
- Lymphomas, which affect lymph nodes throughout the body.
What causes it?
The cause of cancer is not clearly known. However, at its most basic
level, cancer is a disease of the genes. Genes are the blueprints for
our growth and development. Every cell in our body contains our genes,
or genetic material. These genes program the cell to divide at a certain
rate. When changes to the gene occur, it is called a genetic mutation.
These mutations lead to inappropriate growth and division of the cell,
which can sometimes cause cancer.
Genetic mutations, or faulty genes, can be inherited or the result of
an exposure to carcinogens, substances that can cause genetic mutations.
Carcinogens may include:
- medications
- chemicals
- hormones
- viruses
- ultraviolet light
- radiation
Who has it?
The National Cancer Institute estimates that approximately 8.9
million Americans have cancer or a history of cancer. One-half of
American men and one-third of American women will develop cancer during
their lifetimes. More than 1.3 million cancers will be diagnosed this
year.
Cancer is the second leading cause of death in the U.S. with more
than 500,000 deaths annually-more than 1,500 people a day. Cancer causes
one in four deaths in this country. Cancer rates are approximately 16
percent higher among African-American men than Caucasian men. After
steadily increasing for 17 years, the incidence and death rates for all
cancers declined between 1990 and 1995. Across the board, incidence
rates dropped an average of 0.7 percent each year and overall death
rates declined by approximately 0.5 percent per year.
What are the risk factors?
Risk factors are characteristics that increase your chance for
developing a condition. Exposure to certain substances in the
environment may increase the risk of cancer. In fact, many cancers can
be prevented by:
- not using any tobacco products
- eating a proper diet
- avoiding the sun
One-third of all cancer deaths are attributed to smoking. The Surgeon
General and Centers for Disease Control and Prevention estimates that
smoking accounts for about 400,000 deaths per year. While smoking is
most often associated with lung cancer, it is also a cause of cancers of
the:
- mouth
- pharynx
- larynx
- esophagus
- pancreas
- uterus
- kidneys
- bladder
Other risk factors that cannot be controlled include increasing age
and family history. For example, women with a mother, sister, or
daughter who has had breast cancer are twice as likely to get the
disease. Prostate cancer also appears to have a hereditary link.
What are the symptoms?
Symptoms vary greatly with the location and type of cancer. If you
notice one of the early warning signs, consult your doctor immediately.
Many cancers can be cured if caught early.
Some of the early warning signs in adults include:
- a change in bowel or bladder habits
- a sore throat that does not heal
- unusual bleeding or discharge
- thickening or a lump in the breast or other part of the body
- indigestion or difficulty swallowing
- an obvious change in an existing wart or mole
- a nagging cough or hoarseness
- unexplained weight loss
- persistent fever, chills, or night sweats
Fortunately, screening tests can detect more than one-half of all new
cancers. These include cancers that affect the:
- breasts
- tongue
- mouth
- colon
- rectum
- cervix
- prostate
- testes
- skin
Early detection means early treatment, and early treatment means
increased survival rates. For example, 97 percent of women who are
diagnosed with breast cancer at an early stage are alive five years
after remission. If breast cancer is detected after it has spread, the
rate decreases to 21 percent.
If all Americans participated in regular detection programs, the
survival rate of many cancers could reach 95 percent, according to the
American Cancer Society.
Once you are diagnosed with cancer, your doctor will use a staging
system to determine how advanced the cancer is at the time of diagnosis.
He/She will measure the cancer's development through a course of
treatment. Staging systems can differ according to the type of cancer.
One type of staging involves a "TNM" rating:
- A "T" refers to the size of the tumor. Tumors are graded on a
scale of one to four, with four being the most advanced.
- An "N" refers to how much the cancer has affected the lymph
nodes, which exist throughout the body. Lymph node involvement is
graded on a scale of zero to three.
- An "M" rating is used to identify if the cancer has spread,
which is referred to as "metastasized." Metastases are assigned a
zero if the tumor has not spread or a one if it has.
Another staging system uses the Roman numerals I to IV. Stage I
cancers are usually small and curable and stage IV cancers are the most
advanced and most difficult to successfully treat.
How is it treated?
Treatment may provide a cure, relieve discomfort, or serve as a
preventive measure against recurring tumors. There are three types of
treatments most commonly used for cancer. Sometimes these treatments are
used individually and other times they are used in combination.
- Surgery - the oldest and most commonly used method of treatment
for solid tumors. The concept is simple: cut the cancer out of the
body. Surgery also has an important role in making a diagnosis and
determining the severity of the disease.
- Radiation - the use of high-energy X-rays and gamma rays to
destroy tumors. Therapeutic doses of radiation are normally built up
through a series of treatments that take place over several weeks or
by having radioactive implants placed directly in the tumor.
Radiation can destroy cells that were not visible to the surgeon
when a tumor was removed. Radiation can also be used to slow the
spread of cancer and to offer relief from pain in conditions such as
bone cancer.
- Chemotherapy - the use of chemicals or medications to treat
cancer. The drugs used in chemotherapy interfere with cancer cells'
ability to divide and reproduce. While the ultimate goal of
chemotherapy is to destroy malignant cells without harming normal
cells, selectivity is difficult because only subtle differences
exist between normal and cancerous cells. Treatment may be deemed
successful if normal cells are able to recover, and tumor cells are
destroyed. Chemotherapy is the main treatment for metastatic cancer.
Your doctor will recommend the best option for you depending on the
following:
- your type of cancer
- the stage of your cancer
- your age
- medical history
- general health
What is on the horizon?
Researchers are currently studying more than 300 new drugs for
treating or preventing cancer. In addition to new drugs, the following
therapies are under study:
- Gene therapy - an area of interest to many researchers. The idea
here would be to replace the defective genes in cancer cells with
normal, healthy genes, thereby correcting the cells' overactive
replication problem. The challenge is finding a way to get the
healthy genes into the cancer cells.
- Cancer vaccines - to treat existing cancers by teaching the
body's immune system to target and destroy cancer cells.
- Antiangiogenic therapy - Angiogenesis is the rapid formation of
new capillaries for transporting blood to the tissues. Under normal
circumstances, this process is rare and lasts only a short time.
Tumors have been known to stimulate angiogenesis when they spread
into tissues other than the ones where they originated. By
preventing the formation of new capillaries, scientists hope to
deprive the tumor of its blood supply, and therefore, its ability to
spread.
- Chemoprevention - an approach to cancer prevention that uses
nutrients, natural products, or man-made compounds to inhibit or
reverse the process of cancer. For example, on April 6, 1998, the
Breast Cancer Prevention Trial released findings that suggested the
drug tamoxifen could reduce the risk of breast cancer by 45 percent
in women who are at high risk. Investigators were so impressed with
these findings that they released the information 14 months earlier
than originally expected, giving women at risk for breast cancer a
jump on taking advantage of tamoxifen therapy. The U.S. Food and
Drug Administration approved tamoxifen for use in reducing breast
cancer risk on October 29, 1998. Tamoxifen is a powerful, poisonous
drug, and users need to discuss the pros and cons of such treatment
with their doctors to choose the best course of action for their
individual situation.
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