Saturday, April 17, 2010

THE SILENT KILLER;CANCER

What Is Cancer?

The body is made up of hundreds of millions of living cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person's life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries. Cancer begins when cells in a part of the body start to grow out of control. There are many kinds of cancer, but they all start because of out-of-control growth of abnormal cells. Cancer cell growth is different from normal cell growth. Instead of dying, cancer cells continue to grow and form new, abnormal cells. Cancer cells can also invade (grow into) other tissues, something that normal cells cannot do. Growing out of control and invading other tissues are what makes a cell a cancer cell. Cells become cancer cells because of damage to DNA. DNA is in every cell and directs all its actions. In a normal cell, when DNA gets damaged the cell either repairs the damage or the cell dies. In cancer cells, the damaged DNA is not repaired, but the cell doesn't die like it should. Instead, this cell goes on making new cells that the body does not need. These new cells will all have the same damaged DNA as the first cell does. People can inherit damaged DNA, but most DNA damage is caused by mistakes that happen while the normal cell is reproducing or by something in our environment. Sometimes the cause of the DNA damage is something obvious, like cigarette smoking. But often no clear cause is found. In most cases the cancer cells form a tumor. Some cancers, like leukemia, rarely form tumors. Instead, these cancer cells involve the blood and blood-forming organs and circulate through other tissues where they grow. Cancer cells often travel to other parts of the body, where they begin to grow and form new tumors that replace normal tissue. This process is called metastasis. It happens when the cancer cells get into the bloodstream or lymph vessels of our body. No matter where a cancer may spread, it is always named for the place where it started. For example, breast cancer that has spread to the liver is still called breast cancer, not liver cancer. Likewise, prostate cancer that has spread to the bone is metastatic prostate cancer, not bone cancer. 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. Not all tumors are cancerous. Tumors that aren't cancer are called benign. Benign tumors can cause problems -- they can grow very large and press on healthy organs and tissues. But they cannot grow into (invade) other tissues. Because they can't invade, they also can't spread to other parts of the body (metastasize). These tumors are almost never life threatening.

Who Gets Cancer?





Over one million people get cancer each year. About 1 out of every 2 American men and 1 out of every 3 American women will have some type of cancer at some point during their lifetime. Anyone can get cancer at any age; but about 77% of all cancers are diagnosed in people age of 55 and older. Cancer can be found in Americans of all racial and ethnic groups, but the rate of cancer occurrence (called the incidence rate) varies from group to group.
Today, 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.
What Are the Risk Factors for Cancer?

Smoking and drinking alcohol cause some people to get certaintypes of cancer. All cancers caused by cigarette smoking and heavy use of alcohol could be prevented completely. The best thing is to never use tobacco at all. Cigarettes, cigars, pipes and smokeless tobacco all cause cancer and should not be used. People who already smoke should try to quit -- we know that former smokers have less risk of cancer than do people who continue to smoke.
Many of the more than 1 million skin cancers that are diagnosed every year could have been prevented by protecting the skin from the sun's rays and avoiding indoor tanning. 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.
About one third of the cancer deaths expected every year are related to nutrition, overweight or obesity, and physical inactivity, and thus could also be prevented. We know that our diet, (what we eat) is linked to some types of cancer, but the exact reasons are not yet clear. The best advice is to eat a lot of fresh fruits and vegetables, whole grains like pasta and bread, and limit foods high in saturated fat, like high-fat dairy products, processed meats (like bacon, hot dogs, and luncheon meats), and red meats. It is also important to get to and stay at a healthy weight and get at least 30 to 45 minutes of physical activity on at least 5 days per week. You can get more information on this in our document, American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention.
Certain cancers are related to infectious diseases, such as hepatitis B virus (HBV), human papilloma virus (HPV), human immunodeficiency virus (HIV), Helicobacter pylori (H. pylori), and others. Many of these could be prevented through behavioral changes, vaccines, or antibiotics.
There is no way to prevent most cancers, but the best plan is to avoid risk factors you can control and make healthy lifestyle choices. Also see the section, "Cancer screening and early detection" for more information on things you can do to prevent cancer.
What Are the Risk Factors for Cancer?

Smoking and drinking alcohol cause some people to get certaintypes of cancer. All cancers caused by cigarette smoking and heavy use of alcohol could be prevented completely. The best thing is to never use tobacco at all. Cigarettes, cigars, pipes and smokeless tobacco all cause cancer and should not be used. People who already smoke should try to quit -- we know that former smokers have less risk of cancer than do people who continue to smoke.
Many of the more than 1 million skin cancers that are diagnosed every year could have been prevented by protecting the skin from the sun's rays and avoiding indoor tanning. 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.
About one third of the cancer deaths expected every year are related to nutrition, overweight or obesity, and physical inactivity, and thus could also be prevented. We know that our diet, (what we eat) is linked to some types of cancer, but the exact reasons are not yet clear. The best advice is to eat a lot of fresh fruits and vegetables, whole grains like pasta and bread, and limit foods high in saturated fat, like high-fat dairy products, processed meats (like bacon, hot dogs, and luncheon meats), and red meats. It is also important to get to and stay at a healthy weight and get at least 30 to 45 minutes of physical activity on at least 5 days per week. You can get more information on this in our document, American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention.
Certain cancers are related to infectious diseases, such as hepatitis B virus (HBV), human papilloma virus (HPV), human immunodeficiency virus (HIV), Helicobacter pylori (H. pylori), and others. Many of these could be prevented through behavioral changes, vaccines, or antibiotics.
There is no way to prevent most cancers, but the best plan is to avoid risk factors you can control and make healthy lifestyle choices. Also see the section, "Cancer screening and early detection" for more information on things you can do to prevent cancer.
What Causes Cancer?



Some kinds of cancer are caused by things people do. For example, smoking causes cancers of the lungs, mouth, throat, bladder, kidneys and some 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.
Certain inherited DNA changes can increase the risk for developing some cancers and are responsible for the cancers that run in some families. For example, the BRCA genes (BRCA1 and BRCA2) are tumor suppressor genes -- they keep tumors from growing. Changes (mutations) in these genes can be passed on (inherited) from parents. When they are mutated, they no longer suppress abnormal growth, and cancer is more likely to develop.
But in most 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.
Cancer Screening and Early Detection



There are tests, called screening tests, which adults should have in order to find cancers at an early stage when they are most treatable. Screening can prevent cancers of the cervix, colon, and rectum by allowing doctors to take out pre-cancerous tissue before it becomes cancer. Screening can also detect cancers of the breast, colon, rectum, cervix, prostate, oral cavity, and skin at early stages. For most of these cancers, early detection has been shown to reduce the number of deaths caused by cancer.
Cancers that can be prevented or detected earlier by screening account for at least half of all new cancer cases. For complete information on cancer screening and early detection please see our document, American Cancer Society Guidelines for the Early Detection of Cancer.
Signs and Symptoms of Cancer



What are signs and symptoms?
A symptom is a signal of disease, illness, injury, or that something is not right in the body. Symptoms are felt or noticed by the person who has them, but may not be easily seen by anyone else. For example, chills, weakness, aches, and feeling short of breath may be symptoms of pneumonia.
A sign is also a signal that something is not right in the body. But signs are signals that can be seen by a doctor, nurse, or other health care professional. Fever, fast breathing, and abnormal breathing sounds heard through a stethoscope may be signs of pneumonia.
Having one symptom or sign may not be enough to figure out what's causing it. For example, a rash in a child could be a sign of a number of things, such as poison ivy, an infectious disease like measles, a skin infection, or a food allergy. But if the child has the rash 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 alone do not give the doctor enough clues to figure out the cause of an illness. Then medical tests, such as x-rays, blood tests, or a biopsy may be needed.
How does cancer cause 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, how big it is, and how much it affects nearby organs or tissues. If a cancer has spread (metastasized), symptoms may appear in different parts of the body.
As a cancer grows, it can begin 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 cause early symptoms.
But sometimes cancer starts in places where it will not cause any symptoms until it 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 cause symptoms until they begin to grow around nearby nerves (this causes a backache). Others grow around the bile duct and block the flow of bile. This causes a yellowing of the eyes and skin called jaundice. By the time a pancreatic cancer causes these signs or symptoms, it is usually in an advanced stage. This means it has grown and spread beyond the place it started – the pancreas.
A cancer may also cause symptoms like fever, extreme tiredness (fatigue), or weight loss. This may be because cancer cells use up much of the body’s energy supply, or they may release substances that change the way the body makes energy from food. 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 which are not usually linked to cancer. For example, some cancers of the pancreas can release substances which cause blood clots in veins of the legs. Some lung cancers make hormone-like substances that raise blood calcium levels. This affects nerves and muscles, making the person feel weak and dizzy.
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 the cancer can be removed with surgery.
A good example of the importance of finding cancer early is melanoma skin cancer. Skin cancer can be easy to remove if it has not grown deep into the skin. The 5-year survival rate (percentage of people living at least 5 years after diagnosis) at this stage is nearly 100%. Once melanoma has spread to other parts of the body, the 5-year survival rate drops below 20%.
Sometimes people ignore symptoms. They may not know that symptoms could mean something is wrong. Or they may be frightened by what the symptoms might mean and don't want to get medical help. Some symptoms, such as tiredness, are more likely to have a cause other than cancer and can seem unimportant, especially if there is an obvious cause or the problem only lasts a short time. In the same way, a person may reason that a symptom like a breast lump is probably a cyst that will go away by itself. But no symptom should be ignored or overlooked, especially if it has been there for a long time or is 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 a doctor, just in case. If cancer is not the cause, a doctor can help figure out what is and treat it, if needed.
Sometimes, it is possible to find cancer before you have symptoms. The American Cancer Society and other health groups recommend cancer-related check-ups and certain tests for people even though they have no symptoms. This helps find certain cancers early, before symptoms occur. For more information on early detection tests, see our document, American Cancer Society Guidelines for the Early Detection of Cancer
How Is Cancer Diagnosed?



A patient's signs and symptoms are not enough to know whether or not cancer is present. If your doctor suspects cancer you will probably need to have more tests done, such as x-rays, blood tests, or a biopsy. In most cases a biopsy is the only way to tell for sure whether or not cancer is present.
To do a biopsy a piece of the lump or abnormal area is taken out and sent to the lab. There a pathologist (a doctor who specializes in diagnosing diseases) looks at the tissue under a microscope to see if it contains cancer cells. If there are cancer cells the doctor tries to figure out exactly what type of cancer it is and whether it is likely to grow slowly or more quickly.
Scans can measure the size of the cancer and whether it has spread to nearby tissues. Blood tests can tell doctors about your overall health and can show how well your organs are working.
What Is Staging?



Staging is the process of finding out how much cancer there is in the body and where it is located. Staging the cancer is a key step in deciding on your best treatment choices. It also gives your health care team an idea of your outlook (prognosis).
Staging can take time, and people are usually anxious to begin treatment right away. Do not worry that the staging process is taking up treatment time. In most cases it is OK because by staging the cancer, you and your health care team will know which treatments are likely to work best. For more information, please see Staging.
How Is Cancer Treated?



The number of treatment choices you have will depend on the type of cancer, the stage of the cancer, and other factors such as your age, health status, and personal preferences. You are a key part of your cancer care team -- you should talk to them about which treatment choices are best for you. Don't be afraid to ask questions. Make sure you understand your options. A cancer diagnosis often makes people feel like they have to hurry to make choices about treatment and services. But take time to look at all the options available to you so you will be as well informed as possible.
The 3 major types of treatment for cancer are surgery, radiation, and chemotherapy. Depending on the type and stage of the cancer, 2 or more of these types of treatment may be combined at the same time or used after one another.
After the cancer is found and staged, your cancer care team will discuss your treatment options with you. It is important to take time and think about your possible choices. In choosing a treatment plan, one of the most important factors is the stage of the cancer. Other factors to consider include your overall health, the likely side effects of the treatment, and the probability of curing the disease, extending life, or relieving symptoms.
In considering your treatment options it is often a good idea to seek a second opinion, if possible. This may give you more information and help you feel more confident about the treatment plan you have chosen. It is also important to know that your chances for having the best possible outcome are highest in the hands of a medical team that is experienced in treating the type of cancer you have.
What treatment will be best for me?
Your cancer treatment will be based on your unique situation. Certain types of cancer respond very differently to different types of treatment, so figuring out the type of cancer is a key step toward knowing which treatments will work best. The cancer's stage (how widespread it is) will also determine the best course of treatment. This is because early-stage cancers respond better to different treatments than later-stage ones. Your overall health, your lifestyle, and your personal preferences will also play a part in deciding which treatment options are best for you. Not all types of treatment will work well 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.
Before making treatment decisions, ask about and be sure you understand the goal of treatment in your situation. Is the purpose of the treatment to cure the cancer, keep it under control, or treat the problems it is causing? Know that the goal of treatment can change over time, so you may need to ask about this again at some point.
Cancer Treatment Side Effects
Cancer treatment can cause many different side effects. The kinds of side effects depend mostly on the type of treatment used. Side effects vary from patient to patient. Some people have no side effects at all, while others have quite a few. This is because every person responds to treatment differently. There is no way to predict who might or might not have side effects.
Many side effects of treatment can be managed or treated. And most side effects go away over time. In the meantime, there are ways to reduce the discomfort they may cause. Tell your doctor or nurse about any side effects you notice so they can help you manage them. But your doctor and nurse are the best people to talk to you about your treatment, side effects, and any other medical concerns you may have.

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