Understanding Cancer

Doctors diagnose more than one million Americans a year with some form of cancer, and each one is unique. The type of cancer, the stage of the cancer, the cellular makeup of the individual and the tolerance for treatments and medications make each case distinct.

In addition, every person who confronts cancer brings something special to the mix. Merely receiving a cancer diagnosis can be devastating, and prescribed next steps — coping with the effects of the disease and treatments — can be overwhelming physically and emotionally. In fact, the emotional side effects can be just as hard as the physical side effects, and there may be many life changes to come. Family and friends may also become worried or confused.

Regardless, cancer no longer carries the power over humans that it once did. Advancements in research, scientific technology, new treatment options and clinical trials bring more hope than ever. Even with cancers that typically come with an unfavorable prognosis, such as mesothelioma, the medical community is making progress. Patients have more treatment options now than ever.

What is Cancer?

Cancer is a broad term used for a group of at least 100 different diseases. Although there are a number of different types of cancer, they all start to develop when abnormal cells grow in the body at an alarming rate.

There are trillions of cells in the body that grow, divide and die regularly. During childhood, these cells mature and divide faster to allow the body to develop and grow. In adulthood, cells generally only divide to replace dying cells or to help heal injuries to the body.

Cancer cells are different than normal, healthy cells in the body. These abnormal cells don’t die; instead, they prosper and divide, creating more abnormal cells. It is common for these growing cancerous cells to invade other tissues, while normal cells do not, and form tumors.

Both normal and cancerous cells contain DNA. If a normal cell’s DNA is damaged, it either repairs itself or dies, while a cancerous cell with damaged DNA does not repair itself or die, but, rather, it creates similar cells with damaged DNA, spreading the cancer.

There are five primary types of cancer, each defined based on where in the body a tumor originates:
Carcinoma – The most common type of cancer in humans. It originates in the skin or in tissue that lines the body’s internal organs. Examples include lung cancer, breast cancer, prostate cancer, rectum/colon cancer, pancreatic cancer and ovarian cancer.
Sarcoma – A type of cancer that arises from certain tissues, such as bone, muscle, fat, cartilage or blood vessels. Examples include soft tissue sarcomas and osteosarcoma.
Leukemia – A cancer of the blood cells that begins in the bone marrow. It is characterized by an abnormal increase of white blood cells.
Lymphoma and myeloma – These cancers develop in the cells of the immune system.
Central nervous system cancers – The central nervous system is the medical term for the brain and spinal cord, where these cancers develop.

Coping with Cancer

Getting a cancer diagnosis can lead to anger, sadness and depression. You may ask yourself why this is happening to you, and you might not know where to turn for help. As hard as it is, dealing with these emotions is an essential part of coping with the disease.

Emotions can change from hopelessness to hopeful on a daily basis and it is important to be honest with your loved ones and healthcare professionals about the way you’re feeling. Some patients may benefit from seeking the help of a mental health professional or a therapist for emotional support.

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Seeking help to sort out emotions can also help to plan how and when you’re going to tell your family and friends you have cancer in a way that you feel comfortable. Sharing a cancer diagnosis or prognosis can heightened a number of emotions, but it is also an important step of coping.

Living with cancer is rarely easy. You may worry about your treatment options, your prognosis, how you’ll keep your job, how your family and friends will react. But doctors and mental health professionals can help you make the most informed decisions that best fit you and your life.

Tumors and Other Signs and Symptoms of Cancer

Some signs and symptoms are typically associated with cancer, but each type of cancer may differ. Symptoms can vary from patient to patient.

If you are experiencing some of the below symptoms, it does not necessarily mean you have cancer. Please visit your healthcare provider if you have concerns or questions.

One of the most prominent signs of cancer is a malignant tumor, which can cause pain or other symptoms. In some cases, cancerous tumors may be felt though the skin. This is most common in cancers of the breasts, testicles, lymph nodes or soft tissues of the body. Once a tumor has grown, it may become noticeable by touch or visible through many imaging techniques.

Other symptoms may be present before there is visible tumor growth.

General symptoms of cancer include:
Unexplained weight loss or loss of appetite - Most people with cancer experience unexplained weight loss, but it is most common in cancers of the pancreas, stomach, esophagus or lungs.
Chronic pain - This is a common symptom of most cancers, but it is especially common in bone cancers or testicular cancer. A constant headache can indicate a brain tumor and back pain is common among colon, rectum or ovary cancers.
Persistent low-grade fever - Almost all cancer patients will experience a fever at some point, but fevers most often occur in patients whose cancer has metastasized, especially in cancers that affect the immune system.
Chronic fatigue - Fatigue typically becomes more prevalent as the cancer grows. Blood loss, which occurs in some stomach and colon cancers, can also cause persistent fatigue.
A change in bowel habits or bladder function - Signs of colon cancer include long-term constipation, diarrhea or changes in stool size and signs of bladder or prostate cancer include pain or blood during urination.
Skin changes - Itchiness and changes in the color of skin (brow, yellow or red) may be a sign of skin or other types of cancers.
Sores that do not heal - Bleeding sores in the mouth may be a sign of oral cancer.
Coughing, shortness of breath and hoarseness - Chronic cough and shortness of breath are often associated with mesothelioma and lung cancers.
Unusual bleeding or discharge - Coughing up blood may be a sign of lung cancer. Blood in the stool may be a sign of colon or rectal cancer. And blood in the urine may be a sign of bladder or kidney cancer. Such internal bleeding can have other causes, but it should not be taken lightly and always should be investigated by a physician.

Diagnosing Cancer

If your trusted physician suspects that you may have cancer, you will likely undergo a series of tests to confirm or refute those suspicions. After a routine physical and after your doctor has felt for lumps to determine the location of a possible tumor, your doctor may attempt to confirm the diagnosis with imaging technology, laboratory tests and a biopsy.

Imaging Techniques

Diagnostic imaging allows doctors to take a closer look inside the body. A variety of machines take photos of the body’s structures to help determine the diagnosis. The type of equipment used depends on your symptoms and what part of the body needs to be examined.

Diagnostic imaging types:
Radiographs (X-rays) - X-rays use a broad beam of radiation at a single angle to produce shadow-like images. They are most often used on the chest and abdominal area and they are best at showing problem areas in the bones, but they can also show some problem areas in organs and soft tissues. X-rays are the fastest, easiest and cheapest form of diagnostic imaging.
Computed Tomography (CT) Scans - CT scans, also known as Computed Axial Tomography (CAT) scans, are a more sophisticated and complex form of x-rays. They produce a cross-section of the body’s bones, organs and soft tissues by using a thin beam of radiation to create multiple pictures of the body at different angles. The information is fed to a computer. These scans can also produce even clearer photos by using a contrast dye that is given to a patient orally, intravenously or as an enema.
Positron Emission Tomography (PET) Scans - PET scans create an image of the entire body after the patient is injected with a low dose of radioactive material, such as sugar. The scan takes pictures of areas with high radiation levels that might indicate a tumor. PET scans can also help determine how the tumor is responding to treatment.
Magnetic Resonance Imaging (MRI) Scans - MRI scans, like CT scans, create a cross-section of the inside of the body, but instead of a beam of radiation, it uses strong magnets linked to a computer. This technique used with a contrast dye is the most effective way to discover a brain tumor. It can also help doctors determine if a tumor is malignant or benign, if the tumor has metastasized and what course of treatment is best.
Ultrasounds - Ultrasounds produce images of the body called sonograms by emitting high frequency, inaudible sound waves that bounce off organs in the body and create echoes. The echoes are produced into real time images that are visible on a computer screen. This technique is a good way to examine soft tissues and fluid-filled cysts, which make different echo patterns.

Laboratory Tests

Laboratory tests are often used in addition to diagnostic imaging techniques. This is to further determine the location of the cancer and how far the cancer has spread. These tests will measure sugar, fat and protein levels and analyze DNA, as well as test urine, blood, other body fluids and body tissues to assess the functionality of the body’s organs and to discover any biological markers of cancer.

Biopsies

After laboratory tests provide results, a doctor may order a biopsy to sample tumor cells. This is considered a definitive test for cancer. A pathologist will examine the sample under a microscope to determine if the cells are cancerous and to help determine the stage of the cancer.

There are a number of different types of biopsy procedures, including:
Needle Biopsy - A doctor removes the sample from a needle attached to a syringe. Needle size may vary and other equipment may be used to assist in the procedure if necessary.
Surgical Biopsy - When a needle biopsy is not applicable, a surgical biopsy may be recommended. For this procedure, a surgeon will first place the patient under anesthesia then make an incision to remove all or part of a tumor.
Endoscopic Biopsy - An endoscope is a medical instrument consisting of a long, thin tube with a light and video camera attached. A doctor can use an endoscope to look further inside a body cavity and to remove a small sample from a tumor.
Laparoscopic Biopsy - A laparoscopic biopsy is similar to an endoscopic biopsy, but a doctor uses a device called a laparoscope instead of an endoscope to examine the abdominal or belly. The same technique used to examine the chest is called thoracoscopy or mediastinoscopy.
Laparotomy and Thoracotomy - This is a more invasive biopsy when other options are not applicable. A laparotomy consists of a surgical cut into the abdominal to remove a sample from a suspicious area and to examine nearby areas. A similar procedure that examines the chest is called a thoracotomy.
Skin Biopsy - Some skin biopsies remove the outer layers of the skin, while others require surgery to remove deeper layers of the skin. The type of skin biopsy taken from a doctor depends on the type of suspected tumor.

How Screening Can Catch the Cancer Early

Another way to detect cancer is to receive routine screening at a doctor’s office. This can be a preventive measure and done without feeling or seeing any cancer-related symptoms. It is important to receive appropriate screening as recommended by a physician, because it could detect cancer at an early stage, which is associated with higher survival rates, better reaction to treatment and an increase in the chance to live cancer free.

There are many ways to screen for cancer. Your physician will decide which is best for you based on your health, age and risk factors. Some of the most common screening techniques include:

A mammogram is a type of x-ray used to detect breast cancer. It is recommended that women with a family history of breast cancer start receiving mammograms at the age of 35, while other women are recommended to start at age 40.

A pap smear is conducting by a gynecologist who scrapes cells from the cervix to check for cervical cancer. Women are recommended to start receiving pap smears at age 21 or three years after being sexually active.

A colonoscopy is a procedure to check for colon or rectal cancer. It involves a lighted tube to examine the rectum and colon. Men are recommended to start receiving regular colonoscopies at age 50.

Treating Cancer

While there is no cure for cancer yet, treatment options are available. Depending on the type, location and stage of the cancer, among other factors, a team of doctors will recommend a course of proper treatment. Before deciding on a treatment plan, you should first consider the risks, costs and benefits associated with your options.

Every patient has options and should take the time to decide what the best treatment plan is for them. Each patient should make sure their physical, emotional and spiritual needs are being considered by the team overseeing their care, their loved ones and their caregiver.

Treatments generally aim to cure the disease, but some may intend to temporarily control the disease or minimize symptoms, which is usually the case for a cancer that is in its later stages, especially with aggressive cancers such as mesothelioma.

Standard Treatment Options: Surgery, Chemotherapy and Radiation

Standard treatment options include surgery, chemotherapy and/or radiation therapy or a combination of two or more of these options, which is called multimodal treatment therapy.

Surgery is a viable option if the cancer is in its early stages or if it is localized (has not spread). Surgeons generally aim to remove all tumor growth, but they may also remove surrounding tissue or lymph nodes to avoid the cancer growing back. Surgery is the most common type of treatment and has the greatest possibility to cure most types of cancers.

Chemotherapy generally treats cancers that have metastasized, or spread to more than one area in the body. It can be used to try to cure the cancer, to slow its growth, to keep it from spreading and/or to relieve symptoms. There are many different combinations of different drugs used for chemotherapy. Doctors choose the combination based on many factors including the type and stage of cancer.

Radiation therapy is typically used to treat localized cancers. It uses high-energy rays to shrink tumors or kill cancer cells so they cannot grow and spread to different areas in the body, but it can also damage healthy cells in the process. Radiation can be delivered by a machine outside the body, by materials placed inside the body near the tumor or by injection of liquids or capsules.

Side Effects of Standard Treatment

Cancer and its treatments are associated with a variety of physical and emotional side effects that vary from person to person and depend on the type of treatment received.

The most common side effects of surgery, chemotherapy and radiation:
Anemia: Anemia is the medical term for when your body has a low count of red blood cells. It can make you tired and/or weak.
Chemo Brain: It is common to experience some short-term memory problems or not think as clearly as before chemotherapy. This is called chemo brain and can last for months or years.
Fatigue: Feeling constantly tired and drained is a common symptom of standard cancer treatment.
Hair Loss: Certain chemotherapy drugs can result in hair loss, which can also lead to the development of emotional side effects.
Feeling Emotional Receiving a cancer diagnosis and going through treatment is never an easy time. It is common to feel sad, angry, confused or depressed.
Lymphedema: The build-up of lymphatic fluid that leads to swelling of the arms or legs is known as lymphedema. Lymphedema can develop as a result of cancer itself, and some people develop it after surgery or radiation therapy.
Mood Changes: Your attitude can change from hopelessness to optimism on a daily basis. Joining a support group or talking with a mental health counselor can help.
Nausea/Vomiting: Nausea and vomiting are among the most common side effects of chemotherapy, but not all mesothelioma chemotherapy drugs cause these troublesome side effects. Medication for nausea and vomiting are quite effective, and complementary therapies like acupressure can help.
Pain: Pain can be a symptom the cancer itself or a side effect of treatment, especially following aggressive surgery.

One way to reduce the side effects from treatment is through complementary and alternative medicines.

Complementary and Alternative Treatment Options

Complementary and Alternative Medicines (CAM) are generally used to reduce symptoms, curb side effects of other treatments and reduce stress while increasing an overall quality of life. These methods focus on treating the patient’s mind, body and spirit and any physical and psychological symptoms. Healthcare professionals recommend that these treatments be used in addition to standard treatment options, not as a substitute. Before starting any CAM therapies, consult your doctor first.

Examples of CAM include:
  • Acupuncture
  • Aromatherapy
  • Chiropractic Care
  • Massage Therapy
  • Meditation
  • Tai-Chi
  • Natural Medicines ( Including Astragalus, Celandine, Mistletoe, Cat's Claw and Vitamin C)
  • Naturopathic and Osteopathic Manipulative Therapies
  • Yoga

Finding a Doctor

Finding the right doctor to oversee your care is one of the most important steps in your treatment process. You will want a specialist who is board certified and has experience in treating your type of cancer.

This may be difficult if you’re dealing with a rare cancer, such as mesothelioma, but the doctor who diagnosed you may be able to point you in the right direction. Location and the type of insurance accepted are also important when choosing a hospital and doctor.

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