Cancer

Posted by | January 24, 2015 | Blog | No Comments
Cancer, also called malignancy or neoplasm, develops when cells in a specific part of the body begin to grow out of control. Unlike normal cells, cancer cells do not stop reproducing after they have doubled 50-60 times.
Normal body cells grow, divide, and die in an orderly, natural fashion. Normal cells divide more rapidly during the early years of an individual’s life. After adulthood is reached, cells in most parts of the body divide only to replace worn-out or dying cells and to repair injuries. Cancer cells continue to grow and divide forming new abnormal cells.
Cancer cells usually form a tumor. Some cancers, such as leukemia or cancer of the bone marrow and blood, do not form tumors. Instead, these cancer cells circulate through other tissues where they grow.
Not all tumors are cancerous. Benign (non-cancerous) tumors do not metastasize (spread) to other parts of the body and, with very rare exceptions, are not life threatening. Different types of cancer can grow at different rates and respond to different treatments. Malignant, or cancerous, tumors may metastasize and cause further damage to organs and tissues in the body.
Cancer cells develop because of damage to DNA (the material inside the nucleus of a cell that carries genetic information). DNA occurs in most cells of the body and is the blueprint for how the body grows, functions, and stays healthy. Usually, when DNA becomes damaged the body is able to repair it. In cancer cells, the damaged DNA is not able to be repaired. Individuals can inherit damaged DNA, such is the case with inherited cancers. More often, though, an individual’s DNA becomes damaged by exposure to something in the environment, such as smoking or radiation from the sun.
The immune system, which is made up of special cells, proteins, tissues, and organs, defends individuals against invasion by pathogens (disease-causing agent), such as cancer cells, bacteria, and viruses. The differences between cancer cells and normal cells may not be as easily detected, and the immune system may not always recognize cancer cells as pathogens. Most healthy individuals have immune systems that can keep up with the pathogens but, sometimes problems with the immune system can lead to illness and infection.
Cancer cells sometimes travel through the blood or lymphatic system to other parts of the body. The cancerous cells begin to grow and replace normal tissue in a process called metastasis. Regardless of where cancer may spread, it is always named for the place it began. For instance, colon cancer that spreads to the liver is still called colon cancer, not liver cancer.
Symptoms and treatment depend on the cancer type and how advanced it is. Treatment plans may include surgery, radiation, and/or chemotherapy. The most common cancers are breast cancer, lung cancer, bowel or colon cancer, prostate cancer, bladder cancer, non-Hodgkin’s lymphoma, stomach cancer, melanoma, esophageal cancer, pancreatic cancer, leukemia, and ovarian cancer.
According to the American Cancer Society (ACS), cancer is the leading cause of death among Americans under the age of 85. Half of all men and one third of all women in the United States will develop cancer during their lifetimes. Although cancer occurs in Americans of all racial and ethnic groups, the rate of cancer occurrence varies from group to group. Two-thirds of individuals diagnosed with cancer are aged over 65 years. In 2005, 7.6 million people died of cancer out of 58 million deaths worldwide. Based on projections, cancer deaths will continue to rise and an estimated 9 million people will die from cancer in 2015, and 11.4 million may die in 2030.
Early diagnosis makes it more likely that cancer can be treated successfully. It is important that individuals are aware of possible symptoms and that individuals see a doctor for regular check ups.

TYPES OF CANCER
There are over one hundred types of cancer that can affect the human body. Each of the types of cancer has its own name, behavior, and course of treatment. All cancers involve the abnormal growth of cells. The most commonly found cancers in humans include carcinoma, sarcoma, leukemia, lymphoma, and adenoma.

Carcinoma: More than 85% of cancers are carcinomas. Carcinomas start in the cells that line and cover internal and external organs. The most common carcinomas are lung cancer, breast cancer, skin cancer, and bowel cancer
Sarcoma: Sarcoma begins in supportive tissues of the body, such as muscle, bone, cartilage, blood vessels, fat, and connective tissue.
Leukemia: Leukemia is cancer of the blood cells that grows in the bone marrow.
Lymphoma: Lymphomas develop in the lymph nodes and tissues of the immune system.
Adenoma: An adenoma is a tumor (usually benign) that begins in glandular tissue, such as the adrenal, pituitary, or thyroid gland.

Risk Factors:

Age: The chances of developing cancer increases with age. In the United States, more than 60% of cancers occur in people older than 65. The risk of developing cancer doubles every five years after the age of 25. The increased cancer rate is probably due to a combination of increased and prolonged exposure to carcinogens and weakening of the body’s immune system.
Environmental Factors: The environment we live in can cause an individual to have an increased risk of developing various types of cancers. Studies have reported that individuals exposed to high amounts of benzene, which is commonly found in gasoline, cigarettes, and pollution, are at an increased risk for developing cancer.
Certain chemicals found in pesticide products, such as lawn and garden chemicals, may increase the risk of developing cancers such as lymphoma. Long-term use of hair products, including permanent hair dyes (especially dark colors) and hair straightening chemicals doubles an individual’s risk of developing lymphoma, particularly among women and persons who used hair dyes before 1980. These dyes contained more carcinogenic (cancer-causing) substances than the dyes used today, due to changes in regulation by the U.S. Food and Drug Administration (FDA).
Studies have reported that exposure to chemicals and pesticides can significantly increase the chances of developing breast cancer. Being overweight increases the chances of developing many types of cancer, such as ovarian cancer. A high fat diet may increase the chances of developing colon cancer. Exercising at least 30 minutes a day, five days a week may reduce the risk of developing cancer.
Diet and lifestyle: Exposure to charred red meat has been reported to increase the risk of developing colon cancer. Diets low in fruits and vegetables are linked to an increased risk of cancers including cervical cancer.
Heredity: Heredity or genetics plays a large role in cancer development. A family history of cancer, such as breast, ovarian, or colon cancer, increases the risk of the individual developing that type of cancer. When cancer is genetic, a mutated gene has been passed down. However, this does not always mean that the genetically pre-disposed individual will always develop cancer. Genetic tests are available for many cancers that are hereditary.
Personal history of cancer: If an individual has had any type of cancer, there is an increased risk of developing that cancer again. Cancer can be in remission, or a period of time when the cancer is responding to treatment or is under control, and then return at a later time.
Pre-existing medical conditions: Pre-existing medical conditions can increase an individual’s risk of developing various forms of cancer. Inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease increase the risk of colon cancer. Individuals with diabetes have as high as a 40% increased risk of developing colorectal cancer. A recent report found that men with testicular cancer had a higher rate of colorectal cancer. Men who receive radiation therapy for prostate cancer have also been reported to have a higher risk of rectal cancer.
Ethnicity: Some research suggests that ethnicity may play a role in the development of various types of cancer. However, it is important to note that the following statistics may be correlations that do no necessarily have to do with ethnicity/genetics, but may be influenced by social factors associated with people of certain ethnicities (such as diet, access to healthcare, and quality of healthcare). Caucasian families have about a 17% risk for developing lung cancer, while African-Americans have a much higher risk, around 25%. Jews of Eastern European descent (Ashkenazi Jews) have a higher incidence of developing colon cancer. Caucasian women are more likely to develop breast cancer than African-American or Latino women. In the United States, African American men have a 60% higher incidence rate of developing prostate cancer as compared to Caucasian men.
Sun Exposure: Individuals who spend a considerable amount of time in the sun can develop skin cancer, especially if the skin is not protected by sunscreen or clothing. UV rays from the sun can damage the DNA of skin cells and cause the mutation into cancerous cells. Tanning is the skin’s injury response to excessive UV radiation, and increases the risk of skin cancer. Every time an individual gets sunburned or is exposed to too much UV radiation, there is an increased risk of damaging skin cells and developing skin cancer. One or more severe, blistering sunburns can increase the risk of skin cancer as an adult.
Tobacco: Smoking cessation decreases the risk for developing various types of cancer. According to the National Cancer Institute (NCI), smoking causes 30% of all cancer deaths in the United States and is responsible for 87% of cases of lung cancer. Smoking affects the lungs and kidneys and has been reported to cause pancreatic, cervical, and stomach cancers and acute myeloid leukemia. Cancers of the mouth, larynx, bladder, cervix, and esophagus are also related to tobacco. A study found that exposure to secondhand smoke increases the risk of breast cancer in pre-menopausal women and lung cancer in the general population.
Weak immune system: Individuals with a weakened immune system, including those living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), leukemia, and those taking immunosuppressant drugs after an organ transplant, are at a greater risk for developing certain types of cancer, including skin cancer.
Viral infections: Practicing unsafe sex can increase the risk of developing human papillomavirus (HPV). HPV is a group of over 100 viruses that increases the risk of developing cervical, anal, vulvar, and vaginal cancer. Hepatitis B virus can cause liver cancer. Some human retroviruses cause lymphomas and other cancers of the blood system. Some viruses produce cancer in certain countries but not in others. For instance, the Epstein-Barr virus causes Burkitt’s lymphoma (a type of cancer) in Africa and cancers of the nose and pharynx in China.

SIGNS AND SYMPTOMS

There are over one hundred different types of cancer. They are all unique with their own symptoms and characteristics. Each cancer affects the body in a different way. Although cancers differ greatly, there are a few cancer symptoms that are commonly experienced by most cancer patients. Symptoms can be general (also called non-specific), such as pain or unexplained weight loss. Other symptoms are more specific, such as with unusual bleeding in the vagina, common in vaginal cancer, or difficulty swallowing, common in esophageal cancer.

Non-specific symptoms:
Depression: Cancer often results in depression. Depression can be related to the symptoms of the illness, a fear of dying, or a loss of independence. Additionally, some cancers may produce tumors that directly cause depression by affecting normal brain function.

Fatigue: Fatigue, or extreme tiredness, is one of the most commonly experienced symptoms of cancer. Fatigue may occur early in cancers that cause a chronic loss of blood, including colon or stomach cancers and leukemia. Fatigue is usually more common when the cancer is advanced, but still occurs in the early stages.
Fever: Most cancer patients experience a fever at some point, particularly if the cancer or its treatment (including chemotherapy and radiation) 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.
Neurological and muscular symptoms: Cancer can grow directly onto or compress nerves, causing any of several neurological and muscular symptoms, including a change in sensation (such as tingling sensations) or muscle weakness. When a cancer grows in the brain, symptoms may be hard to pinpoint but can include confusion, dizziness, headaches, nausea, changes in vision, and seizures.
Pain: Pain is normally present when cancer progresses. However, pain can be present early on in some cancers, such as bone or testicular cancers.
Respiratory symptoms: Cancer can compress or block physical structures, such as the airways in the lungs or trachea, causing shortness of breath, cough, or pneumonia. Shortness of breath can also occur when the cancer causes a fluid or bleeding into the lungs or anemia (a lack of red blood cells which carry oxygen to tissues).
Skin changes: Skin changes such as jaundice, hyperpigmentation (darkening of the skin), abnormal hair growth, erythema (reddening), boils, and skin itchiness can indicate certain types of cancers.
Unintentional weight loss: Most individuals with cancer will lose weight at some time with their disease. Losing 10 or more pounds without dieting or intending to lose weight can be one of the first symptoms experienced with cancer, particularly cancers of the pancreas, stomach, esophagus, or lung.
 
Specific symptoms:

Bladder cancer: Individuals with bladder cancer may have blood in the urine, pain or burning upon urination, frequent urination, or cloudy urine.

Bone cancer: Individuals with bone cancer may often experience pain in the bone or swelling around the affected site, fractures in bones, weakness, fatigue, weight loss, repeated infections, nausea, vomiting, constipation, problems with urination, weakness or numbness in the legs, and/or bumps and bruises that do not heal easily.
Brain cancer: Individuals with brain cancer often experience dizziness, drowsiness, abnormal eye movements or changes in vision, weakness, loss of feeling in arms or legs or difficulties in walking, fits or convulsions, changes in personality, memory, or speech, headaches that tend to be worse in the morning and ease during the day, and headaches that may be accompanied by nausea or vomiting.
Breast cancer: Although most lumps are not cancerous, individuals with breast cancer may have a lump or thickening of the breast; the most common sign of breast cancer for both men and women is a lump or thickening in the breast. Often, the lump is painless. Other symptoms of breast cancer may include: a spontaneous clear or bloody discharge from the nipple often associated with a breast lump, retraction or indentation of the nipple, a change in the size or contours of the breast, flattening or indentation of the skin over the breast, and redness or pitting of the skin over the breast (similar to the skin of an orange).
Colorectal cancer: Individuals with colorectal cancer often experience rectal bleeding (red blood in stools or black stools), abdominal cramps, constipation alternating with diarrhea, weight loss, loss of appetite, weakness, changes in bowel habits, or pale complexion.
Kidney cancer: Individuals with kidney cancer often experience blood in urine, dull ache or pain in the back or side, or a lump in the kidney area, sometimes accompanied by high blood pressure or abnormality in red blood cell count.
Leukemia: Individuals with leukemia often experience weakness, paleness; fever and flu-like symptoms; bruising and prolonged bleeding; enlarged lymph nodes, spleen, liver; pain in bones and joints; frequent infections; weight loss; or night sweats.
Lung cancer: Individuals with lung cancer often experience a wheezing, persistent cough for months, blood-streaked sputum, persistent ache in chest, congestion in lungs, or enlarged lymph nodes in the neck.
Melanoma: Individuals with melanoma often experience a change in mole or other bump on the skin, including bleeding or change in size, shape, color, or texture.
Non-Hodgkin’s lymphoma: Individuals with non-Hodgkin’s lymphoma often experience painless swelling in the lymph nodes in the neck, underarm, or groin, persistent fever, feeling of fatigue, unexplained weight loss, itchy skin and rashes, small lumps in skin, bone pain, swelling in the abdomen, and liver or spleen enlargement.
Oral cancer: Individuals with oral cancer often experience a lump in the mouth, ulceration of the lip, tongue or inside of the mouth that does not heal within a couple of weeks, dentures that no longer fit well, or oral pain, bleeding, foul breath, loose teeth, and changes in speech.
Ovarian cancer: Individuals with ovarian cancer often experience abdominal swelling abnormal vaginal bleeding (in rare cases), and digestive discomfort.
Pancreatic cancer: Individuals with pancreatic cancer often experience upper abdominal pain and unexplained weight loss, pain near the center of the back, inability to eat fatty foods without experiencing gas, bloating, nausea, or vomiting, yellowing of the skin, abdominal masses, and enlargement of liver and spleen.
Prostate cancer: Individuals with prostate cancer often experience urination difficulties due to blockage of the urethra, urinary retention creating frequent feelings of urgency to urinate, especially at night, incomplete bladder emptying, burning or painful urination bloody urine, tenderness over the bladder, and dull ache in the pelvis or back.
Stomach cancer: Individuals with stomach cancer often experience indigestion or heartburn, discomfort or pain in the abdomen nausea and vomiting, diarrhea or constipation, bloating after meals, loss of appetite, weakness and fatigue, and bleeding such as vomiting blood or blood in the stool.
Uterine cancer: Individuals with uterine cancer often experience abnormal vaginal bleeding, a watery bloody discharge in postmenopausal women, painful urination, pain during intercourse, and pain in pelvic area.
Cancer remission: Remission is a period of time when the cancer is responding to treatment or is under control. Cancer cells stop growing out of control. In a complete remission, all the signs and symptoms of the disease disappear. It is also possible for a patient to have a partial remission in which the cancer shrinks but does not completely disappear. Remissions can last anywhere from several weeks to many years. Complete remissions may continue for years and be considered cures. If the disease returns, another remission often can occur with further treatment. A cancer that has recurred may respond to a different type of therapy, including a different drug combination. Recurrence of cancer may not respond to the same medications and treatments as the cancer did before remission.
Spontaneous remission of cancer refers to exceptional and unexplained partial or complete disappearance of cancer without medical intervention.

There are over one hundred different types of cancer. They are all unique with their own symptoms and characteristics. Each cancer affects the body in a different way. Although cancers differ greatly, there are a few cancer symptoms that are commonly experienced by most cancer patients. Symptoms can be general (also called non-specific), such as pain or unexplained weight loss. Other symptoms are more specific, such as with unusual bleeding in the vagina, common in vaginal cancer, or difficulty swallowing, common in esophageal cancer.
 

DIAGNOSIS
Cancer is diagnosed based on an individual’s symptoms, the results of a physical examination, and sometimes the results of screening tests. Confirmation that cancer is present requires diagnostic tests.

Screening:
Screening tests serve to detect the possibility that a cancer is present before symptoms occur. Screening tests are an important prophylactic measure for detecting cancer early, and healthcare professionals recommend cancer screening. Screening tests usually are not perfect; results are confirmed or disproved with further examinations and tests. Diagnostic tests are performed once a doctor suspects that an individual has cancer.

Recommendations for cancer screening are influenced by many factors, including age, race, previous medical history, and lifestyle. These screening recommendations are for individuals with no symptoms and with an average risk of cancer. For individuals with a higher risk, such as those with a strong family history of certain cancers or those who have had a previous cancer, screening may be recommended more frequently or to start at a younger age. Screening tests other than those listed here may also be recommended. An individual’s physician will help decide when to begin screening and which tests should be used.
Breast cancer: Breast self-examination is recommended monthly after age 20. A physical examination by a healthcare provider is recommended every three years between the ages of 20 and 39, then yearly. A mammography is recommended yearly starting at age 40.
Cervical cancer: A papanicolaou (Pap) test is recommended yearly for individuals younger than 30 years of age. Some women 65-70 years of age or older who have had three or more normal Pap tests in a row may choose to stop having cervical cancer screening. For women over 30, some doctors recommend testing every three years with a conventional Pap test plus the human papillomavirus DNA test.
Lung cancer: Chest x-ray, sputum cytology (examining the sputum for changes in cells), and computed tomography (CT) are not recommended on a routine basis. If an individual presents with symptoms of lung cancer, such as persistent hoarseness or cough, these tests may be performed.
Prostate cancer: A rectal examination is recommended yearly for men after age 50. A prostate-specific antigen (PSA) blood test is also recommended yearly after age 50.
Rectal and colon cancer: A stool examination for occult (hidden) blood should be performed yearly after age 50. A sigmoidoscopic examination should be performed every five years beginning at age 50, or a colonoscopic examination every 10 years beginning at age 50. In a sigmoidoscopic exam, the doctor uses a flexible, slender, and lighted tube to examine the rectum and sigmoid colon (approximately the last two feet of the colon). The test is fast but can sometimes be uncomfortable. If a polyp or colon cancer is found during this exam, the doctor will recommend a colonoscopy to look at the entire colon and remove any polyps for further examination under a microscope.
Skin cancer: A physical examination should be part of a routine checkup. More frequent examinations may be needed for individuals at high risk for developing skin cancer, such as those with fair skin or frequent sunburns. Whole-body photography is not routinely needed, although it may be helpful for those with multiple moles or in whom examination of the skin is difficult.

Diagnosis:
Generally, when a doctor first suspects cancer, some type of imaging study, such as x-ray, ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI) is performed. Although these tests can show the presence, location, and size of an abnormal mass, they usually can not confirm that cancer is the cause. Cancer is confirmed by finding cancer cells on microscopic examination of samples from the suspected area. Usually, the sample must be a piece of tissue, although sometimes examination of the blood is enough (such as in leukemia). Obtaining a tissue sample is termed a biopsy. Biopsies can be performed by cutting out a small piece of tissue with a scalpel (surgical knife), but very commonly the sample is obtained using a hollow needle. Such tests are commonly done without the need for an overnight hospital stay and are called outpatient procedures. Doctors often use ultrasonography or a computerized tomography (CT) scan to guide the needle to the right location. Because biopsies can be painful, the individual is usually given a local anesthetic (such as lidocaine or Xylocaine®) to numb the area.
In cases with findings on examination or imaging tests that suggest cancer, measuring blood levels of tumor markers may provide additional evidence for or against the diagnosis of cancer. Tumor markers are substances produced by tumor cells or by other cells of the body in response to cancer or certain benign (non-cancerous) conditions. Tumor markers can be found in the blood, the urine, the tumor tissue, or in other tissues. Different tumor markers are found in different types of cancer, and levels of the same tumor marker can be altered in more than one type of cancer. In addition, tumor marker levels are not altered in all people with cancer, especially if the cancer is early stage. Some tumor marker levels can also be altered in patients with non-cancerous conditions. In individuals who have been diagnosed with certain types of cancer, tumor markers may be useful to monitor the effectiveness of treatment and to detect possible recurrence of the cancer. For some cancers, the level of a tumor marker drops following treatment and increases if the cancer recurs. Common cancer tumor markers include: alpha-fetoprotein (AFP), which may be raised in individuals with colon cancer; beta2 (ß2)-microglobulin, which may occur in individuals with multiple myeloma; carcinoembryonic antigen (CEA), which may be raised in individuals with colon cancer; prostate-specific antigen (PSA), which may be increased in individuals with prostate cancer; and carbohydrate antigen 27.29 (CA27.29), which may be increased in individuals with breast cancer. Using tumor markers for cancer diagnosis is beneficial because of the ease of obtaining and measuring their presence; also, there is less discomfort for patients

Dr. Diana believes in taking care of your health and making sure that your health remains the best that it can be and that is why Dr. Diana is partnering with a Main lab across Canada that will offer blood screening for many cancers that can be performed once a year and will allow to see any changes that may be taking place in your immune system. These blood tests will be very affordable and maybe covered under your extended health care plan.