Bile
Duct Cancer, Gallbladder Cancer, Nasopharyngeal Cancer,
Oophoroma, Oral Cavity and Lip Cancer, Carcinoma
of Kidney and other cancers. are all included in this
category.
Orthodox cancer treatment (surgery, radiation &
chemotherapy) has showed, in some cases, potential
in relieving symptoms and improving the patient's
quality of life. But in most other cases, the death
rate of surgery, the side effects of radiation and
chemotherapy are always beyond that patients can tolerate.
What Is Cancer?
Cancer
is a group of more than 100 different diseases. Cancer
occurs when cells become abnormal and keep dividing
and forming more cells without control or order.
All
organs of the body are made of cells. Normally, cells
divide to produce more cells only when the body needs
them. This orderly process helps keeps us healthy.
If
cells keep dividing when new cells are not needed,
a mass of tissue
forms. This mass of extra tissue, called a growth
or tumor, can be benign or malignant.
Benign
tumors are not cancer. They can usually be removed
and, in most cases, they do not come back. Most important,
cells from benign tumors do not spread to other parts
of the body. Benign tumors are rarely a threat to
life.
Malignant
tumors are cancer. Cancer cells can invade and damage
nearby tissues and organs. Also, cancer cells can
break away from a malignant tumor and enter the bloodstream
or the lymphatic system. This is how cancer spreads
from the original (primary) tumor to form new tumors
in other parts of the body. The spread of cancer is
called metastasis. Most cancers are named for the
type of cell or the organ in which they begin. When
cancer spreads, the new tumor has the same kind of
abnormal cells and the same name as the primary tumor.
For example, if lung cancer spreads to the liver,
the cancer cells in the liver are lung cancer cells.
The disease is called metastatic lung cancer (it is
not liver cancer).
Screening
and Early Detection
Sometimes,
cancer can be found before the disease causes symptoms.
Checking for cancer (or for conditions that may lead
to cancer) in a person who does not have any symptoms
of the disease is called screening.
Screening
may involve a physical exam, lab tests, and/or procedures
to look at internal organs, either directly or indirectly.
During a physical exam, the doctor looks for anything
unusual and feels for any lumps or growths. Examples
of lab tests include blood and urine tests, the Pap
test (microscopic examination of cells collected from
the cervix), and the fecal occult blood test (to check
for hidden blood in stool). Internal organs can be
seen directly through a thin, lighted tube (such as
a sigmoidoscope, which lets the doctor see the rectum
and the lower part of the colon) or indirectly with
x-ray images (such as mammograms to check the breasts).
Doctors
consider many factors before recommending a screening
test.
They weigh factors related to the individual, the
test, and the cancer that the test is intended to
detect. For example, doctors take into account the
person's age, medical history and general health,
family history, and lifestyle. In addition, they assess
the accuracy and the risks of the screening test and
any follow up tests that may be necessary. Doctors
also consider the effectiveness and side effects of
the treatment that will be needed if cancer is found.
People may want to discuss any concerns or questions
they have with their doctors, so they can weigh the
pros and cons and make an informed decision about
whether to have a screening test.
Symptoms
of Cancer
You
should see your doctor for regular checkups and not
wait for problems to occur. But you should also know
that the following symptoms may be associated with
cancer: changes in bowel or bladder habits, a sore
that does not heal, unusual bleeding or discharge,
thickening or lump in the breast or any other part
of the body, indigestion or difficulty swallowing,
obvious change in a wart or mole, or nagging cough
or hoarseness. These symptoms are not always a sign
of cancer. They can also be caused by less serious
conditions. Only a doctor can make a diagnosis. It
is important to see a doctor if you have any of these
symptoms. Don't wait to feel pain: Early cancer usually
does not cause pain. TOP
Diagnosis
If
you have a sign or symptom that might mean cancer,
the doctor will do a physical exam and ask about your
medical history. In addition, the doctor usually orders
various tests and exams. These may include imaging
procedures, which produce pictures of areas inside
the body; endoscopy, which allows the doctor to look
directly inside certain organs; and laboratory tests.
In most cases, the doctor also orders a biopsy, a
procedure in which a sample of tissue is removed.
A pathologist examines the tissue under a microscope
to check for cancer cells.
Imaging
Images
of areas inside the body help the doctor tell whether
a tumor is present. These images can be made in several
ways. In many cases, the doctor uses a special dye
so that certain organs show up better on film. The
dye may be swallowed or put into the body through
a needle or a tube.
X-rays
are the most common way doctors make pictures of the
inside of the body. In a special kind of x-ray imaging,
a CT or CAT scan uses a computer linked to an x-ray
machine to make a series of detailed pictures.
In
radionuclide scanning, the patient swallows or is
given an injection of a mildly radioactive substance.
A machine (scanner) measures radioactivity levels
in certain organs and prints a picture on paper or
film. By looking at the amount of radioactivity in
the organs, the doctor can find abnormal areas.
Ultrasonography
is another procedure for viewing the inside of the
body. High-frequency sound waves that cannot be heard
by humans enter the body and bounce back. Their echoes
produce a picture called a sonogram. These pictures
are shown on a monitor like a TV screen and can be
printed on paper.
In
MRI, a powerful magnet linked to a computer is used
to make detailed pictures of areas in the body. These
pictures are viewed on a monitor and can also be printed.
Endoscopy
Endoscopy
allows the doctor to look into the body through a
thin, lighted tube called an endoscope. The exam is
named for the organ involved (for example, colonoscopy
to look inside the colon). During the exam, the doctor
may collect tissue or cells for closer examination.
Laboratory
Tests
Although
no single test can be used to diagnose cancer, laboratory
tests such as blood and urine tests give the doctor
important information. If cancer is present, lab work
may show the effects of the disease on the body. In
some cases, special tests are used to measure the
amount of certain substances in the blood, urine,
other body fluids, or tumor tissue. The levels of
these substances may become abnormal when certain
kinds of cancer are present.
Biopsy
The
physical exam, imaging, endoscopy, and lab tests can
show that
something abnormal is present, but a biopsy is the
only sure way to know whether the problem is cancer.
In a biopsy, the doctor removes a sample of tissue
from the abnormal area or may remove the whole tumor.
A pathologist examines the tissue under a microscope.
If cancer is present, the pathologist can usually
tell what kind of cancer it is and may be able to
judge whether the cells are likely to grow slowly
or quickly.
Staging
When
cancer is found, the patient's doctor needs to know
the stage, or extent, of the disease to plan the best
treatment. The doctor may order various tests and
exams to find out whether the cancer has spread and,
if so, what parts of the body are affected. In some
cases, lymph nodes near the tumor are removed and
checked for cancer cells. If cancer cells are found
in the lymph nodes, it may mean that the cancer has
spread to other organs.
Treatment
Cancer
is treated with surgery, radiation therapy, chemotherapy,
hormone therapy, or biological therapy. Patients with
cancer are often treated by a team of specialists,
which may include a medical oncologist (specialist
in cancer treatment), a surgeon, a radiation oncologist
(specialist in radiation therapy), and others. The
doctors may decide to use one treatment method or
a combination of methods. The choice of treatment
depends on the type and location of the cancer, the
stage of the disease, the patient's age and general
health, and other factors.
Some
cancer patients take part in a clinical trial (research
study) using new treatment methods. Such studies are
designed to improve cancer treatment.
Methods of Treatment
Surgery--Surgery
is local therapy to remove the tumor. Tissues around
the tumor and nearby lymph nodes may also be removed
during theoperation.
Radiation
Therapy--In radiation therapy (also called
radiotherapy), high-energy rays are used to damage
cancer cells and stop them from
growing and dividing. Like surgery, radiation therapy
is local therapy; it can affect cancer cells only
in the treated area. Radiation may come from a machine
(external radiation). It also may come from an implant
(a small container of radioactive material) placed
directly into or near the tumor (internal radiation).
Some patients get both kinds of radiation therapy.
External
radiation therapy is usually given on an outpatient
basis in a
hospital or clinic 5 days a week for several weeks.
Patients are not radioactive during or after the treatment.
For
internal radiation therapy, the patient stays in the
hospital for a few days. The implant may be temporary
or permanent. Because the level of radiation is highest
during the hospital stay, patients may not be able
to have visitors or may have visitors only for a short
time. Once an implant is removed, there is no radioactivity
in the body. The amount of radiation in a permanent
implant goes down to a safe level before the patient
leaves the hospital.
Chemotherapy--Treatment
with drugs to kill cancer cells is called
chemotherapy. Most anticancer drugs are injected into
a vein (IV) or a muscle; some are given by mouth.
Chemotherapy is systemic treatment, meaning that the
drugs flow through the bloodstream to nearly every
part of the body.
Often,
patients who need many doses of chemotherapy receive
the drugs through a catheter (a thin flexible tube).
One end of the catheter is placed in a large vein
in the chest. The other end is outside the body or
attached to a small device just under the skin. Anticancer
drugs are given through the catheter. This can make
chemotherapy more comfortable for the patient. Patients
and their families are shown how to care for the catheter
and keep it clean. For some types of cancer, doctors
are studying whether it helps to put anticancer drugs
directly into the affected area.
Chemotherapy
is generally given in cycles: A treatment period is
followed by a recovery period, then another treatment
period, and so on. Usually a patient has chemotherapy
as an outpatient--at the hospital, at the doctor's
office, or at home. However, depending on which drugs
are given and the patient's general health, the patient
may need to stay in the hospital for a short time.
Hormone
Therapy--Some types of cancer, including
most breast and
prostate cancers, depend on hormones to grow. For
this reason, doctors may recommend therapy that prevents
cancer cells from getting or using the hormones they
need. Sometimes, the patient has surgery to remove
organs (such as the ovaries or testicles) that make
the hormones; in other cases, the doctor uses drugs
to stop hormone production or change the way hormones
work. Like chemotherapy, hormone therapy is systemic
treatment; it affects cells throughout the body.
Biological
Therapy--Biological therapy (also called
immunotherapy) is a form of treatment that uses the
body's natural ability (immune system) to fight infection
and disease or to protect the body from some of the
side effects of treatment. Monoclonal antibodies,
interferon, interleukin-2 (IL-2), and several types
of colony-stimulating factors (CSF, GM-CSF, G-CSF)
are forms of biological therapy.
Side
Effects of Cancer Treatment
It
is hard to limit the effects of treatment so that
only cancer cells are removed or destroyed. Because
treatment also damages healthy cells and tissues,
it often causes unpleasant side effects.
The
side effects of cancer treatment vary. They depend
mainly on the type and extent of the treatment. Also,
each person reacts differently. Doctors try to plan
the patient's therapy to keep side effects to a minimum
and they can help with any problems that occur.
Surgery--The
side effects of surgery depend on the location of
the
tumor, the type of operation, the patient's general
health, and other factors. Although patients are often
uncomfortable during the first few days after surgery,
this pain can be controlled with medicine. Patients
should feel free to discuss pain relief with the doctor
or nurse. It is also common for patients to feel tired
or weak for a while. The length of time it takes to
recover from an operation varies for each patient.
Radiation
Therapy--With radiation therapy, the side
effects depend on the treatment dose and the part
of the body that is treated. The most common side
effects are tiredness, skin reactions (such as a rash
or redness) in the treated areas, and loss of appetite.
Radiation therapy also may cause a decrease in the
number of white blood cells, cells that help protect
the body against infection. Although the side effects
of radiation therapy can be unpleasant, the doctor
can usually treat or control them. It also helps to
know that, in most cases, they are not permanent.
Chemotherapy--The
side effects of chemotherapy depend mainly on the
drugs and the doses the patient receives. Generally,
anticancer drugs affect cells that divide rapidly.
These include blood cells, which fight infection,
help the blood to clot, or carry oxygen to all parts
of the body. When blood cells are affected by anticancer
drugs, patients are more likely to get infections,
may bruise or bleed easily, and may have less energy.
Cells that line the digestive tract also divide rapidly.
As a result of chemotherapy, patients may have side
effects, such as loss of appetite, nausea and vomiting,
hair loss, or mouth sores. For some patients, the
doctor may prescribe medicine to help with side effects,
especially with nausea and vomiting. Usually, these
side effects gradually go away during the recovery
period or after treatment stops.
Hair
loss, another side effect of chemotherapy, is a major
concern for
many patients. Some chemotherapy drugs only cause
the hair to thin out, while others may result in the
loss of all body hair. Patients may feel better if
they decide how to handle hair loss before starting
treatment.
In
some men and women, chemotherapy drugs cause changes
that may result in a loss of fertility (the ability
to have children). Loss of fertility may be temporary
or permanent depending on the drugs used and the patient's
age. For men, sperm banking before treatment may be
a choice. Women's menstrual periods may stop, and
they may have hot flashes and vaginal dryness. Periods
are more likely to return in young women.
In
some cases, bone marrow transplantation and peripheral
stem cell
support are used to replace tissue that forms blood
cells when that tissue has been destroyed by the effects
of chemotherapy or radiation therapy.
Hormone
Therapy--Hormone therapy can cause a number
of side effects. Patients may have nausea and vomiting,
swelling or weight gain, and, in some cases, hot flashes.
In women, hormone therapy also may cause interrupted
menstrual periods, vaginal dryness, and, sometimes,
loss of fertility. Hormone therapy in men may cause
impotence, loss of sexual desire, or loss of fertility.
These changes may be temporary, long lasting, or permanent.
Biological
Therapy--The side effects of biological therapy
depend on the type of treatment. Often, these treatments
cause flu-like symptoms such as chills, fever, muscle
aches, weakness, loss of appetite, nausea, vomiting,
and diarrhea. Some patients get a rash, and some bleed
or bruise easily. In addition, interleukin therapy
can cause swelling. Depending on how severe these
problems are, patients may need to stay in the hospital
during treatment. These side effects are usually short-term;
they gradually go away after treatment stops.
