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Vital Information – Cancer

Guide

What Is Cancer?

According to the National Cancer Institute, Cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.

Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors.

Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemia’s, generally do not form solid tumors.

Cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system and form new tumors far from the original tumor.

Unlike malignant tumors, benign tumors do not spread into, or invade, nearby tissues. Benign tumors can sometimes be quite large, however. When removed, they usually don’t grow back, whereas malignant tumors sometimes do. Unlike most benign tumors elsewhere in the body, benign brain tumors can be life threatening.
Cancer is a genetic disease—that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide.

Genetic changes that cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA caused by certain environmental exposures. Cancer-causing environmental exposures include substances, such as the chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun.

Terms
Metastatic Cancer: the process by which cancer cells spread to other parts of the body. For example, breast cancer that spreads to and forms a metastatic tumor in the lung is metastatic breast cancer, not lung cancer. Metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes.

Types of Cancer

There are more than 100 types of cancer. Types of cancer are usually named for the organs or tissues where the cancers form. For example, lung cancer starts in cells of the lung, and brain cancer starts in cells of the brain. Cancers also may be described by the type of cell that formed them, such as an epithelial cell or a squamous cell.

You can search National Cancer Institute’s website for information on specific types of cancer based on the cancer’s location in the body or by using our A to Z List of Cancers. We also have collections of information on childhood cancers and cancers in adolescents and young adults. Here are some categories of cancers that begin in specific types of cells.

Carcinoma

Carcinomas are the most common type of cancer. They are formed by epithelial cells, which are the cells that cover the inside and outside surfaces of the body. There are many types of epithelial cells, which often have a column-like shape when viewed under a microscope. Carcinomas that begin in different epithelial cell types have specific names: Adenocarcinoma is a cancer that forms in epithelial cells that produce fluids or mucus. Tissues with this type of epithelial cell are sometimes called glandular tissues. Most cancers of the breast, colon, and prostate are adenocarcinomas.

Basal cell carcinoma is a cancer that begins in the lower or basal (base) layer of the epidermis, which is a person’s outer layer of skin.

Squamous cell carcinoma is a cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. Squamous cells also line many other organs, including the stomach, intestines, lungs, bladder, and kidneys. Squamous cells look flat, like fish scales, when viewed under a microscope. Squamous cell carcinomas are sometimes called epidermoid carcinomas.

Transitional cell carcinoma is a cancer that forms in a type of epithelial tissue called transitional epithelium, or urothelium. This tissue, which is made up of many layers of epithelial cells that can get bigger and smaller, is found in the linings of the bladder, ureters, and part of the kidneys (renal pelvis), and a few other organs. Some cancers of the bladder, ureters, and kidneys are transitional cell carcinomas.

Sarcoma

Soft tissue sarcoma forms in soft tissues of the body, including muscle, tendons, fat, blood vessels, lymph vessels, nerves, and tissue around joints.

Sarcomas are cancers that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments).

Osteosarcoma is the most common cancer of bone. The most common types of soft tissue sarcoma are leiomyosarcoma, Kaposi sarcoma, malignant fibrous histiocytoma, lip sarcoma, and dermatofibrosarcoma protuberans.

Leukemia
Cancers that begin in the blood-forming tissue of the bone marrow are called leukemias. These cancers do not form solid tumors. Instead, large numbers of abnormal white blood cells (leukemia cells and leukemic blast cells) build up in the blood and bone marrow, crowding out normal blood cells. The low level of normal blood cells can make it harder for the body to get oxygen to its tissues, control bleeding, or fight infections. There are four common types of leukemia, which are grouped based on how quickly the disease gets worse (acute or chronic) and on the type of blood cell the cancer starts in (lymphoblastic or myeloid). Our page on leukemia has more information.

Lymphoma

Lymphoma is cancer that begins in lymphocytes (T cells or B cells). These are disease-fighting white blood cells that are part of the immune system. In lymphoma, abnormal lymphocytes build up in lymph nodes and lymph vessels, as well as in other organs of the body.

There are two main types of lymphoma:

Hodgkin lymphoma – People with this disease have abnormal lymphocytes that are called Reed- Sternberg cells. These cells usually form from B cells.

Non-Hodgkin lymphoma – This is a large group of cancers that start in lymphocytes. The cancers can grow quickly or slowly and can form from B cells or T cells.

Multiple Myeloma

Multiple myeloma is cancer that begins in plasma cells, another type of immune cell. The abnormal plasma cells, called myeloma cells, build up in the bone marrow and form tumors in bones all throughout the body. Multiple myeloma is also called plasma cell myeloma and Kahler disease.

Melanoma

Melanoma is cancer that begins in cells that become melanocytes, which are specialized cells that make melanin (the pigment that gives skin its color). Most melanomas form on the skin, but of brain and spinal cord tumors. These tumors are named based on the type of cell in which they formed and where the tumor first formed in the central nervous system. For example, an astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. Brain tumors can be benign (not cancer) or malignant (cancer).

Other Types of Tumors:

Germ Cell Tumors

Germ cell tumors are a type of tumor that begins in the cells that give rise to sperm or eggs. These tumors can occur almost anywhere in the body and can be either benign or malignant.
Our page of cancers by body location/system includes a list of germ cell tumors with links to more information.

Neuroendocrine Tumors

Neuroendocrine tumors form from cells that release hormones into the blood in response to a signal from the nervous system. These tumors, which may make higher-than-normal amounts of hormones, can cause many different symptoms. Neuroendocrine tumors may be benign or malignant.

Brain and Spinal Cord Tumors

There are different types:

Carcinoid Tumors

Carcinoid Tumors Carcinoid tumors are a type of neuroendocrine tumor. They are slow-growing tumors that are usually found in the gastrointestinal system (most often in the rectum and small intestine).

Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.

Visit the National Cancer Institute’s online page on gastrointestinal carcinoid tumors for more information. Related Resources, Cancer Staging, Tumor Grade, Pathology Reports, Metastatic Cancer, Common Cancer Myths and Misconceptions.

Differences between Cancer Cells and Normal Cells

Cancer cells differ from normal cells in many ways that allow them to grow out of control and become invasive. One important difference is that cancer cells are less specialized than normal cells. That is, whereas normal cells mature into very distinct cell types with specific functions, cancer cells do not. This is one reason that, unlike normal cells, cancer cells continue to divide without stopping.

In addition, cancer cells are able to ignore signals that normally tell cells to stop dividing or that begin a process known as programmed cell death, or apoptosis, which the body uses to get rid of unneeded cells.

Cancer cells may be able to influence the normal cells, molecules, and blood vessels that surround and feed a tumor—an area known as the microenvironment. For instance, cancer cells can induce nearby normal cells to form blood vessels that supply tumors with oxygen and nutrients, which they need to grow. These blood vessels also remove waste products from tumors.

Cancer cells are also often able to evade the immune system, a network of organs, tissues, and specialized cells that protect the body from infections and other conditions. Although the immune system normally removes damaged or abnormal cells from the body, some cancer cells are able to “hide” from the immune system.

Tumors can also use the immune system to stay alive and grow. For example, with the help of certain immune system cells that normally prevent a runaway immune response, cancer cells can actually keep the immune system from killing cancer cells. According to the American Cancer Society, the following Are

Signs and Symptoms of Cancer:


Tumors can also use the immune system to stay alive and grow. For example, with the help of certain immune system cells that normally prevent a runaway immune response, cancer cells can actually keep the immune system from killing cancer cells.

According to the American Cancer Society, the following Are Signs and Symptoms of Cancer:

  • Unexplained Weight gain or loss with no known reason
  • Fever
  • Fatigue
  • Pai.
  • Change in bowel habits or bladder functions
  • Sores that do not heal
  • White patches inside the mouth or white spots on the tongue
  • Unusual bleeding or discharge
  • Thickening or lump on or under the skin, the breast or other parts of the body
  • Indigestion or trouble swallowing, problems with eating, such as: Discomfort after eating
  • A hard time swallowing
  • Changes in appetite
  • Recent change in a wart or mole or any new skin change
  • Nagging cough or hoarseness
  • Skin changes, such as: A new mole or a change in an existing mole
  • Breast changes, such as: Change in size or shape of the breast or nipple, Change in texture of breast skin
  • Hoarseness or cough that does not go away
  • Difficult or painful urination
  • Abdominal pain
  • Unexplained night sweats
  • Unusual bleeding in the stool, discharge in the urine and vaginal bleeding
  • Feeling weak or very tired

Most often, these symptoms are not due to cancer. They may also be caused by benign tumors or other problems. If you have symptoms that last for a couple of weeks, it is important to see a doctor so that problems can be diagnosed and treated as early as possible.

Usually, early cancer does not cause pain. If you have symptoms, do not wait to feel pain before seeing a doctor.

Cancer can cause many different symptoms


The signs and symptoms listed above are the more common ones seen with cancer, but there are many others that are not listed here. If you notice any major changes in the way your body works or the way you feel – especially if it lasts for a long time or gets worse – let a doctor know. If it has nothing to do with cancer, the doctor can find out more about what’s going on and if needed, treat it. If it is cancer, you’ll give yourself the chance to have it treated early, when treatment works best. To learn more about symptoms for a specific cancer, visit National Cancer Institute online.

Cancer Treatment
There are many types of cancer treatment. The types of treatment that you have will depend on the type of cancer you have and how advanced it is. Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy. You may also have immunotherapy, targeted therapy, or hormone therapy.

Questions to ask your doctor about cancer Treatment

  • What are the ways to treat my type and stage of cancer?
  • What are the benefits and risks of each of these treatments?
  • What treatment do you recommend? Why do you think it is best for me?
  • When will I need to start treatment?
  • Will I need to be in the hospital for treatment? If so, for how long?
  • What is my chance of recovery with this treatment?
  • How will we know if the treatment is working?
  • Would a clinical trial (research study) be right for me?
  • How do I find out about studies for my type and stage of cancer?

How Cancer Arises, Causes and Risk Factors

Cancer is a genetic disease, it is caused by changes to genes that control the way our cells function, especially how they grow and divide. Genetic changes that cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA caused by certain environmental exposures. Cancer-causing environmental exposures include substances, such as the chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun. (Our Cancer Causes and Risk Factors page has more information.)

Each person’s cancer has a unique combination of genetic changes. As the cancer continues to grow, additional changes will occur. Even within the same tumor, different cells may have different genetic changes.

In general, cancer cells have more genetic changes, such as mutations in DNA, than normal cells. Some of these changes may have nothing to do with the cancer; they may be the result of the cancer, rather than its cause.

Cancer risk factors include exposure to chemicals or other substances, as well as certain behaviors. They also include things people cannot control, like age and family history. A family history of certain cancers can be a sign of a possible inherited cancer syndrome.

The list below includes the most-studied known or suspected risk factors for cancer. Although some of these risk factors can be avoided, others—such as growing older—cannot. Limiting your exposure to avoidable risk factors may lower your risk of developing certain cancers.

  • Age
  • Alcohol
  • Cancer-Causing Substances
  • Chronic Inflammation
  • Diet
  • Hormones
  • Immunosuppression
  • Infectious Agents
  • Obesity
  • Radiation
  • Sunlight
  • Tobacco

“Drivers” of Cancer

The genetic changes that contribute to cancer tend to affect three main types of genes—proto- oncogenes, tumor suppressor genes, and DNA repair genes. These changes are sometimes called “drivers” of cancer.

Proto-oncogenes are involved in normal cell growth and division. However, when these genes are altered in certain ways or are more active than normal, they may become cancer-causing genes (or oncogenes), allowing cells to grow and survive when they should not.

Tumor suppressor genes are also involved in controlling cell growth and division. Cells with certain alterations in tumor suppressor genes may divide in an uncontrolled manner.

DNA repair genes are involved in fixing damaged DNA. Cells with mutations in these genes tend to develop additional mutations in other genes. Together, these mutations may cause the cells to become cancerous.

As scientists have learned more about the molecular changes that lead to cancer, they have found that certain mutations commonly occur in many types of cancer. Because of this, cancers are sometimes characterized by the types of genetic alterations that are believed to be driving them, not just by where they develop in the body and how the cancer cells look under the microscope.

When Cancer Spreads

In metastasis, cancer cells break away from where they first formed (primary cancer), travel through the blood or lymph system, and form new tumors (metastatic tumors) in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor. A cancer that has spread from the place where it first started to another place in the body is called metastatic cancer. The process by which cancer cells spread to other parts of the body is called metastasis.

Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that spreads to and forms a metastatic tumor in the lung is metastatic breast cancer, not lung cancer.

Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes.

Treatment may help prolong the lives of some people with metastatic cancer. In general, though, the primary goal of treatments for metastatic cancer is to control the growth of the cancer or to relieve symptoms caused by it. Metastatic tumors can cause severe damage to how the body functions, and most people who die of cancer die of metastatic disease.

Tissue Changes that Are Not Cancer

Not every change in the body’s tissues is cancer. Some tissue changes may develop into cancer if they are not treated, however. Here are some examples of tissue changes that are not cancer but, in some cases, are monitored:

Hyperplasia occurs when cells within a tissue divide faster than normal and extra cells build up, or proliferate. However, the cells and the way the tissue is organized look normal under a microscope. Hyperplasia can be caused by several factors or conditions, including chronic irritation. Dysplasia is a more serious condition than hyperplasia. In dysplasia, there is also a buildup of extra cells. But the cells look abnormal and there are changes in how the tissue is organized. In general, the more abnormal the cells and tissue look, the greater the chance that cancer will form.

Some types of dysplasia may need to be monitored or treated. An example of dysplasia is an abnormal mole (called a dysplastic nevus) that forms on the skin. A dysplastic nevus can turn into melanoma, although most do not.

An even more serious condition is carcinoma in situ. Although it is sometimes called cancer, carcinoma in situ is not cancer because the abnormal cells do not spread beyond the original tissue. That is, they do not invade nearby tissue the way that cancer cells do. But, because some carcinomas in situ may become cancer, they are usually treated.

Normal cells may become cancer cells. Before cancer cells form in tissues of the body, the cells go through abnormal changes called hyperplasia and dysplasia. In hyperplasia, there is an increase in the number of cells in an organ or tissue that appear normal under a microscope. In dysplasia, the cells look abnormal under a microscope but are not cancer. Hyperplasia and dysplasia may or may not become cancer. (Credit: Teresa Winslow)

Take control of your health, and help reduce your cancer risk.

  • Stay away from all forms of tobacco.
  • Get to and stay at a healthy weight.
  • Get moving with regular physical activity.
  • Eat healthy with plenty of fruits and vegetables.
  • Limit how much alcohol you drink (if you drink at all).
  • Protect your skin.
  • Know yourself, your family history, and your risks.
  • Get regular check-ups and cancer screening tests.

There’s no sure way to prevent cancer but there are things you can do to help reduce your chances of getting it.

Tobacco

Many cancers might be prevented if people didn’t use tobacco.

Smoking damages nearly every organ in the human body and accounts for some 30% of all cancer deaths. Cigarettes, cigars, pipes, and oral (smokeless) tobacco products cause cancer and should not be used. People who use tobacco should try to quit. Studies clearly show that ex-smokers have less cancer than people who continue to smoke. It’s best to never use tobacco at all and to stay away from secondhand smoke.

Alcohol

Drinking alcohol is linked to a higher risk of certain types of cancer.

Some people think that certain types of alcohol are safer than others. But ethanol is the type of alcohol found in all alcoholic drinks, whether they are beers, wines, or liquors (distilled spirits). Overall, it’s the amount of alcohol that’s drunk over time, not the type of drink, which seems to be the most important factor in raising cancer risk.

If you drink, limit your intake to no more than 2 drinks per day for men and 1 drink a day for women. This may help curb your cancer risk.

Drinking and smoking

The combined use of alcohol and tobacco raises the risk of mouth, throat, voice box, and esophagus cancer far more than the effects of either one alone.

Ultraviolet (UV) rays and sunlight

You can lower your chances of getting skin cancer by:

  • Wearing a hat, shirt, and sunglasses when you are in the sun
  • Staying out of the sun between the hours of 10 a.m. and 4 p.m.
  • Using sunscreen with a sun protection factor (SPF) of 30 or higher
  • Not using tanning beds or sun lamps cancer and to learn how to protect yourself and the people you care about from UV skin damage

Diet

We know that our diet (what we eat or don’t eat) is linked to some types of cancer, but the exact reasons are not yet clear. The best information we have suggests a lower cancer risk for people who:

  • Eat a lot of fresh vegetables and fruits (at least 2½ cups a day)
  • Choose whole grains rather than refined grains and sugars
  • Limit red meats (beef, pork, and lamb)
  • Limit processed meats (such as bacon, deli meats, and hot dogs)
  • Choose foods in amounts that help them get to and stay at a healthy weight
  • Limit alcohol intake to 1 alcoholic drink a day or less for women and 2 or less for
    men

Vaccines that reduce cancer risk

We now know some cancers are caused by infections, mostly viruses. One virus that’s clearly linked to cancer is human papilloma virus (HPV). It’s been linked to cervical cancer, anal cancer, many genital cancers, and even head and neck cancers. There are 2 vaccines to help prevent HPV infections, so they should help prevent the cancers caused by HPV. But most adults have already been infected with HPV, and the vaccines haven’t been proven to help people who already have HPV. Still, young people who are not yet sexually active should have a lower future cancer risk if they get one of the vaccines before they’re exposed to HPV. The American Cancer Society recommends them for girls aged 11 and 12, though they can be given to girls and boys as young as 9.

Early detection

To find cancer early, while it’s small and before it has spread, adults should have regular tests called cancer screening tests. These tests help doctors find common cancers before they cause symptoms. For example, regular screening can find cancers of the breast, colon, rectum, cervix, mouth, and skin early. If cancer is found early, it can be easier to treat. Survival also tends to be longer for those with early cancer detection. Talk to your doctor about which screening tests might be right for you.

Biopsy

This is the removal of a small section of the tumor, the sample will be analyzed by a histopathologist in order to establish a precise diagnosis. Surgical procedure. This may be a needle biopsy, where a very fine needle is used to take a tiny sample of the tumor. Occasionally a surgeon may remove the whole tumor prior to diagnosis; a resection biopsy.

Haematology

Is the branch of medicine that specializes in the study and treatment of blood and blood tissues (including bone marrow.) A blood count is where the various type’s cells in the blood are measured. This may aid diagnosis and will be used during treatment to monitor toxicity. The Hematologist may also examine samples from a bone marrow aspiration (needle into the bone) and samples of spinal fluid from a lumbar puncture (needle between the vertebra of the spine.)

Histopathology

The study of cells relating to the disease. (Histology is the microscopic study of cells and tissues, Pathology is the study of the disease.) The histopathologist will determine a precise diagnosis by laboratory tests and microscopic examination of the cells.

Differentiation

Is where normal cells go through physical changes in order to form the different specialized tissues of the body. Malignant cells may range from well-differentiated (closely resembling the tissue of origin) or undifferentiated or anaplastic (bearing little similarity to the tissue of origin). In general, it is the undifferentiated or anaplastic histology’s which are more aggressive.

Tumour Markers

A substance in the body that may indicate the presence of cancer. Markers may be secreted by the tumor itself or produced by the body in response to the cancer. Tumor markers may aid diagnosis or give an indicator of how treatment is progressing. These markers are usually specific to certain types of cancer. For example, neuron-specific enolase (NSE) is associated with a number of types of cancers, in particular neuroblastoma. Also, alpha fetoprotein (AFP) levels are often abnormally high in patients with Germ cell tumors.

Medical Imaging

Types of medical imaging include:

X-ray – Examination of X-ray films may indicate the site and extent of the tumour and aid in the detection of metastatic spread.

CT Computed tomography (CT or CAT scan) makes a cross-sectional x-ray picture of a “slice” of the body. The machine rotates around the patient taking x-rays from different angles, the images are then processed by a computer.

MRI Magnetic resonance imaging – This is used to determine if the biochemical activity of a tissue responds normally to magnetic forces, tumours may give an abnormal signal.

Ultrasound – The use of sound waves to image the underlying structures of the body. Ultrasonic waves are reflected differently depending on the type of tissue they pass through, aiding the detection of abnormal tissues.

Staging and Prognosis Benign

Not spreading, usually a more mild disease.

Malignant

Cancerous, where the tumour grows uncontrollably and may spread.

In-situ / Invasive Localised

A tumour restricted to a single site.

Metastases

Where the tumor has spread to other parts of the body beyond the primary site. Metastatic sites (secondaries) may be regional or distant from the original tumor.

Staging

Staging is where the disease is categorized as to how far it has spread. The precise staging system used will depend on the type of cancer the patient has. In general, low stage patients are those with localized tumors that are easily resectable, whilst high stage patients are those with widespread metastases. The treatment given may largely depend upon which stage the patient is at diagnosis.

Prognosis

Is the expected outcome of a disease and its treatment, this may be influenced by a variety of factors such as stage, age, site etc. depending on the particular type of cancer. For example, in general a patient with localized disease may have a more favorable prognosis compared to a patient with widespread disease which may be less favorable.

Remission

Is where the symptoms of cancer are no longer present. There is no longer any evidence of the disease using the available investigations.

Relapse

This is when the disease reoccurs after a period in remission.

Refractory

This is where the cancer is resistant to treatment, patient may never go into remission, possibly with stable or progressive disease.

Restaging

This is where the patient is staged again after a period of treatment to access the response to therapy.

Follow-up

When treatment is complete the periodic visits to the physician are needed to monitor the patient and ensure there has been no recurrence of the disease.

Treatment Curative Treatment

Treatment to destroy the cancer.

Palliative Treatment

Treatment which relieves the symptoms and pain.

Surgery

Pre-operative chemotherapy – drugs given to shrink the tumor before surgery. Complete resection this is where all of the tumor has been totally removed during surgery, as opposed to an incomplete resection. The surgical specimen may be examined by a pathologist to determine if it is likely to have removed all of the primary tumor. If there is any tumor left after surgery this may be macroscopic (visible to the eye) or microscopic, in either case radiotherapy may be needed to kill the remaining tumor cells.

Prosthesis – an artificial replacement e.g. for an amputated limb.

Endoprosthesis – a prosthesis which fits inside the body e.g. replacing the thigh bone.

Radiotherapy

External radiotherapy – radioactivity from a source outside the body. Internal radiotherapy – placing radioactive source within the body in or near to the tumor to kill the cancer cells (Brachytherapy). Fractions – the radiotherapy dose is divided into a number of smaller doses to reduce the risk of side effects. There is normally one fraction per day. Hyper fractionated radiotherapy – more than one fraction is given per day. Radiotherapy field – the area towards which the radiotherapy was directed. Total Body Irradiation (TBI) – radiation to the whole body e.g. to destroy all malignant cells prior to bone marrow transplant (BMT).

Chemotherapy

Chemotherapy Since the 1960’s the development and use of drugs has dramatically improved the prognosis for many types of cancer. Chemo- means chemicals, for most types of cancer chemotherapy will consist of a number of different drugs, this is known as combination chemotherapy. Chemotherapy may be given in a variety of ways; Intravenously (IV) -into a vein is the most common, intramuscularly (IM) -injection into a muscle, Orally -by mouth, subcutaneously (SC) – injection under the skin, Intralesional (IL) -directly into a cancerous area, Intrathecally (IT)-into the fluid around the spine, Topically -medication will be applied onto the skin.

Cytotoxic – cytotoxic drugs kill or damage cells. The normal cells of the body grow and die in a controlled way, but cancer cells keep growing and multiplying. Chemotherapy destroys cancer cells by stopping them from growing or multiplying at one or more points during the life cycle of the cell.

Central line – a thin plastic line into a vein in the chest used for the delivery of chemotherapy e.g. HICKMAN® catheter. Drug resistance is where tumor cells become resistant to chemotherapy. Some tumor cells will be chemo-sensitive and are killed by anticancer drugs; the cells that remain are likely to be more resistant. Thus, by selection it is the most resistant cells survive and divide, they may be resistant to a particular drug, a class of drugs, or all drugs.

Bone Marrow Transplantation (BMT)
The bone marrow is destroyed by high dose chemotherapy and possibly radiotherapy which has been given to kill malignant cells in the body. Healthy matching marrow is then transplanted into the patient.

Allogeneic BMT Healthy marrow is taken from a matched donor and used to replace the patient’s bone marrow which has been destroyed by high dose chemotherapy. The donor may be a relative, if the patient has a twin this may be the best match, otherwise a brother, sister, or another unrelated person may donate marrow.

Autologous BMT in an autologous bone marrow transplant the marrow is first taken from the patient. The marrow is usually then purged with chemicals to kill any malignant cells in it, and may then be frozen to preserve it. High dose chemotherapy is given to destroy the patient’s remaining marrow. The frozen marrow is then thawed and transplanted back into the patient.

Cancer Treatment

There are many types of cancer treatment. The types of treatment that you have will depend on the type of cancer you have and how advanced it is. Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy. You may also have immunotherapy, targeted therapy, or hormone therapy.

Clinical trials might also be an option for you. Clinical trials are research studies that involve people. Understanding what they are and how they work can help you decide if taking part in a trial is a good option for you.

When you need treatment for cancer, you have a lot to learn and think about. It is normal to feel overwhelmed and confused. But, talking with your doctor and learning all you can about all your treatment options, including clinical trials, can help you make a decision you feel good about.

The Burden of Cancer In 2015, an estimated 1,658,370 people will be diagnosed with cancer in the United States, and an estimated 589,430 people will die of cancer.

Cancer incidence and mortality help to define the scope of the burden that cancer imposes on society, but these indicators do not fully characterize the impact that cancer has on cancer patients and their families.

In addition to the physical morbidity caused by cancer, cancer is frequently associated with emotional distress and an overall reduction in quality of life.

Cancer has also been observed to be a financial stressor. In a population-based study in western Washington, 197,840 cancer patients were matched with an equal number of controls by age, sex, and zip code. Cancer patients were 2.6 times more likely to file for bankruptcy than the cancer-free controls.

References American Cancer Society.

Cancer Facts and Figures 2015. Atlanta, Ga: American Cancer Society, 2015.

Available online Exit Disclaimer. Last accessed October 30, 2015.

Faller H, Schuler M, Richard M, et al.: Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol 31 (6): 782-93, 2013. [PUBMED Abstract]

Ramsey S, Blough D, Kirchhoff A, et al.: Washington State cancer patients found to be at greater risk for bankruptcy than people without a cancer diagnosis. Health Aff (Millwood) 32 (6): 1143- 52, 2013. [PUBMED Abstract]

The source of all information contained here online or in CCD FOUNDATION’S booklet “What Is Cancer” is quoted from the National Cancer Institute by CW Smith, President CCD Foundation, on January 13, 2016.

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