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Understanding Cancer

Cancer is an overarching term that encompasses several disease states that can affect multiple areas in the body. Cancer can begin anywhere in the body and spread throughout. In cancer, cells begin rapidly dividing without stopping, and this can lead to these cancer cells spreading to multiple sites within the body. Typically, the body monitors and regulates cell formation and growth, but these process are shut down in cancer which leads to the rapid growth of abnormal cells. Depending on the location of the cell growth, there is the potential for these cells to form solid masses known as tumors. If the origin of the cancer is the blood, you will not see tumor formation.

These tumors that form can either be benign or malignant. Benign tumors do not spread to other body parts or surrounding tissues. They typically are not life threatening and can be removed. Once they have been removed, they usually do not grow back. Malignant tumors have cells that spread to the surrounding tissues, and they may break off from the original mass and spread to other areas in the body via the blood or lymph systems. Malignant tumors are not the same as metastatic cancer. Metastatic cancer means that the cancer has spread from the site of origin to form an additional tumor in a new location.

Cancer is a genetic based disorder. This means cancer causing genes were either hereditary and something you were born with, or a genetic mutation was caused by an environmental exposure later in life. Environmental exposures can include tobacco smoke, ultraviolet rays, or radiation exposure. Cancer is not caused by a single genetic mutation, but typically a combination of multiple mutations that lead to abnormal cell growth. Having cancer can also result in even more genetic mutations as the disease progresses.

There are over 100 different types of cancer currently known. They are usually named based on the site where the cancer initially formed. Of these currently known cancers, carcinomas are the most common. A carcinoma is formed by epithelial cells, which line the inside and outside surface areas of the body. Another common type of cancer is sarcoma, which are formed from bones and soft tissues such as fats and muscles. Leukemias originate in the bone marrow where blood is formed. These cause large numbers of abnormal white blood cells to be found in the blood. Lymphomas also affect white blood cells, specifically T and B cells.

Diagnosis and TestingCancer is commonly diagnosed by a biopsy, which involves the examination of cells or tissue samples under a microscope by a pathologist. Lab tests examining the blood, urine, or other body fluids for abnormalities can also be used. Additionally, imaging procedures such as a CT scan, MRI, or ultrasound can be performed which takes images of areas inside the body to see if any tumors are present.

Some cancers can be detected before symptoms occur through the use of screening procedures. Treatment may be more effective if started early, so detecting cancer before symptoms appear can be very beneficial. Screenings are usually done for the following cancers:

  • Breast: A yearly mammogram (X-ray of the breasts) is recommended for women age 40 and older. Clinical breast exams (performed by a doctor or nurse) and breast self-exams can be done to look for lumps and other changes in the breasts.
  • Cervical: A Pap test (or Pap smear) is recommended for women ages 21-65. It examines cells from the cervix to detect any changes and to determine if any cells are precancerous. Beginning at age 30, an HPV test is recommended to look for the human papillomavirus, which can cause these changes.
  • Colorectal: A colonoscopy or sigmoidoscopy can be done for people ages 50-75 to identify precancerous polyps (abnormal growths) in the colon or rectum using a flexible, lighted tube. Fecal occult blood testing can also be done which tests for blood in the stool.

Not all cancer screenings are beneficial and some carry risks. It is important to discuss the benefits and possible risks with a doctor before a decision to be screened is made.

Treatment

Treatment is highly individualized and depends on many factors such as the patient’s age and overall health, the type of cancer, and the severity of disease. There are many treatment options available which include surgery, radiation, chemotherapy, hormone therapy, and stem cell transplants. Some patients may receive only one type of treatment, while others may require a combination of these options to effectively treat the cancer.

Treatment can be subdivided into local or systemic therapy. Local therapy focuses on a specific area of the body. Examples include surgery which removes cancer and radiation which kills or shrinks a tumor. Systemic therapy extends beyond a single area and works throughout the body. Chemotherapy and hormone therapy use medications which travel through the bloodstream and target cancer cells that have moved beyond the original source.

The goals of cancer treatment are different for each patient and can include curing the disease, reducing symptoms, and prolonging life. Cancer research is ongoing and continues to develop treatments designed to ensure the best possible quality of life for every patient.

References
American Cancer Society. http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/treatment-types-landing. Accessed May 14, 2015.

Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/dcpc/prevention/screening.htm. Accessed May 14, 2015.

National Cancer Institute. http://www.cancer.gov/cancertopics/what-is-cancer. Accessed May 14, 2015.

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