What you need to know about cancer

Cancer continues to be everyone’s most feared disease. Of course, that’s understandable. For many years, a diagnosis of cancer was a virtual death sentence. Although that grim reality has changed significantly today, still, to be told that you have cancer is very difficult to accept even now.

The initial moments after receiving a cancer diagnosis are often clouded. Studies show that when people in this situation are asked what they discussed with their doctors, they remember less than five percent of what was said! Stress and tension do affect memory and mental concentration. Just remember though: Cancer is becoming less fearsome, as cure rates have increased. Today, treatments are capable of curing more than half of people diagnosed to have cancer.

It’s important to know and understand the details of your cancer diagnosis and treatment. Equipped with that information, you’ll be better able to work with your doctor in treating your cancer and managing your life.

First Things First

Many people think of cancer as one disease. But there are more than 100 different cancers. To know what you’re dealing with, it’s important to know the name of your cancer.

Cancers are given different names based on the type of tissue from which they develop. Depending on the tissue, cancers tend to behave differently. Most cancers fall into one of the following groups:

• Carcinoma. This is the largest cancer group, comprising 80 percent of all cancers. These cancers develop from cells that cover the body (your skin) and those that make up and line your organs and internal passageways. Most carcinomas affect an organ that secretes something, for example, breast tissue (which secretes milk) or lung tissue (which secretes mucus).

• Sarcoma. This cancer occurs in your body’s connective tissues, such as bones, tendons, cartilage, fat, muscle and blood vessels.

• Lymphoma and leukemia. Lymphoma develops from cells in the lymph glands of your immune system. Leukemia develops from these same cells or from cells that make blood in your bone marrow.

Coming To Terms

Once you know the name of your cancer, you need to understand other aspects of your particular cancer in order to make informed decisions regarding treatment. Here are some of the terms you’ll want to become familiar with:

Tumor. Any abnormal mass of tissue growth is called a tumor. A malignant tumor is cancer. It can spread to nearby tissue and other parts of your body. A tumor that is benign is not cancer. A benign tumor only enlarges locally and rarely threatens life unless it impairs normal function of adjacent organs.

• Primary site. This is the place in your body where the cancer first developed. Common primary sites include the skin, lungs, colon, prostate, breast and liver.

• Metastasis. This refers to the spread of the disease from its primary site to another part of your body. If a cancer is metastatic, it’s still referred to by its primary site name. For instance, ovarian cancer that spreads to the lung is still considered ovarian cancer, not lung cancer.

• Grade. Grade refers to the characteristics cancer cells possess when viewed under a microscope. At one end of the scale are Grade I cancers, which are generally less active. Some prostate cancers, for instance, are very slow growing and are described as Grade I. At the other end are Grade IV cancers, which tend to be aggressive and fast growing. An example of a Grade IV cancer is small cell (also called oat cell) lung cancer.

• Stage. This describes how far a particular cancer has spread. It’s most helpful in selecting treatment options. Generally, there are four cancer stages, labeled I to IV. The lower the number, the less a cancer has spread. Higher stage cancers tend to also be higher grade.

Different systems are used for staging. One of the most commonly used methods looks at three aspects of the cancer to determine its stage. These are: the size of the tumor; whether the cancer has spread (metastasized) through lymphatic vessels to nearby lymph nodes; and, whether the cancer has spread (usually through blood vessels) to other organs in the body.

Treatment Options

Just slightly more than a decade ago, physicians offered either surgery or nonsurgical treatment in the form of radiation or chemotherapy (treatment with drugs). Today’s options are more complex – and often more promising. Doctors tailor treatment for each person with cancer. Treatment methods frequently are combined. Advances include new anticancer drugs and new techniques for delivering radiation.

As you read or hear about advances in cancer treatment, remember that some of the methods are experimental and unavailable as routine care. There are three main ways to fight cancer. Here’s an overview of each, and a summary of some of the most promising new approaches:

Surgery. This is the oldest treatment. It works best if the cancer hasn’t spread, and if the growth can be removed without harming vital organs. Your physician may recommend surgery for these reasons:

• Diagnosis. To pinpoint the type and the extent of the tumor growth, doctors remove a sample of tissue or remove a few cells with a fine needle (biopsy). If cancer has spread, your doctor may need samples from several places.

• Treatment. Your physician removes the tumor along with a margin of adjacent normal tissue. Doctors may also remove lymph glands, through which cancer often travels.

• Pain relief. Physician can remove tumors that cause painful symptoms, such as blockage in the bowel or pressure on a nerve.

• Reconstruction. Removing a tumor, such as in the breast, head or neck, can be disfiguring. In addition to treating the disease, surgery can help restore your appearance, as well as your ability to function and enjoy life.

• Radiation therapy. This form of treatment uses high-energy X-rays, electron beams or radioactive isotopes, to destroy cancer cells with minimal damage to healthy tissue. Some cells die right away. More often, radiation harms the genetic material of tumor cells, thereby inhibiting cell growth.

The type and location of cancer helps determine how much radiation you receive. For example, your bones can tolerate more radiation than your kidneys. Here are common types of radiation treatment:

• External radiation (teletherapy). Originating from a machine outside your body, radiation can treat internal tumors with minimal harm to your skin. Sometimes, doctors use radiation during surgery. After removing as much tumor as possible, physicians use radiation on the residual material. This procedure spares normal tissue outside the field of the beam. It’s helpful for recurrent rectal cancer and other tumors that can’t be removed or have a strong risk of occurring again at the original site.

• Internal radiation. Doctors administer radiation to the tumor site. One approach, called brachytherapy, uses implants against cancer of the head, neck and breast, as well as the uterus, cervix, lungs and limbs. Some implants are permanent, using radioactive "seeds" like gold or iodine. They deliver a measured dose of radiation throughout several weeks or months. Your doctor may also advise a removable implant. While you’re under anesthesia, doctors place tubes into the tumor and insert radioactive seeds. The seeds and tubes are removed after treatment ends. Another method of internal radiation is called radioactive iodine therapy. You ingest a liquid medication that collects in the tumor and slows or stops its growth.

• Looking ahead. Having a rich oxygen supply helps cells respond to radiation treatment. New chemicals may improve oxygen supply to cells, while other medications are meant to limit damage to normal tissue. Scientists are evaluating new types of radiation, such as subatomic particles, to keep tumor cells from growing back.

• Chemotherapy. Chemotherapy can be a frightening term, but all it means is treatment with chemicals (drugs or medications). Drugs for cancer became available after World War II. Today, doctors use more than 50 drugs to treat cancer. Unlike surgery and radiation, which focus on a specific location, chemotherapy affects your entire body. Therefore, it can be effective in treating cancers that have spread (metastasized).

• How drugs work. Anticancer medications break the cycle of cancer cells: growing, resting and multiplying. Certain drugs can attack tumor cells at each of these phases. You can take anticancer drugs as a tablet, capsule or liquid. You can also receive drugs via injections.

• Outcome. Following chemotherapy, a tumor may completely disappear. Doctors, however, may continue treatment to increase the chances that all cancer cells are destroyed. Often, chemotherapy eliminates or shrinks the tumor. Some tumors may continue to grow. Your doctor will monitor your condition in case you need different treatment methods or different medications.

‘So, Doctor, how long do i have?’

For many people, the question "How long do I have?" is the first thing that comes to mind when a diagnosis of cancer is given. Unfortunately, there’s no clear-cut answer.

What’s known is that every year, of the thousands of people in this country who are told that they have some form of cancer, current available treatments are capable of curing more than half of them. But some cancers are easier to treat than others. And while many people experience a complete recovery, others may live for a time with their cancer well controlled.

One way your doctor may try to address this question is to look at the one-, five- and 10-year survival statistics for people who have the same type, stage and grade of cancer you do. But keep in mind that these are averages. Contributing to the averages are a small number of people who do far better (and some who do worse) for reasons that aren’t understood.

Ultimately, however, how you’ll do is unique to you, because cancer is an individual experience. Many factors, such as your age and medical history, will influence your doctor’s recommendation about the best approach for you. Close coordination with our doctor is essential.