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Understanding Cancer Basics of Cancer Diagnosis and Treatment
The human body is composed of several healthy cells that divide and replace themselves in a controlled way. The central component is the DNA that exists in the genes of every cell. Some cells get altered due to various reasons like a mutation in the DNA and multiply out of control. These are called cancer cells. These abnormal cancer cells form a cluster of mass which is called a tumour.
It is important to note that not all tumours are cancerous. Benign or noncancerous tumours do not spread to other forms of the body and do not create new tumours. Malignant or cancerous tumours are more dangerous as they grow in size and disrupt certain functions in the body.
Cancer spreads through the process of metastasis, through the lymphatic system or blood vessels and forms tumours in other parts of the body. The cancers that are metastasized are more difficult to treat and more fatal. Tumours can cause serious health problems based on their location and size and will need immediate treatment.
Cancer is mainly caused by genetic mutations to the DNA in the cell. In some cases, it is inherited but can also occur due to some other factors as follows:
Cancer risk increases with age. Some existing health problems can also result in cancer.
Cancer that is inherited has to be managed with treatment, but cancer that is caused because of the exposure to carcinogens, sunlight or lifestyle issues can be prevented by taking certain measures.
Early diagnosis of cancer can help in improved survival rates. Most of the cancers can be detected by regular tests even before the formation of a tumour. In some cases, cancer may be diagnosed while evaluating another severe health condition. The overall diagnostic process will be as follows:
Based on these tests and biopsy reports, the doctor may confirm the diagnosis of cancer. Upon confirmation, the doctor may be further evaluating the tumour to check if it has spread to other regions of the body as it tends to be in many cases. In cases where the diagnosis is negative even in the presence of symptoms, your doctor may ask for a different set of examinations to identify the reasons.
It is difficult to identify if all the cancer cells are destroyed from the body after treatment. Hence, your doctor may not be able to confirm the outcome. A different word called 'remission' is used to explain the current status of the disease. Your doctor will be working towards a complete remission in which the regular tests cannot identify any cancer cells in the body. In some cases, the cancer cells reappear years after remission.
Once the diagnosis is made, the type of cancer and stage of the disease is analysed. Patients will be recommended treatment to slow the growth of the tumour or eradicate it. Doctors will suggest various treatment methods that include chemotherapy, hormone therapy, radiation therapy and immunotherapy.
In this procedure, the cancer cells are killed using different kinds of medication. The chemo medication is injected into the vein through an injection or is provided by a shot to the muscle, under the skin or as an ointment or cream. Oral chemotherapy is also available where the medication is taken in liquid, tablet or capsule form. It can be taken at home as well.
The drugs act by targeting cells that divide and multiply quickly, which is a characteristic of cancer cells. The treatment is not focused like radiation therapy or surgery and affects the whole body. Since this therapy is not target-specific, it can also affect healthy cells which multiply quickly like the cells of the skin, hair, and intestine. This can result in side-effects. Some of the most common side-effects with chemotherapy are as follows:
In particular cases, chemotherapy can cause long-term side-effects like infertility and nerve damage. Consult with the doctor regarding all the risks with chemotherapy before initiating the procedure.
Chemotherapy can be used to destroy all the cancer cells in the body. However, in some cases, the cancer cells may reappear affecting the outcome of the treatment. Patients will be checked for complete remission regularly where all the tests indicate the complete removal of cancer cells. The doctor may sometimes recommend this treatment to control the spread of the cancer to other parts of the body. In some cases, it is used just to reduce the size of the tumour. Chemotherapy may be also combined with other forms of treatment like surgery, radiation therapy or biological therapy to treat cancer.
In this procedure, high-energy waves or particles are used to kill tumour cells without destroying too many healthy cells. Doctors may recommend this treatment alone, or might combine it with surgery/chemotherapy.
This treatment is not painful but can cause side-effects because of the impact on healthy cells. It is difficult to predict the probability of side-effects as it differs between individuals. It depends on the type of radiation, the period of exposure, the region of exposure and also on the patient’s health status. Nausea and fatigue are the early side-effects that get better after some time. Side-effects such as heart and lung problems are called late side-effects which show-up later in life but are often permanent. Patients may also experience other side-effects such as hair loss and skin problems based on the type of radiation.
In some cases where the cancer does not respond to chemotherapy or radiotherapy, surgery is performed to remove as much cancer tissue as possible. The surgeon removes tumours, tissue and the areas affected by cancer like the lymph nodes. Sometimes surgery is combined with other treatment options like chemotherapy and radiotherapy to improve treatment outcomes based on the tolerance level of the patient. In some cases, surgery is performed to identify the extent of cancer, size of the tumour or the extent of the spread.
Surgery is often the ideal approach as it helps in the complete removal of the tumour and gets rid of the disease if it has not spread to other organs. Some additional surgical procedures that are used to manage cancer are as follows:
Patients will be provided with pain medication before and after surgery. They will also be provided certain other medications like antibiotics to prevent infections after the surgery.
Stem cells have a wide variety of functions and have opened up several novel treatment methods to treat cancer. They can repair diseased bone marrow, and the transplantation helps doctors increase the dose of chemotherapy for better treatment outcomes.
Cancer cells have certain features of a healthy cell but act abnormally. Immunotherapy is a treatment where antibodies are used to identify abnormal cancer cells in the body so that the immune system can neutralise them.
Tumours formed by cancer cells depend on hormones and nutrition to grow in size and spread to different parts of the body. In this treatment, certain hormones are blocked to prevent tumour growth and proliferation.
In this treatment, certain medicines are used to interfere with certain compounds or processes that promote the growth of cancer cells or tumors.
In this procedure, a specific drug is injected into the bloodstream. Then a specific light is used to monitor and kill abnormal cancer cells.
Apart from the traditional treatment methods, there are several other alternative medicines to decrease symptoms of cancer and manage the side-effects of the treatment. They include yoga, meditation, acupuncture, hypnosis and relaxation techniques.
It is difficult to identify whether all the cancer cells are eliminated from the body. The doctor will be using the word 'remission' to clarify the current state of cancer. There are two types of remission, as explained below:
In some cases, the cancer cells can reappear in the body, years after remission. It is not unusual and is called recurrence. Although it is difficult to predict the chances of recurrence, you must be aware that this can happen any time after treatment.
Patients and their families will also be offered palliative care by a multidisciplinary team during and after the treatment of cancer. The team includes pharmacists, physical therapists, dietitians, social workers and counsellors. Palliative care helps with pain-relief and improve quality of life along with providing emotional and psychological support.
Palliative care focuses on easing side-effects like nausea, fatigue, pain, and shortness of breath that are common with cancer treatment. Patients will be provided with medication, nutritional support and relaxation techniques along with emotional and spiritual counselling. Care also includes support with legal, insurance and employment issues. Care helps both the patient and the family who act as caregivers. The palliative care team will be provided in direct consultation with the doctor to help handle treatment-related pain and other symptoms. Palliative care can begin once the diagnosis is made to help the patients get through the treatment. Care can be provided at the clinic or at home, based on the patient's requirements.
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