Fight Cancer With Hope

What is Cancer?

Cancer starts when the cells of an organ or tissue in the body become abnormal. They grow and multiply out of control. Normal cells have a life cycle. They reproduce themselves throughout the body to replace worn out tissue, to heal wounds and to maintain healthy organs. When something happens and cells grow out of control they usually form a mass, called a tumour.

Some tumours grow only at the site where they begin (locally). These are called benign tumours. Other tumours grow locally but they might also invade and destroy the normal tissue around them or they might spread to distant parts of the body. These tumours are called malignant tumours or cancers.

What are the five most common cancers in males in Delhi?

Most common is lung cancer followed by tongue, prostate , mouth and larynx. However, taken together as a group, head and neck cancer is the commonest cancer in males in Delhi.

What are the five most common cancers in females in Delhi?

Most common is breast cancer followed by cervix, ovary, gall bladder and uterus.

How does cancer occur?

Most cancers occur by chance (randomly) as a result of damage to their genes. Genes play some role in all cancers. Many genes in the human body help to control how the cells divide and grow. When changes (called mutations) occur in those genes, they may lose that control over the cells. Because most cancers do not happen until a cell is affected by several gene mutations, most cancers are not seen until later in life. Gene mutations may be caused by aging, exposure to chemicals, radiation, hormones or other factors within the body and the environment. Over time, a number of gene mutations may occur in a cell, allowing it to divide and grow in a way that becomes a cancer.

What are risk factors for cancer?

It is usually not possible to know exactly why one person develops cancer and another doesn’t. But research has shown that certain risk factors may increase a person’s chances of developing cancer. Cancer risk factors include exposure to chemicals or other substances like tobacco, as well as certain behaviors like smoking. 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.

Risk factors are different for different cancers. Commonly implicated risk factors include elderly age, smoking, chewing tobacco, alcohol, industrial chemicals, chronic inflammation, diet rich in animal fats and red meat, immunosuppression, infectious agents (some viruses), obesity, radiation exposure, sunlight (skin cancer in fair skin people), etc.

Can cancer be prevented? 

Over half of all cancers can be prevented. Don’t smoke, or quit smoking. Exercise and eat a healthy diet.

Can cancer be detected early?

Yes, screening for cancer can help detect cancer at an early stage. However, such screening strategies are found to be useful in few common cancers only, including breast cancer (screening by mammography), cervical cancer (screening by PAP smear) and colon cancer (screening by colonoscopy).

Is cancer a hereditary disease? 

Most cancers are not caused by an inherited (hereditary) risk. Only 5-10% of all cancers are caused by an inherited gene mutation. While cancer is common, hereditary cancer is not.

Is cancer an infectious disease?

No, cancer is not infectious. It does not spread from one person to another by any mode of contact. However, some viral infections can predispose to development of cancer e.g. HPV infection predisposes to cervical cancer.

How are different cancers named?

Cancers are usually named after the part of the body where the cancer first began. The name does not change even if the cancer spreads to another part of the body. For example, if breast cancer spreads (metastasizes) to the lung, it is called breast cancer with lung metastases. If chemotherapy is indicated as the best treatment, breast cancer drugs would be used to treat the lung metastases. Other cancers such as leukemia (a cancer involving the blood) may not mention a tumour site in the name.

What are common symptoms of cancer?

Different types of cancer vary in their signs and symptoms. Symptoms also depend on how fast cancer grow, how it spread and to what organs it spreads. Common symptoms include a swelling or lump in a body part e.g. breast cancer, long standing oral ulcer (mouth cancer), difficulty in swallowing (oesophagus cancer), change in bowel habits (colon cancer), prolonged cough with or without hemoptysis (lung cancer), obvious changes in a mole (skin cancer).

How cancer spreads?

Sometimes malignant cells break loose from the original (primary) tumour, get carried to other parts of the body and start growing in the new site as an independent secondary cancer. A tumour that has spread in this way has ‘metastasized’ and the secondary tumour (or tumours) is called a metastasis (or metastases).

When one type of cancer spreads to another part of the body, it doesn’t become another type of cancer. For example, if a person with colon cancer develops a metastasis in the lung, then the tumour growing in the lung has the same features as the colon cancer. It is the same cancer in a new place. This is why it is very important for the doctors treating a patient to be able to find the primary site where the cancer started.

Metastasis takes place in many ways: through the lymphatic system, through the blood or by spreading through body spaces such as the abdominal cavity. Cancers can spread by more than one route.

Lymphatic system

The most common way for cancer to spread is through the lymphatic system. The lymph system has its own channels that circulate throughout the body, similar to the veins and arteries of the bloodstream. These channels are very small and carry fluid called lymph throughout the body.

Often when a solid tumour is removed by surgery, the surgeon will remove not only the tumour but the neighboring lymph glands, even though there is no visible sign of cancer in those glands. This is done as a precautionary measure, because if even one cell has broken away from the tumour and lodged in the lymphatic system, the cancer could continue growing and metastasizing.

Circulatory system

Cancer can metastasize through the blood. All cells (healthy and cancer) must have a blood supply in order to live, so all cancer cells have access to the bloodstream. Malignant cells can break off from the tumour and travel through the bloodstream until they find a suitable place to start growing a new tumour. Tumours that spread by blood almost always metastasize through the veins rather than through the arteries. Sarcomas spread through the bloodstream, as do certain types of carcinomas, like carcinoma of the kidneys, testicular carcinoma, and Wilms’ tumour, a type of kidney cancer seen in young children.

Local invasion

Cancers can spread by local invasion — by growing into the healthy tissue that surrounds the tumour. Some cancers that spread this way do not travel very far from the original site. An example of this kind of cancer is basal cell carcinoma of the skin. When this kind of cancer is removed by surgeon, a wide area of healthy tissue surrounding it is also removed and it is usually “cured” immediately. Unless some cells have been left behind, it is very unlikely that it will recur. However, it is possible that a second cancer of the same kind may start to grow at a later time at a completely different site — the new growth would not be connected with the first.

Cancers do not spread in a completely random fashion. Some parts of the body accept metastases more easily than others. For example, cancers rarely metastasize to the skin, but they often metastasize to the liver and lungs. Each type of cancer has its own pattern for metastases. See the individual cancer pages for more information.

What are the treatment options?

Treatment options include surgery, cancer drugs (chemotherapy, targeted therapy, hormonal therapy, immunotherapy) and radiation therapy. These are used singly or in combination (MULTI-MODALITY TREATMENT) depending on cancer type and stage of disease. These treatment modalities have shown to cure cancer (in early stage disease) and extend life along with improvement in quality of life (in advanced stage disease).

The type of treatment or the order of treatment will be different for individual patients, depending on the location/type of the tumour, the stage of the disease at diagnosis and patient/physician preferences. For example, surgery is generally considered the first treatment option in early stage disease. However, sometimes radiation therapy or cancer drugs are used to shrink the tumour before surgery, or chemotherapy may be the best first option. Cancer drugs are often given in combinations called chemotherapy protocols.

Is cancer curable?

Yes, a lot of cancers in early and localized stage are curable with the use of current surgical techniques, systemic chemotherapy/targeted therapy and advancements in radiation techniques.