Cancer Introduction

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GOVT FIRST GRADE COLLEGE B H ROAD SHIMOGA Page 1

INTRODUCTION

Cancer is a complex genetic disease that is caused primarily by environmental

factors. The cancer-causing agents(carcinogens) can be present in food and water, in the

air,and in chemicals and sunlight that people are exposed to. Since epithelial cells cover the

skin, line the respiratory and alimentary tracts, and metabolize ingested carcinogens, it is

not surprising that over 90% of cancers occur in epithelia. The causes of serious ill-health in

the world are changing. Infection as a major cause is giving way to no communicable

diseases such as cardiovascular disease and cancer. In 1996 there were 10 million new

cancer cases worldwide and six million deaths attributed to cancer. In 2020 there are

predicted to be 20 million new cases and 12 million deaths. Part of the reason for this is that

life expectancy is steadily rising and most cancers are more common in an ageing

population. More significantly, a globalization of unhealthy lifestyles, particularly cigarette

smoking and the adoption of many features ofthe modern Western diet (high fat, low fibre

content) will increase cancer incidence.Tobacco use and diet each account for about 30% of

new cancer cases, with infection associated with a further 15%; thus, much of cancer is

preventable. No individual can guarantee not to contract the disease, but it is so strongly

linked to diet and lifestyle that there are plenty of positive steps that can be taken to reduce

the chances: eat more fruit and vegetables, reduce the intake of red meat and definitely do

not smoke. Carcinogens interact with the individuals constitution, both inherited and

acquired, determining vulnerability to cancer induction.

This vulnerability is based on how an individual deals with the carcinogens, ideally

eliminating them in a harmless form before they do any genetic damage or being able to

repair that damage. The science of classical epidemiology has identified populations at high


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cancer risk (e.g. users of tobacco products). However, many lifelong smokers do not get

cancer, perhaps because of the way they handle potentialcarcinogens metabolically, and the

relatively new science of molecular epidemiology attempts to identify high-risk individuals

within populations, such as smokers. Many issues concerning diet and cancer are

controversial (e.g. fat intake and breast cancer). This may be because only certain

polyunsaturated fatty acids generate damaging free radicals; furthermore, the intake level

of antioxidant vitamins that can scavenge these harmful radicals is a confounding factor.

Reducing infection, particularly in the poorer countries, will lead to reductions in cancer

incidence. Infectious agents associated with increased cancer risk include hepatitis B virus

(liver), certain subtypes of human papillomavirus (cervix), the bacterium Helicobacter pylori

(stomach) and human immunodefi-ciency virus (many sites).The management of patients

with cancer is costly, but there is the daunting prospect that 70% of tomorrows patients are

likely to live in countries that between them have only 5% of global resources. Huge steps in

improving the prognosis of patients with cancer are almost immediately achievable with

present-day technology and sufficient financial resource, and all essentially relate to early

detection. Cancer does not develop overnight, instead often evolving over many years with

detectable premalignant lesions presaging the development of full-blown malignancy.

Malignant tumours not only invade surrounding tissue, but are able to colonize

other, often vital,organs, a process known as metastasis. Widespread metastatic disease is

usually a harbinger of imminent patient death. Thus, immediate referral to the oncologist

after detection of any suspicious lump or symptom is paramount; in many parts of the world

with poor health education patients present with very advanced disease. In the same vein,

cancer screening programmes are designed to detect not only early asymptomatic


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malignant tumours but also premalignant lesions. Even in the richer countries, such

programmes are a significant financial burden, and the more cost-effective programmes

target the higher-risk groups denoted by age (e.g. cervical screening, mammography,

colonoscopy) or occupation (e.g. blood in the urine of dye workers for bladder cancer)


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HISTORY

Oldest Descriptions Of Cancer

Human beings and other animals have had cancer throughout recorded history. So

its no surprise that from the dawn of history people have written about cancer. Some of the

earliest evidence of cancer is found among fossilized bone tumors, human mummies in

ancient Egypt, and ancient manuscripts. Growths suggestive of the bone cancer called

osteosarcoma have been seen in mummies. Bony skull destruction as seen in cancer of the

head and neck has been found, too. Our oldest description of cancer (although the word

cancer was not used) was discovered in Egypt and dates back to about 3000 BC. It is called

the Edwin Smith Papyrus and is a copy of part of an ancient Egyptian textbook on trauma

surgery. It describes 8 cases of tumors or ulcers of the breast that were treated by

cauterization with a tool called the fire drill. The writing says about the disease, There is no

treatment.

Origin Of The Word Cancer

The origin of the word cancer is credited to the Greek physician Hippocrates (460-

370 BC), who is considered the Father of Medicine. Hippocrates used the terms carcinos

and carcinoma to describe non-ulcer forming and ulcer-forming tumors. In Greek, these

words refer to a crab, most likely applied to the disease because the finger-like spreading

projections from a cancer called to mind the shape of a crab. The Roman physician, Celsus

(28-50 BC), later translated the Greek term into cancer, the Latin word for crab. Galen (130-

200 AD), another Roman physician, used the word oncos (Greek for swelling) to describe

tumors. is now used as a part of the name for cancer specialists oncologists.


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TYPES OF CANCER


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CANCER SIGNS AND SYMPTOMS

Cancer symptoms are changes in the body caused by the presence ofcancer. They

are usually caused by the effect of a cancer on the part of the body where it is growing,

although the disease can cause more general symptoms such as weight loss or tiredness. It

is advisable that anyone experiencing unusual symptoms that are not normal for them for

more than a few weeks should seek medical attention.

There are more than 200 different types of cancer with a wide range of different

signs and symptoms, making it difficult to produce a definitive list. For information about

the specific signs and symptoms of a specific type of cancer, please see the Wikipedia entry

for that disease.

Typicalsymptomsofcancerinclude:

The presence of an unusuallumpin the body Changes in amoleon theskin A persistentcoughorhoarseness A change inbowelhabits, such as unusualdiarrheaorconstipation Difficulty in swallowing or continuingindigestion Anyabnormalbleeding, includingbleedingfrom thevagina,

orbloodinurineorfaeces

A persistentsoreorulcer Difficulty passingurine Unexplained weight loss
http://en.wikipedia.org/wiki/Symptomshttp://en.wikipedia.org/wiki/Symptomshttp://en.wikipedia.org/wiki/Symptomshttp://en.wikipedia.org/wiki/Cancerhttp://en.wikipedia.org/wiki/Cancerhttp://en.wikipedia.org/wiki/Cancerhttp://en.wiktionary.org/wiki/lumphttp://en.wiktionary.org/wiki/lumphttp://en.wiktionary.org/wiki/lumphttp://en.wikipedia.org/wiki/Melanocytic_nevushttp://en.wikipedia.org/wiki/Melanocytic_nevushttp://en.wikipedia.org/wiki/Melanocytic_nevushttp://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Hoarsenesshttp://en.wikipedia.org/wiki/Hoarsenesshttp://en.wikipedia.org/wiki/Hoarsenesshttp://en.wikipedia.org/wiki/Bowelhttp://en.wikipedia.org/wiki/Bowelhttp://en.wikipedia.org/wiki/Bowelhttp://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Constipationhttp://en.wikipedia.org/wiki/Constipationhttp://en.wikipedia.org/wiki/Constipationhttp://en.wikipedia.org/wiki/Indigestionhttp://en.wikipedia.org/wiki/Indigestionhttp://en.wikipedia.org/wiki/Indigestionhttp://en.wikipedia.org/wiki/Abnormalhttp://en.wikipedia.org/wiki/Abnormalhttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Vaginahttp://en.wikipedia.org/wiki/Vaginahttp://en.wikipedia.org/wiki/Vaginahttp://en.wikipedia.org/wiki/Bloodhttp://en.wikipedia.org/wiki/Bloodhttp://en.wikipedia.org/wiki/Bloodhttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Faeceshttp://en.wikipedia.org/wiki/Faeceshttp://en.wikipedia.org/wiki/Faeceshttp://en.wikipedia.org/wiki/Sorehttp://en.wikipedia.org/wiki/Sorehttp://en.wikipedia.org/wiki/Sorehttp://en.wikipedia.org/wiki/Ulcerhttp://en.wikipedia.org/wiki/Ulcerhttp://en.wikipedia.org/wiki/Ulcerhttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Ulcerhttp://en.wikipedia.org/wiki/Sorehttp://en.wikipedia.org/wiki/Faeceshttp://en.wikipedia.org/wiki/Urinehttp://en.wikipedia.org/wiki/Bloodhttp://en.wikipedia.org/wiki/Vaginahttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Bleedinghttp://en.wikipedia.org/wiki/Abnormalhttp://en.wikipedia.org/wiki/Indigestionhttp://en.wikipedia.org/wiki/Constipationhttp://en.wikipedia.org/wiki/Diarrheahttp://en.wikipedia.org/wiki/Bowelhttp://en.wikipedia.org/wiki/Hoarsenesshttp://en.wikipedia.org/wiki/Coughhttp://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Melanocytic_nevushttp://en.wiktionary.org/wiki/lumphttp://en.wikipedia.org/wiki/Cancerhttp://en.wikipedia.org/wiki/Symptoms


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Unexplainedpain Unexplained tiredness orfatigue Skin changes such as an unexplainedrashor unusual texture Unexplainednight sweats
http://en.wikipedia.org/wiki/Cancer_painhttp://en.wikipedia.org/wiki/Cancer_painhttp://en.wikipedia.org/wiki/Cancer_painhttp://en.wikipedia.org/wiki/Fatigue_(medical)http://en.wikipedia.org/wiki/Fatigue_(medical)http://en.wikipedia.org/wiki/Fatigue_(medical)http://en.wikipedia.org/wiki/Rashhttp://en.wikipedia.org/wiki/Rashhttp://en.wikipedia.org/wiki/Rashhttp://en.wikipedia.org/wiki/Night_sweatshttp://en.wikipedia.org/wiki/Night_sweatshttp://en.wikipedia.org/wiki/Night_sweatshttp://en.wikipedia.org/wiki/Night_sweatshttp://en.wikipedia.org/wiki/Rashhttp://en.wikipedia.org/wiki/Fatigue_(medical)http://en.wikipedia.org/wiki/Cancer_pain


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CAUSES OF CANCER

From the table above we see that almost 70% of cancers are believed to be caused

by Environmental factors - which mean these cancers should be preventable. However it is

not always possible to link a particular cancer-causing substance (carcinogen) and a cancer

as there is usually a long interval latent period - between the exposure and the

cancer.

SMOKING

It is very clear from the table that the link

between cancer and smoking is very strong. In

addition to the cancer deaths caused by smoking

there are deaths from lung, heart and blood vessel

diseases caused by smoking. The risk of dying of

lung cancer is directly related to the number of

cigarettes smoked, age at starting, and smoking habits (how many puffs per cigarette,

length of butt left, type of cigarette including filter and tar content). The risk of developing


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cancers for those who stop smoking gradually falls and after 15 years is similar to those who

have never smoked.

FOOD

There is a wide difference in the incidence of

cancers in different parts of the world. Part of

these differences can be attributed to food

habits. However the relationship between food

and cancers is not as clear as between smoking

and cancers. General guidelines on healthy

eating would include the

followingrecommendations:

Reduce the amount of animal fats consumed. Increase roughage by consuming more unprocessed cereals. Take reasonable amounts of fresh fruits and vegetables. Maintain reasonable body weight.


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FOOD WRAPPINGS, FOOD ADDITIVES AND PESTICIDES

There is no clear association between these and

cancers. The following recommendations, though not

based on firm scientific foundations, seem reasonable:

Reduce the intake of preserved foods. Avoid food additives. Avoid or quickly unwrap food covered with

polyvinyl chloride(cling film) wrapping.

Wash fruits and vegetables to remove pesticides.

OCCUPATION CAUSES

Much of our early understanding of the causes of cancer came from studies of the

risks in industry. There is little doubt that exposure to certain chemicals increases the risk of

developing cancers. The jobs carrying the greatest risks are those in the petro-chemical

industries involving exposure to tars and certain inorganic chemicals. The link between

asbestos exposure and lung cancer is well established.

RADIATION AND HIGH VOLTAGE POWER LINES

Major studies into the risks of people living close to nuclear power stations or high

voltage lines have, suggested that at worst there may be some minor increase of leukemia,

though no of other tumors.


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VIRUSES

Long term infections with the Hepatitis B & C viruses are well established as causing

liver cancers. Hepatitis B vaccination is being carried out to reduce this risk. Less established

are the relationship between Herpes Simplex Type ll and cervical cancers. The HIV linked to

AIDS may allow cancers to grow by suppressing the immune system.

INHERITANCE

For most people with cancer, there is no direct inherited cause. Our genetic make-up

may increase our chances of developing a cancer upon exposure to certain carcinogens. This

may explain why some people who smoke develop lung cancers and others done. There are

certain inherited conditions which run in families where the risk of developing a particular

type of cancer is high. One such condition is called Multiple Ployposis Coli where multiple

fleshy growths in the large intestine may be found in many members of the same family.

There is a great risk that these growths could turn malignant and removal of the large

intestine is recommended


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CANCER SURVIVORS: MANAGING EMOTIONS AFTER CANCER TREATMENT

When you began your cancer treatment, you couldn't wait for the day you'd finish.

But now that you've completed your treatment, you aren't sure if you're ready for life after

treatment as a cancer survivor. With your treatment completed, you'll likely see your cancer

care team less often. Though you, your friends and your family are all eager to return to a

more normal life, it can be scary to leave the protective cocoon of doctors and nurses who

supported you through treatment.

Everything you're feeling right now is normal for cancer survivors. Recovering from

cancer treatment isn't just about your body it's also about healing your mind. So take

time to acknowledge the fear, grief and loneliness you're feeling right now. Then take steps

to understand why you feel these emotions and what you can do about them.

Fear of recurrence in cancer survivors

Fear of recurrence is very common in cancer survivors. Though they may go years

without any sign of disease, cancer survivors say the thought of recurrence is always with

them. You might worry that every ache or pain is a sign of your cancer recurring. Eventually

these fears will fade, though they may never go away completely.

Cope with your fear by being honest with yourself about your feelings. Try not to feel

guilty about your feelings or ignore them in hopes that they'll go away. Ask your doctor

about what you can do to reduce your chance of a cancer recurrence. Once you've done all

you can to reduce that risk, acknowledge your fears. Take control of those fears and do

what you can to influence your future health. Try to:


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Take care of your body. Focus on keeping yourself healthy. Eat a healthy diet withplenty of fruits and vegetables. Fit exercise into your day. Go easy at first, but try to

increase the intensity and amount of exercise you get as you recover. Get enough

sleep so that you wake feeling refreshed. These actions may help your body recover

from cancer treatment and also help put your mind at ease by giving you a greater

sense of control over your life.

Go to all of your follow-up appointments. You may fear the worst when it's time foryour next follow-up appointment. Don't let that stop you from going. Use the time

with your doctor to ask questions about any signs or symptoms that worry you.

Write down your concerns and discuss them at your next appointment. Ask about

your risk of recurrence and what signs and symptoms to watch for. Knowing more

may help you feel more in control.

Be open about your fears. Express your concerns to your friends, family, othercancer survivors, and your doctor or a counselor. If you're uncomfortable with the

idea of discussing your fears, try recording your thoughts in a journal.

Keep busy. Get out of the house and find activities that will take your mind off yourfears. Most cancer survivors report that the fear of recurrence fades with time. But

certain events can trigger your fears. The feelings might be especially strong before

follow-up visits to your doctor or the anniversary of your cancer diagnosis.


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STRESS IN CANCER SURVIVORS

When you were diagnosed with cancer, you might have focused completely on your

treatment and getting healthy. Now that you've completed treatment, all those projects

around the house and the things on your to-do list are competing for your attention. This

can make you feel stressed and overwhelmed. Dont feel you need to do everything at once.

Take time for yourself as you establish a new daily routine. Try exercising, talking with other

survivors and taking time for activities you enjoy.

DEPRESSION AND ANXIETY IN CANCER SURVIVORS

Lingering feelings of sadness and anger can interfere with your daily life. For many

people these feelings will dissipate. But for others, these feelings can develop into

depression.

Tell your doctor about your feelings. If needed, you can be referred to someone who can

help you through talk therapy, medication or both. Early diagnosis and prompt treatment

are keys to successfully overcoming depression


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CANCER TREATMENT

Treatment options depend on the type of cancer, the stage of cancer, certain characteristics

of the cancer cells and your general state of health. Your physician will also consider your

personal wishes and goals when planning your treatment with you.

Treatment for cancer can be either local or systemic, depending on your diagnosis.

Local treatments affect cancer cells in the tumor and the area near it. Systemic treatments

travel through the bloodstream, reaching cancer cells all over the body. Surgery and

radiation therapy are types of local treatment. Chemotherapy, hormone therapy and

biological therapy are examples of systemic treatment.

Types of treatment

SurgerySurgery is therapy to remove the cancerous tumor; the surgeon may also remove some

of the surrounding tissue and lymph nodes near the tumor. Sometimes surgery is done

on an outpatient basis, or the patient may have to stay in the hospital.

Radiation therapy

Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. For

some types of cancer, radiation therapy may be used instead of surgery as the primary

treatment. Radiation therapy also may be given before surgery (neoadjuvant therapy) to

shrink a tumor so that it is easier to remove. In other cases, radiation therapy is given

after surgery (adjuvant therapy) to destroy any cancer cells that may remain in the area.


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Radiation also may be used alone, or along with other types of treatment, to relieve pain

or other problems if the tumor cannot be removed.

ChemotherapyChemotherapy is the use of drugs to kill cancer cells. The doctor may use one drug or a

combination of drugs.

Hormone therapyHormone therapy is used against certain cancers that depend on hormones for their

growth. Hormone therapy keeps cancer cells from getting or using the hormones they

need. This treatment may include the use of drugs that stop the production of certain

hormones or that change the way they work.

Regional perfusion therapyPerfusion therapy is a new treatment that involves administering chemotherapy directly

to the organ or area affected by cancer. Perfusion is used most commonly in treating

sarcoma and melanoma in the limbs, colorectal cancer, liver cancer, and cancers of the

pleura. The treatment has been shown to be more effective for certain cancers than

traditional chemotherapy, while avoiding many of chemotherapy's side-effects.

Biological therapyBiological therapy (also called immunotherapy) helps the body's natural ability (immune

system) to fight disease or protects the body from some of the side effects of cancer

treatment. Monoclonal antibodies, interferon, interleukin-2 and cancer vaccines are

some types of biological therapy.


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Stem cell transplantationStem cell transplantation (SCT) may also be used in cancer treatment. The transplant

may be autologous (the person's own cells that were saved earlier), allogeneic (cells

donated by another person), or syngeneic (cells donated by an identical twin).

Clinical trialsClinical trials (research studies) offer important treatment options for many people with

cancer. Research studies evaluate promising new therapies and answer scientific

questions. The goal of such trials is to find treatments that are more effective in

controlling cancer with fewer side effects.

Many people with cancer want to take an active part in decisions about their medical

care. They want to learn all they can about their disease and their treatment choices.

However, the shock and stress that people often feel after a diagnosis of cancer can make it

hard for them to think of everything they want to ask the doctor. Often it is helpful to

prepare a list of questions in advance. To help remember what the doctor says, patients

may take notes or ask whether they may use a tape recorder. Some people also want to

have a family member or friend with them when they talk to the doctor -- to take part in the

discussion, to take notes, or just to listen.


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These are some questions a patient may want to ask the doctor before treatment begins:

What is my diagnosis?

Is there any evidence the cancer has spread? What is the stage of the disease?

What are my treatment choices? Which do you recommend for me? Why?

What new treatments are being studied? Would a clinical trial be appropriate forme?

What are the expected benefits of each kind of treatment?

What are the risks and possible side effects of each treatment?

Is infertility a side effect of cancer treatment? Can anything be done about it?

What can I do to prepare for treatment?

How often will I have treatments?

How long will treatment last?

Will I have to change my normal activities? If so, for how long?

What is the treatment likely to cost?Patients do not need to ask all their questions or remember all the answers at one time.

They will have many chances to ask the doctor to explain things and to get more

information.


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CONCLUSION

Tremendous strides have been made in reducing the rate of cervical cancer.

However, women continue to be afflicted by a disease that is potentially preventable and

curable. The women who remain most susceptible to the development of cervical cancer

are those who are lost to screening or who do not receive screening at all. Therefore,

family physicians must remain vigilant by screening all appropriate women with routine

Pap smears.

Research is under way to find ways to prevent cervical cancer. The focus of this research is

on HPV. Highly antigenic recombinant vaccines without potentially carcinogenic DNA are

under investigation. A vaccine for pre-exposure prophylaxis has proved effective in animal

models. Clinical trials that investigate post-exposure vaccines are currently under way and

appear to be promising.


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REFRENCE

http://www.medindia.net/education/familymedicine/Cervical-Cancer-

Conclusion.htm

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002267/

http://en.wikipedia.org/wiki/Cancer

http://www.webmd.com/cancer/default.htm

http://www.cancer.org/

http://www.naturalnews.com/cancer.html

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Cancer Introduction