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• General Cancer Questions What is Cancer? Cancer is a group of more than 100 different diseases. Cancer occurs when cells become abnormal and keep dividing and forming more cells without control or order. Normally, cells divide to produce more cells only when the body needs them. This orderly process helps keep us healthy. If cells keep dividing when new cells are not needed, a mass of tissue forms. This mass of extra tissue, called a growth or tumor, can be benign or malignant. Benign tumors are not cancer. Malignant tumors are cancer. Cancer cells can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the bloodstream or the lymphatic system. This is how cancer spreads from the original (primary) tumor to form new tumors in other parts of the body. Most cancers are named for the type of cell or the organ in which they begin. When cancer spreads, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if lung cancer spreads to the liver, the cancer cells in the liver are lung cancer cells. The disease is called metastatic lung cancer (it is not liver cancer). What are some common symptoms of cancer? You should see your doctor for regular checkups and not wait for problems to occur. But you should also know that the following symptoms may be associated with cancer: changes in bowel or bladder habits, a sore that does not heal, unusual bleeding or discharge, thickening or lump in the breast or any other part of the body, indigestion or difficulty swallowing, obvious change in a wart or mole, or nagging cough or hoarseness. These symptoms are not always a sign of cancer. They can also be caused by less serious conditions. Only a doctor can make a diagnosis. It is important to see a doctor if you have any of these symptoms. Don't wait to feel pain: Early cancer usually does not cause pain. What kinds of treatment are available for cancer? Cancer is treated with surgery, radiation therapy, chemotherapy, hormone therapy, or biological therapy. Patients with cancer are often treated by a team of specialists, which may include a medical oncologist (specialist in cancer treatment), a surgeon, a radiation oncologist (specialist in radiation therapy), and others. The doctors may decide to use one treatment method or a combination of methods. The choice of treatment depends on the type and location of the cancer, the stage of the disease, the patient's age and general health, and other factors. Some cancer patients take part in a clinical trial (research study) using new treatment methods. Such studies are designed to improve cancer treatment. What is chemotherapy? The word "chemotherapy" often conjures up fearful images of nausea, pain, fatigue, and hair loss in people's minds; however it is also one of the most effective methods of treating or controlling cancer. Chemotherapy literally means treatment with drugs; any drug which enters the body's system, including the use of aspirin and penicillin, can be described as chemotherapy. Most anticancer drugs are injected into a vein (IV) or a muscle; some are given by mouth. Chemotherapy is systemic treatment, meaning that the drugs flow through the bloodstream to nearly every part of the body. Chemotherapy is given to create the best quality of life possible. This may be accomplished in one of three ways. One way in which chemotherapy can improve the quality of life is to cure; this means that the condition or tumor disappears and does not return. If a cure is not possible, then chemotherapy may be used to control the cancer by halting its spread and growth. If the cancer is so advanced that neither cure nor control are possible, then chemotherapy is administered with the intent of palliation so that the patient's quality, if not quantity, of life is improved to the highest degree possible. Often, patients who need many doses of IV chemotherapy receive the drugs through a catheter (a thin flexible tube). One end of the catheter is placed in a large vein in the chest. The other end is outside the body or attached to a small device just under the skin. Anticancer drugs are given through the catheter. This can make chemotherapy more comfortable for the patient. Patients and their families are shown how to care for the catheter and keep it clean. For some types of cancer, doctors are studying whether it helps to put anticancer drugs directly into the affected area. Chemotherapy is generally given in cycles: a treatment period is followed by a recovery period, then another treatment period, and so on. Usually a patient has chemotherapy as an outpatient -- at the hospital, at the doctor's office, or at home. However, depending on which drugs are given and the patient's general health, the patient may need to stay in the hospital for a short time. The side effects of chemotherapy depend mainly on the drugs and the doses the patient receives. Generally, anticancer drugs affect cells that divide rapidly. These include blood cells, which fight infection, help the blood to clot, or carry oxygen to all parts of the body. When blood cells are affected by anticancer drugs, patients are more likely to get infections, may bruise or bleed easily, and may have less energy. Cells that line the digestive tract also divide rapidly. As a result of chemotherapy, patients may have side effects, such as loss of appetite, nausea and vomiting, hair loss, or mouth sores. For some patients, the doctor may prescribe medicine to help with side effects, especially with nausea and vomiting. Usually, these side effects gradually go away during the recovery period or after treatment stops. Hair loss, another side effect of chemotherapy, is a major concern for many patients. Some chemotherapy drugs only cause the hair to thin out, while others may result in the loss of all body hair. Patients may feel better if they decide how to handle hair loss before starting treatment. In some men and women, chemotherapy drugs cause changes that may result in a loss of fertility (the ability to have children). Loss of fertility may be temporary or permanent depending on the drugs used and the patient's age. For men, sperm banking before treatment may be a choice. Women's menstrual periods may stop, and they may have hot flashes and vaginal dryness. Periods are more likely to return in young women. What is involved in surgery? Historically, surgery is the first and oldest method of cancer treatment, and in many cases can offer the greatest chances for a cure. Technically defined, surgery is local treatment to remove the tumor. Tissue around the tumor and nearby lymph nodes may also be removed during the operation. Surgery is used to accomplish a variety of goals. Preventative or prophylactic surgery is meant to remove potentially precancerous growths, which may become malignant if untreated. Sometimes, people with increased risks of cancer may have organs removed; for instance, women with a strong family history of breast cancer may choose to undergo a prophylactic mastectomy. Diagnostic surgery is used to obtain a tissue sample for further laboratory testing. Staging surgery explores the progression of a disease. Curative surgery involves the complete removal of a tumor, and is one of the most successful treatments for cancer. Restorative or reconstructive surgery is used to restore a person's appearance or bodily function; examples of this type of surgery include breast reconstruction or the installation of prostheses. The side effects of surgery depend on the location of the tumor, the type of operation, the patient's general health, and other factors. Although patients are often uncomfortable during the first few days after surgery, this pain can be controlled with medicine. Patients should feel free to discuss pain relief with the doctor or nurse. It is also common for patients to feel tired or weak for a while. The length of time it takes to recover from an operation varies for each patient. What is radiation therapy? Radiation therapy is among the oldest and most economical ways to treat cancer. In radiation therapy (also called radiotherapy), high-energy rays are used to damage cancer cells and stop them from growing and dividing. Like surgery, radiation therapy is a local treatment; it can affect cancer cells only in the treated area. Radiation may come from a machine (external radiation). It also may come from an implant (a small container of radioactive material) placed directly into or near the tumor (internal radiation). Some patients get both kinds of radiation therapy. Radiation therapy can be administered to accomplish a wide variety of goals, and can be used at many stages of cancer treatment. In an early stage of cancer, radiation can be used to control or even cure the disease. It can be sued in conjunction with surgery to either shrink a tumor before an operation, or to prevent an excised tumor from growing back. It can also be used in cooperation with chemotherapy to aid in shrinking or reducing cancerous spread. External radiation therapy is usually given on an outpatient basis in a hospital or clinic 5 days a week for several weeks. Patients are not radioactive during or after the treatment. For internal radiation therapy, the patient stays in the hospital for a few days. The implant may be temporary or permanent. Because the level of radiation is highest during the hospital stay, patients may not be able to have visitors or may have visitors only for a short time. Once an implant is removed, there is no radioactivity in the body. The amount of radiation in a permanent implant goes down to a safe level before the patient leaves the hospital. Many medical staff are involved in giving radiation therapy; a medical team may include a radiation oncologist, radiation physicist, dosimetrist, radiation therapist, or radiation therapy nurse. With radiation therapy, the side effects depend on the treatment dose and the part of the body that is treated. The most common side effects are tiredness, skin reactions (such as a rash or redness) in the treated area, and loss of appetite. Radiation therapy also may cause a decrease in the number of white blood cells, cells that help protect the body against infection. Although the side effects of radiation therapy can be unpleasant, the doctor can usually treat or control them. It also helps to know that, in most cases, they are not permanent. Immunotherapy / Biotherapy There are five general types of biological response modifiers. They can be used alone or in combination with each other, or they can be used in addition to other cancer treatments. » Interferons are a group of three proteins released by white blood cells in reaction to invading organisms, to improve the immune system's reaction to cancer. Interferon alpha is approved for treatment of some cancers, including melanoma and chronic myeloid leukemia, but is being studied for use on other cancers. » Interleukins are proteins that increase growth and activity in the body's immune cells. Ten interleukins have been identified so far, but IL-2 is approved as an anti-cancer treatment, particularly for kidney cancers and melanomas that have metastasized (spread) to other regions of the body. » Monoclonal Antibodies are created in the laboratory by fusing two different types of cells together. Monoclonal antibodies are designed to attack specific areas on the surface of cells known as antigens. Antigens help the body identify cells that are foreign, like germs or cancer cells, and stimulate an immune response. Monoclonal antibodies show promise both as a cancer treatment and a diagnostic tool. » Vaccines help the body recognize cancer cells and trigger the immune system to destroy them. There are several types of cancer vaccines. Some contain cancer cells that have been killed with radiation so they cannot produce new tumors. Others contain lab-produced antigens designed to attach themselves to cancer cells. Cancer vaccines are used to either help the body reject cancer tumors or to keep them from recurring. » Colony Stimulating Factors work in the bone marrow, where red and white blood cells and platelets are produced. Colony Stimulating Factors increase the division of bone marrow cells, which strengthens the immune system and allows patients to endure higher doses of chemotherapy drugs. For more detailed information on immunotherapies, check out the American Cancer Society website and click on treatment options, or go to Cancernet. Where can I go for more information on clinical trials? • Clincaltrials.gov is a service developed by the U.S. National Institutes of Health through its National Library of Medicine to provide patients, family members and members of the public current information about clinical research studies. It includes an overview of clinical trials and how patients can become involved in them, as well as a search engine for current trials and links to other informational websites. Questions about Clearview How will I pay for treatments? Clearview files all insurance and participates with most plans. Patients without insurance may be eligible for assistance programs through drug companies. If necessary, monthly payment plans can be arranged. How do I make an appointment? Appointments are usually, though not always, made by referral. For information on making your appointment, see the Appointments portion of our website (listed on homepage). Sources: NCI Cancernet; MD Anderson |
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