The cancer journey
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Dr Morton's
the medical helpline©

The cancer journey

Diagnose cancers early

The word 'cancer' sends a chill down most people's spine, but it covers a spectrum of problems. Many cancers can be cured

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It is a sad truth that getting cancer makes people so fearful that they sometimes delay getting help

Cancer covers a whole range of conditions from the annoying small spot on the face which refuses to heal and turns out to be a basal cell carcinoma (BCC) to the elderly lady who comes into hospital as an emergency because she is vomiting because her bowel is obstructed by an advanced ovarian cancer, which she never knew she had.

Some cancers are age related, and if we live to 100 you would be able to find a tiny spot of breast cancer in most women's breasts and of prostate cancer in most men's prostate. Others may be due to viruses, for example it is now certain that human papilloma virus (HPV) is the cause of cervical cancer and some mouth and throat cancers, which makes the introduction of a vaccine to protect youngsters against these viruses before they become sexually active very exciting. Prevention is better than cure. The Epstein-Barr virus which is the cause of glandular fever is strongly associated with a rare variety of lymphoma called Burkitt's lymphoma.

People who have illnesses which affect their immune systems, for example systemic lupus erythematosus (SLE), have a higher chance of developing a cancer somewhere. People who take immunosuppressive medicines are also at more risk. If you have had one cancer then you are more likely to get another somewhere else. This is different to the phenomenon of cancer spread or metastasis, which is when the tumour spreads through the blood stream or lymphatic system or around the inside of the abdomen to other areas.

Excessive sun or chemical exposure can cause cell damage and increase the risk of malignant change. For example BCCs and malignant melanoma are more common in sunny climates and people exposed to asbestos are vulnerable to a cancer of the outer coat of the lung called mesothelioma. Smoking is now well accepted as the main cause of lung cancer.

Why cancers happen is not completely understood. Cells are multiplying and duplicating all the time in the process of tissue repair and in maintaining healthy organs. Normally this cell division process is kept under control by the action of adjacent cells. When cells start to multiply out of control, and the cells start to look misshapen, this is called a cancer. Some cancers only cause trouble in their immediate location and others naturally start to spread widely.

Some cancers run in families and specific genes have been identified that indicate a very high chance of developing a cancer, such that the gene carrier takes a very proactive approach to stop themselves getting a cancer. Take for example Angelina Jolie who had a double mastectomy because of the high chance of getting breast cancer. Some cancers occur in groups, as 'syndromes' such as Lynch syndrome, where families have a high incidence of bowel cancer together with cancer of the uterus, breast, ovary and other organs too.

Symptoms (these are almost too numerous to mention)

When you should contact a doctor

Distinguishing the symptoms that tell us about a cancer from symptoms telling us about others illnesses can be very difficult. It is not surprising that it can take a long time to find the real cause of a set of symptoms and indeed it should be remembered that most pains in the abdomen are NOT due to cancer. 95% of breast lumps are benign. You should speak to a doctor if you have noticed a change in your normal functions, or if you see blood in unusual places, such as the urine, or at an unusual time, for example in between periods.

Available treatments

Cancer research has dramatically improved the treatment of many cancers. For example testicular cancer, which although not a common cancer is the commonest in men aged 15 to 50 years of age, is now cured in 95% of men when caught early by removing the affected testis and having chemotherapy. Even testicular cancer which has spread outside the testicle will be cured in 80% of men with chemotherapy. Some cancers are really not aggressive spreading things. For example a skin basal cell carcinoma will almost certainly be cured by local excision. Some cancers are treated with radiotherapy which may be given by external beams or by placing a radioactive rod or needles into the area being treated.

A new way of giving radiotherapy to breast cancer actually during the surgery has recently been described. This would save the women concerned the difficulties involved in returning for repeated radiotherapy treatments after surgery.

Many women with breast cancer will be treated with surgery, chemotherapy and radiotherapy and then take medication such as Tamoxifen to prevent the chance of tumour recurrence.

The choice of treatment for cancer depends upon many factors including how healthy and fit the person is, and of course their wishes. It is a demanding physical and emotional journey and everything should be done to take a holistic approach to caring for the person as a unique individual.

Finally it should be mentioned that new cancer treatments are being developed all the time through cancer research. This depends on the participation in clinical trials, which are studies designed to determine for sure that one treatment is better than another. This is the way that progress is made.

Related topics

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