The human body is made up of trillions of cells which are responsible for normal function and growth. Cell division is a process through which human cells grow and multiply to form new cells. When these cells grow old or get damaged, they die and are replaced by new cells. Sometimes due to a mutation (change in the genetic make-up), this orderly process is disrupted, and the abnormal or damaged cells grow and multiply rapidly. This leads to the formation of a tumour. These tumours can form anywhere in the body and may be benign or malignant.
Cancer begins with a genetic defect. Genes are located within cell structures called chromosomes. They may change (mutate) if the cell’s regulatory system fails. A single genetic fault is not usually enough to cause cancer. Instead, cancer develops when mutations take place in genes that play a crucial role in regulating cell growth and differentiation.
There are two kinds of cancer genes: Oncogenes (cancer generating genes) – These, when activated, cause an uncontrollable distribution of cell tissue.
- Mutated Tumour suppressor genes ( mutated anti-cancer genes) – These induce cancer due to the termination of their function of Tumour suppression.Damage to genetic material happens continuously in many cells, but the human body contains a defence system developed over a long period that can repair the damage. When this system breaks down, damaged cells can start to divide uncontrollably, eventually leading to cancer.
Sometimes referred to as “chemo, “Chemotherapy is often used to describe drugs that directly kill cancer cells.
Chemotherapy is cancer-specific and is used to treat the cancer.
- To shrink tumours before surgery or radiation therapy.
- To relieve symptoms (such as pain)
- To destroy microscopic cancer cells that may be present after the known tumour is removed surgically to prevent a possible cancer recurrence.
- To control tumour growth when cure is not possible.
As with most drugs, chemotherapy drugs do have side effects. These are undesirable effects that are a direct result of taking chemotherapeutic drugs.
Chemotherapeutic drugs may have varied short-term and long-term side effects. The most commonly affected parts of the body are the mouth, skin, intestines, hair and bone marrow.
Although most anti-cancer drugs have side effects, not everyone will experience them. The occurrence of side effects and their severity depends on many factors. Some of these factors are the duration of the course of treatment, general health of the patient, the dosage of the drug and other drugs that may be given in combination.
Some commonly observed side effects are:
- Fatigue
- Hair loss
- Easy bruising and bleeding
- Infection
- Anaemia (low red blood cell counts)
- Nausea and vomiting
- Appetite changes
- Constipation/ Diarrhoea
- Sores/ ulcers in the oral cavity and throat pain while swallowing
- Nerve and muscle problems such as numbness, tingling, and pain
- Skin and nail changes such as dry skin and colour change
- Weight loss
- Mood changes
- Changes in libido and sexual function
- Fertility problems
Chemotherapy drugs are powerful medications and, unfortunately, also attack the other normal growing cells in your body — including those in your hair roots.
Some chemotherapy drugs are more likely than others to cause hair loss, from a mere thinning to complete baldness. Chemotherapy may cause hair loss all over your body — not just on your scalp. Sometimes your eyelash, eyebrow, armpit, pubic and other body hair also falls out.
Fortunately, most of the time, hair loss from Chemotherapy is temporary. You can expect to regrow your hair three to six months after your treatment ends, though your hair may temporarily be a different shade or texture.
The main goal is to try to keep your weight constant. Though you may not feel well or may not feel like eating, proper attention to nutrition can assist in the easy recovery.
To minimise weight changes and maintain energy levels, you should try to eat a wide variety of high-calorie and high-protein foods, such as:
- Milk, cream, and cheese
- Cooked eggs
- Lean meats such as chicken and fish
- Butter, ghee and oil
- Nuts and dry fruits such as Almonds, pistachios, figs, etc.
Radiation therapy (also called radiotherapy) is a treatment for cancer that uses high doses of Radiation to kill cancer cells and shrink tumours. Radiation therapy does not kill cancer cells right away. It takes days or weeks of treatment before DNA is damaged enough for cancer cells to die. Then, cancer cells keep dying for weeks or months after radiation therapy ends.
Radiation Therapy is categorised as External Beam and Internal Beam.
External beam radiation therapy aims at giving Radiation from outside the body to the cancerous tumour.
Internal radiation therapy is the type of radiotherapy in which a source of Radiation is put close to or inside the tumour temporarily to deliver a high dose of radiation precisely in a very short period of time.
A single dose of Radiation is called a fraction. Most radiation treatments require several fractions. A typical radiation treatment plan has five fractions a week for four to six weeks.
Stereotactic Radiosurgery (SRS): Radiation treatment of a tumour that is applied in a single fraction or 2-3 fractions with a high dose of Radiation.
Benign brain tumours like arteriovenous malformations (AVM), Acoustic schwannomas, meningiomas, and pituitary adenomas can be treated very effectively with SRS without surgery. Brain metastasis can also be treated successfully with SRS.
SRS for functional radiosurgery: It is widely used in the treatment of Trigeminal neuralgia and intractable epilepsy. A relatively new indication is in the treatment of ventricular tachycardia, which does not respond to medications.
Image-Guided Radiation Therapy (IGRT): Radiation treatment that uses real-time x-ray and CT imaging to deliver precisely focused high-energy Radiation to a tumour.
Three-Dimensional Conformal Radiation Therapy (3D-CRT):
A set of CT images is used to identify both the tumour and the normal tissue structures that need to be avoided. Then, radiation beams of varying shapes are designed to enter the patient from multiple angles and the tumour while avoiding nearby healthy tissues.
Intensity-Modulated Radiation Therapy (IMRT):
It is a high-precision radiotherapy technique and can result in better sparing of normal structures than 3D Conformal radiotherapy. It is possible to vary the doses within the tumour in this technique, maximising radiation to the tumour and maximising radiation to the surrounding normal tissue.
Rapid Arc: It is a more advanced form of IMRT. The treatment delivery is faster and delivers a more conformal dose of radiotherapy, and decreases the normal tissue radiation.
Stereotactic Body Radiation Therapy (SBRT): It is one of the most advanced forms of radiotherapy. High doses of radiotherapy can be delivered within a very short period of time (3-5 days). It is mostly used in early prostate cancer, lung cancer, pancreas & early hepatocellular cancer as a curative modality. It can also be used in lung and liver metastasis as a palliative measure.
Side effects depend on the area of the body that has received Radiation Therapy, such as:
- Head and Neck region – dryness in the mouth (xerostomia)
- Abdomen – gastrointestinal disturbance
- Pelvis – altered bowel/ bladder movement
Radiation therapy and Chemotherapy cannot be compared. Each mode of treatment has its own benefits. Depending on the diagnosis and stage of the disease, radiation therapy and Chemotherapy often complement each other.
It is important to know that while these signs and symptoms could be indicators, they do not necessarily mean that you have cancer:
- Persistent cough or blood-tinged saliva
- A change in bowel habits
- Blood in stool
- Unexplained Anaemia
- Breast lump or breast discharge
- Lumps in the testicles
- Blood in the urine (hematuria)
- Hoarseness/ change in voice
- Persistent lumps or swollen glands
- Obvious changes in warts or moles
- Indigestion or difficulty in swallowing
- Unusual vaginal bleeding or discharge
- Unexplained weight loss
- Night sweats or fevers
- Continued itching in the anal or genital areas
- Non-healing sores/ulcers
- Headaches
A PET CT or a PET scan, as it is commonly known, is an imaging test that allows the doctor to check for diseases. This scan uses radioactive tracers which accumulate in the areas of the body where there is an increase in chemical activity, which is characteristic of only certain types of cells and tissues in the body. It can measure the blood flow, amount of oxygen and sugar used, as well as other factors which are indicative of cancerous growth.
Cancer cells have a higher metabolic rate than noncancerous cells. Because of this high level of chemical activity, cancer cells show up as bright spots on PET scans. PET scans are useful both for:
- Detecting Cancer
- Checking the spread of Cancer (Metastasis)
- Checking response to treatment
- Checking for a recurrence
However, these scans should be interpreted carefully by your doctor, as it’s possible for non-cancerous conditions to look like cancer on a scan.
Simply put, a Mammogram is an X-ray of the breast. It is the best screening tool to detect breast cancer as early as even up to 3 years before it can be felt.
A special Dye is injected through the veins and a mammogram is taken. This helps in diagnosing breast cancer and looking for the number of lesions in single or both breasts.
The Pap smear, also known as a cervical smear, is a method used to screen for cervical cancer. A Pap smear may also help find other conditions, such as infections or inflammation.
Cancer is a genetic disease, but it is not necessarily hereditary. All cancers are a result of the mutation of one or more genes (DNA). A hereditary disease is passed from the parents to a child through the inheritance of a defective gene. Very rarely, cancer may be hereditary.
Staging is a way of describing the size and spread of cancer in the body. When the doctor initially makes the diagnosis, they will run a series of tests to establish the stage of cancer, also checking for spread to other parts of the body and, if it has, how far it has spread. This helps in appropriate treatment planning for the patient.
FNAC stands for Fine Needle Aspiration Cytology (FNAC). It is a type of biopsy procedure which is a simple and quick method used to determine if a lump or swelling in superficial areas of the body is cancerous. This test is performed as an outpatient procedure.
No. Cancer is not contagious. However, some infections tend to cause cancer. In fact, certain infections are the leading causes of cancer (Eg. Cervical cancer is caused by HPV or Human Papillomavirus infection). Better sanitation, vaccination, and antibiotics help to drastically reduce cancer caused by infections.
Yes some cancers such as oral cancers, breast, cervical, prostate, head and neck and colorectal cancers can be diagnosed early through screening programs. Early detection is important because when abnormal tissue or cancer is found early, it becomes easier to treat. By the time symptoms appear, cancer may have spread to other parts and may require more complex treatment.
Rectal bleeding does not necessarily mean you have cancer – this is a common misconception. While blood in stools is one of the symptoms of bowel cancer, there are many other conditions that could also be the cause of the bleeding.
Both men and women are vulnerable to any form of cancer, but each gender is more vulnerable to certain types of cancer than the other. Listed below are the most commonly occurring cancers in men, as per the national cancer statistics (ref: cancerindia.org.in)
- Oral
- Lung
- Stomach
- Colorectal
- Oesophagus
Both men and women are vulnerable to any form of cancer. Still, each gender is more vulnerable to certain types of cancer than the other. Listed below are the most commonly occurring cancers in women, as per the national cancer statistics (ref: cancerindia.org.in)
- Breast Cancer
- Cervical Cancer
- Lung cancer
- Gastric Cancer
- Oral Cancer
Simply put, metastasis means the spread of cancer to other parts of the body from its point of origin. This spread may occur through the bloodstream or lymphatic system.
Yes. Cancer that has spread to other regions is the same as primary cancer. This means that if breast cancer spreads to the liver, it is called metastatic breast cancer, not liver cancer.
Cancer treatment options include:
- Surgery: The goal of surgery is to remove cancer or as much of the tumour as possible.
- Chemotherapy: Chemotherapy uses drugs to kill cancer cells.
- Targeted drug therapy: Targeted drug therapy uses drugs to target molecular changes in the cancer cells.
- Immunotherapy: Immunotherapy is a drug treatment that uses the immune system to fight cancer.
- Radiation therapy: Radiation therapy uses high-powered energy beams, such as X-rays or protons to kill cancer cells. Radiation treatment can come from a machine outside your body (external beam radiation), or it can be placed inside your body (brachytherapy).
- Blood and marrow transplant (BMT): A blood and marrow transplant, also known as a stem cell transplant, uses healthy stem cells either from your own bone marrow or from a healthy donor to replace damaged blood cells.
- Hormone therapy: Some types of cancer are fuelled by the hormones in the body. Blocking the production or effect of these hormones may cause the cancer cells to stop growing. Breast cancer and prostate cancer are sensitive to hormone therapy.
Vaccination for cancer is not available. However, you can be vaccinated against certain viruses which are known to cause specific cancers, such as HPV (Cervical cancer) and hepatitis C and B (Liver cancer).
Pancreatic cancer is one of the most aggressive cancers in existence. Pancreatic cancer can go undetected for a long period of time because of the location of the pancreas in the body.Due to its critical location, pancreatic cancer can spread more easily to other vital organs.
It is the time between the primary modality of treatment (surgery +/- radiation therapy +/- chemotherapy) to the time of recurrence of disease or disease progression.
