Cancer is all around us and it is thought that everyone knows someone who has suffered or is suffering with the disease.
Cancer is in the news, in the family, in the back of our minds everyday, every time we have unexplained symptoms, the worst scenario is considered.
Early detection and treatment can save lives, we know that, but what is cancer? We know there are lots of types but do we really know exactly what the process is and how it works?
This article is educational and not diagnostic. Please see your GP or practice nurse if you have signs or symptoms that you are worried about. This is particularly important if you have had cancer before or there is a close family history. Read on to discover just what the 'Big C' is all about........
With over 200 different types affecting all ages, 1 in 2 people in the UK will get cancer at some point in their lifetime.
Human growth is a controlled process down to the cellular level. Genes inside the nucleus of all cells (except red blood cells), instruct the cell on what it will be and how it will grow. Genetic mutations, producing changes within cells, can make them begin to grow and multiply uncontrollably. They can halt the production of proteins that stop the cell dividing. This can happen by chance, as a result of exposure to pathogens such as nicotine or the faults can be inherited.
These cells then form a lump or tumour called the primary tumour or site, where it all begins. This process can happen in tissues (breast) or in the blood where cells build up but don't form a lump, they may head to the bone marrow (where blood cells are formed) and stay there.
Benign tumours are not cancer but can still be problematic. They are slow to grow, do not spread and have a covering of normal cells. They can grow quite large and compress surrounding structures which in areas like the brain, can disrupt function. They can also release hormones which affect the body in different ways.
Malignant tumours are cancers. They grow faster, can spread to surrounding tissues, invade organs and travel in the blood or lymph system to form secondary tumours or metastases.
All tissues have a basement membrane which keeps all the cells together. If a tumour has grown through this membrane, then it is classed as locally invasive and has usually taken the easiest path through to get to the surrounding structures.
All cells need a blood supply, even the cancerous ones, and as the tumour grows, it gets less and less supply so it sends out angiogenic factors to encourage blood vessel growth and thereby facilitating tumour growth. One area of research is looking at disabling these angiogenic processes to stop the growth and shrink the tumour.
Some cancer cells may force their way into tissues through sheer size and number, damaging structures as they go causing bleeding. They may use enzymes to attack and break down tissues and invade. Some cancer cells take on the ability to move around to invade surrounding structures. Research is also looking into the substance which enables this cell mobility.
Cancer cells don't stick together very well and so they break away and travel to other body parts in blood or lymph vessels. These are called circulating tumour cells. They tend to get stuck in the smaller blood vessels and then invade and multiply in that area. In lymph vessels they get carried to the nearest node/gland and get stuck there, where they grow. This is called lymph spread.
The surgeon my remove the tumour and also the local lymph nodes if cancer cells have been found there, ie. the breast and axillary/armpit nodes. There is no way to detect if cells have spread until they settle and start to multiply, so doctors sometimes treat with chemotherapy or other modalities, as well as surgery, to ensure that all the cancer is killed. The classification of the cancer and experience of treating many like it, enables doctors to predict its likely behaviour so that treatment can be adjusted accordingly.
A bit about grades of cancer:
Doctors need a system of grading of cancers so that they can compare and treat effectively. There are two types of grading -
TNM = Tumour Nodes Metastasis
The size of the tumour is graded T (1 - 4), the amount or any lymph spread N (0 - 3), and whether or not there are metastases M (0 or 1).
The Number system describes the grade of tumour from 1 to 4.
1 = small and contained, 2 = larger with lymph involvement, 3 = tissue and lymph spread
4 = metastatic spread and secondary tumours.
If a group of abnormal cells has developed but are very small then they can be classed as pre-cancerous or called a carcinoma in situ. Cells such as this in the breast or cervix can be detected through regular screening.
Despite surgery and chemotherapy/radiotherapy and other drug treatments, cancer can come back. This is often because it had already spread and gone undetected (micro-metastases) or had developed resistance to the treatments used to kill it. A doctor, therefore cannot say you have been "cured", because there is just no way of knowing. Living with this uncertainty can be difficult but generally the risk reduces with time. Organisations such as Cancer Research UK provide counselling and advice on managing this, there is plenty of help.
Again, if you are experiencing anything unusual and you are worried then do visit your GP to have a chat. Early detection increases your chances of survival and many cancers can now be successfully eradicated.
Put yourself in the best possible position by eating well and getting regular exercise. Checking your body for any lumps or bumps will go a long way.
Visit www.cancerresearchuk.org/about-cancer for further information and advice.
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Thanks for reading.