Different types of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. That is why people with cancer need treatment that is aimed at their particular kind of cancer.


Who Gets Cancer?

Over one million people get cancer each year. Approximately one out of every two men and one out of every three women will have some type of cancer at some point during their lifetime. Anyone can get cancer at any age; however, about 77% of all cancers are diagnosed in people age of 55 and older.

Today, millions of people are living with cancer or have been cured of the disease. The sooner a cancer is found and the sooner treatment begins, the better a patient's chances are of a cure. That's why early detection of cancer is such an important weapon in the fight against cancer.

What Are the Risk Factors for Cancer?

A risk factor is anything that increases a person's chance of getting a disease. Some risk factors can be changed, and others cannot. Risk factors for cancer can include a person's age, sex, and family medical history. Others are linked to cancer-causing factors in the environment. Still others are related to lifestyle choices such as tobacco and alcohol use, diet, and sun exposure.

Having a risk factor for cancer means that a person is more likely to develop the disease at some point in their lives. However, having one or more risk factors does not necessarily mean that a person will get cancer. Some people with one or more risk factors never develop the disease, while other people who do develop cancer have no apparent risk factors. Even when a person who has a risk factor is diagnosed with cancer, there is no way to prove that the risk factor actually caused the cancer.

Different kinds of cancer have different risk factors. Some of the major risk factors include the following:

• Cancers of the lung, mouth, larynx, bladder, kidney, cervix esophagus, and pancreas are related to tobacco use, including cigarettes, cigars, chewing tobacco, and snuff. Smoking alone causes one-third of all cancer deaths.

• Skin cancer is related to unprotected exposure to strong sunlight.

• Breast cancer risk factors include several factors: age; changes in hormone levels throughout life, such as age at first menstruation, number of pregnancies, and age at menopause; obesity; and physical activity. Some studies have also shown a connection between alcohol consumption and an increased risk of breast cancer. Also, women with a mother or sister who have had breast cancer are more likely to develop the disease themselves.

• While all men are at risk for prostate cancer, several factors can increase the chances of developing the disease, such as age, race, and diet. The chance of getting prostate cancer goes up with age. A high-fat diet may play a part in causing prostate cancer. Also, men with a father or brother who have had prostate cancer are more likely to get prostate cancer themselves.

Overall, environmental factors, defined broadly to include tobacco use, diet, and infectious diseases, as well as chemicals and radiation cause an estimated 75% of all cancer cases in the United States. Among these factors, tobacco use, unhealthy diet, and physical activity are more likely to affect personal cancer risk. Research shows that about one-third of all cancer deaths are related to dietary factors and lack of physical activity in adulthood.

Can Cancer Be Prevented?

Smoking and drinking alcohol cause some people to get certain types of cancer. These cancers might be prevented by avoiding tobacco and alcohol. The best idea is to never use tobacco at all. Cigarettes, cigars, pipes and smokeless tobacco cause cancer and should not be used. People who already smoke should try to quit. Former smokers have less risk of cancer than do people who continue to smoke.

The chances of getting skin cancer can be lowered by staying in the shade as much as you can, wearing a hat and shirt when you are in the sun, and using sunscreen.

We know that our diet, (what we eat) is linked to some types of cancer, although the exact reasons are not yet clear. The best advice is to eat a lot of fresh fruits and vegetables and whole grains like pasta and bread, and to cut down on high fat foods.

There are tests, called screening examinations, that adults should have in order to find cancer early. If cancer is found early it can often be cured.

What Causes Cancer?

Some kinds of cancer are caused by things people do. Smoking can cause cancers of the lungs, mouth, throat, bladder, kidneys and several other organs, as well as heart disease and stroke. While not everyone who smokes will get cancer, smoking increases a person's chance of getting the disease. Drinking a lot of alcohol has also been shown to increase a person's chance of getting cancer of the mouth, throat, and some other organs. This is especially true if the person drinks and smokes.

Radiation (x-rays) can cause cancer. But the x-rays used by the doctor or dentist are safe. Too much exposure to sunlight without any protection can cause skin cancer.

In many cases, the exact cause of cancer remains a mystery. We know that certain changes in our cells can cause cancer to start, but we don't yet know exactly how this happens. Many scientists are studying this problem.

Signs and Symptoms of Cancer

What Are Symptoms and Signs?

A symptom is an indication of disease, illness, injury, or that something is not right in the body. Symptoms are felt or noticed by a person, but may not easily be noticed by anyone else. For example, chills, weakness, achiness, shortness of breath, and a cough are possible symptoms of pneumonia.

A sign is also an indication that something is not right in the body. But signs are defined as observations made by a doctor, nurse, or other health care professional. Fever, rapid breathing rate, and abnormal breathing sounds heard through a stethoscope are possible signs of pneumonia.

The presence of one symptom or sign may not give enough information to suggest a cause. For example, a rash in a child could be a symptom of a number of things including poison ivy, a generalized infection like rubella, an infection limited to the skin, or a food allergy. But if the rash is associated with a high fever, chills, achiness, and a sore throat, then all of the symptoms together give a better picture of the illness. In many cases, a patient's signs and symptoms do not provide enough clues to determine the cause of an illness, and medical tests such as x-rays, blood tests, or a biopsy may be needed.

How Does Cancer Produce Signs and Symptoms?

Cancer is a group of diseases that may cause any sign or symptom. The signs and symptoms will depend on the size of the cancer, where the cancer is, and how much it affects the surrounding organs or structures. If a cancer spreads, then symptoms may appear in different parts of the body.

As a cancer grows, it begins to push on nearby organs, blood vessels and nerves. This pressure creates some of the signs and symptoms of cancer. If the cancer is in a critical area, such as certain parts of the brain, even the smallest tumor can produce early symptoms.

Sometimes, however, cancers form in places where symptoms may not be produced until the cancer has grown quite large. Pancreas cancers, for example, do not usually grow large enough to be felt from the outside of the body. Some pancreatic cancers do not produce symptoms until they begin to grow around nearby nerves, causing a backache. Others grow around the bile duct, leading to a yellowing of the skin known as jaundice. Unfortunately by the time a pancreatic cancer causes these signs or symptoms, it has usually reached an advanced stage.

A cancer may also cause generalized symptoms such as fever, fatigue, or weight loss. This may be caused by cancer cells releasing substances that change the body’s metabolism. Or the cancer may cause the immune system to react in ways that produce these symptoms.

Sometimes, cancer cells release substances into the bloodstream that cause symptoms not generally thought to result from cancers. For example, some cancers of the pancreas can release substances which cause blood clots to develop in veins of the legs. Some lung cancers produce hormone-like substances that affect blood calcium levels, affecting nerves and muscles and causing weakness and dizziness.

How Are Signs and Symptoms Helpful?

Treatment is most successful when the cancer is found as early as possible. Finding cancer early usually means it can be treated while it is still small and is less likely to have spread to other parts of the body. Usually, this means a better chance for a cure, especially if initial treatment is to be surgery.

A good example of the importance of detecting cancer early is melanoma skin cancer. It is easily removed if has not yet grown deeply into the skin, and the 5-year survival rate (percentage of people living at least 5 years after diagnosis) at this stage is nearly 100%. But once melanoma has spread to other parts of the body, the survival rate drops dramatically.

Sometimes symptoms are ignored because the person is either frightened by their implications and refuses to seek medical help or does not recognize the symptom as being significant. General symptoms, such as fatigue, are more likely to have a cause other than cancer and can easily be dismissed, especially if they have an obvious cause or are only temporary. In a similar way, a person may reason that a more specific symptom like a breast mass is probably a cyst that will go away by itself. But neither of these symptoms should be discounted or overlooked, especially if they have been present for a period of time, such as weeks, or are getting worse.

General Cancer Signs and Symptoms

It is important to know what some of the general signs and symptoms of cancer are. They include unexplained weight loss, fever, fatigue, pain, and changes in the skin. Of course, it’s important to remember that having any of these does not necessarily mean that cancer is present-there are many other conditions that can cause these signs and symptoms as well.

Unexplained weight loss: Most people with cancer will lose weight at some time with their disease. An unexplained (unintentional) weight loss of about 10 pounds may be the first sign of cancer, particularly cancers of the pancreas, stomach, esophagus, or lung.

Fever: Fever is very common with cancer, but is more often seen in advanced disease. Almost all patients with cancer will have fever at some time, particularly if the cancer or its treatment affects the immune system and reduces resistance to infection. Less often, fever may be an early sign of cancer, such as with Hodgkin's disease.

Fatigue: Fatigue may be a significant symptom as the cancer progresses. It may occur early, however, especially if the cancer is causing a chronic loss of blood, as in some colon or stomach cancers.

Pain: Pain may be an early sign with some cancers, such as bone cancers or testicular cancer. Most often, however, pain is a symptom of advanced disease.

Skin changes: In addition to cancers of the skin, some internal cancers can produce visible skin signs such as darkening (hyperpigmentation) yellowing (jaundice), reddening (erythema), itching, or excessive hair growth.

Specific Cancer Signs and Symptoms

In addition to the above general symptoms, you should be watchful for the following common symptoms, which could be an indication of cancer. Again, there may be other causes for each of these, but it is important to bring them to your doctor’s attention as soon as possible so that they can be investigated.

Change in bowel habits or bladder function: Chronic constipation, diarrhea, or a change in the size of the stool may indicate colon cancer. Pain with urination, blood in the urine, or a change in bladder function (such as more frequent or less frequent urination) could be related to bladder or prostate cancer. Any changes in bladder or bowel function should be reported to your doctor.

Sores that do not heal: Skin cancers may bleed and resemble sores that do not heal. A persistent sore in the mouth could be an oral cancer and should be dealt with promptly, especially in patients who smoke, chew tobacco, or frequently drink alcohol. Sores on the penis or vagina may either be signs of infection or an early cancer, and should not be overlooked in either case.

Unusual bleeding or discharge: Unusual bleeding can occur in early or advanced cancer. Blood in the sputum (phlegm) may be a sign of lung cancer. Blood in the stool (or a dark or black stool) could be a sign of colon or rectal cancer. Cancer of the cervix or the endometrium (lining of the uterus) can cause vaginal bleeding. Blood in the urine is a sign of possible bladder or kidney cancer. A bloody discharge from the nipple may be a sign of breast cancer.

Thickening or lump in breast or other parts of the body: Many cancers can be felt through the skin, particularly in the breast, testicle, lymph nodes (glands), and the soft tissues of the body. A lump or thickening may be an early or late sign of cancer. Any lump or thickening should be reported to your doctor, especially if you’ve just discovered it or noticed it has grown in size. You may be feeling a lump that is an early cancer that could be treated successfully.

Indigestion or difficulty swallowing: While they commonly have other causes, these symptoms may indicate cancer of the esophagus, stomach, or pharynx (throat).

Recent change in a wart or mole: Any change in color or shape, loss of definite borders, or an increase in size should be reported to your doctor without delay. The skin lesion may be a melanoma which, if diagnosed early, can be treated successfully.

Nagging cough or hoarseness: A cough that does not go away may be a sign of lung cancer. Hoarseness can be a sign of cancer of the larynx (voice box) or thyroid.

What Is Remission?

Remission is a period of time when the cancer is responding to treatment or is under control. In a complete remission, all the signs and symptoms of the disease disappear. It is also possible for a patient to have a partial remission in which the cancer shrinks but does not completely disappear. Remissions can last anywhere from several weeks to many years. Complete remissions may continue for years and be considered cures. If the disease returns, another remission often can occur with further treatment. A cancer that has recurred may respond to a different type of therapy, including a different drug combination.

What Is Staging?

Staging is the process of finding out how far the cancer has spread. Staging the cancer is a vital step in determining your treatment choices, and it will also give your health care team a clearer idea of the outlook for recovery. Staging can take time, and people are usually anxious to begin treatment soon. Do not worry that the staging process is taking up treatment time. Keep in mind that by staging the cancer, you and your health care team will know which treatments are likely to be the most effective before beginning the treatment.

There is more than one system for staging. The TNM system is the one used most often. It gives three key pieces of information:

T describes the size of the tumor, and whether the cancer has spread to nearby tissues and organs.

N describes how far the cancer has spread to nearby lymph nodes.

M shows whether the cancer has spread (metastasized) to other organs of the body.

Letters or numbers after the T, N, and M give more details about each of these factors. For example, a tumor classified as T1, N0, M0 is a tumor that is very small, has not spread to the lymph nodes, and has not spread to distant organs of the body. Once the TNM descriptions have been established, they can be grouped together into a simpler set of stages, stages 0 through stage IV (0-4).

In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more serious, widespread cancer.

After looking at your test results, your doctor will tell you the stage of your cancer. Be sure to ask your doctor any questions you might have about what the stage of your cancer means and how it will impact your treatment options.

How Is Cancer Treated?

The number of treatment choices you have will depend on the type of cancer, the stage of the cancer, and other individual factors such as your age, health status, and personal preferences. You are a vital part of your cancer care team - you should discuss with them which treatment choices are best for you. Don't be afraid to ask as many questions as you have. Make sure you understand your options. A cancer diagnosis usually gives people a sense of urgency in making choices about treatment and services. However, take the time to consider all the options available to you so you will be as well informed as possible.


How is Cancer Treated?

The four major types of treatment for cancer are surgery, radiation, chemotherapy, and biologic therapies. You might also have heard about hormone therapies such as tamoxifen and transplant options such as those done with bone marrow.

What Treatment Will Be Best for Me?

Your cancer treatment will be entirely based on your unique situation. Certain types of cancer respond very differently to different types of treatment, so determining the type of cancer is a vital step toward knowing which treatments will be most effective. The cancer's stage (how widespread it is) will also determine the best course of treatment, since early-stage cancers respond to different therapies than later-stage ones. Your overall health, your lifestyle, and your personal preferences will also play a part in deciding which treatment options will be best for you. Not all types of treatment will be effective in your situation, so be sure that you understand your options. Don't be afraid to ask questions; it is your right to know what treatments are most likely to help you and what their side effects may be.

Palliative versus Curative Goals: Before starting treatment, ask about the goal of treatment. Is the purpose of the treatment to cure the cancer, control it, or treat symptoms? Sometimes the goal of treatment can change.

Biologic Therapies

There is a lot of evidence that suggests that the immune system, the body's natural defense mechanism, plays a major role in the body's response to cancer. At least some forms of cancer occur when the immune system fails to destroy cancer cells or to prevent their growth. Biologic therapy is an effective treatment for certain cancers. It is sometimes called immunotherapy, biotherapy, or biological response modifier therapy. Biologic therapies use the body's immune system to fight cancer or to lessen the side effects of some cancer treatments.

Biologic therapies can act in several ways in cancer treatment. These include interfering with cancer cell growth, acting indirectly to help healthy immune cells control cancer, and helping to repair normal cells damaged by other forms of cancer treatment.

There are several kinds of biologic therapy now in use. More than one kind of biologic therapy may be used, or biologic therapy may be combined with chemotherapy or radiation therapy to treat cancer.

Chemotherapy

While surgery and radiation therapy are used to treat localized cancers, chemotherapy is used to treat cancer cells that have metastasized (spread) to other parts of the body. Depending on the type of cancer and its stage of development, chemotherapy can be used to cure cancer, to keep the cancer from spreading, to slow the cancer's growth, to kill cancer cells that may have spread to other parts of the body, or to relieve symptoms caused by cancer.

Chemotherapy is treatment with powerful medicines that are most often given by mouth or by injection. Unlike radiation therapy or surgery, chemotherapy drugs can treat cancers that have spread throughout the body, because they travel throughout the body in the bloodstream. Often, a combination of chemotherapy is used instead of a single drug.

Chemotherapy is given in cycles, each followed by a recovery period. The total course of chemotherapy is often about six months, usually ranging from three to nine months. After a cancer is removed by surgery, chemotherapy can significantly reduce the risk of cancer returning. The chances of cancer returning and the potential benefit of chemotherapy depend on the type of cancer and other individual factors.

Side effects of chemotherapy

Side effects of chemotherapy depend on the type of drugs, the amounts taken, and the length of treatment. The most common are nausea and vomiting, temporary hair loss, increased chance of infections, and fatigue. Many of these side effects can be uncomfortable or emotionally upsetting. However, most side effects can be controlled with medicines, supportive care measures, or by changing the treatment schedule. If you experience side effects, ask your doctor about ways to help ease or eliminate them. Also, keep your doctor informed of all side effects that you experience, as some may require immediate medical attention.

Fatigue is one of the most common side effects of radiation and chemotherapy. Like most other side effects, it will disappear once the treatment is complete. You can help yourself by getting enough rest, eating a well-balanced diet, drinking plenty of liquids, and by planning your activities to include frequent rest periods.

Though it is not medically harmful, hair loss can be an upsetting side effect. Most people feel that their hairstyle is a part of their identity, so it is only normal that hair loss is distressing. Some people experience hair loss during chemotherapy treatments (and sometimes with radiation treatment to the head) while others do not, even with the same drugs. Not all drugs cause hair loss. When it does occur, the hair almost always grows back after the treatments are completed. If hair loss does occur, it usually begins within two weeks of the start of therapy and gets worse 1-2 months after the start of therapy. Hair regrowth often begins even before therapy is completed. Most people are able to find suitable ways of managing the hair loss until it grows back, with specially designed hats, scarves, and wigs.

People having chemotherapy sometimes become discouraged about the length of time their treatment is taking or the side effects they are having. If that happens to you, talk to your doctor. There are ways to reduce the side effects or make them easier to manage. Keep in mind that the expected benefits of the treatment should outweigh any problems you might have because of it.

Complementary and Alternative Therapies

Complementary and alternative therapies are a diverse group of health care practices, systems, and products that are not part of usual medical treatment. They may include products such as vitamins, herbs, or dietary supplements, or procedures such as acupuncture, massage, and a host of other types of treatment. There is a great deal of interest today in complementary and alternative treatments for cancer. Many are now being studied to find out if they are truly helpful to people with cancer.

You may hear about different treatments from family, friends, and others, which may be offered as a way to treat your cancer or to help you feel better. Some of these treatments are harmless in certain situations, while others have been shown to cause harm. Most of them are of unproven benefit.


Cancer Pain

Pain is one of the reasons people fear cancer so much. If someone you know has cancer, it is normal to be afraid of witnessing pain. In fact, there are some cancers, which cause no physical pain at all. When it does occur, cancer pain can happen for a variety of reasons. Some people have pain as a result of the growth of a tumor or as a result of advanced cancer, while others may experience pain as a result of treatment side effects. You should also know that doctors can treat and manage cancer pain with modern techniques and medicines. A great deal of progress has been made in pain control, so pain can be reduced or alleviated in almost all cases. Even patients with advanced disease can be kept comfortable.

You may also be concerned that someone taking pain medication for cancer will become addicted to the medication. However, all evidence shows that people who take prescribed drugs for cancer pain do not become addicted. In addition, some methods of pain reduction, such as acupuncture and guided imagery, do not involve drugs.

Fatigue

If you are fighting cancer, chances are you’re also fighting fatigue. Fatigue is the most common side effect of cancer treatment, and it often hits unexpectedly. Everyday activities -- talking on the telephone, shopping for groceries, even lifting a fork to eat -- can become daunting tasks.

Cancer-related fatigue feels very different from everyday fatigue, said Lillian Nail, PhD, RN, a cancer survivor who has studied this side effect at the University of Utah School of Nursing. " ‘Overwhelming’ is the most common description," said Dr. Nail. "When compared with the fatigue experienced by healthy people, cancer-related fatigue is more severe, it lasts longer, and sleep just doesn’t bring relief." The causes of cancer-related fatigue are not fully known. Problems like a low blood count, sleep disruption, stress, eating too little, and other factors may contribute to this condition.

Some signs of cancer-related fatigue are:

Feeling tired, weary or exhausted even after sleeping
Lacking energy to do your regular activities
Having trouble concentrating, thinking clearly, or remembering
Feeling negative, irritable, impatient, or unmotivated
Lacking interest in normal day-to-day activities
Spending less attention on personal appearance
Spending more time in bed or sleeping

Rest, But Not Too Much

Plan your day so you have time to rest. Take short naps or breaks, rather than one long rest period. However, while sleep and rest are important, don’t overdo it. Too much rest can decrease your energy level. In other words, the more you rest, the more tired you will feel. If you have trouble sleeping, talk to your health care professional.

Stay Active

Stay as active as you can. Regular exercise -- especially walking -- has been found to be the best remedy for fatigue. Add other activities that are less strenuous, like bird watching, listening to music, or reading. To help you plan your activities, keep a diary of how you feel each day. In assessing your fatigue, physicians may ask how severe it is (rated from 0-10), what are the patterns to it, and what makes it better or worse? Keep a detailed record of how you feel.

Save Your Energy

Plan ahead. Spread your activities throughout the day. Don’t push yourself by standing too long or by doing activities in extreme temperatures. Even long, hot showers or baths can drain you of energy. Store items within easy reach, so you won’t have to strain to get them from overhead storage. Take rest breaks between activities to save your energy for the things you want to do. Most of all, prioritize. Decide which activities are really important to you and which ones aren’t.

Get Help with Tasks

Ask your family or friends to help with tasks you find difficult or tiring, like mowing the lawn, preparing meals, doing housework, or running errands. Don’t force yourself to do more than you can manage. It may be difficult for others to understand if rest does not make your fatigue go away. Explaining that the fatigue you feel is different from the fatigue you had before treatment will help them understand.

Get Support

Sharing your feelings with others can ease the burden of fatigue. You can learn coping hints from others by talking about your situation. Ask your health care professional to put you in touch with a support group in your area.

Eat Well

Drink plenty of water and juices. Eat as nutritiously as you can. Try to eat at least five servings of fruits and vegetables each day.

Call Your Doctor

Call your doctor if you feel too tired to get out of bed over a 24 hour period, if you feel confused, dizzy, lose your balance or fall, have a problem waking up, have a problem catching your breath, and if the fatigue becomes progressively worse. Fatigue caused by cancer treatment is temporary, experts say. Your energy will slowly come back, especially if you stay moderately active.

What to Look For:

Feeling like you have no energy
Increased sleeping
Lack of desire to do normal activities
Decreased attention to personal appearance
Feeling tired even after sleeping
Difficulty concentrating