Under normal circumstances, cells grow and divide to produce more cells as the body needs them. When a cell is old or damaged, it dies and is replaced by a new cell. However, sometimes cells keep dividing when new cells are not needed. As a result, these extra cells form a mass of tissue, called a tumor. Not all tumors are cancerous; tumors may be benign or malignant.

• Benign tumors are not cancer. They can often be removed, and, in most cases, they do not come back. Cells from benign tumors do not spread to other parts of the body. Most important, benign tumors are rarely life-threatening.
• Malignant tumors are cancer. Cells in these tumors are abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can break away from a malignant tumor and spread to other parts of the body through the blood and lymph systems. The spread of cancer from one area of the body to another area is called metastasis.

Not all cancers form tumors. Leukemia and lymphoma are cancers that arise in blood- forming cells. The abnormal cells circulate in the bloodstream and lymphatic system.

Most cancers are named for the organ or type of cell where the cancer first formed. For example, cancer that starts in the lung is lung cancer, cancer that starts in the breast is breast cancer, and cancer that starts in cells of the skin, known as melanocytes, is called melanoma.

When cancer spreads (metastasizes) from its original location to another part of the body or to lymph nodes it has the same cell type and the same name. For example, if lung cancer spreads to the brain, the cancer cells in the brain are lung cancer cells. The cancer in the brain is called metastatic lung cancer, not brain cancer.

Possible Causes and Prevention of Cancer

Even though it is not clearly understood why one person gets cancer and another does not, it is known that cancer is not caused by an injury, such as a bump or bruise. However, certain viruses, such as HPV/ human papillomavirus, may increase the risk of some types of cancer, however, cancer is not contagious; no one can “catch” cancer from another person.

Cancer develops over time because of factors related to lifestyle, heredity, and the environment. Some cancer risk factors can be avoided. Other cancer risk factors, such as an inherited gene, are unavoidable, but it may be helpful to be aware of them through genetic testing. People can help protect themselves by avoiding known risk factors whenever possible. Tobacco, diet, being overweight, ultraviolet light, alcohol consumption, hormone replacement therapy, and family history are known risk factors that increase the likelihood of cancer.

Testing

You may undergo several tests and diagnostic procedures. These are important for: diagnosing cancer; determining where the cancer has spread; determining how you are responding to treatment.

Laboratory Tests

Blood and urine tests can give the doctor important information about a person’s health. Tumor markers, found in blood and/or urine, measure the amount of specific substances, which may be elevated when certain types of cancer are present in the body. However, lab tests alone cannot be used to diagnose cancer.

Imaging

Images are pictures of areas inside the body that can be obtained in several ways. Each test shows things a little differently, so you may have several different tests.

A CT or computed tomography is an imaging test that uses special x-rays to create pictures of cross-sections of the body.

An MRI or magnetic resonance imaging is an imaging test that uses powerful magnets and radio waves to create detailed pictures of the body. These pictures can show the difference between normal and abnormal tissue.

A PET or positron emission tomography uses radioactive glucose (sugar), called a tracer, to look for cancer in the body. Cancer cells show up brighter because they take up more glucose than normal cells.

Ultrasound uses high-frequency sound waves to look at organs and structures inside the body. It may be used to view the heart, blood vessels, kidneys, liver, and other organs, or to help guide doctors doing a biopsy or procedure.

X- rays use radiation to create pictures of the inside of the body. X-rays are a common way to view organs and bones inside the body.

Biopsy

A biopsy is almost always necessary to help the doctor make a diagnosis of cancer.
A biopsy is the removal of cells or tissue, which will be examined under a microscope by a pathologist. Tissue may be removed in three ways: endoscopy, needle biopsy, or surgical biopsy.

• Endoscopy: a doctor can look at areas inside the body through a thin, lighted tube. Endoscopy allows the doctor to see what’s going on inside the body, take pictures, and remove tissue or cells for examination.
• Needle biopsy: a doctor takes a small tissue sample by inserting a needle into the abnormal (suspicious) area.
• In a surgical biopsy or excisional biopsy, a surgeon removes an entire lymph node or tumor along with a margin of normal tissue. In an incisional biopsy, a doctor removes just a portion of the tumor. If cancer is present, the entire tumor may be removed immediately or during another operation.

Patients sometimes worry that having a biopsy or surgery for cancer will spread the disease. Doctors use special techniques and take many precautions to prevent cancer from spreading during surgery. Also, a margin of normal tissue is often removed along with the tumor.

Treatment

Cancer treatment depends on; the type of cancer, the size, location, and stage of the disease; a person’s overall general health; and other factors. The doctor will develop a personalized treatment plan to fit each person’s situation.

People with cancer are often treated by a team of specialists, which may include a surgeon, radiation oncologist, medical oncologist, and others. Cancers may be treated with surgery, radiation therapy, IV therapy, hormone therapy, immunotherapy, or targeted therapy. The doctors may decide to use one treatment method or a combination of methods.

Methods of Treatment and Side Effects

Cancer treatment can be either local or systemic. Local treatments affect cancer cells in the tumor and the area near it. Surgery and radiation therapy are types of local treatment. Systemic treatments travel through the bloodstream, reaching cancer cells all over the body. IV therapy, hormone therapy, immunotherapy, and targeted therapy are examples of systemic treatment.

The side effects of cancer treatment depend on the type and extent of the treatment. A patient’s response to treatment is closely monitored by physical exams, blood tests, scans, and other tests. Doctors and nurses will explain the possible side effects of treatment and may suggest ways to reduce or eliminate problems that may occur.

IV therapy, also called Chemotherapy is a treatment that uses drugs to destroy cancer cells. It works by keeping the cancer cells from growing and dividing to make more cells. Your doctor may recommend one drug, a combination of drugs, or IV therapy be combined with other forms of treatment.

Hormone therapy is a treatment that removes, blocks, or adds hormones to kill or slow the growth of cancer cells. (Also called hormonal therapy or endocrine therapy.) is used to treat breast and prostate cancers that use hormones to grow. Another type of hormone therapy is surgery to remove organs, such as the ovaries or testicles, which produce hormones.

Immunotherapy is a treatment using medication designed to boost the body’s natural defenses to fight cancer. It uses materials made by the body or in a laboratory to boost, target, or restore a person’s immune system. The immune system is a network of cells, tissues, and organs that work together to protect the body from infection.

Certain types of immunotherapy attack cancer or slow its spread to other parts of the body. Other types make it easier for the immune system to destroy cancer cells. Your doctor may recommend immunotherapy alone or combined with IV therapy.

Targeted therapy attacks specific cancer cells and keeps them from growing, reproducing, and/or kills them. Unlike IV therapy, targeted therapies do not impact normal cells. IV therapy, hormone therapy, immunotherapy, or targeted therapy may be given into a vein (IV); injected into a muscle or under the skin; or are given by mouth. The side effects depend on the drug type and the dose. See Section 3 for more information on side effects.

Clinical Trials are research studies that offer important treatment options for many people with cancer. Research studies evaluate promising new therapies and answer scientific questions. The goal of such trials is to find treatments that are more effective in controlling cancer with fewer side effects.

Radiation therapy uses high-energy rays to kill cancer cells. Radiation therapy may be used before surgery to reduce the size of the tumor making it easier for the surgeon to remove. Or, radiation therapy may be used following surgery to destroy any cancer cells that may remain in the area. Radiation may be used: alone; with other types of treatment such as IV therapy/biotherapy or surgery; or to relieve pain. See Section 4 for more information on Radiation Therapy.

Surgery is a therapy used to remove cancer; the surgeon may also remove some of the surrounding normal tissue and lymph nodes near the tumor. The side effects of surgery depend on many factors, including the size and location of the tumor, the type of operation, and a person’s overall, general health.

Bone marrow transplant or stem cell transplant may be used in cancer treatment. The transplant may be autologous (a person’s own cells that were saved before undergoing treatment), allogeneic (cells donated by another person), or syngeneic (cells donated by an identical twin). Both bone marrow or stem cell transplant provides the patient with healthy stem cells, which are immature cells that become mature blood cells. The
healthy stem cells replace stem cells that have been damaged or destroyed by very high doses of IV therapy and/or radiation therapy.