Cancer Information: Diagnosis and Treatment (Answers to Your Questions)

Q: I’ve recently read about leukemia treatment… What happens in the body for this disease to develop?
A: There are three kinds of blood cells: white, red and platelets.
White blood cells are responsible for protecting your body against outside harm and infections.  The three types of white blood cells (granulocytes, monocytes, and lymphocytes) all have different roles in preventing the body from being affected.
Red blood cells deliver oxygen from the lungs to all the parts of the body to provide for their normal functioning; they are also responsible for collecting carbon dioxide and carrying it all the way back to the lungs.
Platelets are blood cells that form blood clot and help stop bleeding.
Blood cells are produced in the bone marrow, which fills your bones. If the person is healthy, the blood cells are more likely to become mature and turn into one of the blood cell types. Blood cells that haven’t matured entirely are stem cells: they can turn into either platelets, red or white blood cells, depending on the body’s needs.
Leukemia is a condition when the process of stem cells maturation is disrupted. Due to some genetic modifications (mutation), the cells turn cancerous and start to grow and develop uncontrollably. As they grow, they replace stem cells that are responsible for the production of healthy new cells and take over the bone marrow. As a result, not enough new cells are produced to cover the needs of the body. These cells can also affect other organs as they spread beyond the bone marrow – for example, brain, kidneys and lymph nodes.

Q: How is skin cancer classified?
A: The three most commonly found kinds of cancer (based on the type of cells involved) are:
§    Basal cell carcinoma is the least serious kind that is diagnosed in most cases of skin cancer. It usually looks like a bump – smooth, pearly or waxy, scaly or red.
§    Squamous cell carcinoma looks like a rough flat lesion or a firm nodule. It can become crusty, bleed and itch, and the danger is greater than in the case of basal cell carcinoma, as it can actually travel through the lymph nodes.
§    Melanoma, the most dangerous kind of all skin cancers is characterized by the abnormal activity of the cells responsible for skin pigmentation. It accounts for ¾ of all skin cancer-related deaths.
In most cases skin cancers will be removed using different methods: biopsy (elimination of the affected area along with the surrounding tissue), Moh’s surgery (the removal of a cancer lesion layer by layer, leaving smaller marks and sparing healthy tissues) and some others. If the operation involved cutting away a lot of tissue, reconstructive surgery is used to deal with the wounds and make the operated area look more aesthetic.
However, some cases may require additional cancer treatment, such as chemotherapy, radiation therapy or the use of biological response modifiers (to help the immune system deal with the disease). Sometimes radiotherapy is recommended instead of a surgery, if a particular case requires it. Some cancer patients are required to go through additional trials before being recommended a certain kind of cancer treatment.

Q: I’ve been searching for some cancer information and I can’t figure out the difference between Hodgkin’s disease and lymphoma. Can you help me?
A: Lymphoma is what we call all the cancers affecting the lymphatic system. The lymphatic system is a network of nodes and vessels carrying lymph (a particular fluid that contains white cells and fights any infection entering the body) through the body. The lymph nodes can be found everywhere in the body, while their clusters are concentrated in certain spots, such as the underarms, chest, neck, groin and abdomen. The lymphatic system also includes thymus, bone marrow and tonsils.
Lymphoma is a condition when lymphocytes (the white blood cells responsible for fighting the infection) start dividing and spreading uncontrollably. It’s especially dangerous, as it can originate anywhere in the body, since the lymph nodes are everywhere, and then spread very fast to other areas.
Hodgkin’s disease is simply a kind of lymphoma. It was named after Thomas Hodgkin – the doctor that first discovered it in the nineteenth century, and the difference lies in the way cancerous cells look when you see them through the microscope. All other kinds of lymphoma are also referred to as “non-Hodgkin’s” and account for most cases of cancer diagnosis.
Lymphomas account for 5% of all cases of cancer in the US, but the number grows steadily. Lymphomas are not extremely dangerous and in most cases can be successfully cured without the danger of reappearing.

Q: I need chemotherapy, where can I get it?   
A: Chemotherapy is available in hospital, at the doctor’s office, in a clinic, and sometimes can be performed at home. The place where chemotherapy can be performed depends on what chemicals are going to be used, and also what the patient’s insurance covers. Most people receive chemotherapy in the outpatient departments of the hospital, so they can go back home right after it. There are some cancer medications that can be taken orally, but in most cases the patient requires an intravenous injection, which has to be performed by a nurse.
One more thing you need to know about chemotherapy is that it can be administered in cycles. This is done to make sure all the cells have been captured and destroyed, as the first injection may not “recognize” all the kinds of them. The cycles may include, for example, a couple of weeks of intensive therapy, and a couple of weeks of rest. This is also done to give your body a break and let the healthy cells restore and function properly.
Chemotherapy is given according to a certain schedule that proved to be efficient. Some chemicals have to be administered on a daily basis, some need to be taken every week for some months, while some drugs can be taken for some years once a month. Every schedule is designed to suit the needs of a particular patient, so they can differ.

Q: In what way is radiation therapy used to help people with cancer diagnosis?
A: There are some methods that can be used to provide radiation treatment. In most cases it’s external therapy, which is performed in the outpatient department of the hospital. The patient needs to lie down, while the beam of radiation is concentrated on the affected spot. The exact area (also called the treatment port) is found in the process of X-raying. The area is previously outlined with a special kind of ink that doesn’t disappear for some time, so that there is no need for additional X-raying next time. It’s important to define the exact spot to protect healthy tissues from the radiation beam.
The dosage of radiation the patient receives is defined by the doctor and depends on a number of factors, such as the health of the person, the size, location and gravity of cancer, and some others. It’s usual to give the patient some rest, when the treatment will not be administered, so that the healthy cells would be able to recover.
Another method is internal radiation. This cancer treatment involves a radioactive pellet or a wire being implanted into or close to the tumor. It’s usually sealed inside a container and can destroy cancerous cells just as effectively. Some sources of radioactivity can be prescribed for oral administration or be given through an injection.
Internal radiation therapy leads to the patient’s body emitting some radiation also. If the patient takes an unsealed radiation source, hospital stay is obligatory, and the patient is kept in isolation to prevent any visitors from getting affected. If the implant is sealed in a container, the danger of the substance escaping is minimal, but since fetuses are very vulnerable and can be easily affected by the smallest amounts of radiation, pregnant women are not allowed to visit such patients during their stay in the hospital.

Q: I’ve heard that chemotherapy is more efficient than radiation therapy and surgery. Is it true?
A: Both radiation therapy and surgery are highly efficient and are used in the cases when the cells haven’t started to spread and travel to other parts of the body. The cells that have started to spread present the biggest danger, as they become very hard to control and deal with.
Systemic therapy (chemotherapy is one of the two kinds of it, the other one being hormone therapy) is used to deal with advanced cancers. While the drugs used in hormone therapy block certain hormones contributing to the growth of cancerous cells, the ones used in chemotherapy are quite toxic and travel through the body detecting and killing rogue cells.
Chemotherapy toxic drugs are created with the only purpose: to destroy and disable the cells that, following their mutation, started to grow and develop uncontrollably. The effects of chemotherapy drugs can be compared with those of antibiotics used to deal with the bacteria. These chemicals stop the replication of DNA, preventing the cells from further multiplication; some of them also interact with the enzymes that contribute to the growth of the abnormal cells. Combination therapy, as we can see it from the name, uses several kinds of chemicals to tackle the problem from a variety of aspects, making the treatment more effective.
Chemotherapy, however, is considered an adjuvant cancer treatment, meaning that surgery and radiation are the primary methods. In some cases neoadjuvant chemotherapy is used to shrink the tumor to prepare it for radiation treatment (as it becomes easier to destroy the cells when they are concentrated in a smaller area). Another use of this method is shrinking the tumor to relieve some symptoms it’s contributing to.
Cancer is being constantly studied, and new drugs succeed the old ones, each time being more effective and less harmful for the patient.

Q: There is plenty of cancer information, and everywhere it’s said smoking increases the risk of developing cancer. How much of it is actually true?
A: Apart from contributing to cancer incidence, smoking is responsible for a huge number of deaths in the US. Every year 430,000 people die because of the conditions connected with smoking. If you are a smoker, the risk of lung cancer diagnosis increases 10 times, not speaking of other possibilities of cancer: your pancreas, urinary bladder, uterine cervix, esophagus, kidneys, stomach and other organs are likely to be affected by different kinds of cancer.
Today smokers can quit in a variety of ways. There are hundreds of nicotine substitutes: patches, chewing gum, nasal spray, etc. They provide the person addicted to cigarettes with low dosages of nicotine to fight the craving. Nicotine withdrawal therapy can last for some time – depending on how long it will take the person to deal with the psychological aspects of the addiction.
Zyban (bupropion) is a highly efficient, although not very much advertised, drug used to reduce the unpleasant symptoms of quitting. It can be used alone, or combined with other remedies for the best effect. According to one finding, Zyban used along with a nicotine patch helped about 60% of people stay smoke-free without any particular effort during over a month.
Although many cigarette brands promote the use of special filters to reduce the amount of nicotine and tar, it appears to be yet another myth, as people smoke more of such cigarettes a day. Some other claims (products changing the way tobacco tastes, dietary supplements that help fight the craving, etc.) have not been proved either.

Related Articles