text: Frequently Asked Questions About Cancer
  The cells of our bodies grow and multiply in a process known as cell division. It must be extremely tightly controlled if all the cells in our body are to grow in the right place, and for all our organs and tissues to function properly. If cells divide too quickly the consequences can be disastrous.
  Cancer is essentially a disease of cell division. Uncontrolled cell division can have many causes, and can happen in any type of cell in the body, but it usually results from defects or damage in one or more of the genes involved in cell division. If these genes become damaged (mutated) in some way, for example by exposure to cigarette smoke or ultraviolet radiation, the cell can start to divide uncontrollably. These defective cells can multiply to form a lump of abnormal tissue called a tumor.
  A benign tumor is not cancer, does not spread, can usually be completely removed, is not likely to recur and does not usually present a serious threat to health.
  A malignant tumor is cancer, and can invade neighboring tissue and organs through blood or lymph system (this is the system which helps fight infection). This is called metastasis and can start new or secondary cancers.
  The cells in almost any part of the body can become cancerous (only the hair, nails and teeth cannot get cancer). There are several hundred different types of cancer. Each happens for different reasons and each type of cancer is different. Some cancers develop slowly, others quickly, some cancers have known causes whilst others have unknown causes. When cancer comes back in a person who appeared to be free of the diseases after treatment, it is called a recurrence.
  For a cancer to grow bigger than the head of a pin, it must grow its own blood vessels. This is called angiogenesis. Sometimes cells move away from the original (primary) cancer, either by the local tissue fluid channels (lymphatics) or in the blood stream, and invade other organs. When these cells reach a new site, they may continue to grow and form another tumor at that site. This is called a secondary cancer or metastasis.
  Things can get much worse, however, if the cancer becomes malignant and spreads. This happens when a single cancerous cell breaks away from the main tumor and starts growing and dividing elsewhere in the body. Once a tumor metastasizes, it is much more difficult to treat, and can make you much more ill because more areas of the body are affected.
  Anything that damages the genes in our cells can ultimately cause cancer. The vast majority of cancers are caused by DNA damage that accumulates over a person’s lifetime (‘sporadic’ cancer). Cancers that are directly caused by genetic faults inherited from a parent are less common.
  Smoking, chewing tobacco, taking gutka and pan masala, high- fat diet, lack of exercise or exposure to chemicals (cancer-causing substances) in the work place over long periods of time may be risk factors for some adult cancers.
  Family history, inheritance, and genetics may play an important role in some adult and childhood cancers. It is possible for cancer of varying forms to be present more than once in a family. Some gene alterations are inherited. However, this does not necessarily mean that the person will develop cancer. It indicates that chance of developing cancer increases. There are two important types of genes that, when mutated, can cause cancer-tumour suppressor genes and oncogenes.
  During the course of a day, we are continually exposed to things that damages our DNA. Things that damage the DNA are called carcinogens, and they include: Tobacco, Car exhausts fumes, the sun, Natural and manmade radiation, asbestos, pesticides, fertilizers.
  Many of these things cause damage because they react with the molecules in our cells to form free radicals. Free radicals are highly damaging molecules, and can wreck havoc on the sensitive machinery inside a cell.
  Age is an important factor for cancer. Cancer can occur at any age, but the risk of developing cancer increases with age. Over 70% of all newly diagnosed cancers occur in people aged 60 years or more. This is because the longer we live, the greater the number of potentially cancer causing mutations in our DNA.
  Some viruses are linked to certain types of cancer. Possibly, the virus alters a cell in some way. This does not mean that these cancers spread from person to person like an infection, and does not mean that everyone infected with these viruses will develop cancer.
  – Changes in bowel or bladder habits
  – Unusual bleeding or discharge
  – A sore that does not heal
  – Indigestion of difficulty swallowing
  – A nagging cough or hoarseness
  – A thickening or lump in the breast or elsewhere
  – An obvious change in wart or mole
  A physician can detect cancer by taking medical history, performing routine check ups, cancer screening tests, imaging techniques and tissue biopsy.
  – Digital rectal examination
  – Pelvic examination
  – Breast self examination
  – PAP test
  Diagnostic blood tests
  These tests are designed to identify tumor caused impairment.
  Blood tests like CBC’s- complete blood counts and differential blood cell counts.
  Tumor markers- Tumor markers are substances either released by cancer cells into the blood or urine or substances created by the body in response to cancer cells. Tumor markers are used to evaluate how well a patient has responded to treatment and to check for tumor recurrence. Eg Alpha fetoprotein (AFP), carcinoeembryonic antigen (CEA), Prostate specific antigen (PSA) etc are used to indicate the presence of tumor.
  Imaging is the process of producing valuable pictures of body structures and organs. It is used to detect tumors and other abnormalities, to determine the extent of disease, and to evaluate the effectiveness of treatment. Imaging may also be used when performing biopsies and other surgical procedures.
  Surgery is complete or partial removal of tumor. It is used in several ways to help cancer patients. It provides the best chance to stop many types of cancer, and it also plays a part in diagnosing, staging, and supporting cancer treatment. Several types of surgery are helpful to people with cancer. Some surgeries are used in combination with other types of treatment. The goal of surgery is to eliminate the cancer or in the case of advanced disease, relieve symptoms and to achieve long term remission. The goal is to
  – Remove primary cancer
  – Leave an area around the cancerous a\site that is free of cancer cells. Therefore, no cancer cells are present in the tissue surrounding the surgery site.
  – Remove nearby lymph nodes. The nodes are then examined to see if they contain any cancer cells. This is important to correctly stage the cancer. Having surgery for cancer is different for every patient, depending on the type of surgery, type of cancer, and the patient’s health.
  2) Radiation Therapy
  Radiation therapy uses precisely targeted high energy rays to kill cancer cells. It does this by damaging a cell’s internal components (molecule), causing the cells to commit suicide by apoptosis. Radiotherapy is usually required for one of the Comprehensive Blood & Cancer Centers following reasons:
  – As a standalone treatment to cure cancer.
  – To shrink a cancer before surgery
  – To reduce risk of cancer coming back after surgery.
  – To complement chemotherapy
  – To control symptoms and improve quality of life if a cancer is too advanced to cure
  Radiation therapy is given through different methods, depending on the types of cancer, the location of the cancer, and the patient’s health. Sometimes, radiation therapy is used in combination with other treatments.
  Chemotherapy is the use of anticancer drugs to destroy cancer cells. Chemotherapy reaches all parts of the body, not just the cancer cells. The oncologist will recommend a treatment plan for each individual. Specific treatment will be based on:
  – Your overall health and medical history
  – The type and stage of the cancer
  – Your tolerance for specific medications and procedures
  – Expectations for the course of disease Your opinion or preference
  The frequency, dosing and choice of chemotherapies are determined by a number of factors (e.g. the extent of cancer, the patient’s response to and recovery from chemotherapy, the overall health of the patient).
  The oncologist will also determine how long and how often you will have chemotherapy treatments. Chemotherapy treatments are often given in cycles; a treatment for a period of time, followed by a recovery period, then another treatment.
  – Shrink tumors
  – Slow cancer’s growth
  – Keep the cancer from spreading
  – Relieve diseases related symptoms
  – Prolong survival
  Chemotherapy is used to treat many different types of cancer. The type, location, and stage of the cancer as well as your general health will largely determine if chemotherapy is appropriate and which agents ought to be used.
  Each type of treatment for lung cancer has adverse effects that may last for a few months; some complications, however, can be permanent. You may be able to speed up your recovery by being aware of the side effects before you start treatment. You might be able to take steps to prevent them or shorten the length of time they last. Remember that your body is unique, and so are your emotional needs and your personal circumstances. In some ways, your cancer is like no one else’s no one can predict precisely how you will respond to
  Comprehensive Blood & Cancer Centers cancer or its treatment. Statistics can point an overall picture, but you may have special strengths such as a healthy immune system, a history of good nutrition, a strong family support system, or a deep spiritual faith. All of these have an effect on how you cope with cancer.
  If you are being treated for cancer, be aware of the battle that is going on in your body. Radiation therapy and chemotherapy add to the fatigue caused by the disease itself. Rest as much as you need to so that you feel better as time goes on. Exercise once you feel rested enough. Ask your cancer care team whether your cancer or its treatment might limit your exercise program or other activities. Do as much as you can to help yourself stay healthy and active. Even after a diagnosis of lung cancer is made, it still is very important that you quit smoking. Studies have shown that patients who continue to smoke after the diagnosis of lung cancer have worse outcomes than those who stop. Quitting also helps improve your appetite and overall health and can reduce your chance of developing a new cancer.
  Eat a balanced diet of healthy foods, including plenty of fruits, vegetables and whole grains. Once you get your strength back, try to exercise a few hours each week. Your health care team can suggest the types of exercise that are right for you. A cancer diagnosis and its treatment are major life challenges, with an effect on you and everyone who cares for you. Dietary Do’s and Don’ts
  – Have small frequent meals instead of 2-3 large meals.
  – It is important to prevent weight loss hence have food which are calorie dense and high in protein
  – Have lots of high carbohydrate foods like cereals, potatoes, suran, fruits.
  – Cereals are good sources of fiber which help relieve constipation
  – Include all pulses, peas, soya in form of soyamilk, soyaflour, soya nuggets, nutrela in your diet
  – Soya bean is a very good source of vegetable protein, it contains phytoestrogens and isoflavones which have cancer protective properties
  – Include milk in your diet, add skimmed milk powder to regular milk to increase protein content of the milk.
  – Incorporate the skimmed milk powder in products like curds cheese paneer milkshakes custards porridge pudding to increase protein content.
  – Use milk instead of water to prepare the dough of chapatti
  – Include eggs in your diet as they are complete source of proteins
  – Increase the nutritive value of dais by sprouting them.
  – Add soya flour to whole wheat flour in proportion of 1:4 while making chapattis
  – Can also add chana, bajra, ragi, jowar flour to whole wheat flour to improve the nutritive value of chapattis.
  – Dry fruits nuts, peanuts, should be included in your diet to increase the protein content
  – Wash fruits and vegetables thoroughly to protect them from causing any infection
  – Have 5-7 servings of fruits and vegetables daily, they are rich in antioxidants and are cancer protective
  – Include plenty of liquids like water, lime juices, soups, fruit juices, coconut water, buttermilk, milkshakes to your diet.
  – Have mashed potato baked vegetable with melted cheese and butter
  – Avoid aerated drinks
  – Avoid spicy food, gas producing food and food that is difficult to digest
  – Avoid very sour and extreme temperature food
  – Avoid artificial sweeteners, refined foods.
  – Avoid alcohol, smoking and chewing tobacco