ADVERTISEMENT
Cancer Data Verified

Cancer: The Emperor of Maladies

Published on Jan 04, 2015 and last reviewed on Feb 03, 2023   -  6 min read

Abstract

Carcinogenesis is a multi-step process. A plethora of factors are responsible for this process. This article highlights the basic terminologies frequently used in the field of oncology. It also discusses the steps involved in the genesis of cancer and gives valuable tips for preventing and combating this dreaded disease.

Cancer: The Emperor of Maladies

Cancer has been rightly called "The Emperor of Maladies." Hippocrates was the first to use the terms carcinomas, and carcinoma. In Greek, these words refer to a crab and more often than not, cancer cells have finger-like projections. It is wrongly assumed that cancer is known as the 'crab disease' because of its firm grip on the life of a patient.

Cancer-Causing Cells:

  • The medical term for any type of cancer is neoplasm. It refers to the proliferation of an abnormal mass of cells. These cells are called dysplastic cells.
  • They are different from normal cells and in that they are poorly differentiated.
  • This means that they do not bear any resemblance to normal cells, whereas well-differentiated cancer cells bear some resemblance to normal cells.
  • Poorly differentiated cells are also called undifferentiated cells. As a rule of thumb, poorly differentiated cells spread and invade tissues more rapidly by a process called metastasis.
  • Cells in the human body have a limited lifespan and once they are done with their functions, they undergo programmed cell death. This physiological process is called apoptosis.
  • Cancer is the result of a faulty apoptotic mechanism. That is, cells that are normally programmed to die after a certain time do not die and instead persist.
  • When an injury is incited in the form of toxins and repeated inflammation, these cells become cancerous or malignant.
  • Malignancy may also be due to faulty DNA repair mechanisms.
  • Whenever a cell is injured, several repair genes are called into play.
  • These are further classified into nucleotide excision repair genes and mismatch repair genes.
  • To give the details of the other types of DNA repair genes is beyond the scope of this article. Suffice it to say that when these repair genes fail to repair the inciting event, say an inflammation or a toxin-related injury, the cells do not undergo apoptosis and instead become malignant.

Carcinogenesis:

  • Carcinogenesis is a multi-step process.
  • It comprises inherited cancer syndromes, familial components, and complex interactions at the molecular and cellular levels.
  • Genes that promote the cell growth are called protooncogenes, and those that suppress cell growth are called tumor suppressor genes.
  • In physiological conditions, an equilibrium exists between the protooncogenes and the tumor suppressor genes.
  • Cancer is the result of a sort of disequilibrium between these two regulatory mechanisms.
  • As a tumor enlarges in size, new blood vessels keep sprouting all throughout and feed the cancer cells. This emergence of new blood vessels is termed angiogenesis.

Grading and Staging of Cancer:

  • Differentiation is used as a parameter to grade cancer.
  • Grading is done on the basis of how quickly cancer cells spread or invade neighboring tissues.
  • Grading refers to the degree of abnormality seen in the tissue under the microscope.
  • Often, the terms grading and staging are interchanged, and are wrongly done so. Grading is not the same as staging.
  • Staging refers to the size of the original tumor, also called a ''primary'' tumor.
  • The cells that have spread to other tissues to form abnormal masses are called secondaries.

Treatment of Cancer:

Treatment of cancer has come a long way.

  • Molecular profiling, targeted gene therapy, receptor profiling are some of the advances in the field of cancer chemotherapy.
  • A plethora of drugs is available to treat the disease at various stages.
  • The term neoadjuvant chemotherapy refers to shrinking the tumor before surgical resection.
  • A class of drugs has emerged called "MABs," which means monoclonal antibodies. Some examples include Trastuzumab (Herceptin), Cetuximab, Alemtuzumab, etc.

Side Effects of Chemotherapy:

  • Chemotherapy is a necessary evil. It comes with its fair share of side effects like nausea, vomiting, blisters in the mouth, mucositis, hair fall, extreme fatigue, and depression.
  • The most common side effect of chemotherapy is CINV which stands for chemotherapy-induced nausea and vomiting.
  • Surprisingly, there are drugs to counter CINV too.
  • Aprepitant and Ondansetron are commonly used to counter CINV.

Psycho-oncology:

  • Having had a brief introduction to the basic terminologies, it is important to focus on the deleterious effects cancer has on the patient's functionality. A new field has emerged in recent years and is titled psychooncology.
  • This field focuses on designing psychological interventions which help in tiding over the cancer crisis.
  • These interventions may be as simple as talking to someone close, discussing the ongoing treatment and the available future options. All this requires is an empathetic listener.
  • This process serves as a sort of catharsis and provides emotional ventilation.

A similar but more refined approach is used by therapists in Cognitive Behavioural Therapy. Other psychological interventions include hypnotherapy, talk therapy, and family therapy. Each of these therapies needs to be individualized, as there is no one-size-fits-all treatment.

Effects of Cancer on an Individual:

  • The quality of life of a patient with cancer is severely hindered.
  • Studies have found disturbances in the domains of sleep, mood, employment, finance, and anxiety levels.
  • All these factors contribute to a decline in socio-occupational functioning.
  • Cancer chemotherapy can itself result in secondary depression.
  • It is advisable to liaise with a psychiatrist for assessment and appropriate intervention.
  • The primary care physician needs to bear in mind the drug-drug interactions between anti-depressants and drugs used in chemotherapy. It is vital to rope in an expert in the field of mental health, and such decisions are best left to professionals.

Prevention of Cancer:

  • The aphorism prevention is better than cure is very apt with regard to cancer. A healthy lifestyle offsets what is called ''bad genes," and turns on ''good genes."
  • Studies have consistently shown that the only way to prolong longevity after the age of forty is via caloric restriction.
  • US based preventive medicine expert Dr. Dean Ornish in his seminal work on the prevention of cancer has categorically stated that a healthy lifestyle turns off the bad genes and switches on the good genes.
  • He advocates a plant-based diet, adequate sleep, curbing stress, spending more time with family, and having good interpersonal relationships as the necessary wherewithal to prevent and combat cancer.
  • Brisk walking for forty-five minutes per day for 5 to 7 days a week is also beneficial. As it is a non-weight bearing exercise, walking is completely injury free.
  • Another preventive measure would be to avoid all forms of radiation as and when possible. However, this is easier said than done. Cardiologists, orthopedic surgeons, and all those involved in vessel intervention operate under fluoroscopic guidance. This itself exposes them to sufficient radiation. One particular study found 6 cases of neuroblastoma in cardiologists in the US.
  • Radical surgeries (for example, removal of breasts - mastectomy) are not needed by one or all. Neither is genetic testing recommended to all and sundry. It may be useful in those who have a strong family history of cancer, those who are constantly exposed to radiation, and those whose other family members have had cancer at an early age. In such cases, advanced genetic testing as a preemptive measure is recommended.
  • However, screening for any kind of cancer should start in everyone aged over forty years.
  • Men aged over forty five years should get their Prostate-Specific Antigen (PSA) levels done annually. It is a biomarker to detect prostate cancer in the early stages.
  • Women above forty years, on the other hand, need to undergo annual mammograms and PAP smears. The importance of breast self examination (BSE) cannot be stressed more in this regard.

All said and done; given all the advances in medical science to detect cancer early, cancer can still be a curse. It may, and it will escape early detection in a vast majority of cases. This is because people are still at a nascent stage to map every possible mutation. Cancer, after all, is a permutation and combination of mutations. I came, I became a mutant, and I conquered, is what the cancer cells seem to be crying hoarse. Hope is something that helps everyone to look at a better future. And hope is necessary for doleful amounts in tiding over a cancer crisis.

Also read this article to know about childhood cancers --> https://www.icliniq.com/health-articles/health-topics/cancer/all-about-childhood-cancers

ADVERTISEMENT

Frequently Asked Questions


1.

How Does Cancer Begin?

When the cells inside the human body grow old, they become damaged and eventually die. New cells take the place of such dead cells. At times this smooth process is interrupted, and abnormal cells that are damaged grow and multiply, leading to the development of cancer.

2.

What Are the Symptoms of Cancer?

 
- Fatigue.
- Lump.
- Area of thickening which can be felt under the skin.
- Unintended weight loss.
- Unexplained weight gain.
- Skin changes.
- Yellowish discoloration of the skin.
- Change in the bowel routine.
- Abnormal bladder habits.
- Persistent cough.
- Troubled breathing.

3.

Who Is at Risk for Cancer?

There are several factors that determine individual risk of cancer, such as family history, age, habits, etc. thus, and cancer is highly individualistic. That being said, age plays a vital role in the development of cancer, and thus, individuals who are above the age of 65 are more prone to developing cancer, regardless of gender.

4.

Can Cancers Be Treated?

Surgery, medications, and radiation are a few treatment modalities for cancer. None of them promise a complete recovery from cancer. Molecular profiling, targeted gene therapy, and receptor profiling is some of the advances in the field of cancer chemotherapy.

5.

How Long Can We Have Cancer Without Knowing?

The presence of cancer can be hidden within the patient without any signs or symptoms from anywhere between several months to years. Studies have found disturbances in the domains of sleep, mood, employment, finance, and anxiety levels.

6.

Can Blood Tests Detect Cancer?

Blood tests can not detect cancer completely and can only give an indication of cancer-like symptoms. All said and done, and given all the advances in medical science to detect cancer early, cancer can still be a curse. It may, and it will escape early detection in a vast majority of cases. This is because we are still at a nascent stage of mapping every possible mutation.

7.

Do Cancer Patients Stop Eating?

Loss of appetite and being unable to eat are common clinical manifestations in patients suffering from advanced stages of cancer. Cancer chemotherapy can itself result in secondary depression. All these factors contribute to decline in socio-occupational functioning.

8.

Is Cancer Painful at the End?

No, the majority of the patients, who suffer from cancer, do not have pain, even in the last stage. Even if they do suffer from pain, there are several ways to manage the same. The primary care physician needs to bear in mind the drug-drug interactions between antidepressants and drugs used in chemotherapy. It is vital to rope in an expert in the field of mental health, and such decisions are best left to professionals.

9.

Do Cancer Patients Feel Cold?

Feeling extreme cold and other alterations in body temperature is common in patients suffering from cancer. Chemotherapy is a necessary evil. It comes with its fair share of side effects like nausea, vomiting, blisters in the mouth, mucositis, hair fall, extreme fatigue, and depression.

Last reviewed at:
03 Feb 2023  -  6 min read

RATING

16

Tags:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers


Cancerous Conditions Related to the Eye

Article Overview: Cancer is a leading cause of mortality and morbidity in the developed world and is on the rise among all age groups and social strata. The eye is also not spared from cancerous afflictions and has a whole plethora of cancerous and precancerous conditions that require proper evaluation and care by ophthalmologists. This article looks at the main cancers of the eye and has been written to be a basic guide to the common man about what important symptoms s/he will need to be concerned about and those problems that would need an immediate consultation with an ophthalmologist. Read Article


Manjunath Natarajan
Manjunath Natarajan
Ophthalmology (Eye Care)

Cancer is a leading cause of mortality and morbidity in the developed world and is on the rise amongst all age groups and social strata. The eye is also not spared from cancerous afflictions and has a whole plethora of cancerous and precancerous conditions that require proper evaluation and care by ...  Read Article

What are the small clustered cystic areas seen in the left breast.

Query: Hello doctor, I have multiple small clustered cystic areas seen in the left breast.  Read Full »

Please help me interpret my Pap smear reports.

Query: Hello doctor, I had irregular bleeding for eight weeks. Since ten days it is better. Please examine my pap smear report and HPV report. I got it done as there was irregular bleeding. I have PCOD and diabetes. Currently, I am taking Metformin XR 850 mg. Please let me know whether all looks fine.  Read Full »

Popular Articles Most Popular Articles

Do you have a question on Cancer or Metastasis?

Ask a Doctor Online

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.