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| CANCER ? |
Battling cancer is a tough time in anyone’s life, perhaps the toughest. It is very important to properly care for yourself during treatment. You will undoubtedly need assistance from friends and family. Ask for it! You will have many emotions, including fear and depression, during this time. Talk about them! Eat well and exercise. And last develop good communication with your doctor and rest of your team. They are here for you. |
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| What is Cancer? |
Cancer is a general term used to describe cells that grow and spread around the body in an uncontrolled way. Our body is made up of millions of tiny cells which replace themselves whenever necessary. The cells in our body grow and multiply in a process known as cell division. It must be extremely tight 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. If the genes involved in cell division are 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 a lump of abnormal tissue called a tumor. |
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| What do terms Benign and malignant mean? |
| A tumor may be benign or malignant: |
A benign tumor is not cancer, does not spread, can be usually completely removed, is not likely to recure and does not usually present a serious threat to health. |
A malignant tumor is cancer, and can invade neighboring tissue and organs 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 while others have unknown causes. When cancer comes back again to a person who appeared to be free of the diseases after treatment, it is called recurrence. |
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| How does cancer spread? |
A malignant tumor is made up of cancer cells. When it develops, this malignant tumor may be confined to its original site. This is known as a cancer in situ (or carcinoma in situ). If these cells are not treated, they may spread beyond normal boundaries and into surrounding tissues, becoming invasive cancer. |
Some benign tumors are precancerous and may progress to cancer if left untreated. Other benign tumors do not develop into cancer. |
Sometimes cells move away from the original (primary) cancer, either by 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. |
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| How does cancer make you ill ? |
Cancerous cells divide uncontrollably. On its own, a single tumor can make you quite ill, for example by pressing against nerves, blocking the digestive system or blood vessels, or by releasing hormones that can affect the normal workings of your body. |
Things can get much worse, however if the cancer becomes malignant and spreads. Once a tumor metastasize, it is much more difficult to treat, and can make you much more ill because more areas of the body are affected. |
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| Types of Cancers? |
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Bladder Cancer: Cancer that forms in tissues of the bladder (the organ that stores urine). Most bladder cancers are transitional cell carcinomas (cancer that begins in cells that normally make up the inner lining of the bladder). Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation. |
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Breast Cancer: Cancer that forms in tissues of the breast, usually the ducts (glands that make milk). It occurs in both men and women, although male breast cancer is rare. |
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Colon Cancer: Cancer that forms in the tissues of the colon (the longest part of the large intestine).
Most colon cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). |
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Rectal Cancer: Cancer that forms in the tissues of the rectum (the last several inches of the large intestine before the anus). |
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Endometrial Cancer: Cancer that forms in the tissue lining the uterus (the small, hollow, pear shaped organ in a woman’s pelvis in which a baby grows). Most endometrial cancers are adenocarcinomas. |
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Kidney Cancers: Cancer that forms in tissues of the kidneys. Kidney cancer includes renal cell carcinoma (cancer that forms in the lining of very small tubes in the kidney that filter the blood and remove waste products) and renal pelvis carcinoma (cancer that forms in the center of the kidney where urine collects). It also includes Wilms’ tumor, which is a type of kidney cancer that usually develops in children under the age of 5. |
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Leukemia: Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the blood stream. |
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Lung Cancer: Cancer that forms in tissues of the lung, usually in the cells lining air passages. The two main types are small cell lung cancer and non-small cell lung cancer. These types are diagnosed based on how the cells look under a microscope. |
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| Melanoma: A form of skin cancer that begins in melanocytes (the cells that make the pigment melanin). Melanoma usually begins in a mole. |
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Non-Hodgkin’s Lymphoma: NHL. Any of a large group of cancers of the immune system, NHLs can occurs at any age and are often marked by enlarged lymph nodes, fever, and weight loss. There are many different types of NHL, which can be divided into aggressive (fast-growing) and indolent (slow growing) types and can be classified as either B-cell or T-cell NHL. B-cell NHLs include Burkitt’s lymphoma, diffuse large B-cell lymphoma, follicular lymphoma, immunoblastic large cell lymphoma, and mantle cell lymphoma. T-cell NHLs include mycosis fungoides, anaplastic large cell lymphoma, and precursor T-lymphoblastic lymphoma. Lymphomas related to lymphoproliferative disorders following bone marrow or stem cell transplantation are usually B-cell NHLs. Prognosis and treatment depend on the stage and type of disease. |
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Pancreatic Cancer: A disease in which malignant (cancer) cells are found in the tissues of the pancreas. Also called as the exocrine cancer. |
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Prostate Cancer: Cancer that forms in the tissues of the prostate (a gland in the male reproductive system found in front of the rectum). Prostate cancer usually occurs in older men. |
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Skin Cancer: Cancer that forms in the tissues of the skin. When cancer forms in cells that make pigment, it is called melanoma. When cancer forms in cells that that do not make pigment it may begin in basal cells (small, round cells in the base of the outer layer of skin) or squamous cells (flat cells that form the surface of the skin). Both types of skin cancer usually occur in skin that has been exposed to sunlight, such as the skin on the face, neck, hands, and arms. |
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Thyroid Cancer: Cancer that forms in the thyroid gland (an organ at the base of the throat that makes hormones that help control heart rate, blood pressure, body temperature, and weight). Four main types of thyroid cancer are papillary, follicular, medullary, and anaplastic thyroid cancer. The four types are based on how the cancer cells look under the microscope. |
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| What Cause Cancer? |
There is no single cause for cancer. Scientists believe that it is the interaction of many factors together that produces cancer. The factors involved may be genetic, environmental, or constitutional characteristics of an individual. |
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. |
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| What are the risk factors for cancer? |
A risk factor is anything that may increase a person’s chance of developing a disease. A risk factor does not necessarily cause the disease, but it may make the body less resistant to it. The following risk factors and mechanisms have proposed as contributing to the development of the cancer. |
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Lifestyle factor:
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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. |
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| Genetic factors: |
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 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-tumor suppressor genes and oncogenes. |
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| Environmental Hazards: |
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 man made 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. |
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| Age: |
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 cancer 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. |
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| Viruses: |
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. |
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| What are the warning signs of cancer? |
The chances of curing the Cancer increases with early detection. The Indian Cancer Society and other organizations recommend paying attention to seven warning signs of cancer:
1. Changes in bowel or bladder habits.
2. Unusual bleeding or discharge.
3. A sore that does not heal.
4. Indigestion or difficulty swallowing.
5. A nagging cough or hoarseness.
6. A thickening of lump in the breast or elsewhere.
7. 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. |
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| What is cancer screening? |
| The tests designed to detect cancer when one doesn’t have any symptoms. They include, |
1. Digital rectal examination
2. Pelvis examination
3. Breast self examination.
4. PAP test.
5. Mammography. |
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| How is cancer Diagnosed? |
There is no single test that can accurately diagnose cancer. The complete evaluation of a patient usually requires a thorough history and a physical examination along with diagnostic testing. Many tests are needed to determine whether a person has cancer, or if another condition (such as infection) is mimicking the symptoms of cancer. There are a number of ways to diagnose cancer. |
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| Diagnostic blood tests: They are designed to identify a tumor caused impairment. |
Blood tests like CBCs-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. |
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| Imaging Techniques: |
Imaging is a 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. |
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| What are the treatment methods available for cancer? |
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There is no single treatment for cancer, doctors have a range of options available and must decide which is best for the patient. They will often combine several types of treatment for greater effect, taking into account all sorts of factors. |
1. Surgery: 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 cancers, 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 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 very 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. |
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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 following reasons: |
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• As a stand alone 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 to improve quality in life if a cancer is too advanced to cure. |
Radiation therapy is given through different methods, depending on types of cancer, the location of the cancer, and the patient’s health. Sometimes, radiation therapy is used in combination with other treatments. |
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3. Chemotherapy: 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: |
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• 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. |
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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. |
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| Follow up care |
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Follow-up care is important after treatment. Your health care team will explain what tests you need and how often they should be done. Make a special effort to keep all appointments with your cancer care team and follow their instructions carefully. The health care team will determine which test should be done and how often, based on the types of cancer, its stage at diagnosis, and its response to treatment.
Your doctor will take a medical history and examine you to check for new symptoms or signs that might indicate if your cancer is recurring or progressing. Chest x-ray may be taken to look for a recurrence or for a new tumor.
It is not uncommon for a new cancer to develop. Blood tests may be done to help look for recurrent cancer and for certain side effects of treatment. Additional blood tests and imaging tests may be performed, based on the results of routine tests and examinations. It is important for you to report any new or recurring symptoms to your doctor right away so that any problems related to a recurrent cancer or side effects of the treatment can be dealt with promptly.
Each type of treatment for cancer have some 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. Statistics can point an overall picture, but you may have special strengths such as healthy immune system, a history of good nutrition, a strong family support system, or a deep spiritual faith. All of these have an affect on how you cope with the 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. Eat a balanced diet of healthy foods, including plenty of fruits, vegetable and whole grains. Once you get your strength back, try to exercise a few hours every 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.
1. Have small frequent meals instead of 2-3 large meals.
2. It is important to prevent weight loss hence have food which are calorie dense and high in protein.
3. Have lots of high carbohydrate foods like cereals, potatoes, suran, fruits.
4. Cereals are good sources of fiber which help relieve constipation.
5. Include all pulses, peas, soya in form of soyamilk, soyaflour, soya nuggets, nutrela in your diet.
6. Soya bean is a very good source of vegetable protein; it contains phytoestrogens and isoflavones which have cancer protective properties.
7. Include milk in your diet, add skimmed milk powder to regular milk to increase protein content of the milk.
8. Incorporate the skimmed milk powder in products like curds, cheese, paneer, milkshakes, custards, porridge pudding to increase protein content.
9. Use milk instead of water to prepare the dough of chapatti.
10. Include eggs in your diet as they are complete source of protein.
11. Include the nutritive value of dais by sprouting them.
12. Add soya flour to whole wheat flour in proportion of 1:4 while making chapattis.
13. Can also add chana, bajra, ragi, jowar flour to whole wheat flour to improve the nutritive value of chapattis.
14. Dry fruit nuts, peanuts should be included in your diet to increase the protein content.
15. Wash fruits and vegetables thoroughly to protect them from causing any infection.
16. Have 5-7 servings of fruits and vegetables daily, they are rich in antioxidants and are cancer preventive.
17. Include plenty of liquids like water, lime juices, soups, fruit juices, coconut water, buttermilk, milkshakes in your diet.
18. Have mashes potato baked vegetable with melted cheese and butter.
19. Avoid aerated drinks.
20. Avoid spicy food, gas producing food and food that is difficult to digest.
21. Avoid very sour and extreme temperature food.
22. Avoid artificial sweeteners, refined foods.
23. Avoid alcohol, smoking and chewing tobacco.
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