What you must know about cancer — and why

I have family who has been recently diagnosed with cancer. I’ve had family members who have battled with cancer before. A few survived for a short period. Many didn’t.

You must have heard that Hugh Jackman is fighting his own battle with skin cancer. He has undergone several procedures to keep it under control. Everybody fears cancer for good reasons. Angelina Jolie had her breasts and ovaries removed to avert cancer even before she was positively diagnosed with one.

We all know at least one person who is battling with cancer right now. It has become so prevalent that at least 1 of 6 deaths worldwide can be attributed to cancer. In 2015 alone, 8.8 million people died of cancer causes according to the World Health Organization. That makes cancer the second leading cause of death, next to Ischaemic heart disease and stroke.

Cancer is not unique to any particular group. It does not discriminate. Yet, 70 per cent of deaths due to cancer are recorded in developing countries where diagnostics are poor and access to treatment can be a challenge. Many of these deaths could have been prevented.

What is cancer?

WHO defines cancer as “a generic term for a large group of diseases characterized by the growth of abnormal cells beyond their usual boundaries that can then invade adjoining parts of the body and/or spread to other organs”.

Cancer can start in any part of our body. From there, cancer can metastasize or spread to other parts of the body away from its original site of tumor growth. Metastases is what robs us of the people we love and care about. Cancer happens in many stages. Some cancers metastasize gradually while some do at record speeds.

According to WHO, the top 5 cancers causing deaths in men (in order of frequency) are lung, liver, stomach, colorectal and prostate cancers. In women, the more prevalent causes of cancer deaths are breast, lung, colorectal, cervical and stomach cancers.

What causes cancer?

There are many things about cancer that we are only beginning to understand while many remain to be the subjects of research. Every minute we spend not knowing what the root cause of cancer is, we lose at least 16 cancer patients in the fight. Until then, the experts will be working on pinning down the mechanisms of cancer development so we can attack it where it will hurt it the most.

Until then, here is what the world knows about the causes of cancer:

1. Ultraviolet radiation and radiation from other sources, including tanning beds and hospital equipment such as X-Rays. As for radiation and radiofrequency emitted by our home appliances, computer screens and mobile phones, the evidence is mixed and inconclusive. Some studies have linked these equipment and gadgets to increased incidence of leukemia and brain tumors. The WHO’s International Agency for Research on Cancer has previously classified extremely low frequency electric and magnetic fields as “possibly carcinogenic”.

2. Chemical carcinogens including the chemicals found in a cigarette stick, asbestos, nitrates used as preservatives in the food that we eat and in the tap water we drink, and a host of other toxic chemicals. Find out more about toxic chemicals in personal care products we use everyday here.

3. Viral, bacterial or parasitic infections such as Human papillomavirus (HPV) which is associated with the development of cervical, vulvar, vaginal, penile, anal and liver cancers.

4. Poor habits and lifestyle choices including smoking, alcohol and drug abuse, obesity and lack of exercise. These compromise our body’s immune system.

5.  Ageing which generally causes body processes to slowdown and become more prevalent to errors, possibly in DNA coding and cell development.

6. Genetics, although still frequently used as a factor in cancer screening, many health experts are now putting low value to genetic factors when it comes to cancer development. Although immune response, whether weak or strong, can also run in families. The discovery of human oncogenes, the first one having been found by leading cancer researcher Robert Weinberg, point out that bad genes are more commonly acquired rather than inherited. Oncogenes are bad genes that bypass the natural controls set up in a normally functioning cell.

Every cell in our body is made to function in a very specific, highly specialized manner. All of these factors have the potential, singly or in combination, to alter the cells, their characteristics, behavior and function.

Early signs of cancer

Cancer can manifest in many ways — some make itself apparent in early stages while some, much later in its development. It also depends on what part of the body the cancer cell originated from and where it has spread.

The key to cancer survival depends on early diagnosis but, prior to that, it requires you to be more vigilant and observant about significant changes in your body. Have yourself checked if you feel there could be something wrong. Cancer Research UK lists the following as the most common signs and symptoms of cancer:

  1. breathlessness
  2. unexplained vaginal bleeding
  3. persistent heartburn or indigestion
  4. croaky voice or hoarseness
  5. looser poo or pooing more often
  6. persistent bloating
  7. difficulty swallowing
  8. sore that won’t heal
  9. mouth or tongue ulcer that won’t heal
  10. heavy night sweats
  11. unusual breast changes
  12. blood in your poo
  13. blood in your pee
  14. unexplained weight loss
  15. new mole or changes to a mole
  16. coughing up blood
  17. persistent cough
  18. problems peeing
  19. unexplained pain or ache
  20. unusual lump or swelling anywhere

The Environmental Working Group also sums up what cancer experts often term as the hallmarks of cancer, taking off from the studies made by Douglas Hanahan and Robert Weinberg. Cancer develops and spreads when the following conditions are present:

1. Self-sufficient cell division. The cell bypasses the stimulation and inhibition controls that are normally programmed in a cell. It becomes a “renegade cell”, the only objective of which is to survive and keep proliferating even at the expense of other cells.

2. Limitless division. Characterizes the situation where the cell undergoes continuous, unregulated multiplication of cells.

3. Absence of apoptosis. Since cells are assigned highly specialized functions, each one is made in very specific ways that come with what can be thought of as controls and buttons. Apoptosis can be thought of as “cell suicide” and it happens when the cell itself detects that something is wrong with either its structure or programming. The problem with cancer cells is that it does not have this function. Even when it is flawed, it doesn’t die and, instead, persist and spread.

4. Unlimited replication potential. Normal cells have a life span, signalled by the length of telomeres. Each time a cell divides, its telomere shortens until such time when the cell can no longer divide. In the case of cancer cells, this mechanism does not exist, making its cell division function practically limitless and boundless.

5. Growth of new blood vessels. Tumors are like parasites. It will plant itself on the body, growh its own blood vessels, and uproot more nutrients and oxygen to support its growth at the expense of healthy cells around it. It simply doesn’t care as long as it survives.

6. Presence of metastasis.  Cancer spreads to other parts of the body via rapid cell division combined with invasion of otherwise healthy tissues. It can travel to other parts of the body by bypassing tissue cavities, through the bloodstream or via the lymphatic system. As cancer cells mutate, they deviate from their original, highly specialized functions until these start to affect the normal functioning of the organ where it originated and those where it has metastasized.

7. Ability of cancer cells to survive in oxygen-deprived environments. This means that cancer cells can be persistent.

8. Ability of cancer cells to evade the immune system. This allows cancer cells to proliferate.

9. Occurrence of gene alterations. Changes in the DNA makeup causes cancer cells to behave differently, taking on properties where no regulation mechanisms are present to control it — how frequently it divides, until when it divides, and where it grows.

10. Presence of chronic inflammation. This causes healthy cells to be overrun by free radicals, as well as create an environment that favors the further spread of cancer cells.

Cancer prevention

WHO estimates that up to 50% of cancers are preventable and that at least a third are caused by poor habits and lifestyle choices. Cancers with infectious origins such as HPV and hepatitis can be prevented by vaccination.

It takes the following actions to prevent cancer:

  1. Increased awareness and information
  2. Regular medical checkups
  3. Screening
  4. Avoidance of risk factors
  5. Vaccination
  6. Better nutrition
  7. More active lifestyle
  8. Smart sun exposure
  9. Avoiding carcinogenic chemicals in food consumed and products used
  10. Avoiding environmental, including occupational, exposures to carcinogens

Cancer treatment

There are two key information needed before a cancer treatment strategy can be drawn out:

1. Where the tumor is located?
2. How far has it spread?

The most common treatment strategies involve:

1. surgery
2. radiation1
3. chemotherapy

Radiation and chemotherapy work by attempting to slowdown the process of cell division to stop the rapid spread of cancer cells.  The main issues with current treatment options is that these are non-specific, non-targeted treatment mechanisms that affect the entire body. Use of surgical procedures for cancer prevention has been questioned because it does not guarantee a patient will remain cancer free after surgery. Radiation and chemotherapy do not just slowdown cell division of or kill cancer cells but those of healthy cells as well.

Radiation and chemotherapy are associated with a host of side effects including hair loss, nausea and fatigue, organ toxicity, among many others.

Cancer survival can depend on many factors other than treatment. It has to be complemented by a healthier lifestyle, beginning with a healthy diet. Some cancer research studies have shown how certain foods like green tea and berries can help induce apoptosis in cancer cells, killing these safely and effectively without harming healthy cells. The support of families and emotional and psychological well-being of a cancer patient may also affect the success of treatment.

There have been many attempts to connect terminal diseases, including cancer, to the positive benefits of faith and healing. Most point out the increased well-being and enhanced tolerance of patients to the pain associated with cancer treatment. Even the Cancer Research UK encourages cancer patients to seek healing options if that will provide them relief from the stress, anxiety and depression associated with cancer [http://www.cancerresearchuk.org/about-cancer/cancers-in-general/treatment/complementary-alternative/therapies/healing]

For more about the healing power of faith and mind, read this.

Our future with cancer

The number of cancer patients is expected to balloon to 22 million new cases every year for the next two decades.  As much as we’d like to have a fail-safe mechanism already instituted when it comes to cancer prevention and treatment, it has been a challenging disease to overcome. Yet, we can look at a brighter future.

Here are some of the developments we hope will continue to bring practical benefits very soon:

1. DNA mapping a tumor to make treatment more person-specific rather than the current one-shot-fits-all approach

2. Immunotherapy and chemotherapy strategy that strengthens and trains the immune system to identify and tackle cancer cells

3. Liquid biopsy, a new way for early detection of cancer and for reoccurrence among cancer survivors to be prevented much earlier

4. Multi-gene panel testing which tests for the presence of so called cancer susceptibility genes

5. Development of molecule-targeted and inhibitor drugs for more precise treatment strategies for specific types of cancers

6. Treatment strategies targeting antiangiogenesis, which attempts to prevent tumor growth and proliferation by preventing the growth of blood vessels that deliver nutrients and oxygen to support its survival.

Would I have been able to influence the health condition of people I know — have known — who face cancer? Besides providing assurance, emotional and spiritual support, I wasn’t sure how else I could have helped. Treatment doesn’t come easy nor does it come cheap from where I stand. I can only hope that I tried to find out more about cancer much earlier but, I remain grateful to own a platform to share what I’ve been finding out about cancer through this website but also via a resource most of us now already own a piece of — social media.

My experience with cancer is not unique — standing on the sidelines, observing, hoping that cancer won’t become my problem one day but, isn’t it already? Hasn’t it been my problem for a long time too? I strongly believe it’s about time we all take cancer more personally. Share this article if you care. Get involved in the discussions by commenting below.

Main references used:

“Cancer” World Health Organization. http://www.who.int/cancer/en/

“Everything we think we know – and know we don’t know – about cancer” based on the book, “Betrayed by Nature: The War on Cancer” by Dr Robin Hesketh. http://www.cam.ac.uk/research/news/everything-we-think-we-know-and-know-we-dont-know-about-cancer

“Key signs and symptoms of cancer” Cancer Research UK.  http://www.cancerresearchuk.org/about-cancer/cancer-symptoms

“Rethinking Carcinogens: New view of cancer development focuses on subtle, combined effects” Environmental Working Group. 2015. http://static.ewg.org/reports/2015/rethinking_carcinogens/rethinking_carcinogens.pdf?_ga=1.185530473.1392707575.1483974955

Soffe, Emilie. “What we know and don’t know about cancer” TED-Ed Lessons. http://blog.ed.ted.com/2016/02/04/what-we-know-and-dont-know-about-cancer/

“Sustainable Development Goal 3” United Nations https://sustainabledevelopment.un.org/sdg3

“Clinical Cancer Advances 2017: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology” Journal of Clinical Oncology. http://ascopubs.org/doi/full/10.1200/JCO.2016.71.5292

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