Cancer is a disease which occurs when changes in a group of normal cells within the body lead to uncontrolled, abnormal growth forming a lump called a tumour; this is true of all cancers except leukaemia (cancer of the blood). If left untreated, tumours can grow and spread into the surrounding normal tissue, or to other parts of the body via the bloodstream and lymphatic systems, and can affect the digestive, nervous and circulatory systems or release hormones that may affect body function.
Cancer tumours can be divided into three groups: benign, malignant or precancerous.
1. Benign tumours are not cancerous and rarely threaten life. They tend to grow quite slowly, do not spread to other parts of the body and are usually made up of cells quite similar to normal or healthy cells. They will only cause a problem if they grow very large, becoming uncomfortable or press on other organs - for example a brain tumour inside the skull.
2. Malignant tumours are faster growing than benign tumours and have the ability to spread and destroy neighbouring tissue. Cells of malignant tumours can break off from the main (primary) tumour and spread to other parts of the body through a process known as metastasis. Upon invading healthy tissue at the new site they continue to divide and grow. These secondary sites are known as metastases and the condition is referred to as metastatic cancer.
3. Precancerous (or premalignant) describes the condition involving abnormal cells which may (or is likely to) develop into cancer.
Cancer staging
The classification of cancer by anatomical extent of the disease, i.e. stage, is essential to patient care, research and cancer control. The UICC TNM staging system is the common language adopted by oncology health professionals to communicate on the cancer extent for individual patients. Once the stage of cancer is known and understood, this is often a basis for deciding appropriate treatment and individual prognosis. It can also be used to inform and evaluate treatment guidelines, and constitutes vital information for policy-makers developing or implementing cancer control, prevention plans and research.
The TNM classification focuses on the anatomical extent of the tumour and is determined by assessing the following categories:
· T describes the size of the main (primary) tumour
· N describes whether the cancer has spread to the nearby lymph nodes
· M describes whether the cancer has metastasised (spread from the primary tumour to another part of the body)
Managing and treating cancer
Your treatment depends on the type of cancer, where your cancer is, how big it is, whether it has spread, and your general health. The general types of treatments include: surgery, chemotherapy, radiotherapy, hormone therapy, immunotherapy, and gene therapy.
Surgery
If a cancer has not metastasised (spread), surgery can remove the entire cancer which may completely cure the disease. Often, this is effective in removing the prostate or a breast or testicle.
Radiotherapy
Radiation treatment or radiotherapy uses high-energy rays to reduce a tumour or destroy cancer cells as a stand-alone treatment and in some cases in combination with other cancer treatments.
Chemotherapy
Chemotherapy uses chemicals to interfere with the way cells divide - damaging of DNA - so that cancer cells will destroy themselves. These treatments target any rapidly dividing cells (not necessarily just cancer cells), but normal cells usually can recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is generally used to treat cancer that has spread or metastasised because the medicines travel throughout the entire body. It is a necessary treatment for some forms of leukaemia and lymphoma.
Immunotherapy
Immunotherapy uses the body's own immune system to fight the cancer tumour. Immunotherapy may treat the whole body by giving an agent that can shrink tumours.
Hormone therapy
Several cancers have been linked to some types of hormones, including breast and prostate cancer. Hormone therapy works to change hormone production in the body so that cancer cells stop growing or are killed completely.
Gene therapy
The goal of gene therapy is to replace damaged genes with ones that work to address a root cause of cancer: damage to DNA. Other gene-based therapies focus on further damaging cancer cell DNA to the point where the cell destroys themselves. However, gene therapy is new and has not yet resulted in any successful treatment
Survivorship
Survivorship focuses on health and the physical, psychological, social and economic issues affecting people after the end of the primary treatment for cancer, including people who have no disease after finishing treatment, people who continue to receive treatment to reduce the risk of the cancer coming back and people with well controlled disease and few symptoms, who receive treatment to manage cancer as a chronic disease.
Survivorship care includes issues related to follow-up care, the management of late side-effects of treatment, the improvement of quality of life and psychological and emotional health. Survivorship care includes also future anticancer treatment where applicable. Family members, friends and caregivers should also be considered as part of the survivorship experience.
Palliative care
Palliative care runs throughout a patient’s journey from diagnosis to cure or end of life, and is designed to relieve symptoms and improve a cancer patient’s quality of life. It can be used to respond to troubling symptoms such as pain or sickness, and also to reduce or control the side effects of cancer treatments. In advanced cancer, palliative treatment might help someone to live longer and to live comfortably, even if they cannot be cured.
Key Cancer Facts
Cancer is the second-leading cause of death worldwide.
10 million people die from cancer every year.
More than 40% of cancer-related death could be preventable as they are linked to modifiable risk factors such as smoking, alcohol use, poor diet and physical inactivity.
Almost at least one third of all deaths related to cancer could be prevented through routine screening, and early detection and treatment.
70% of cancer deaths occur in low-to-middle income countries.
Millions of lives could be saved each year by implementing resource appropriate strategies for prevention, early detection and treatment.
The total annual economic cost of cancer is estimated at US$1.16 trillion.
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