WHAT IS CANCER

Q1. What is Cancer?
Ans. Cancer is an abnormal growth of a body cell or group of cells. If it is not destroyed or removed. Cancer can spread very rapidly, and eventually lead to death.

Q2. What is the difference between normal and cancerous growth?
Ans. There are billions of cells in the human body. Normally, they grow in a well- regulated pattern. When cancer sets in, a group of cells suddenly starts multiplying haphazardly and forms a lump or “tumour”.

Q3. How many kinds of tumours are there?
Ans. There are two kinds of tumours- Malignant & Benign. A benign tumour is more common, and is generally harmless. It doesn’t spread to other parts of the body. A malignant tumour on the other hand, never stops growing unless until treated and can spread to other parts of the body. Cancer is the name given to a malignant growth.

Q4. Is cancer contagious or infectious?
Ans. No, since cancer is not caused by a germ, it is not “catching”, and cannot be transmitted from one person to another.

Q5. Is cancer a blood disease?
Ans. No, cancer cells may move through the blood stream to another part of the body indicating spread of disease. Cancer can, however, develop in certain tissues which form the blood cells.

Q6. How does cancer spread?
Ans. In 3 ways:
a. Cancer cells grow through the walls of blood vessels and are carried by the blood stream to other parts of the body.
b. They enter the lymphatic stream and are carried to the lymph glands.
c. They grow directly in contiguity from one tissue to another.

Q7. How fast does cancer grow?
Ans. There is no definite rate of growth of cancer tissue. Some cancers grow fast and some are slow growing. For example, it takes 2 to 5 years for breast cancer to develop to 1cm.

Q8. Is cancer a single disease?
Ans. No. The term “cancer” includes all forms of malignant growth. Very many varieties are known. These have certain characteristics in common, such as uncontrolled growth, a tendency to spread widely in the body and fatal termination if not treated early and adequately. They differ in certain characteristics, such as location in the body, microscopic appearance, and response to treatment.


Q9. How can you tell if you have cancer?
Ans. There are 7 early warning signals. But the real tragedy about cancer is that it produces very minor symptoms at first. So you could have cancer and not know it. The best way to detect cancer is to have a regular yearly check-up.

Q10. How does a doctor tell if growth is cancerous?
Ans. By performing a biopsy or FNAC i.e. examining a small portion of the tissue under a microscope. In advanced cases, physical examination alone may reveal the diagnosis. But the chances of cure at late stage are very poor.

Q11. Are cancer and leprosy related?
Ans. No. Leprosy is caused by a germ, Both the symptoms and the treatment for the two diseases are entirely different.

Q12. Is cancer a modern disease?
Ans. As long ago as 3,000 BC., Egyptian historians made references to “tumours and ulcers”. Mummies from the Gizeb Pyramids were found to have cancer involving the bones. But the incidence of cancer is increasing. It is related to our life styles and urbanization i.e. tobacco, alcohol use, pollution, preserved and junk food etc. It is becoming a disease of modernization.


Q13. Are some people more prone to certain types of cancer?
Ans. Yes. Your life-style may make you more prone to some cancers. e.g. cancers of the colon, lungs and skin are common in Britain and U.S.A., Cancers involving the oral cavity are more common in India. In women, cancer of the breast, uterus and gall bladder are common.

Q14. What are your chances of getting cancer?
Ans. One out of every 8 Indians develop cancer in their lifetime. There are about 8.5 lakh cancer patients in India alone (Year, 2000). Though cancer can occur at any age, the incidence is high after the age of 40 to 45.

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Q29. How can one guard against cancer?
Ans. Prevention is better than cure. More than half of the cancers are preventable! Avoid smoking and tobacco chewing in any form. Alcohol should only be taken in moderation. It is better avoided. Take low fat, vegetarian diet. Avoid ill fitting dentures, Report to doctor immediately if you notice any of seven warning signals.

Q30. What is meant by a “precancerous lesion”?
Ans. Any abnormal condition that, if permitted to continue, may develop into cancer with passage of time. Cancer does not in day’s or week’s time. It takes many years to develop. It passes through many stages Normal cell?Abnormal cell?Precancerous lesion?Frank cancer?Metastasic cancer.

Q31. What are some of the more important precancerous lesions?
Ans. White spots on mucous (lining) membranes, especially of the mouth; non healing sores caused by jagged teeth and ill fitting dental plates; dark coloured moles which itch or bleed. These should all be investigated by a physician and adequately treated. Submucous fibrosis with inability to open mouth, polyps in large intestine, Barret’s oesophagus associated with reflux oesophagitis are some of the conditions which should alarm the patient and physician. These require careful monitoring.

Q32. What precautions should be taken to avoid cancer of the mouth?
Ans. Cancer of mouth is largely preventable disease. Avoid use of tobacco in any form (pan parag, pan masala, gutaka etc.) Any sore in mouth which does not heal in three weeks time should be examined by doctor and if required biopsied. Keep the mouth clean. Have jagged teeth filed or removed. Do not use an ill-fitting dental plate, which causes a sore on the gums or cheek. If white spots appear in the mouth or on the tongue, stop the use of tobacco and see a doctor.

Q33. What precautions should be taken to avoid cancer of the skin?
Ans. Dark coloured moles and warts, which become itchy or bleed or ulcerate should be removed. Fair-skinned people should avoid overexposure to direct sun rays. Recurrent blisters on the lip should be carefully examined. Skin should always be kept clean.

Q34. Should all moles be removed?
Ans. N0. A flat colourless mole is probably as harmless as a freckle. Bluish-black hairless moles, especially when subjected to irritation, should be removed. Any mole or wart showing changes in size or colour or bleeding should be promptly and completely removed and the tissue examined by a pathologist to determine if cancer is present.

Q35. Can immunity to cancer be acquired as with diptheria or typhoid fever?
Ans. Production of immunity is possible only in diseases caused by germs. As cancer is not caused by germs, immunity cannot be developed against it. But scientists are exploring possibilities of vaccines for cancer.

Q36. Why do many people wait before consulting a physician when cancer may be present or suspected?
Ans. Primarily because of fear. Ignorance of the signs of cancer and the vital importance of early treatment also play a role. Some people also think there is a social disgrace in having cancer and so hide the fact from their physicians and often from friends and relatives. This is not a justifiable attitude.

Q37. Can a tuberculous person ever have cancer?
Ans. He can. The presence of tuberculosis or any other disease gives no assurance that cancer will not develop.

Q38. Why don’t the white corpuscles in the blood kill cancer?
Ans. The chief function of white blood corpuscles is to protect the body against bacteria or germs. They kill germs and combat infection. Current research is being undertaken to promote such activity by certain kinds of white blood corpuscles.

Q39. How can we control cancer?
Ans.
a. By a prompt visit to a physician when suspicious signs or symptoms appear. Intelligent alertness by the individual may well save his life.
b. By having complete, annual physical examinations, as a routine. Women over 35 should be examined once a year.
c. By confirming diagnosis at he earliest possible moment, followed by adequate treatment.
d. By a widespread knowledge, both layman and professional, of the character of cancer, its causes, methods of spread, and by recognizing the value of early diagnosis and adequate treatment, as the means of protection.
e. Most important is prevention of cancer by change of lifestyles.

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Q40. How can you tell if you have cancer without seeing a doctor?
Ans. You can only suspect. A regular thorough physical check-up is your best guard against cancer, plus an examination when one of the seven danger signals or warning appears. You are the first line of defence against cancer because, you alone, can recognize a danger signal.

Q41. What are some of the early signs of cancer?
Ans. There are seven common ones. They are often called the Seven Danger Signals of Cancer.
1. Change in bowel or bladder habits.
2. A sore that does not heal.
3. Unusual bleeding or discharge.
4. Thickening or lump in breast or elsewhere.
5. Indigestion or difficulty in swallowing.
6. Obvious change in wart or mole.
7. Nagging cough or hoarseness.
You should at once consult a doctor upon the appearance of any sign.

Q42. Is pain an early symptom of cancer?
Ans. No, except in a cancer involving bone or nerve tissue. Pain usually is a late symptom and when it occurs, the growth is often far advanced.

Q43. Why should cancer be diagnosed and treated early?
Ans. The sooner it is found it is less likely to have spread to other parts of the body. Early cancer can be cured.

Q44. How long it is safe to wait before consulting a physician?
Ans. Any delay is dangerous. Go at once to a doctor and ask for a thorough examination.

Q45. Why are periodic examination necessary?
Ans. The earlier a cancer is treated the greater are the chances of a cure. Through periodic examinations, cancer may be detected in its early stages before the individual has noticed any sign or symptom in himself.

Q46. Where can you get a Cancer check-up?
Ans. RGCI&RC has all screening facilities. Any individual with or without warning signals can come for check-up. Indian cancer society also runs several check up clinics.

Q47. What comprises a thorough cancer check-up?
Ans. Thorough cancer check up means examination of all accessible body parts like head and neck, oral cavity, chest, abdomen, breast, vaginal and rectal examination. Cancer screening at RGCI&RC also includes certain blood tests, X-ray chest, US whole abdomen, mammogram, pap’s smear, sputum exam, stool for occult blood and PSA (for prostate). Clinical examination and all investigations are done at nominal rates.

Q48. Is the check-up painful?
Ans. The check-up takes only an hour and is completely painless. You may phone and get an appointment.

Q49. What in mammography?
Ans. Mammography is a special X-ray examination of the breast tissues. It is a quite sensitive test to pick up early lesions of the breast.

Q50. What is a pap smear?
Ans. The Papanicolaou test, (or pap smear) is in fact a microscopic examination of the cells exfoliated from the uterus and cervix. The doctor takes a swab from the tissue surface for examination. This test warns patients of the presence of early pre-cancerous lesion.

Q51. Is bleeding always a sign of cancer?
Ans. No. Bleeding should be promptly and carefully investigated, to determine if it is due to cancer. A small percentage of patients with blood stained discharge from nipple have cancer. Bleeding from other body openings, such as rectum or bladder, should be carefully investigated to rule out cancer. Unnatural vaginal bleeding, especially after the age of 50 can be a very suspicious sign of cancer.

Q52. Does blood in stool indicate cancer?
Ans. Stool streaked with bright blood or the occurrence of black or “tarry” stool should
lead to prompt and thorough investigation. The assumption that rectal bleeding is merely due to hemorrhoids, or piles, is most dangerous, since such bleeding may be due to multiple causes, including cancer.

Q53. Does blood in the urine indicate cancer?
Ans. It may. But it may also be caused by conditions other than cancer. A careful examination is essential to rule out cancer.

Q54. Is it true that cancer generally develops among people in poor health?
Ans. There is no known relation between the status of one’s health and the development of cancer. Poor genital hygiene and poor oral hygiene may be contributory factor in cancer causation.

Q55. How can we diagnose cancer of the stomach?
Ans. Upper G-I endoscopy is the best investigation for diagnosing stomach cancer. A flexible tube (Endoscope) is passed through mouth and introduced into food pipe and stomach for telescopic visualization. Biopsy can be taken if any lesion is found in stomach or food pipe.

Q56. How can cancers in the head and neck region diagnosed?
Ans. Cancers in the head and neck region can be diagnosed by simple clinical examination which includes visualisation of oral cavity and voice box with the help of head light and mirror. Any growth, ulcer or white patch is biopsied to confirm the clinical diagnosis. This is then reported by an experienced Histo-pathologist in the laboratory. In India more than 40% of male cancers arise in mouth and throat.

Q57. What techniques are used to detect cancer?
Ans. There is no substitute to good clinical examination. Ultrasound, X-Rays, CT Scan, MRI & Mammography are some of diagnostic imaging tools. Various blood tests (PSA, AFP) and endoscopic procedures are also available to clinch the diagnosis. Cytology (FNAC) or Biopsy of lesion is desirable before starting any treatment.

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Q58. How should cancer be treated?
Ans. By surgery, chemotherapy, radiotherapy or a combination of all these in the earliest possible stage of the disease. All these methods are available in India at various Hospitals. RGCI & RC provides all diagnostic and treatment facilities under one roof. The emphasis on cancer treatment should be on multimodal management.

Q59. Are radiation treatments good for all kinds of cancer?
Ans. No. Treatment depends on type and location of the growth. Some cancers will not respond to radiation treatment but must be treated by surgery or with hormones and chemotherapy.

Q60. How does Radiation act?
Ans. Radiation destroys dividing cells including cancer cells. Normal cells are also damaged. But now sophisticated machines are available which spare normal tissues and destroy cancer tissue with precision.

Q61. What is Internal Radiation?
Ans. Wires or tubes containing radioactive material are inserted into the cancer growth or in the tissue surrounding it, and removed after treatment is concluded. Radio-active material in suitable containers may also be placed in contact with the growth as in cancer cervix. Now a days, endo-luminal RT is also available for cancer of tubular structures like bronchus.

Q62. How effective is Surgery?
Ans. Surgery is most effective in the early stages when cancer has not yet spread. Major advances in plastic and reconstructive surgery, and anaesthesiology have ensured a very high degree of success.

Q63. What is Chemotherapy?
Ans. Chemotherapy implies treatment with anti-cancer drugs and injections. Today we have a large number of highly effective drugs for cancer control.

Q64. Can the spread of cancer be stopped or retarded temporarily?
Ans. At times only. Certain types of cancerous growths, which can not be expected to be curable, may be controlled temporarily by CT/Hormones/RT. Sooner or later, however, these growths fail to respond to further treatment.

Q65. What should you do if you think you may have cancer?
Ans. Report at once for a thorough examination by the Cancer Specialist.

Q66. Is cancer curable?
Ans. More than 80% of cancers today are completely curable if treated early. At times, however, cures have been obtained after the cancers have been present for a long time. The type of cancer and stage of cancer have an important bearing on its curability.

Q67. Is it ever possible to state that a cancer has been completely cured. If so, how much time must pass before the “cure” is recognized?
Ans. After a cancer patient has been treated and has remained free of recurrence of disease for a period of five years, the chances for re-appearance of the tumour are small. Occasionally cancer recurs ten or twenty years later. So, a life long follow up is a must for cancer patients to detect recurrence of disease as well as to detect other cancers.

Q68. If you have been cured of cancer, can you develop another cancer?
In the same place?
In some other part of the body?
Ans. Yes. Regardless of a patient’s past medical history including-------------------------- ----- the successful treatment of a previous cancer, he/she should be examined at regular intervals. Because of the tendency for cancer to re-appear at the place of a previously existing growth or nearby, a patient should have a regular follow up as advised by the Doctor. A new cancer may also appear at another part of the body.

Q69. Is there any known vaccine cure for cancer?
Ans. No. A vaccine is of value only against a disease due to a germ. Cancer is not caused by a germ, therefore serums are of no value in its treatment, But researches age ongoing to find tumour vaccines for different cancers.

Q70. Is it ever safe to rely on salves to “cure” cancer?
Ans. No. Paste or salve can not penetrate the tissues deep enough to destroy deep seated cancer cells.

Q71. What are side effects of Chemotherapy?
Ans. Chemotherapy causes temporary side effects like nausea, vomiting, loss of hair and bone marrow suppression. Side effects of chemotherapy vary with drug schedule used.

Q72. Will hormones cure cancer?
Ans. There is evidence today to indicate that treatment with certain hormones may prolong life, and alleviate pain and suffering in certain breast and prostate cancers. Hormones are also useful as adjuvant after definitive treatment.

Q73. What is Immunotherapy?
Ans. Immunotherapy is a new development based on the theory that the human body can be taught to defend itself against diseases including cancer. Immunotherapy is being tried in cancers like melanoma, renal cell carcinoma etc.

Q74. What is the latest and most successful of the recently reported cancer treatments?
Ans. There is no single modality of treatment, which can achieve cure. Emphasis is on multimodal treatment e.g. combination of surgery, radiotherapy, chemotherapy and hormone treatment. Now gene therapy & immunotherapy are upcoming modes of treatment buy they are in experimental.

Q75. Is any real progress being made in cancer research? Along what lines?
Ans. A lot of progress has been made in cancer research. We have understood cancer behaviour better. Diagnostic facilities have improved. Operative methods and radiation techniques have also improved. Newer chemotherapy drugs have been launched. Future is not far off when we will have gene therapy and vaccines for cancer treatment.

Q76. What are your chances of getting cured?
Ans. More than 80% of the patient treated adequately in the early stages can be cured. Your chances of recovery are excellent, if you report for treatment very early after the cancer has developed.

Q77. Can you lead a normal life after cancer?
Ans. The sooner you come for treatment, the better the quality of life after cancer. Most cancer patients can return to their normal lives, even during treatment.

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Q78. Are cancers in men and women different?
Ans. There are no fundamental differences in cancers in men and women. Most important thing is that common male cancers (lung and oral) are preventable because they are caused by tobacco. Female cancers (Breast, cervix) can be detected early and cured.

Q79. What forms of cancer are more common among men than women?
Ans. Cancer of the mouth, throat, gullet, stomach, rectum, larynx, lung, skin and brain are all more common in men than in women. Gall bladder and thyroid cancers are more frequent in women.

Q80. Does smoking or tobacco and pan chewing cause cancer?
Ans. Smoking and tobacco chewing are known to cause cancer of the mouth, throat, lungs etc. Therefore, it is best to play safe. If you smoke or chew tobacco, make every effort to stop. Stop smoking and tobacco chewing and prevent caner!

Q81. Can cancer result from sexual intercourse?
Ans. No. There is no known relationship between cancer and sexual activity on the part of the male or female. However women who have multiple sexual partners run a greater risk of getting cervix cancer.

Q82. Is cancer of the prostate common? At what age does it generally occur?
Ans. Yes. Cancer of the prostate is one of the most common forms of cancer in older men in USA. Men should be on guard against this form of cancer especially as they approach 60. A thorough physical examination, including a rectal examination, blood test (PSA) and TRUS are the only ways to discover this hidden cancer early enough for cure.

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Q83. Do more women than men die of cancer?
Ans. No. The misconception that cancer is primarily a woman’s disease is due to the frequency of cancer of the breast and cancer of the reproductive organs in women, in comparison with the more varied occurrence of cancer in men.

Q84. Does cancer occur more frequently among married or unmarried women?
Ans. Reports from death certificates show that above the age of 40, the cancer death rate is higher among single women than among married women of the same ages. Single women have higher death rates from cancer of the breast and married women have more cancer of the cervix. Physicians believe that having the first child around the age of 20 is preventive against caner of the breast. Multiple sexual partners increase the risk of cancer of the cervix.

Q85. Is there danger is watching a lump in the breast to “see what happens”?
Ans. Yes, a very grave danger. Time is the most important factor in the control of cancer and waiting to “see what happens” may permit a curable cancer to become incurable. This may allow it to spread to other parts of body and make the treatment more difficult.

Q86. Are all breast lumps cancerous?
Ans. No. Only small percentage of lumps are cancerous. Careful physical examination and mammography can differentiate benign from malignant lump. Biopsy & FNAC of lump by a competent pathologist can clinch the diagnosis.

Q87. What precautions should be taken to avoid cancer of the breast?
Ans. Every woman above the age of 40 should have her breasts examined annually by a physician. Every woman after the age of 35 years should be taught how to examine her own breasts (monthly after her periods). Screening Mammography should be encouraged at the age of 40 years onward and then every 2 yearly. Soon we will have genetic markers to detect high risk group of women who are likely to develop breast cancer or ovarian cancer.

Q88. How should you examine your breasts?
Ans. Self examination of the breast should be done in the following ways after periods are over. Post menopausal women should examine their breasts every month.
1. Sit or stand in front of mirror, with your arms relaxed at your sides, and examine your breasts carefully for any changes in size and shape. Look for any puckering or dimpling of the skin, and for any discharge or change in the nipples. Compare one breast with the other.
2. Raise both your arms over your head, and look for exactly the same changes. See if there is any change since you last examined your breasts.
3. You should feel for a lump or thickening in the breast tissues. Lie down on your bed, or on the floor. Put a pillow or a bath towel under your left shoulder, and place your left hand under your head. With the fingers of your right hand held together flat, press gently but firmly with small circular motions to feel the inner, upper quarter of your left breast, starting at your breast bone and going outward toward the nipple line. Also feel the areas around the nipple.
4. With the same gentle pressure next feel the lower, inner parts of your breast.
5. Now bring your left arm down to your side, and still using the flat part of your fingers, feel under your armpit.
6. Use the same gentle pressure to feel the upper, outer quarter of your breast from the nipple line to where your arm is resting.
7. And finally, feel the lower, outer section of your breast, proceeding from the outer part to the nipple.
8. Repeat the entire procedure, for the right breast.

Q89. What precautions should be taken to avoid cancer of the uterus (womb)?
Ans. Have all unnatural vaginal discharges investigated. Up to the age of thirty-five have an annual examination by Gynaecologist. Bleeding after the age of 50 years.(After menopause) calls for a physician’s examination at once. Avoid multiple sex partners. Cervix cancer can be prevented by screening.

Q90. Do uterine fibroids ever become cancerous?
Ans. Fibroid tumours only very rarely undergo malignant change.

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Q91. Can cancer develop in children? At what age?
Ans. No age is free from cancer. Certain forms of cancer, especially of the eyes and blood are found in young children.

Q92. If a parent dies of cancer, are the children more likely to have the disease?
Ans. The answer is no. In many families where a parent had cancer, the disease does not appear in the children. Again, a person whose family has no record of cancer may develop it. A tendency to develop breast cancer however runs in families. Even colon cancers are known to be familial.

Q93. Does cancer develop more quickly in children than in older people?
Ans. The rate of growth at any age depends upon the type of cancer, though cancer does grow faster at younger ages.


Q94. If detected in time, can cancer in a child be cured more quickly than in an adult?
Ans. The cure of cancer has little relationship with age. It depends upon the extent of growth at the time it is detected, the adequacy of the treatment given, as well as the type of cancer detected.

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Q95. How can deaths be reduced?
Ans. Cancer deaths can be reduced by following means:
1. Cancer is preventable by living a simple life like no tobacco chewing or smoking, vegetarian high roughage low fat diet, no alcohol and use of fresh fruits & fresh vegetables. Half of the cancers can be prevented by changing our own life styles.
2. Early detection by screening before symptoms appear.
3. Early detection in symptomatic patients. Treat them stage, early with multimodal treatment.
4. Provide good care under one roof with all ultramodern gadgetary. Even if it is advanced disease, try to improve quality of life. “Add life to years in advanced cases”.

Q96. Does cancer usually cost more to cure, than other major diseases?
Ans. It often does. It depends upon the type of cancer you have and how much must be done to treat it. Many hospitals provide free treatment to those who cannot afford to pay.

Q97. Why are quacks dangerous?
Ans. For the following reasons, among others:
1. Few quacks are medically trained; therefore, they have no fundamental knowledge about cancer.
2. They cause the patient to lose valuable time that should be used to obtain correct treatment.
3. The pastes and “medicines” used by quacks have no value in curing cancer.
4. The quack takes the patient’s money under false pretenses, thus depriving him of the means for obtaining competent treatment in time to enable him/her to be cured.

Q98. How can I differentiate a quack from a reputable physician?
Ans. If a person advertise a cure, guarantees a cure, or employs a method of diagnosis or treatment not generally accepted or endorsed by the medical profession, may be classed as a quack. No reputed ethical physician will do any of these things.

Q99. Is cancer frightening?
Ans. Only if you neglect it. Today more and more people are not only winning their fight against cancer, they are also able to lead a normal, active lives.

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