Dr. Arunabha Sengupta

Dr. Arunabha Sengupta

Consultant Surgical Oncologist

General FAQ’s

Cancer General FAQ’s
What is Cancer?

Cancers are basically Abnormal or Pathological Growth of cells defying the normal regulations of the body.

All living bodies are made up of many different types of cells. Everyday some of these cells die and some divide and multiply to produce more cells in order to maintain growth and replenish the loss. Various factors regulate this ongoing process but basically the genes dictate by giving commands to cells as to how they should behave. A gene that gets mutated due to various causes gives faulty commands whereby cells that are supposed to die do not die and cells that are not supposed to multiply begin to grow in abnormal number. And a tumour is formed. Some of these tumors acquire the capacity to invade nearby tissues but also to spread to other parts of the body and ultimately cause death. Because these tumours do not obey the normal regulatory mechanism of the body these are called malignant tumours or cancers.

Does Cancer means it is the end of the life?

No. Of course not. Over the past decade the survival rate from cancer has increased dramatically for the common cancers detected in early stages. Some are now deemed as curable diseases. Cancer is now as considered as just another chronic disease which can be contained, Most deaths from cancer occur due to late diagnosis and late treatment. But certainly cancer is a difficult disease to treat, which is a multi step procedure where every step has to logically and sequentially follow one another.

What Causes Cancer?

Infections of Human Papilloma Virus (HPV) for uterine cervical cancer, Epstein-Barr virus for Burkitt lymphoma and Helicobacter pylori for gastric cancer, hepatitis B virus for liver cancer, AIDS virus for Kaposi’s sarcoma.

1) Tobacco for Lung, Mouth Cavity and Throat Cancers, Chemical Dye for Urinary Bladder Cancer, too much exposure to Sun for Skin Cancer.
2) Betel Leaf Concoctions (Pan) for Oral Cancer.
3) Semi Cooked and Smoked Preparations of Meat, Salted Meat and Fish, Pickles, and Pepper for Mouth and Esophageal and Stomach Cancer.
4) Alcohol for Oral, Esophageal, Pancreas, and Liver Cancer. Red Meat and Fats for Colon Cancer.
5) Use of Exogenous Hormones for Uterine, Breast, and Prostate Cancers.
6) Rich Food, Less Physical Activity for Breast, and Colon Cancers.

Is Cancer Contagious?

No. Ono one can catch cancer from another person. But some cancer causing viruses can be transmitted from one person to another by close body contact.

Can Cancer be prevented?

Yes, to a great extent. The two major cancers that affect Indian population like oral cancer caused by pan and tobacco and uterine cervical cancer caused by HPV viruses are both preventable. Good and healthy life style, avoidance of known cancer causing substances like tobacco, rich food etc. can prevent cancer to some extent. Now some preventive drugs like tamoxifen for breast cancer, aspirins for colon cancer, vitamin A derivatives for oral cancer and vaccines to prevent cervical cancer and liver cancer are now available.

Cancer that are caused by faulty inherited genes cannot be prevented now, but soon they too will become preventable by genetic engineering as we now know what defects in which genes cause what cancers.

For the present, the most important thing is prevention by early detection. This is done by having regular checkups and screening examinations like pap test of cervical smears, mammography, occult blood test of stool, colonoscopy, etc so that the disease is caught in an early stage when a cure is possible.

What are some of the common signs and symptoms of Cancer?

Cancer can cause a variety of symptoms and signs and that depends on the organ or organs it has affected. Breast cancer typically presents with a lump. A colon cancer will cause passage of blood with stool. A kidney cancer might simply cause anaemia or low grade unexplained fever. A brain tumour might cause change in behaviour. Often the symptoms and signs are very minimal till the advanced stage of the disease and contrary to popular belief many cancers often do not start with loss of general health and do not cause pain until a very late stage of the disease.

Classically Specialists Speak of Seven Danger Signals

1) New Thickening or Lump in any part of the Body, Particularly Breast and also Neck and Lower part of the Face.
2) A New Mole or Change in an Existing Wart or Mole
3) A Sore that does not Heal
4) Nagging Cough or Hoarseness
5) Changes in Bowel or Bladder Habits
6) Persistent Indigestion or Difficulty Swallowing
7) Unusual Bleeding or Discharge.

Unexplained change in weight is also an important symptom. In short, any illness that persists even after treatment for sometime should be investigated. A qualified doctor must be consulted, necessary investigations done and if required a biopsy must be performed. Biopsy is the only way to know for certain whether cancer is present. There is no particular danger attached to it.

Suppose the doctor says, it is cancer. What happens next?

The doctor now determines the stage of the disease by a few other tests like x-rays, CT scans, blood tests, which show how far the disease has progressed in the body. The stage of the disease finally decides the intent and nature of the treatment. There are internationally set and accepted rules of staging a cancerous disease and that is universally followed all over the world. And for each patient there are internationally set guidelines how a particular patient, after all his or her biological parameters are considered, should be treated.

How then is the cancer treated?

Basically all cancers are treated by surgery, radiation, and chemotherapy, either singly or in combination or sequentially. It absolutely depends on the type of cancer and the stage of the disease in which it has been diagnosed and also on the patient’s physical condition. A stage IV breast cancer will require an entirely different approach from a stage II colon cancer. Other therapies like hormone therapy and biological therapy which target the very process of the cancer formation itself are also employed regularly. For most of the early stage common cancers that affect the solid organs (As opposed to the blood and blood forming organs) surgery is generally employed to get rid of the primary tumor and then if required to follow up with other methods of treatment. (See fact sheet on surgical oncology). The two other most commonly used therapies are radiotherapy and chemotherapy both of which act using the same biological principles that destroy the cancer cells’ ability to survive and multiply. Radiotherapy acts locally, only to the tumour bearing part of the body where the radioactive rays are delivered while chemotherapy, which means injecting cytotoxic drugs, acts throughout the body. Often radiotherapy and chemotherapy are concurrently used to help the action of each other. Both have some side effects which go away when the therapies are over. Hormone therapy is used to treat cancers that are hormone dependant like breast, ovary and prostate cancer. Biological therapy and targeted therapies target a particular factor that help in the growth of that particular cancer.

What about the therapies other than ‘ALLOPATHY’?

Relaxation and meditation certainly helps, not in curing the disease but in helping to cope with the psychological trauma and tolerating the side effects of prolonged and toxic treatment. Supportive treatment with specialized diet have also been found to be helpful but there is not enough evidence to prescribe or recommend any particular dietary formula except to say that a bland non toxic easily digestible diet rich in vitamins, anti oxidants, and fibers, and low in fat is best. Amongst the ingredients of an average Indian diet fish, turmeric, tomato, garlic and lemon have been found to be having anti cancer properties. Beside these general supportive measures, the established scientific agencies all over the world have so far not found any alternative therapy or drug which had been scientifically proven to be effective.

We often hear about grand discoveries or miracle drugs from the practitioners of alternative medicine but none so far have stood the test of time. Most of the sensational discoveries or wonder drugs from this world have later been proved to be plain hoaxes. Whatever may be their worth, from the current medical knowledge about cancer it can be safely said that there will never be one single drug that will cure cancers of all types and stages simply because cancer is not one single disease.

Is it a painful disease?

Not always. It again depends on which body parts are affected. A growth that involves bone and nerve tissues causes more pain than a cancer growing within the body cavity. However cancer pain can be treated satisfactorily and no patient should suffer from pain. That is a major goal for any cancer treatment.

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