🎗️ CANCER
🔬 Understanding Cancer: What is It?
Cancer is a group of many related diseases that begin in cells, the body's basic building blocks. 🧬 To understand cancer, it is helpful to know what happens when normal cells become cancerous. 🔄
The body is made up of many types of cells. 👥 Normally, cells grow and divide to produce more cells as they are needed to keep the body healthy. ✅ Sometimes, this orderly process goes wrong. ⚠️ New cells are formed when the body does not need them, and old cells do not die when they should. The extra cells form a mass of tissue called a growth or tumor. 🔴 Not all tumors are cancerous. 🚫
🔍 Benign vs. Malignant Tumors
Tumors can be benign or malignant. ⚖️
✅ Benign Tumors are NOT cancerous:
- Benign tumors are rarely life-threatening. 😊
- Generally, benign tumors can be removed, and they usually do not grow back. ✂️
- Cells from benign tumors do not invade the tissues around them. 🚫
- Cells from benign tumors do not spread to other parts of the body. ❌
⚠️ Malignant Tumors ARE cancerous:
- Malignant tumors are generally more serious than benign tumors. They may be life-threatening. 💀
- Malignant tumors often can be removed, but sometimes they grow back. 🔄
- Cells from malignant tumors can invade and damage nearby tissues and organs. 💥
- Cells from malignant tumors can spread (metastasize) to other parts of the body. 🌐 Cancer cells spread by breaking away from the original (primary) tumor and entering the bloodstream 🩸 or lymphatic system. The cells can invade other organs, forming new tumors that damage these organs. The spread of cancer is called metastasis. 📈
📊 Prevalence
Millions of Americans are living with a diagnosis of cancer. 🇺🇸 About 1.4 million new cases of cancer are diagnosed in the United States each year, and more than 550,000 people die each year because of the disease. 💔 Cancer is the second leading cause of death in the United States 🥈 and one of the leading causes of death worldwide. 🌍
⚠️ Risk Factors
Doctors often cannot explain why one person develops cancer and another does not. 🤷 But research shows that certain risk factors increase the chance that a person will develop cancer. These are the most common risk factors for cancer: 📋
- 👴 Growing older
- 🚬 Tobacco
- ☀️ Sunlight
- ☢️ Ionizing radiation
- 🧪 Certain chemicals and other substances
- 🦠 Some viruses and bacteria (indirectly)
- 💊 Certain hormones
- 👨👩👧👦 Family history of cancer
- 🍺 Alcohol
- 🍔 Poor diet, lack of physical activity, or being overweight
Many of these risk factors can be avoided. ✅ Others, such as family history, cannot be avoided. 🧬 People can help protect themselves by staying away from known risk factors whenever possible. 🛡️
1️⃣ Growing Older 👴
The most important risk factor for cancer is growing older. ⏰ Most cancers occur in people over the age of 65. But people of all ages, including children, 👶 can get cancer, too.
2️⃣ Tobacco 🚬
Tobacco use is the most preventable cause of death. 🚫 Each year, more than 180,000 Americans die from cancer that is related to tobacco use. 💀
Using tobacco products or regularly being around tobacco smoke (environmental or secondhand smoke) increases the risk of cancer. 📈 Smokers are more likely than nonsmokers to develop cancer of the lung, 🫁 larynx (voice box), 🗣️ mouth, 👄 esophagus, bladder, kidney, throat, stomach, pancreas, or cervix. They also are more likely to develop acute myeloid leukemia (cancer that starts in blood cells). 🩸
People who use smokeless tobacco (snuff or chewing tobacco) are at increased risk of cancer of the mouth. 👄⚠️
Quitting is important for anyone who uses tobacco—even people who have used it for many years. ✅ The risk of cancer for people who quit is lower than the risk for people who continue to use tobacco. 📉 (But the risk of cancer is generally lowest among those who never used tobacco.) 🚭 Also, for people who have already had cancer, quitting may reduce the chance of getting another cancer. 🎯
3️⃣ Sunlight ☀️
Ultraviolet (UV) radiation comes from the sun, ☀️ sunlamps, and tanning booths. It causes early aging of the skin 👵 and skin damage that can lead to skin cancer. 🦀
4️⃣ Ionizing Radiation ☢️
Ionizing radiation can cause cell damage that leads to cancer. 💥 This kind of radiation comes from rays that enter the Earth's atmosphere from outer space, 🌌 radioactive fallout, radon gas, x-rays, 🩻 and other sources.
5️⃣ Certain Chemicals and Other Substances 🧪
People who have certain jobs (such as painters, 🎨 construction workers, 👷 and those in the chemical industry) have an increased risk of cancer. Many studies have shown that exposure to asbestos, benzene, benzidine, cadmium, nickel, or vinyl chloride in the workplace can cause cancer. ⚠️
6️⃣ Some Viruses and Bacteria 🦠
Being infected with certain viruses or bacteria may increase the risk of developing cancer:
- Human papillomaviruses (HPVs) 🦠: HPV infection is the main cause of cervical cancer. It also may be a risk factor for other types of cancer.
- Hepatitis B and hepatitis C viruses 🩸: Liver cancer can develop after many years of infection with hepatitis B or hepatitis C.
- Human T-cell leukemia/lymphoma virus (HTLV-1): Infection with HTLV-1 increases a person's risk of lymphoma and leukemia.
- Human immunodeficiency virus (HIV) 🦠: HIV is the virus that causes AIDS. People who have HIV infection are at greater risk of cancer, such as lymphoma and a rare cancer called Kaposi's sarcoma.
- Epstein-Barr virus (EBV): Infection with EBV has been linked to an increased risk of lymphoma.
- Human herpes virus 8 (HHV8): This virus is a risk factor for Kaposi's sarcoma.
- Helicobacter pylori 🔬: This bacterium can cause stomach ulcers. It also can cause stomach cancer and lymphoma in the stomach lining.
7️⃣ Certain Hormones 💊
Doctors may recommend hormones (estrogen alone or estrogen along with progestin) to help control problems (such as hot flashes, 🥵 vaginal dryness, and thinning bones) that may occur during menopause. However, studies show that menopausal hormone therapy can cause serious side effects. ⚠️ Hormones may increase the risk of breast cancer, heart attack, 💔 stroke, 🧠 or blood clots. 🩸
8️⃣ Family History of Cancer 👨👩👧👦
Most cancers develop because of changes (mutations) in genes. 🧬 A normal cell may become a cancer cell after a series of gene changes occur. Tobacco use, 🚬 certain viruses, 🦠 or other factors in a person's lifestyle or environment can cause such changes in certain types of cells.
Some gene changes that increase the risk of cancer are passed from parent to child. 👶 These changes are present at birth in all cells of the body.
It is uncommon for cancer to run in a family. 🚫 However, certain types of cancer do occur more often in some families than in the rest of the population. For example, melanoma and cancers of the breast, ovary, prostate, and colon sometimes run in families. 👨👩👧👦 Several cases of the same cancer type in a family may be linked to inherited gene changes, which may increase the chance of developing cancers. However, environmental factors may also be involved. 🌍 Most of the time, multiple cases of cancer in a family are just a matter of chance. 🎲
9️⃣ Alcohol 🍺
Having more than two drinks each day for many years may increase the chance of developing cancers of the mouth, 👄 throat, esophagus, larynx, liver, and breast. 🍷 The risk increases with the amount of alcohol that a person drinks. 📈 For most of these cancers, the risk is higher for a drinker who uses tobacco. 🚬🍺
🔟 Poor Diet, Lack of Physical Activity, or Being Overweight 🍔
People who have a poor diet, do not have enough physical activity, 🛋️ or are overweight ⚖️ may be at increased risk of several types of cancer. For example, studies suggest that people whose diet is high in fat 🍔 have an increased risk of cancers of the colon, uterus, and prostate. Lack of physical activity 🚶♂️❌ and being overweight are risk factors for cancers of the breast, colon, esophagus, kidney, and uterus. ⚠️
🚨 Symptoms
Cancer can cause many different symptoms. These are some of them: 📋
- A thickening or lump in the breast 🤱 or any other part of the body
- A new mole or a change in an existing mole 🔴
- A sore that does not heal 🩹
- Hoarseness or a cough that does not go away 🗣️😷
- Changes in bowel or bladder habits 🚽
- Discomfort after eating 🍽️😣
- A hard time swallowing 😮
- Weight gain or loss with no known reason ⚖️
- Unusual bleeding or discharge 🩸
- Feeling weak or very tired 😴
Most often, these symptoms are not due to cancer. ✅ They may also be caused by benign tumors or other problems. Only a doctor can tell for sure. 👨⚕️ Anyone with these symptoms or other changes in health should see a doctor to diagnose and treat problems as early as possible. ⏰
Usually, early cancer does not cause pain. 🚫 If someone finds that he/she has these symptoms, they should not wait to feel pain before seeing a doctor. ⚠️
🔬 Diagnosis of Cancer
1️⃣ Lab Tests 🧪
Tests of the blood, 🩸 urine, or other fluids can help doctors make a diagnosis. These tests can show how well an organ (such as the kidney) is doing its job. Also, high amounts of some substances may be a sign of cancer. These substances are often called tumor markers. 📊 However, abnormal lab results are not a sure sign of cancer. Doctors cannot rely on lab tests alone to diagnose cancer. 🚫
2️⃣ Imaging Procedures 📸
Imaging procedures create pictures of areas inside your body that help the doctor see whether a tumor is present. 🔍 These pictures can be made in several ways:
- X-rays 🩻: X-rays are the most common way to view organs and bones inside the body.
- CT scan 🖥️: An x-ray machine linked to a computer takes a series of detailed pictures of your organs. You may receive a contrast material (such as dye) to make these pictures easier to read.
- Radionuclide scan ☢️: You receive an injection of a small amount of radioactive material. It flows through your bloodstream and collects in certain bones or organs. A machine called a scanner detects and measures the radioactivity. The scanner creates pictures of bones or organs on a computer screen or on film. Your body gets rid of the radioactive substance quickly.
- Ultrasound 📡: An ultrasound device sends out sound waves that people cannot hear. The waves bounce off tissues inside your body like an echo. A computer uses these echoes to create a picture called a sonogram.
- MRI 🧲: Magnetic Resonance Imaging uses radiofrequency waves and a strong magnetic field rather than X-rays, to provide remarkably clear and detailed pictures of internal organs and tissues. A strong magnet linked to a computer is used to make detailed pictures of areas in your body. Your doctor can view these pictures on a monitor and can print them on film.
- PET scan 📊: You receive an injection of a small amount of radioactive material. A machine makes pictures that show chemical activities in the body. Cancer cells sometimes show up as areas of high activity. 📈
3️⃣ Biopsy 🔬
In most cases, doctors need to do a biopsy to make a diagnosis of cancer. 🩺 For a biopsy, the doctor removes a sample of tissue and sends it to a lab. A pathologist looks at the tissue under a microscope. 🔬
💊 Treatment of Cancer
Cancer treatment can include surgery, ✂️ radiation therapy, ☢️ chemotherapy, 💉 hormone therapy, 💊 and biological therapy. 🧬 The doctor may use one method or a combination of methods, depending on the type and location of the cancer, whether the disease has spread, the patient's age and general health, and other factors. 📋
Because treatment for cancer can also damage healthy cells and tissues, it often causes side effects. ⚠️ Some patients may worry that the side effects of treatment are worse than the disease. 😰 However, patients and doctors generally discuss the treatment options, weighing the likely benefits of killing cancer cells and the risks of possible side effects. Doctors can suggest ways to reduce or eliminate problems that may occur during and after treatment. 🩺
✂️ Surgery
Surgery is an operation to remove cancer. 🏥 The side effects of surgery depend on many factors, including the size and location of the tumor, the type of operation, and the patient's general health. Patients have some pain after surgery, 😣 but this pain can be controlled with medicine. 💊 It is also common for patients to feel tired or weak for a while after surgery. 😴
☢️ Radiation Therapy
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells in a targeted area. 🎯 Radiation can be given externally by a machine that aims radiation at the tumor area. It can also be given internally; needles, seeds, wires, or catheters containing a radioactive substance are placed directly in or near the tumor. 💉
💉 Chemotherapy
Chemotherapy is the use of drugs that kill cancer cells throughout the body. 💊 Healthy cells can also be harmed, especially those that divide quickly. ⚠️ The doctor may use one drug or a combination of drugs. The side effects of chemotherapy depend mainly on the drug(s) and the dose(s) the patient receives. Hair loss is a common side effect of chemotherapy; 🦲 however, not all anticancer drugs cause loss of hair.
Anticancer drugs may also cause temporary fatigue, 😴 poor appetite, nausea and vomiting, 🤢 diarrhea, 🚽 and mouth and lip sores. 😮 Drugs that prevent or reduce nausea and vomiting can help with some of these side effects. Normal cells usually recover when chemotherapy is over, so most side effects gradually go away after treatment ends. ✅
💊 Hormone Therapy
Hormone therapy is used to treat certain cancers that depend on hormones for their growth. 📈 It works by keeping cancer cells from getting or using the hormones they need to grow. 🚫 This treatment may include the use of drugs that stop the production of certain hormones or that change the way hormones work. Another type of hormone therapy is surgery to remove organs that make hormones. ✂️ For example, the ovaries may be removed to treat breast cancer, or the testicles may be removed to treat prostate cancer.
Hormone therapy can cause a number of side effects. ⚠️ Patients may feel tired, 😴 or have fluid retention, weight gain, ⚖️ hot flashes, 🥵 nausea and vomiting, 🤢 changes in appetite, and, in some cases, blood clots. 🩸 Depending on the type of hormone therapy used, these side effects may be temporary, long lasting, or permanent. ⏰
🧬 Biological Therapy
Biological therapy uses the body's immune system, 🛡️ directly or indirectly, to fight disease and to lessen some of the side effects of cancer treatment. The side effects caused by biological therapy vary with the specific treatment. In general, these treatments tend to cause flu-like symptoms, 🤧 such as chills, 🥶 fever, 🤒 muscle aches, weakness, and loss of appetite, nausea, vomiting, and diarrhea. Patients also may bleed or bruise easily, 🩹 get a skin rash, 🦠 or have swelling. These problems can be severe, but they go away after the treatment stops. ✅
💭 Conclusion
As we can see, cancer can cause many adjustment problems for the patients. 😔 We will talk about the psychosocial interventions for all high-mortality conditions that we have discussed so far in our next lecture. 💙