Cancer – Information for Patients

The term cancer includes all forms of malig­nant growth. Many different varieties arc known, depending on the tissue from which they arise, the location in the body, the rate of growth, and the response to treatment. Cancer cells do not approximate the mature character of the cells of the tissue from which it grows; rather, its cells are seen in all stages of maturity, and dividing cells are seen throughout the tumor. From this the pathologist can determine the rates of growth and classifies the tumor into grades I through IV. Grade I is slowly growing and grade IV is rapidly progressing. Grades II and III are intermediate rates.

Certain characteristics are common to all can­cers, however. Cancer cells never rest in their growth. They continue to grow, and, if un­treated, the results are always fatal. They spread by three methods. The malignant growth in­filtrates and destroys surrounding parts. It sets up secondary growths in neighboring and distant regions of the body. These new tumors may occur by implantation on another structure in the vicinity, such as a fragment of cancer of the ovary breaking off to take root on a piece of intestine. A distant structure may become in­volved by a secondary growth as a fragment breaks off to pass through the blood vessels or lymphatic vessels to the new part. This method of dissemination is called metastasizing, and the new tumor is called a metastasis.

Malignancies of certain organs have a pre­dilection for the areas to which they metastasize, depending on the available blood and lymphatic vessel routes. The lymph nodes draining the region, the lungs, liver, bones, and brain—all are common sites, but any structure may be involved by the secondary growths. The metastases so spread are of the same cell type as the parent lesion.

Cancer growths usually grow quite rapidly and never cease growing, although periodically they may slow down in their progression. Al­though cancer is not so common in younger in­dividuals, no age is free from the disease and it grows more rapidly in the young when it does strike. Most types grow rapidly but a few types grow slowly.

Cancer is not a disease of the blood per se, but blood plays a role in that it may be a mechanical carrier of metastases. Cancer may develop in the blood-forming organs such as the bone marrow, to give rise to the malignant dis­ease known as leukemia, where the blood cells released to the circulation are cancerous blood cells. But development of cancer in the circulat­ing cells has not been described.

The white blood cells do not attack the can­cer cells as they do germs and other irritants in inflammatory reactions. Moreover, there is no known body defense against cancer.

The only exact way to determine the nature of a tumor is by examination of a small portion of it under a microscope. But in some cases physical examination alone may give the diag­nosis. Too often, however, the disease is far advanced when this is possible. Usually physical examination arouses suspicion of a lesion, and biopsy confirms or rules out cancer.

There are certain abnormal conditions which, if permitted to continue, may develop into can­cer. These are called precancerous lesions.

Some of the more common ones are: the whitish plaque type of dermatitis which occurs on the lips and mouth (leukoplakia), chronic scaly areas of skin, chronic sores from ill-fitting den­tures and jagged teeth, dark-colored moles sub­jected to irritation, unrepaired childbirth injuries, some chronic inflammations, and other sores which do not heal readily.

Certain lesions often erroneously thought to be precancerous, such as corns, simple freckles, and hemorrhoids (piles), are not. In the case of hemorrhoids, however, the patient should be examined to determine whether any of the tis­sues above the hemorrhoids exhibit cancer. Fre­quently the block of flow of blood in abdominal veins by cancer gives rise to hemorrhoids. This may be the first sign of an internal cancer. More­over, bleeding thought to be from hemorrhoids may be coming from a cancer in the tissues above the anus. Cancer does not occur in hemor­rhoids, but all patients with hemorrhoids must be investigated for cancer in the tissues above and about the hemorrhoids.

Dark-colored moles are precancerous lesions, and should be removed, especially if subject to irritation. Those about the collar, the waistline, and shaving areas are especially important. The flat, colorless mole is harmless, but the bluish- black hairless moles must be removed. When there is noted any change in color or size of any mole, excision is imperative. Good oral hygiene is a defense measure against cancer. Any areas of irritation or chronic sores should receive prompt medical attention. Itchy scaling lesions of the skin should be treated before they become open sores. Individuals with fair complexions should especially avoid continued overexposure to di­rect sun rays. Any chronic lesions of the lips must be carefully and repeatedly examined.

In short, defense measures against cancer are directed at avoiding all unnecessary abuse to any tissue, and the prompt investigation of all chronic lesions. These measures must include protection from overexposure to the sun, mod­eration in the use of tobacco, practical breast garments which do not bind, prompt repair of all birth injuries to the womb, repair of jagged teeth and ill-fitting dentures, medical attention for all chronic symptoms, and treatment of all lesions which may be precancerous.

There are no known mental diseases which initiate or influence the course of cancer. The relation of smoking and cancer of the lips and lungs is uncertain. Cancer cannot be initiated or transmitted by sexual intercourse.

At present the best known controls of cancer are through prompt medical attention when sus­picious signs or symptoms appear. It has been recommended that everyone have a complete physical examination annually. If over 35 years of age, examination twice a year is more ad­visable. Treatment of cancer is successful only when initiated early in the course of the disease. The sooner cancer is found, the less likely it is to have spread to other parts of the body. Early diagnosis is the most important factor in the successful treatment of cancer.

The American Cancer Society has publicized common warning symptoms which may be symp­toms of cancer. These are The Seven Danger Signals of Cancer.

If any one of these develops, you will probably be the first to notice it. This does not necessarily mean that you have cancer; it means that the symptoms must be investigated immediately. Any delay is dangerous.

You cannot tell whether you have cancer or some other disease without seeing your doctor.

Regular, thorough physical examinations by your family physician are your best defense against cancer, plus immediate medical attention when one of the seven danger signals appears. Memorize the list, so that you will know when to appear for examinations other than for your regular check-ups. Through the periodic exam­inations, cancer may be detected in its early stages before the person has noted any symptoms in himself. And recognizing danger signals pro­vides the best protection between examinations.

The thorough cancer examination can be done in most doctors’ offices and most hospitals, or in combination when special tests are needed. The first step is a complete medical history and physical examination, which must include exam­ination of the breasts, genitalia, and rectum. No part may be excluded. When indicated, x-ray ex­aminations and microscopic examination of the blood, urine, and any suspected tissue should be done. Other special laboratory procedures may be indicated.

There is no reliable blood test for cancer.

Pain is not a symptom of cancer in the early stages, except in cases of cancer of nerve tissue and in some cases of bone cancer. Pain is a late symptom, and the neoplasm may be beyond hope for treatment if the patient waits until pain develops. Bleeding is not always a sign of can­cer, but it must be investigated carefully to as­certain what the cause is. Bleeding from the nipples, rectum, and bladder are especially sus­picious. Unnatural vaginal bleeding, especially after the change of life, must be carefully in­vestigated. Bleeding from the bowels is often not bright red blood; rather, it may appear as black or “tarry” stools. This calls for immediate study. Diagnosis of cancer of the gastrointestinal sys­tem usually requires special contrast x-ray studies.

Cancer can be cured only by surgery or x-ray or a combination of both. The x-ray may be that emitted from an x-ray machine or from radium. The action of either on cancer cells is the same. With proper usage and dosage the x-ray destroys cancer cells without serious in­jury to normal cells in the region. But not all kinds of cancer will respond to x-ray therapy. The radiologist has to know the exact type and grade of cancer before he begins treatment. This usually necessitates biopsy. In the types which will not respond to x-rays, surgery is the only answer.

Radium is used by placing a calculated amount in a special container and applying it in contact with the growth or in the nearby vicinity. The x-rays from the radium pass through the container into the neoplasm, and after a specified length of time the container is removed. Another method of radium therapy is by inserting hollow needles filled with radium into the cancer or its adjacent tissue, and allow­ing them to remain for a specific period of time. The gas known as radon, which emanates from radium, may also be used in cancer treatment. This gas is put into small containers which are called radon seeds. The seeds are then imbedded into the neoplasm.

All forms of radium therapy must be very specifically employed. The amount of radium, the time period of application, the resistance of the neoplasm, the adjacent tissues, and the dis­tance of the neoplasm from the radium source, are only a few of the factors the radiologist must consider. Radium treatment is expensive because radium itself is very expensive due to its scarcity.

Surgical treatment of cancer is directed at re­moving the lesion. Since the new growth tends to spread and infiltrate into the surrounding tissues, it is necessary to remove tissues on all sides of the mass to the extent that none of the infiltrat­ing processes remain. The entire lesion must be removed, and a surrounding area of supposedly normal tissue must be removed with it. In most areas this is possible, but when the new growth is next to a vital organ, a greater risk of leaving a fragment behind exists. Not only is the primary neoplasm removed, but in many cases the lymph nodes draining the area are also removed. This guards against leaving behind a fragment of the growth which may have broken into the lym­phatic vessels and passed to the regional lymph nodes.

Occasionally a cancer is curable by surgery and x-rays even after having been present for a considerable length of time. The type of cancer has an important bearing on its curability, but in most cases cancer can be cured only in the early stages, necessitating early diagnosis, of course. A person who has been cured of cancer may develop another in the same place or in any other part of the body. There is no immu­nity developed to cancer, and because there is a tendency for cancer to recur in the same place, a patient must have follow-up investigations after treatment is completed at least every six months, and preferably more often. It is difficult to determine when a patient is actually cured of cancer. The follow-up examinations must con­tinue for at least five years before it can be as­sumed that there will be no recurrence. Reap­pearance of cancer is rare after a five-year period without signs of recurrence, but actually once cancer has been diagnosed the person must be considered a cancer patient for at least eight or ten years to be absolutely sure that there will be no recurrence. The rate of growth of a recurrence is unpredictable, as it is with the primary neoplasm.

Malignant cells never ccase to grow. But, to be sure, there are periods of very slow growth just as there are periods of rapid spread. The role that hormones play in cancer is still under investigation, and it is too early to state whether hormonal therapy will cure cancer. But in cer­tain cases hormones will definitely slow the growth of the neoplasm to a minimum, thereby prolonging life and alleviating suffering. This is especially successful in cancer of the breasts and the prostate gland.

A few chemical compounds have demon­strated some ability to destroy some cancerous growths. A compound known as nitrogen mus­tard has proved of some value in leukemia and some other cancers. Many chemical agents are being investigated, but the totally successful compound is yet to be found.

Certain isotopes are also under investigation for the treatment of cancer. To date they have proved of limited value. A small percentage of thyroid gland cancers and certain cancers of the bone marrow and other blood-forming organs respond to radioactive iodine or radioactive phosphorus. Many other isotopes are now being evaluated.

Studies of many other forms of cancer therapy are being conducted in the research laboratories. Hormones and isotopes offer some promise, but surgery and x-ray still remain the chief weapons against the disease. There is no known serum cure for cancer; there are no salves or medicines which offer a cure; nor are there any “shots” which can cure the disease. Ultraviolet and infrared rays have no curative effect on cancer cells, regardless of the intensity or the time of application.

In recent years a few cultists have attempted to capitalize on the disease of cancer. This is done by advertising and even guaranteeing a cure by some special secret method. To be sure, if any­one has a method of cure for cancer but keeps the method secret from the medical profession, then that person is responsible for all cancer deaths. He is not a humanitarian. Many of the testimonials used by the cultists in their adver­tising are from people who probably never had cancer in the first place. These few “cancer quacks” take the patient’s money under false pretenses and thus deprive the patient of the means of competent treatment. They cause the patient to lose valuable time in acquiring proper treatment. The pastes, “medicines,” and shots employed by the cultists have no proved value in the treatment of cancer. Most of these prac­titioners are not medically trained so have no more knowledge of the disease than their pa­tients. The public must be made to realize that anyone who advertises a “special” cure, guaran­tees a cure, or employs diagnostic or treatment methods not endorsed or accepted by the medi­cal profession, is not a reputable or ethical physi­cian. Through its educational programs the American Cancer Society has attempted to in­form the public of the detrimental effects of con­sulting the cultists.

Cancer Statistics

The American Cancer Society has collected an abundance of statistical data concerning can­cer. Some of the more significant facts may be presented here. These data are about people. They concern you and your family, even though it may be more comforting to think of these as applicable only to other persons. But no one is exempt from the figures. These are the “cold facts”:

Cancer remains the second greatest cause of death in America, being exceeded only by heart diseases. It is estimated that, at some time, one out of every five Americans will develop cancer. One out of every seven deaths is now due to cancer, and, if the present rates continue, over 22,000,000 Americans now living will die of this disease. It is estimated that 220,000 Americans die of cancer each year. This means 600 deaths per day or one cancer death every two and a half minutes in the United States. Each year more than 70,000 cancer patients are saved from dying of cancer; yet, only two out of every five persons realize that cancer is curable. Cancer strikes, on the average, in one out of every two families. Half the deaths from cancer are of persons under 65 years of age. Hundreds of scientists, supported by millions of dollars, are engaged in a constant search for the causes and cures of cancer.

The most significant factor of all is that ap­proximately one out of every three cancer deaths each year could be prevented if the case were de­tected in time and promptly treated. This means that there are 70,000 needless cancer deaths each year. Do not forget your annual physical examination from your family doctor if you are under 35; or your semi-annual physical examina­tion if you are over 35, and watch for the danger signals.

Summary of Cancer

Cancer is a malignant neoplasm. It differs from benign tumors in that it is composed of immature, constantly growing cells which infil­trate into adjacent tissues and pass to other parts of the body to set up new areas of uncontrolled growths. There are no known body defenses against cancer. The only means of accurately determining the nature of a cancer is by micro* scopic study of the lesion, just as with all other diseases. There are a few lesions which may be­come malignant, so they should be excised be­fore any cancerous change occurs. Other defense measures are through abstinence from all chronic abuse to tissue. To safely guard against cancer, individuals must have examinations by their family physician every year if under 35 and every six months if over 35, and must promptly seek medical attention if any of the seven danger signals develops. Early diagnosis is essential for a cancer cure. The only proved treatment of value for cancer at this time is through surgery and x-ray. Cancer is the second greatest cause of death in the United States. The American Cancer Society has contributed greatly to our present knowledge of cancer.

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