INTRODUCTION
According to the American Cancer Society, 1/3rd to 1/2th of Americans will develop some form of cancer in their lifetime. Over 4800 people get diagnosed with cancer each day in the United States alone. Over 9.6 million people died of cancer worldwide in 2020. In Canada, 200,000 Canadians were diagnosed with cancer and 80,000 died of cancer in the year 2020.
The word cancer refers to all the different conditions that have a few similarities- Thyroid, Breast, Lung, Prostate, Colon, Bladder, Skin, Blood, etc. The only thing cancer has in common is the uncontrolled growth of cells and these cells have a way of finding wound all kinds of safeguards.
What is Cancer actually?
Cancer is an incredibly rare disease. Do not look into the number of patients diagnosed or the number of deaths. What I mean by rare, you will understand once we go down a bit further. Our common answer to what cancer is: people tell us that, Cancer is uncontrolled cell growth. The cell which shouldn’t be divided gets divided and creates a mass we call it a tumor.
This tumor grows and pings on organs and organ systems and eventually affect the function of healthy organ taking their nutrients. These tumors can again split up and go to other parts of our body. This, if unchecked, can eventually cause death. Now, let's understand cancer in a little more detailed manner.
UNDERSTANDING CANCER
To understand Cancer, we need to start from the very basics. Let’s understand what a cell is. The cell is the basic and the smallest fundamental part that can live on its own, which makes up all living organisms and the tissues of our body. We have 200 different cell types in our body and cancer can originate in any one of these. Thus, we can see there can be 200 different types of cancer cells originating.
Genetic causes: At its heart cancer is a genetic disease. This doesn’t mean that it is caused by parents, that is a hereditary disease. Less than 5% is heredity cancer disease, but 95% of cases are genetic diseases. What genetics here means is that there are changes or variations or mutations at the level of DNA in a cell that eventually starts down the cancerous path.
So, at the basic level, different cells have different functions to perform and protein inside the cell helps for this functional path. Proteins work in pathways to complete all their functions, whether they are general functions or specialized functions. The DNA is the information center of a cell to make all these proteins.
So, DNA is a roadmap or blueprint that provides the instructions to make any protein the cell needs to function. So, we can think of DNA as an encyclopedia that contains genes, and these genes give the instructions to make different proteins. Every cell is provided with the complete instruction book, but the cell just makes the protein that is required at that time. Since the genes are having all the instructions, it also makes them highly vulnerable to mutation or changes. Let’s see how mutation or changes happen exactly.
How does Mutation happen?
One of the reasons is that the cell has to divide continuously. This is to ensure the replacement of old cells which are dying- this is the normal lifecycle of a cell. So, whenever a cell divides, it creates a daughter cell. By creating a daughter cell, it also has to copy all the genes (instructions book) from the main cell to the daughter cell to get all the instructions.
So, this copying of encyclopedia happens smoothly all the time, but in some cases, it can create small errors while copying to daughter cells. In most cases, the mistakes are corrected by our immune system. But in some cases, where the code for critical function such as cell division doesn’t copy correctly, this can lead to the cell not having a correct functional pathway. This eventually leads to a start of a cancerous cell division.
The other way, the mutation can happen is actually through exposure to carcinogens. These carcinogens can sometimes act directly on the DNA to cause cell mutation. If the cell has this mutated code, it can pass on this code to its daughter cell and it's going to be an exponential growth.
Researchers now got to read the instructions in genes of a normal cell and a tumor cell through gene sequencing. By this, we can know where the mutation is, which protein is affected, so we could understand which proteins are actually driving the cancer. We thought by this we could finally get an answer to tumor and cancer cells. But what we found out was quite different.
If we take a tumor cell from six different people having the same cancer, let’s say colon cancer, the sequence of genes of these cells was different. Even though it is the same cancer cell; the sequence of code is different. This has been done over and over again in many different types of cancer and the result is the same, no two same cancer cells are similar. This tells us that every tumor of the same cancer is different.
Even more bizarre, if we take one tumor, open it up, it will be having many cells. If we take out one cell at a time and study them. We can see no two cells have a similar mutation spectrum. This means no two cells of the same tumor are similar.
To add to this complex, we saw the tumor is not static. Tumors over time evolve among themselves, usually to the responses of treatment that we are giving.
Now, we can see that 200,000 people with cancer having 200 different types of cancer, with every similar cancer looking differently, to having each cell in a tumor looking different from one another. And again, these cells evolving over time.
How do you study a disease where every instance of the disease is different and every instance of a disease can have more than one disease process and where it changes over time? Thus, we can see cancer is an incredibly rare disease as no two cells are similar even within one tumor.
CAUSES
Substances that cause cancer is known to be a carcinogen. If these substances are allowed to accumulate in our body for an extended period of time, there is a greater likelihood of our cells getting damaged, leading to the growth of cancer cells.
Environmental factors:
Lifestyle factors (nutrition, tobacco use, physical exercise)
Natural occurring exposure (UV rays, infection agents)
Medical treatments (Radiation and medicine)
Workplace and household exposure
Pollution
Exposure to Chemical substances (These can damage our DNA and be dangerous to our health)
Asbestos
Formaldehyde
Radon
Passive tobacco smoke
Soot
Wood dust
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SYMPTOMS
No matter what age you are, it is good to understand the symptoms and signs related to cancer. Treatment works best at the early stages when the tumor has just started to progress. Not all symptoms lead to cancer, but it is best to consult a doctor and get it checked in these scenarios.
Sign of bone cancer starts from prolonged pain in the bone and joints.
Headaches that last for days and don’t get better with treatment might be a sign of a brain tumor.
If you’re feeling tired all the time and taking rest is not helping with the fatigue, it might be a possible sign of leukemia, colon or stomach cancer.
If fever persists for days and medications aren’t helping much, signs of blood cancer like lymphoma might be a possibility.
Possible signs of differences in your skin through rashes, bumps, darkened, itches, spouts of hair- these can be signs of liver, ovarian, kidney cancer or lymphoma.
Prolonged dry coughing is a sign of lung cancer and hoarseness may mean cancer to your voice box or thyroid gland.
An unusual bleed like blood in your poop or urine is a symptom of the colon or rectal cancer or tumor in your urinary tract.
MEN: If you have a swollen prostate, pain when you pee, blood in your urine- these are signs of prostate cancer. A lump, pain, ache in your scrotum is a sign of testicular cancer.
WOMEN: Viginal bleeding or discharge happening between periods or after menopause is a sign of endometrial cancer. If your breast feels different, find lumps, changes in size, discharge from your nipples, see spots of changes in the skin around nipples- these are possible early signs of breast cancer.
NORMAL TREATMENTS
For a long time, the best cancer therapy we have had is to send in a treatment so toxic, it attacks all rapidly dividing cells in the human body instead of just the cancer.
RADIATION
The kind of radiation used is ionizing radiation. It works simply because it can tear DNA into shreds. Once the DNA is mangled beyond recognition, it can no longer make copies and divide among themselves. But by this, it damages the DNA of healthy cells as well, that is why the doctor aims it precisely right at the tumor to avoid radiation to healthy cells.
CHEMOTHERAPY
This is a collection of drugs to fight cancer cells. These kinds of drugs can stop cancer cells from dividing, but still, there are healthy cells as well. Hair follicles need to go on producing hair, so some drugs inhibit this growth and that’s why chemo causes hair loss. Along with this, there are a number of side effects as you can see from the image above.
SPECIAL TREATMENTS
Gene sequencing
Researchers are able to detect the mutant DNA in the blood before it could grow and before we could see it on imaging. By this, we can predict what drugs are effective and where.
Cancer snipers
Researchers were able to figure out what is actually going on in the DNA, the chromosomes. So, by targeting this chromosome and eliminating it, we can cure specific types of cancer. But by this, special drugs are to be created to target these chromosomes.
Activating natural cures
Some cancer cells have the ability to turn OFF or kill the immune cells or immune system. So, by turning ON our immune system, we are activating our own body’s natural response to fight our cancer cells. This is done through special drugs.
Supercharging your body
Sometimes our immune system doesn’t recognize the cancer cells. Taking cells out of our body, that is the immune cells (T cells), training the cells giving special instructions so that it can recognize cancer cells. By now, your immune system knows which cells to attack. This happens in patients where cancer comes back after a period of time.
Reinforcements
They genetically engineer viruses and bacteria’s to be able to fight cancer. Example: genetically engineered measles virus was used to cure multiple myeloma (cancer that forms in a type of white blood cell).
Proton therapy
This is a type of radiation therapy where protons are used instead of X-rays to treat cancer. At high energy, protons can destroy cancer. With this therapy, there is less radiation dose outside the tumor.
Robotic surgery
In cancer surgery, robotic techniques enable a radical operation to be performed with preservation of nerves and other critical structures, due to better visualization. This is particularly important in rectal, gynecologic and prostate cancer surgeries. Robotic surgical techniques have revolutionized cancer surgery and improved the survival rate and quality of life in cancer patients. The Da Vinci and Raven 4 are the leading surgical techniques used for cancer surgeries.
Antiangiogenic Therapy
All cancer starts out as a harmless, microscopic tumor (0.5mm3) and it doesn’t get any larger as it doesn’t have blood supply or nutrients. The body’s ability to work angiogenesis properly prevents blood vessels from feeding cancer and this is one of the most important defense mechanisms against cancer. Antiangiogenic therapy selectively aims at the blood vessels that are feeding the cancer cells (tumor cells). The above image shows Antiangiogenic medications for different types of cancer and Antiangiogenic therapy for each cancer survival rate.
PREVENTION
DIET
What we add to our diet that is naturally antiangiogenic, that could boost the body’s defense system and beat back those blood vessels that are feeding cancer. Can we eat to starve these cancer blood vessels? The list of food and angiogenesis dietary factors is in the image above.
“Men who consume 2-3 servings of cooked tomatoes per week have a reduced risk for developing prostate cancer by 40-50%”.
Prevention of Tobacco (Both active and passive smoking)
Prevention of Alcohol use (Mild use is acceptable)
A healthy diet (Plant-based food, fruits, vegetables)
Physical activities (Make physical activity a routine in your life)
Avoid overexposure to Sun (Protect with sunscreen and protective clothing)
CONCLUSION
Diagnosis and treatment of cancer is a key component in the control of cancer among people. Its main goal is to cure cancer patients or prolong their life considerably, ensuring a better quality of life. Cancer development needs to be linked to an early detection program so that cases are detected at an early stage when treatment is more effective and there is a higher chance of survival.
It also needs to be integrated with a palliative care program, so that patients with prolonged cancers, who can no longer benefit from treatment, will get adequate relief from their physical, psychological, psychosocial and spiritual suffering. Furthermore, programs should educate patients, family and community members about the cancer risk factors and the need for taking preventive measures to avoid developing cancer.
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