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Health Topics A-Z
Cancer
How Do I Know If I Have Cancer?
The earlier cancer is diagnosed and treated, the better the chance of its being cured. Some types of cancer — such as those of the skin, breast, mouth, testicles, prostate, and rectum — may be detected by routine self-examination or other screening measures before the symptoms become serious. Most cases of cancer are detected and diagnosed after a tumor can be felt or when other symptoms develop. In a few cases cancer is diagnosed incidentally as a result of evaluating or treating other medical conditions.
Diagnosis begins with a thorough physical examination and a complete medical history. Lab studies of blood, urine, and stool can detect abnormalities that may indicate cancer. When a tumor is suspected, imaging tests such as X-rays, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and fiberoptic scope examinations help doctors determine its location and size. To confirm the cancer diagnosis, a biopsy is performed: A tissue sample is surgically removed from the suspected malignancy and studied under a microscope to check for cancer cells.
If the diagnosis is positive (meaning cancer is present), other tests are performed to provide specific information about the cancer; this essential follow-up phase of diagnosis is called staging. The most important thing doctors need to know is whether cancer has spread from one area of the body to another. If your initial diagnosis is made by a primary care doctor, or if symptoms persist even though you are told that you do not have cancer, seek a second opinion. In any event, before the actual treatment begins, it is extremely important that you get a confirming opinion by a doctor who specializes in cancer treatment.
What Are the Treatments?
A comprehensive cancer program combines both curative and supportive treatment. Curative treatment attempts to eradicate or slow the disease with some combination of surgery, radiation therapy, chemotherapy, and possibly hormone therapy or immunotherapy. When cancer is no longer detected, a patient is said to be in remission. Generally, patients who remain cancer-free for five or more years are considered cured. Some cancers cannot be cured, but all can be treated, and in most cases the patient will improve.
WARNING! Beware of Cancer Quackery
Supportive care from nurses and other professionals accompanies cancer treatment. The goal is to relieve pain and other symptoms, maintain general health, and provide emotional, psychological, and logistical support to patients and their families. Similar supportive treatment is available to rehabilitate patients after curative treatment. Supportive therapy such as hospice care for cancer patients nearing the end of their lives provides relief from pain and other irreversible symptoms. Most mainstream care is geared toward providing supportive treatment through the broad resources of a cancer treatment center. The best complementary cancer therapies, which are generally provided outside a hospital, also provide excellent supportive care.
Conventional Medicine
Goals of treatment vary according to how advanced a cancer is at diagnosis and whether it is considered curable. If cure seems likely, the patient is treated aggressively in the hope of long-term remission and cure. Cancer not considered curable can still be treated in an effort to prolong life and help make the patient comfortable.
The four standard cancer treatments are surgery, radiation, chemotherapy and biological therapy with hormones and other biological agents. Each is designed to remove or kill the malignant cells and can be used either to effect a cure or to relieve severe symptoms. Surgery and radiation destroy cancer cells locally, while chemotherapy and biological therapy uses drugs to kill cancer cells that spread through the body. Surgery can treat localized tumors successfully but only rarely cures metastatic cancer. Radiation and chemotherapy are used mainly to reduce tumor size before surgery, as well as to minimize the chance of recurrence after surgery and to treat metastatic cancer.
Because chemotherapy and radiation can affect healthy as well as diseased cells, they typically cause side effects. With chemotherapy, side effects may include nausea, vomiting, fatigue, temporary hair loss, mouth sores or dryness, difficulty swallowing, diarrhea, and increased vulnerability to infection. Radiation may have some of the same effects, depending on the area of the body that is irradiated, as well as irritation to the overlying skin. Medication can help curb side effects during treatment, and most side effects resolve when the treatment is concluded.
Hormone therapy is standard treatment for some types of cancers that grow faster in the presence of particular hormones — for example, cancer of the breast, prostate, or uterus. By blocking either the production or the action of the hormones, this therapy slows tumor growth and may extend survival for several months or even years.
Although still largely experimental, immunotherapy is emerging as another mode of cancer treatment, with the goal of destroying cancer cells without affecting healthy cells. It does not attack cancer cells directly but employs various techniques to manipulate the body's immune system into fighting cancer more aggressively.
Gene therapy — a promising subcategory of immunotherapy — manipulates genetic material inside either cancerous cells or the immune cells intended to attack them, in order to make the cancer cells easier targets. Immunotherapy and other experimental treatments generally are reserved for patients with metastatic or recurrent disease who have not responded well to standard treatment.
Patients who have practiced good nutrition tend to respond better to treatment, with fewer side effects. Because weight loss and malnutrition may become problems for cancer patients, clinical nutrition programs are fundamental parts of mainstream care. Most hospitals also offer support groups or individual counseling to help patients deal with mental and emotional difficulties.
As cancer advances, pain may become a significant problem. Fortunately, moderate to severe cancer pain can be managed effectively with prescription medication, such as codeine and morphine. Addiction does not occur with opioid drugs given for true pain, and research shows that people in less pain respond better to treatment and enjoy better quality of life.
Alternative Medicine
Alternative and unconventional treatments for cancer are numerous and varied. While some legitimate therapies offer real support, many questionable therapies have no benefits, may be dangerous, and may harm patients by delaying appropriate care. Even the most promising unconventional therapies do not cure cancer and should never replace standard treatment. Instead, supportive therapies should complement conventional care.
Appropriate complementary therapies improve quality of life and may relieve physical and emotional stress. The act of seeking complementary therapy is beneficial in its own right: It gives patients a sense of control over their illness and the opportunity to play a role in their own care. Before trying any complementary cancer therapy, investigate it thoroughly to make sure it is potentially beneficial and absolutely safe. Then check with your doctor to be sure it will not compromise standard treatment.
Body Work
By promoting relaxation, body-work therapies such as qigong and reflexology ease muscle tension and may alleviate other symptoms such as nausea and chronic pain. Because many body-work therapies provide comforting physical contact, they can lessen the anxiety, depression, and isolation that cancer patients often feel. Massage therapy should be used only after consulting your medical doctor.
Exercise
Exercise can help control fatigue, muscle tension, and anxiety. Patients tend to feel better if they do exercises such as walking or swimming, which calm the mind as well as strengthen the body.
Mind/Body Medicine
Some mind/body therapies work to improve quality of life through behavior modification; others encourage expression of emotions. Behavior therapies such as guided imagery, progressive muscle relaxation, hypnotherapy, and biofeedback are used to alleviate pain, nausea, vomiting, and the anxiety that may occur in anticipation of or after cancer treatment. Individual or group counseling and art or music therapy let patients confront problems and emotions caused by cancer and receive support from fellow patients. Patients who pursue these types of therapies tend to feel less lonely, less anxious about death, and more optimistic about recovery.
Nutrition and Diet
Scientific evidence suggests that nutrition may play a role in cancer prevention. But no diet has been shown to slow or reverse cancer — and no diet cures cancer. Vitamins, minerals, and other nutrients may inhibit the development of cancer by neutralizing carcinogens, ensuring proper immune function, or preventing tissue and cell damage. Researchers are particularly interested in antioxidants — vitamins A (particularly beta carotene), C, E, and selenium — but are also studying folic acid, vitamin B-6, magnesium, zinc, coenzyme Q10, and phytonutrients (substances in food that seem to prevent cancer), among others.
Solid research shows cancer is more likely to recur in people who eat a diet high in animal fat or polyunsaturated fat and who drink a lot of alcohol. Drinking green tea may help prevent some cancers, but it's not clear if it affects cancer survival.
Because too much of some vitamins can be harmful, many experts are cautious about dietary supplements. Instead, they advise a varied diet that includes lots of fresh fruits, vegetables, and whole grains; avoids processed, smoked, cured, fried, or barbecued foods; emphasizes lean cuts of meat and low-fat seafood; and minimizes sugar, fats, and alcohol.
Many customized diets for cancer emphasize vegetarianism, and patients who follow a nutritionally sound vegetarian diet tend to feel better. Unfortunately, many anticancer diets also promote fasting, purging, and taking supplemental "immune-boosting" vitamins, minerals, and other concoctions that do not treat cancer and may be both harmful and expensive.
As a rule, patients should avoid any diet that claims to cure cancer, advocates abandoning standard treatment, causes severe weight loss or weakness, requires severe food restriction, or costs a lot of money.
Acupuncture and Acupressure
Acupuncture and acupressure are perfect examples of "complementary" medicine for cancer. While neither claim to cure the disease, evidence shows that they help reduce symptoms of the illness and side effects of the treatment.
The National Institutes of Health affirms that acupuncture is an effective remedy for the vomiting and nausea often experienced after chemotherapy, radiation, and surgery. Acupressure can also work to alleviate nausea, and may be helpful in controlling pain. Electro-acupuncture, in which electric current is applied to the acupuncture point, can be effective for cancer-related pain as well.
Herbs
Numerous herbal remedies profess to fight cancer and its related symptoms; unfortunately, little solid evidence exists to prove their efficacy. A few herbs may help with specific complaints: Ginger tea and peppermint tea or lozenges may ameliorate nausea, valerian can help with anxiety and stress, capsaicum cream might relieve muscle aches, and St. John's wort may help combat depression.
Be cautious in your use of herbs: Consult your doctor, research carefully, and confer with an expert on herbal remedies.
Homeopathy
Homeopathic preparations may ease the nausea, fatigue, and anxiety associated with cancer and its treatment. While some believe that homeopathic medicines only act as "placebos," evidence exists that using homeopathy increases people's sense of self-control and lessens the severity of their symptoms. Safe and free of side effects, homeopathy only presents a danger if its use delays conventional treatment.
Social Support and Spirituality
Having the support of friends and family can help you deal with the depression, fear, and anxiety that accompany a serious illness. In some cases, a strong support network can even affect the length of survival of cancer patients; studies have shown that men who experience limited social contact have a shorter survival time, while women with good social support survive longer. Strong social support may even help keep your disease in remission, by stimulating a higher level of natural killer cells.
Prayer can relieve stress, create a sense of meaning and purpose, and provide solace. Being an actively spiritual person may have even more benefits; in some cases, cancer patients who believed themselves to be spiritual people suffered less anxiety and depression, and even less pain, from their disease.
Controversial Cancer Treatments
The search for new cancer treatments is a vigorous and highly controversial branch of medical research. All treatments must be thoroughly tested and proven effective before they are authorized for general use. Supporters of some experimental treatments claim remarkable recoveries; critics insist that objective trials, not anecdotal claims, are the only true measure of their worth.
The following treatments have their share of advocates but have thus far been deemed ineffective or unproven in independent tests and clinical trials: hydrazine sulfate, studied by Dr. Joseph Gold as a cancer therapy since the 1970s; Dr. Stanislaw Burzynski's treatment with antineoplastons, originally synthesized from human urine; the "immuno-augmentative therapy" of the late Dr. Lawrence Burton; Dr. Emanuel Revici's "biologically guided chemotherapy"; Dr. Gaston Naessens' "714X" therapy; shark cartilage supplements; oxygen therapy; hydrogen peroxide therapy, and ozone therapy.
At-Home Care
Relieving side effects of treatment:
- After radiation therapy, be gentle to your skin. Do not scrub it, expose it to sunlight, or wear tight clothing. Aloe vera ointment is gentle and soothing, and you can ask your radiation oncologist or radiation therapist about other nonirritating lotions.
- Eat light snacks throughout the day rather than three heavy meals. Also try eating food cold or at room temperature to avoid nausea.
- If your treatment involves lowering your white blood cell count, steer clear of sick people; tell your doctor about any fever or unusual symptoms.
- In addition to taking prescribed medication, try relaxation techniques such as yoga or meditation.
- Join a cancer support group.
- Get plenty of rest.
- Rather than feeling compelled to maintain a "positive attitude," express your emotions honestly. Don't worry if you sometimes feel depressed or afraid: These are normal and legitimate reactions that will not make your cancer worse.
- Fill your days with activities you enjoy. Reading a good book, listening to music, and talking with friends are simple pleasures but surprisingly therapeutic.
SOURCES: National Cancer Institutes. WebMD Medical Reference from the American College of Physicians: “Oncology I Cancer Epidemiology and Prevention.”