What is Cancer?

Human body is made up of different types of cells, in healthy condition cells grow, divide at controlled rate, become mature and then replaced by body eventually. However, in case of Cancer, body cells mutate and grow at abnormal rate. These abnormal cells eventually form a mass called lump or tumor. Cancerous cells can spread to nearby tissues and can travel to distant places in the body to form new tumors.

There are two types of tumors

Benign Tumor – noncancerous, do not spread (remain local)
Malignant Tumor – cancerous, spreads to other parts of body

Cancer typically has four stages

Stage 0: Cancer is found in the place it started and not yet spread to nearby tissues.

Stage I: Cancer is found and not yet grown deeply into nearby tissues.

Stages II and III: These are larger tumors which have grown more deeply into nearby tissues and nearby lymph nodes

Stage IV: Cancer that has spread to other organs or parts of the body. This stage of cancer is called metastatic or advanced cancer state.

Types of Cancer

Till date 100+ types of cancers are known. The “organs or tissues where the cancer originates” determines the “Type of Cancer”. Cancer can also be named after the “type of cell” that formed it.

Broadly depending upon the origin, they are referred as

Carcinoma
Sarcoma
Leukemia
Melanoma
Brain and Spinal Cord Tumors
Lymphoma
Multiple Myeloma
Other Types of Tumors

Symptoms of Cancer

Typically, cancer does not cause pain in early stages. However, the signs and symptoms of cancer depends on following

Type of cancer
Location of cancer
Size of tumor
Degree of organs affected nearby

Below are some typical signs and symptoms of cancer,

Unexplained weight loss
Fever
Fatigue
Pain
Skin changes
change in a wart or mole
Persistent cough or hoarseness
Trouble urinating
Pain when urinating
Blood-stained urine
Blood-stained stools
Jaundice e.g., pancreatic cancer
Skin that is itchy, red, scaly, dimpled, or puckered
Bowel habit or bladder function changes
Unhealed sores
Unusual bleeding or discharge
A thickening or lump in a part of the body, such as a breast
Indigestion or trouble swallowing
Nausea and vomiting
Appetite changes
Fever or night sweats
A white or red patch on the tongue or in your mouth
Bleeding, pain, or numbness in the lip or mouth
Headaches, Seizures, Vision changes, Hearing changes- neurological conditions
and many more

Diagnostics

Types of screening tests vary according to cancer type and age group of patient. Typically carried diagnostic tests in cancer field can be found on below links

Types of Cancer | Cancer.Net (Tests according to cancer type)

How Cancer Is Diagnosed – National Cancer Institute

Tests to Find and Diagnose Cancer

Global Cancer Statistics

Below are some important links to refer global Cancer data spread.

WHO-CancerReport-2020-Global Profile (paho.org)

Cancer Today (iarc.fr)

Cancer statistics, 2020 – Siegel – 2020 – CA: A Cancer Journal for Clinicians – Wiley Online Library

Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries – PubMed (nih.gov)

Cancer (who.int)

Treatment Options

Many treatment options are available and are very well-tolerated. Practitioners generally apply single or combination mode of treatment based on following factors

Type of cancer
Stage of cancer
Location of cancer
Tumor size
Treatment history
Health status of patient
Presence of other diseases e.g. diabetes, heart issues

Chemotherapy:

This is commonly used therapy. This therapy uses drugs to destroy cancer cells. Chemotherapy is typically applied to treat tumor and to reduce adjacent cancer symptoms. Chemotherapy can be given via oral, intravenous, intramuscular, intrathecal, intraperitoneal, intraarterial or via topical route. Depending upon the disease condition, type of drug, type of combination drugs and doses are selected (1st, 2nd and 3rd line chemotherapy).

Radiation Therapy

Radiation therapy uses radiation to kill and shrink tumors. Radiation therapy is generally combined with other treatment options. Types of radiation therapy include

-External beam radiation

-Internal beam radiation therapy

Immunotherapy

This therapy uses hormones and other drugs which work with immune system to treat cancer. Immunotherapy helps to boost performance of immune system to fight cancer. Many types of immunotherapy options are available like Immune checkpoint inhibitors, T-cell transfer therapy, Monoclonal antibodies, Treatment vaccines (to boost immune system’s response to cancer cells) and Immune system modulators. Immunotherapy is typically given via intravenous (IV), oral, topical and intravesical route.

Surgery

In this procedure surgeon removes cancer from body mechanically. This procedure is spread from few to several hours and needs hospital stay. Depending upon disease state, surgery could be open body or minimally invasive. Typically, surgical procedure is combined with many other treatment options.

Hormone Therapy

This therapy uses hormones to slows or arrest the growth of cancer. Hormone therapy is most often combined with other type of cancer treatments. It is given via oral and injection. Typically, it is used to treat breast and prostate cancers. Hormone therapy is based on two mechanisms

-Therapy that blocks the body’s ability to produce hormones

-Therapy that interferes with body hormone performance

Photodynamic Therapy (PDT)

This therapy uses a drug which is activated by light, called a photosensitizer or photosensitizing agent, to kill cancer cells. PDT is often used as a locally to treat specific part of body.

Stem Cell Transplant

This procedure aims to restore blood-forming stem cells in patients who already received high doses of chemotherapy or radiation therapy. Stem cells transplant is a complicated and costly procedure.

Targeted Therapy

This therapy uses newer drugs that block genes or proteins found in the cancer cells. Mechanism of action typically involves arresting cancer growth, killing cancerous cells, boosting immune response, or block the hormonal supply. Targeted therapies are based on

-small-molecule drugs

-monoclonal antibodies

Aerosolization Therapy

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is an innovative approach used by surgeons to deliver chemotherapy into the peritoneal cavity as a pressurized normothermic aerosol. This therapy proved to be safe, cost effective and patient friendly. PIPAC can used alone or in combination either with standard chemotherapy, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Vaccines:

There is no vaccine for cancer. But there are vaccines for some viruses that are known to cause liver, cervical, anal, throat, and penile cancers, e.g. human papillomavirus (HPV) and hepatitis B. These vaccines protects against the virus not from cancer.

Ongoing Clinical Trials

Many new drugs, targeted therapies, surgical procedures, hormonal therapies, aerosolization therapies and combination of them is being tested in several clinical trials conducted globally. On below sites you can find recent developments in the field.

Home – ClinicalTrials.gov

Find NCI-Supported Clinical Trials – National Cancer Institute

Clinical Research Trials | CenterWatch

EmergingMed Clinical Trial Navigation Service

Clinical Trials register – Search for cancer

Search Clinical Trials – Center for Information & Study on Clinical Research Participation (ciscrp.org)

Looking For Help – Lazarex Cancer Foundation