• Describe the diagnosis and staging of cancer.
• Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
Today, millions of people across the world seek to have a more comprehensive, holistic and integrative approach to medicine and health care that is ever more sensitive to their needs as an individual. This particularly holds true for cancer patients. With the transforming patient demographics and increased consumer demands, there is a heightened need as well as the application of complementary and alternative medicine products and treatments for curing cancer which has fueled the emerging fields of oncology and integrative medicine to provide a better approach to cancer care. The present paper discusses the basics of cancer and diagnosis, staging and approach to care of cancer.
Cancer is a category of disease that typically includes cell growth that is out of control in nature. There are more than 100 types of cancer diagnosed till now and each of them is classified by the initially affected cell type (Tang, 2012). Cancer damages the body by uncontrollably dividing the cells to form masses or lumps of tissues known as tumors, except in case of leukemia or blood cancer where there is a prohibition of normal blood functioning as cells abnormally divide and grow in the blood stream due to cancer (Tang, 2012). Tumors grow at a varied speed and interfere with the normal physiological functions such as digestion, circulation, nervous system associated functions. Even the tumors release harmful chemicals that change the normal body functions (Rakoff-Nahoum, 2006). When the tumors are spotted in a single place and demonstrate limited growth then they are known as benign tumors whereas in those cases where the cancerous cells move throughout the body with the help of blood or lymphatic systems, damaging healthy cells, then the condition is known as malignant tumor. A malignant cancerous cell is capable of dividing and growing, making new blood vessels for feeding and this process is known as angiogenesis (Grunfeld, 2006). The normal body cells are destined to follow an orderly path of grow, divide and die in which apoptosis process helps in programmed cell death once its life is finished. But this process is suppressed in case of cancer where the abnormal cancerous cells only divide and grow and do not die. Cancer can be caused if an individual is in continuous exposure to any carcinogen such as tobacco, asbestos, x-rays and gamma radiations, arsenic, the sun and compounds found in car exhaust fumes. A damaged or mutated DNA in an individual can inhibit the functions of oncogene and tumor suppressor gene that leads to uncontrolled cell growth. Cancers are classified into five broad groups: Carcinoma, Sarcoma, Lymphoma Leukemia and Adenoma (Holleb et al., 1991).
The presence of cancer can primarily be diagnosed by looking the affected tissue under microscope. As soon as the screening test indicates any possibility of cancer, biopsy is performed. Biopsy is a surgical removal of the small piece of the infected tissue for examining it microscopically (Holleb, fink and Murphy, 1991). This will tell the doctor whether any tumor is actually present and if present, then whether it is malignant or just benign. Tissue can be removed using one of any three of methods that are needle biopsy, endoscopy or surgical biopsy. Surgical biopsy includes excisional biopsy or incisional biopsy which respectively involves removing of the entire tumor or removal of just a piece of tissue from the affected area and then removing the tumor immediately or in another operation, if the tumor is present (Bozzeti, 2010).
Once the tumor has been removed fully or partially, the next step is to determine the aggressiveness of the cancer or how fast it is growing to other parts of the body. The abnormal tissue is observed under the microscope and the cells are looked for their well differentiated nature or poorly differentiated nature from the normal cells of the tissue. If the tumor cells looked identical to normal cells, then they are well differentiated and if they do not resemble to normal cells of the same tissue, then the condition is undifferentiated cells. The poorly differentiated cells or undifferentiated cells are more aggressive in nature and they grow and spread faster. Once the diagnosis is made, the doctor starts the process to find out the extent of the cancer. This process is known as staging (Shaffer, 2008).
Staging determines how far the cancer has spread in the body. Any decision regarding treatment of cancer is dependent upon staging only. The four common cancer stages are (becker, 1981):
The staging process is carried out by number of methods such as MRI, ultrasound, CT or CAT scans, bone marrow biopsy and blood tests. Once the staging is done, the treatment begins.
The most conventional treatment of cancer is surgery. It is possible to completely cure a cancer patient if the cancer is not metastasized because it involves only removal of the infected tissue, for example in case of breast or prostate or testicle cancer. However if the disease is spread then it is impossible to remove all the cancerous cells through surgery. Radiation treatment or radiotherapy is another approach that destroys the cancer cells through radiations (gamma rays or high energy x-rays) that are focused on cancer cells. Radiotherapy can be used as a standalone therapy to treat cancer by shrinking a tumor or fully destroying cancer cells, for example in case of leukemia and lymphoma, however, it is being used in combination with other therapies to cure cancer (Gorin, 2010).
Chemotherapy is another treatment that makes use of certain chemicals that interfere and inhibit the process of cell division by damaging their DNA so that they can commit suicide (by enhancing their apoptosis). Normal cells are affected in this process but they can recover from the chemicals in few days but the cancer cells fully die. This therapy is very effective but occurs in phases as the body gets exposure to harmful chemicals so it needs time to heal in between the phases. There is a range of side effects associated with chemotherapy, such as nausea and vomiting, hair loss and fatigue (Becker, 1981; Gorin, 2010). This therapy can be used in combination approaches to kill cancer in case of notorious cases. Immunotherapy, gene therapy and hormone therapy are three more therapies used to treat cancer. Hormone therapy is particularly used in case of breast cancer and prostate cancer by respectively focusing on reduction of levels of estrogen and level of testosterone by the use of tamoxifen, a common drug (Campbell, 2002). Gene therapy works by replacing the damaged genes with those genes that work for damaging the DNA of cancer cells.
Complementary therapies have side effects which can be equally painful as the suffering of a disease. Therefore, complementary therapies are added along with conventional therapies to enhance the level of cancer care and therapeutic outcome (Grunfeld, 2006). The use of an individual approach for curing a cancer patient helps in improving the patient’s quality of life. Individual approach takes help of naturopathic medicine, pain management, nutrition and exercise, spiritual support and mind body medicine to cure and take care of a cancer patient. Nutrition therapy for example, provides varied and healthful diet that significantly improves the body response towards the treatment and hugely bolsters the immune system (Grunfeld, 2006). Naturopathic medicines make use of plant based supplements of food and medicine to help body heal itself naturally. Gentle exercise can prevent any damage to cardiovascular health, flexibility and muscle mass due to harmful side effects of conventional therapies and helps the patient heal at rapid rate (Grunfeld, 2006).
Conclusion
Cancer has a cure if the disease is timely diagnosed and staged. Conventional therapies and complementary therapies are well collaborated and implemented mutually so as to offer individual based multidimensional approach to care of cancer.
References
Becker, T. M. (1981). Cancer Chemotherapy: a manual for nurses. Little Brown GBR.
Bozzetti, F. (2010). Basics in clinical nutrition: nutritional support in cancer. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, 5(3), e148-e152.
Campbell, J. B. (2002). Breast cancer-race, ethnicity, and survival: a literature review. Breast cancer research and treatment, 74(2), 187-192.
Gorin, S. S. (2010). Theory, measurement, and controversy in positive psychology, health psychology, and cancer: basics and next steps. Annals of Behavioral Medicine, 39(1), 43-47.
Grunfeld, E. (2006). Looking beyond survival: how are we looking at survivorship?.Journal of Clinical Oncology, 24(32), 5166-5169.
Holleb, A. I., Fink, D. J., & Murphy, G. P. (Eds.). (1991). American Cancer Society textbook of clinical oncology. Amer Cancer Society.
Rakoff-Nahoum, S. (2006). Cancer Issue: Why Cancer and Inflammation?. The Yale journal of biology and medicine, 79(3-4), 123.
Runnebaum, I. B. (1996). Basics of cancer gene therapy. Anticancer research,17(4B), 2887-2890.
Shaffer, E. A. (2008). Gallbladder cancer: the basics. Gastroenterology & hepatology, 4(10), 737.
Tang, D. G. (2012). Understanding cancer stem cell heterogeneity and plasticity.Cell research, 22(3), 457-472.
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