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An Introduction to Cancer

IN THIS CHAPTER YOU’LL DISCOVER

→ What Cancer Is

→ How This Disease Affects the Body

→ The Major Types of Cancer

→ How Genetics Impacts Cancer

→ Lifestyle and Environmental Factors That Contribute to Cancer

→ Tips for Cancer Prevention

JOANNE FILINA WAS 37 when she was diagnosed with a potentially deadly form of leukemia. Her doctor told her that the blood disease would probably kill her. Determined to beat the odds, Joanne decided to head to a leading cancer clinic, where she found the attitude of the doctors there to be rooted, instead, in positivity. After aggressive treatment, her cancer is now in remission.

At age 33, Mike Craycraft felt a testicular lump; his immediate thought was that he had cancer. He even made his own “bucket list,” culminating in a giant good-bye party that he’d throw for himself. Although his immediate assumption was correct, today Craycraft is also cancer-free, and looking forward to many more decades ahead.

Anna Strazzante was diagnosed at the age of 41 with a potentially life-threatening and difficult-to-treat form of bladder cancer. “I felt like I’d been kicked in the stomach. It just seemed like I was living in a nightmare that I couldn’t awaken from,” she recalls. But today, Anna is not only cancer-free, she is a marathon runner — a sport she took up following her treatment.

Joanne, Mike, and Anna are just three of the cancer survivors you’ll meet in this book. They are among the 13.7 million people living in the United States who are beating cancer. And this statistic does not include cancers that were caught in their earliest stages, so the tally is undoubtedly much higher.

If you are diagnosed with cancer today, you are more likely to survive than at any time in history. The mission of this book is to give you the tools to do it.

What Is Cancer?

Our bodies are comprised of trillions of living cells, all of which make up our organs and features — from the hair on our scalp to the toenails on our feet. These cells are preprogrammed to grow, divide into new cells, and die in an orderly fashion. Cancer takes hold when cells begin to grow uncontrollably. Instead of dying, these cells continue to grow, forming new, abnormal cells. In effect, they become immortal.

How Does Cancer Affect the Body?

In most cases, cancer damages the body because of its capacity to spread to vital organs, ultimately engulfing them and destroying their ability to perform their life-sustaining functions.

The precise way in which cancer affects the body, though, depends on the type of cancer. Most cancers are comprised of cells that clump together and form solid masses, or tumors. They spread by sending off cancerous cells that travel in the lymph system, taking up residency and colonizing in other organs. These cancers are known as “malignancies,” a word that comes from Latin, meaning “to act maliciously, or with evil intent.” It is an apt term.

But there are exceptions. Brain cancer, for instance, does not spread to other organs, but its growth can destroy the delicate structure within the body’s vital command center. Leukemia results in armies of abnormal cells that destroy the blood’s critical, oxygen-carrying function.

Major Types of Cancer

All cancers fall within one of these four major categories:

Carcinoma is the most common type of cancer. In fact, 80 to 90 percent of all cancers are carcinomas. They are solid tumors that begin in the epithelial tissue of the cells in our body, which form the covering or lining of the organs, glands, and other bodily structures. Lung, breast, prostate, colon, rectal, and pancreatic cancer, for instance, are all carcinomas.

Sarcoma begins in the connective tissue, between bones and cartilage, or in the fat, muscles, and also blood vessels. Sarcomas can develop anywhere in the body, but half of them occur in the arms and legs.

Blood cancers are those that form in the bone marrow, in the blood itself, or in the lymph system — the interconnected, cleansing superhighway that occupies spaces and vessels between tissues and organs, by which lymphatic fluid circulates throughout the body. Lymph is a colorless fluid containing white blood cells that keep the tissues healthy and free of toxins.

Central nervous system cancers begin in the tissues of the brain and spinal cord. Most of these cancers occur in or spread to the brain.

DID YOU KNOW . . .

Fifty percent of all cancers are diagnosed as one of these four major types: breast, colon, lung, and prostate cancer. All other cancers, which comprise the remaining 50 percent, are cancers that are designated as “rare” because they occur in fewer than 200,000 people a year.

Common Symptoms of Cancer

Many types of cancers have different symptoms, which occur depending on where the disease is located, its type, and how large the tumor may have grown. That said, there are some common symptoms that indicate the presence of cancer. It’s important to realize, though, that many diseases, including some that are not serious, can cause these symptoms as well.

UNEXPLAINED WEIGHT LOSS

The first sign of cancer may be an unexplained loss of 10 pounds or more. This happens most often with cancers of the pancreas, stomach, esophagus (swallowing tube), or lung(s). Weight loss can also be a later sign of other types of cancers, as they rob the body of vital nutrients in order to feed their own growth. As a general rule, doctors agree that an unexplained weight loss of five percent or more of your normal body weight in a six-month to one-year period — especially for older adults — is a signal for concern and requires medical evaluation.

FEVER

A rise in normal temperature is the body’s way of attempting to fight off an infection. There are several reasons why cancer can cause a fever. The body may be reacting to substances produced by the tumor, or the fever may be due to blockages the tumor causes in the kidney, bladder, or bowel. Fever can also be an early sign of a blood cancer like leukemia or a non-Hodgkin’s lymphoma.

PAIN

Pain can be an early symptom of testicular cancer. A headache that does not get better with time or treatment can indicate a possible brain tumor. Back pain is not usually an early warning sign of cancer, but an indication it has spread. Such pain can be caused by colon or ovarian cancer.

SUDDEN SHORTNESS OF BREATH

Belabored breathing, wheezing, fatigue, and trouble swallowing are sometimes early signs of lung cancer.

SKIN CHANGES

Redness, swelling, dark or bruised-looking patches, or itchy skin can also be an indication of inflammatory breast cancer. Itchy skin can be a symptom of lymphoma as well. Changes in any wart, mole, or freckle, whether in color, size, shape, or border, can signal the dangerous form of skin cancer known as melanoma.

SORES THAT DO NOT HEAL

A skin cancer may bleed and resemble a sore. A long-lasting sore in the mouth could be an oral cancer. Sores on the penis or vagina are commonly caused by infection or virus, but may also be an early warning sign of cancer.

ABNORMALITIES IN THE MOUTH

White patches inside the mouth and white spots on the tongue can indicate leukoplakia, a chronic condition caused by tobacco use. If unchecked, this can become mouth cancer.

UNUSUAL BLEEDING OR DISCHARGE

Bleeding or discharge with no apparent cause should spark concern, and could signal either early or advanced cancer. For instance, spitting up blood can indicate lung cancer. Blood in the stool can be a sign of colon or rectal cancer, and uterine cancer can cause abnormal vaginal bleeding. Blood in the urine can indicate bladder or kidney cancer, and a bloody discharge from the nipple can signal breast cancer.

THICKENINGS OR LUMPS IN THE BODY

Cancerous cells clump together, so it’s not surprising that many cancers can be felt through the skin. A lump is a well-known tip-off to breast cancer, of course. Lumps elsewhere in the body, especially the arms and legs, can indicate a sarcoma, which is a soft tissue cancer. Lumps in the armpit, neck, or groin area can indicate lymphoma.

INDIGESTION OR TROUBLE SWALLOWING

Persistent difficulty digesting or swallowing may be indicative of cancer of the esophagus (the swallowing tube), stomach, or pharynx (area where nasal passages connect to one’s mouth and throat).

Genetics and Cancer

Cancer has always been with us. Indeed, our knowledge of cancer dates back to early recorded history. Later, the ancient Greek physician Hippocrates (460 BCE–377 BCE) gave cancer its name by describing several types of cancer with the Greek word carcinos (crab or crayfish) to denote the appearance of a cut, solid tumor with veins stretched out that suggested the claws of a crab to him.

The reason that cancer dates back to the birth of humankind is because it originates from deep within us — within our very genetic makeup. Deoxyribonucleic acid (DNA) contains the self-replicating genetic material, or genes, occupying every cell of our body. Our genes are arranged on chromosomes. Each cell in the human body contains 46 chromosomes, or 23 pairs, half obtained from each parent.

Here’s a rundown on the types of genes involved in the development of cancer:

Proto-oncogene: These are genes that normally direct how a cell divides, but have the potential to undergo mutation and become an oncogene. The prefix “onco-” comes from the Greek oncos, meaning mass or tumor.

Oncogene: This is the product of a proto-oncogene that has developed a defect, mutated, and could result in a cancer. Scientists believe that we all carry oncogenes, but that they remain harmless unless triggered.

Tumor suppressor gene: These are genes we also carry that protect cells and slow their division. If something goes awry in this gene, the cancer is enabled to grow. The different genes involved in specific types of cancer are further discussed in those respective chapters.

How Genetics Works

The cells of our body contain genes that are comprised of DNA, which is known as the “genetic code,” and orchestrates their functioning. The genetic code that oversees this process is contained in the 23 pairs of chromosomes; half of the code is located in a female’s egg, and the other half in the male’s sperm. Eggs and sperm are known as “germ cells.”

When the egg and sperm meet at the moment of conception, their individual chromosomes combine to create our complete DNA code. Our DNA programs the cells to live, multiply, and then die. If, for some reason, the cell ceases to respond to the DNA’s growth-inhibiting signals, it can become cancerous.

The impact of inherited genetics varies with the type of cancer. A minority of cancers — perhaps only about five to 10 percent of cancers — are directly inherited. But genetics also plays a broader role, because certain genetic mutations also increase the likelihood that a person will develop cancer. These account for cancers that seem to run in families, but do not follow the normal, direct genetic rules of inheritance.

The mutation of a gene into a cancer-causing one is not a simple process. It takes mutations in several genes for a person to develop cancer. What specifically causes mutations to occur in these genes is largely unknown. These are known as “sporadic” mutations, as they occur not due to heredity, but by chance. They may occur from aging, tobacco use, sunlight or chemical exposure, or from factors we don’t yet understand, but they are not caused by genetic inheritance.

Most cancers are diagnosed in those aged 60 and older. This is because mutations in some genes become more common as we age. At the same time, aging weakens the immune process. As the immune system becomes weaker, it’s less able to prevent these cancer-causing mutations from occurring.

Personal Genetic Testing

Genetic testing, which is also sometimes called “predictive testing,” seeks to find specific inherited changes, or mutations, in a person’s genetic makeup that could cause them to have a predisposition to develop cancer.

Even if you’ve been diagnosed with cancer, you should consider genetic testing for the following two reasons:

• • Genetic testing can tip you off to an increased risk for developing a related form of the disease and alert you to take steps to prevent it. For instance, inheriting a BRCA gene increases the risk of developing both breast and ovarian cancer.
• • Confirmation of a genetic mutation can enable you to alert your relatives that they should be tested as well, which could save their lives. There is an inherited form of colon cancer, and those people with the genetic mutation should undergo screening tests far earlier.

Currently, there are about 900 genetic tests available for all diseases, including many forms of cancer, such as breast, ovarian, prostate, endocrine, and some very rare cancers. Because of genetic trends in culture and bloodline, some individuals are highly encouraged to undergo genetic testing. For example, people of Ashkenazi (Eastern European) Jewish ancestry have been found to be at increased risk for BRCA gene mutations that cause breast and ovarian cancer. As well, testing is recommended for those with two or more family members diagnosed with the following characteristics:

• • Adult cancer at an earlier than expected age (under 50)
• • Developed the same type of cancer (in some cases, this might not necessarily be the exact same type, as breast and ovarian cancer can be considered the same for purposes of determining genetic predisposition)
• • Two or more different cancers in the same person
• • A rare cancer, such as male breast cancer or sarcoma

Lifestyle Factors That Contribute to Cancer

TOBACCO

Tobacco use is linked to 30 percent of all cancers overall and 87 percent of lung cancers. While it should come as no surprise that tobacco use is the major cause of cancer of the lungs, mouth, lips, nose, pharynx, larynx (voice box), and esophagus, it’s also linked to the development of cancers of the stomach, pancreas, cervix, kidney, colon/rectum, bladder, uterus, and ovaries, as well as acute myeloid leukemia. Cigarettes are not the only culprit — these cancers are also linked to cigar and chewing tobacco use. Smokers who switch to e-cigarettes are not necessarily safe, as the risks related to this product have not yet been evaluated.

EXCESSIVE ALCOHOL USE

Not surprisingly, alcohol is a major cause of liver cancer, and the risk increases the more alcohol is consumed. But alcohol overuse is also linked to breast, mouth, pharynx, larynx, esophageal, colon and rectal cancer, and possibly pancreatic cancer as well.

OBESITY

Obesity is associated with an increased risk of cancers of the esophagus, breast (postmenopausal), uterus, colon and rectum, kidney, pancreas, thyroid, gallbladder, and possibly prostate. This is because excess body fat isn’t inert. When it is located in the abdomen, for instance, it cushions the surrounding organs and produces certain hormones that may help enable cancer to thrive.

DID YOU KNOW . . .

There are a lot of direct-to-consumer testing kits on the market, but the FDA warns these tests may not be accurate and that they could also lead people to make serious medical decisions without enough information. They also can cause people to panic. If you believe may have an inherited genetic condition, consult a qualified genetics counselor who can perform the test and also put it into perspective. See the appendix for more information.

STRESS

When you talk to cancer patients, they will often trace the beginnings of their disease to a time when they were undergoing stress. But is there a true association between the two? Scientists have long tried to tease out what seems to be a connection between stress and cancer, and they’ve been zeroing in on two areas that may indicate some sort of correlation there: stress on the immune system, and also the production of stress hormones, which can impact cellular growth.

It is the job of the immune system to prevent diseases like colds and flu, but it also patrols the body to prevent cancerous cells from developing. Since stress can hamper the immune system, scientists have been looking at whether this could lead to the development of cancer, but this is very difficult to prove empirically.

As well, when one undergoes stress, the body releases certain hormones including adrenaline and cortisol, which, over time, exert an unhealthy effect. Some scientists believe that the outpouring of adrenaline under stress, for instance, can cause the death of healthy cells, making way for the possible growth of cancerous ones. But this research is only in its early stages.

Stress, though, can play an indirect role, leading to cancer-causing habits like smoking, alcohol overuse, and binging on unhealthy foods packed with fat, sugar, salt, and worse; therefore, it makes sense that you should reduce your stress when it comes to not only battling the disease, but, as much as possible, preventing it in the first place.

Carcinogens and Environmental Hazards

Carcinogens are cancer-causing substances — often chemicals — that can increase a person’s risk of developing cancer.

CERTAIN FOODS AND COOKING PRACTICES

Some forms of cancer can be caused by the foods we eat or the way in which they are prepared. For example, fatty foods and a lack of fiber may be linked to colon cancer, although evidence is conflicting. There is also conflicting research on grilling poultry and meats to the point of charring, so it’s probably best to eat these sparingly if at all.

Additives and Preservatives

Salt and pickling are associated with high rates of cancer of the esophagus, stomach and the nasopharynx, which is the upper part of the pharynx. These cancers are rare in the United States but common in China, where salted fish and pickled vegetables are eaten in much larger quantities. Flavor enhancers like monosodium glutamate (MSG) and preservatives used in processed food are also suspected of causing cancer, as is recombinant bovine growth hormone (rBGH), a hormone fed to cows to increase milk production.

CHEMICALS

There are scores of chemicals known to cause cancer in humans. Some of these known and suspected carcinogens are found in the following substances:

Pesticides

Chemicals linked with the development of cancer include DDT, PCBs, and dioxin, which are found in a vast array of products, including some pesticides and lawn care products, cosmetics, and plastic bottles. Although DDT was banned years ago, the residue from it will linger forever.

Hair Dye

One-third of American women and 10 percent of men use permanent hair dye. In the past, some chemicals contained in these dyes have been linked to certain cancers in animal studies. Over the years, many of these chemicals have been removed, but there is concern about some that remain. Evidence in studies is mixed but, over the years, research has found an increase in bladder cancer in hairstylists and barbers.

CERTAIN ENERGY EMISSIONS

Sunbathing and Tanning Beds

Radiation that comes from the sun can cause skin cancer and melanoma. This is true whether the radiation comes from natural sunshine or tanning beds.

Electromagnetic Fields

It’s well known that ionizing radiation, such as that emitted by X-rays and CT scans, can cause can cause cancer. But what about non-ionizing radiation, which are known as EMFs, or extremely low frequency electromagnetic fields (ELFs)? High voltage power lines, cell phone towers, home appliances, and electronics create such fields. Proponents of the theory that EMFs cause cancer point to changes in cells in test tubes and laboratory rats, but there is also evidence to the contrary as well.

Can Cancer Be Cured?

Many people who attempt to disparage our ability to cure cancer point to 1971, when president Nixon signed the National Cancer Act into law declaring a “war on cancer,” and today, this disease seems as big a scourge as ever.

But this is not true. First, our understanding of cancer has increased tremendously. Although cancer was once considered a single disease, we now know that there are hundreds of different types that can all act differently, and some kinds of cancers can even seemingly transform themselves into others.

Second, we underestimated the difficulty of eradicating cancer. The biological cause of cancer is deeply rooted in our DNA, the programming that oversees the functioning of our entire body. The process that enables us to grow from babies into adults is the same process that goes awry when cancer forms.

Third, we’ve now seen that all attempts to find a “magic bullet” that would cure or protect us from all types of cancer have failed.

But the progress that has been made against many forms of cancer is remarkable. As you’ll see from this book, cancers that were once almost sure killers, like testicular cancer, non-Hodgkin’s lymphoma, and leukemia, have been transformed by time and progress into diseases that are considered either curable or manageable. The mortality rate of other types of cancers has also declined, and researchers are working diligently — and optimistically — to add more types of cancer to this list.

TIPS for Cancer Prevention

Some types of cancers are preventable. For example, not smoking, or quitting, reduces the risk of lung cancer and many other cancers as well. But the causes of a variety of cancers are not yet well-established, so information on how to prevent them is lacking. But, over the years, some clear patterns have emerged. While this book is concerned with how to survive cancer, here are the ways to help prevent the most common types of cancer from occurring:

• • Don’t smoke. If you do, quit. Smoking is the main cause of lung cancer and accounts for one-third of all cancers.
• • Watch your weight. Excessive weight is linked to some forms of cancer, including colon and breast cancer.
• • Eat a colorful diet. Fruits and vegetables that are the most colorful contain the most pigment, which makes them rich in antioxidants, protecting the body’s cells from oxidation — a metabolic process that ages them and can lead to cancer. In general, rely on healthful foods for your vitamins and nutrients over supplements.
• • Eat meat (especially red meat) sparingly, and avoid cured meats, like deli ham, bologna, and salami, bacon, and hot dogs. They contain nitrates and nitrites, which are linked to increased colon and stomach cancer risk.
• • Enjoy a high fiber diet. While studies are mixed, the general consensus has shown that fiber may protect against colon cancer.
• • Get a colonoscopy. A new study shows that colon cancer has decreased by 30 percent in the last decade, which coincided with a tripling of the rate of people getting colonoscopies.
• • Exercise regularly. Physical activity not only keeps weight down and reduces stress, but also keeps hormone levels balanced.
• • Consider alternative and complementary treatments along with conventional medicine but speak with your doctor first.
• • Drink alcohol sparingly or not at all.
• • Avoid sun exposure and tanning beds, which are both proven to cause melanoma.
• • Choose organically grown fruits and vegetables.
• • Avoid using pesticides in or around your home. If you must handle harmful chemicals, do so safely.