Cancer Control Tookit

Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. The cancer cells form tumors that destroy normal tissue. If cancer cells break away from a tumor, they can travel through the blood stream or the lymph system to other areas of the body, where they might form new tumors (also known as Metastases). If this growth is not controlled, cancer might be fatal.

Not all irregular growths of abnormal cells lead to cancer. A tumor can be either benign (non-cancerous) or malignant (cancerous). Benign tumors do not metastasize and, with very rare exceptions, are not life threatening. Benign tumors usually grow slowly, remain localized, and do not destroy surrounding normal tissue.

All cancers develop because of damage or mutation of the genes that control cell growth and division. These genetic changes can be caused by exposure to external factors (for example, tobacco, poor diet, alcohol, chemicals, sunlight, radiation, and infectious organisms) or internal factors (for example, inherited mutations, hormones, immune conditions, and mutations that occur from metabolism). Approximately five to 10 percent of cancers are caused by various inherited gene mutations that predispose people to developing certain cancers.

External and internal factors often act together on in sequence to initiate or promote cancer development. Many years often pass between exposures or mutations and detectable cancer. Because of this, it is often difficult to directly identify causes of specific cancer cases.

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Who gets Cancer?

Anyone can get cancer at any age; however, middle and older aged people are most likely to develop cancer. In Indiana, during 2011, 71 percent of all cancers cases occurred among people ages 55–84. And, individuals who have been exposed to certain external and internal risk factors have an increased risk of developing cancer. For example, according to the American Cancer Society, the risk of developing lung cancer is about 23 times higher in male smokers and 13 times higher in female smokers, compared to lifelong nonsmokers.

How is Cancer Staged?

A cancer’s stage is based on the primary tumor’s size and location in the body, and whether it has spread to other areas of the body. There are two main staging systems used to classify tumors.

  • TNM staging system — This system assesses tumors in three ways: extent of the primary tumor (T), absence or presence of regional lymph node involvement (N), and absence or presence of distant metastases (M). Once the T, N and M are determined, a stage of I, II, III or IV is assigned, with stage I being early stage and IV being advanced.
  • Summary staging — This is useful for descriptive and statistical analyses of cancer data. An in situ tumor is at the earliest stage when it has not invaded surrounding tissue; it can only be diagnosed by microscopic examination. A localized tumor has not spread beyond the primary organ. A regional or distant tumor has spread to other parts of the body, either through the blood or lymph systems. With an unstaged/unknown tumor, there is insufficient information available to determine the stage of the disease.

Staging is essential in determining treatment and assessing prognosis. It is a strong predictor of survival; generally, the earlier the stage, the better the prognosis. Locally and nationally, about half of newly diagnosed cases are either in situ or localized.

How is Cancer Treated?

Treatment depends on the cancer type and stage, specific diagnosis, and overall health of the individual. Cancer is treated by one or more of the following therapies:

  • Surgery removes the tumor by cutting out the cancerous mass; it is mostly used for localized tumors.
  • Chemotherapy uses either intravenous or oral drugs to destroy cancer cells. It is used with the intention of curing or inducing remission in cancers in early stages.
  • Hormone therapy might be given to block the body’s natural hormone and to slow or stop the growth of certain cancers.
  • Immunotherapy (or biologic therapy) is used to stimulate and strengthen a person’s own immune system to destroy the cancer cells.
  • Radiation or radiotherapy uses high-energy rays to destroy or slow the growth of cancer cells. It can be done with the intention of curing some cancers that have not spread too far from their site of origin or to relieve symptoms.

Can Cancer be Cured?

Many cancers can be cured if detected and promptly treated. For most types of cancer, if a person’s cancer has been in remission (which means that all signs and symptoms of the disease are absent) for five years, the cancer is considered cured. However, the length of remission at which a person is considered cured differs by cancer type. Certain skin cancers, such as a basal cell carcinoma, are considered cured as soon as the lesion is removed. For other cancers (for example, pancreatic cancer), eight to 10 years must pass before the person is considered cured.

Prevention

Many cancers can be prevented by modifying external risk factors and making lifestyle changes, such as eliminating tobacco use, improving dietary habits, increasing physical activity, losing weight and avoiding excessive sun and infectious disease exposure. Additionally, many cancers can be prevented or identified at an early stage if people receive regular medical care and obtain early detection cancer screenings.

Resources

Additional and online resources: