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Oncology: Basics & Beyond

Oncology

What Does Oncology Treatment Mean?

Owing to the potential of rapidity of cell division & invasion in the adjacent areas, tumors are classified as benign & malignant. Benign tumors multiply at a slower rate & are localized in nature. On the other hand, malignant ones divide rapidly & posses a tendency to metastasize i.e encroach adjacent/distant tissues. Depending upon the onset, location & severity of tumor, various treatment approaches can be made. MedcureIndia gives a brief idea to its readers about the treatment variables in the following lines.

Causes of Cancer:

Cancer is a multifactorial phenomenon occurring as a result of:

  • Smoking/tobacco/alcohol: Precancerous conditions such as oral submucus fibrosis & cancer stages like squamous cell & verrucous carcinoma occur in the oral cavity due to excessive smoking & tobacco consumption. Chronic smoking also leads to lung cancer.
  • Immunosupression: A reduced level of immune system always predisposes to a cancer environment. In such cases, there are less immunity cells to fight against cancer ones resulting in their rapid growth. Stomach & neuroendocrine cancers occur mostly due to this.
  • Environmental changes: Too much exposure to UV rays/radiation or sun may lead to different stages of skin cancer.
  • Genetic mutations also may occur after birth leading to cancer as a result of unfavourable environment.
  • Viral infections: The most common virus leading to cancer is Human Papilloma Virus HP.

Signs & Symptoms Of Cancer:

A lot many times signs of cancer go unnoticed, majorly because they are painless symptoms. However these should be considered as warning signs and immediately brought to a doctor’s notice.

  • Easy bruising/bleeding/discharging and skin rashes
  • Lump in the breast or para-breast region
  • Chronic blood in stools
  • Soreness in throat/difficulty in swallowing, hoarseness in voice
  • Increase in number/growth or change in the colour of wart/mole
  • Reduced mouth opening

Diagnostic Tests For Cancer:

  • Lab procedures: Blood , urine and stool samples are examined for presence of any abnormal cells. However, it cannot be the sole method of cancer detection, often unreliable.
  • Imaging techniques: These include x-rays, CT scans, MRIs, endoscopy for the location and extent of cancer.
  • Biopsy: A small part of tumor is resected and studies with biologic markers and dyes for the estimation of type and staging of cancer.
  • Fine needle aspiration cytology FNAC: A needle is inserted into the tumor mass & the contents are aspirated. These are then examined for any abnormal growth cells indicating a cancer stage.

Types of Cancer Diseases:

No human body part is ever spared by cancer mass. Cancers may be classified according to the location, degree of onset, stage of metastasis or the severity. Cancer according to location include :

  • Head and neck region:
  • Eye: These include melanoma and retinoblastoma which may cause total loss of vision. Melanoma pertains to excessive multiplication of pigment containing cells called melanocytes. Mostly occurs due to genetic mutations of such cells.
  • Nose: This manifests in the form of nasopharngeal cancer due to viral infections, genetic mutations or weed/ganja inhalation. Subsequently cancer may spread to the paranasal areas and involve the maxillary sinuses.
  • Oral cavity: This may involve the oral mucosa, tongue and lips. E.g squamous cell carcinoma, verrucous carcinoma according as a result of tobacco consumption. Parotid gland and duct cancer occur as a result of viral infections. Minor salivary glands may also get affected.
  • Thyroid and parathyroid cancer: This occurs as a result of excessive exposure to radiation. The most commonly encountered thyroid cancers are follicular and papillary ones. It is relatively common in females and owing to its metastatic nature, requires aggressive treatment approach.
  • Thoracic region:
  • These include lung cancers such as thymoma, thymic carcinoma and malignant mesothelioma occurring as a result of nicotine deposition in the alveoli due to excessive smoking.
  • Breast cancer: May occur as a benign fibroid mass or an aggressive metastatic one involving one or both the breasts. A lump in the breast area, dimpling in the para-breast region or change in the shape are the warning signs. These signs are mostly ignored by women owing to their painless nature.
  • Gastrointestinal region:  These include tumors of the esophagus, stomach, small and large intestine, pancreas, liver and bile duct, gall bladder, anal, rectal and appendix cancers. The causes for these cancers are multi factorial.
  • Stomach cancers such as adenocarcinoma occur in the cardiac or fundic region of the stomach in the lining epithelium. They result into regurgitation of gastric juices, irritation in the lower esophageal tube, soreness and bleeding.
  • Pancreatic adenocarcimona affects the pancreatic cells secreting digestive enzymes. In cases of tumor, there is excessive growth of tumor mass leading to malfunctioning of these enzymes. As a result of this, severe abdominal/back pain, loss of apetite and light coloured stools are seen.
  • Bile duct cancer also known as cholangiocarcinoma occurs as a result of blocking of the hilum/opening where liver tissues pour their secretions into the bile duct. Chronic jaundice is the most common symptom; however may go unnoticed.
  • Genitourinary region:
  • Cervical/vaginal/uterine/ovarian cancer: Occur in females due to a variety of reasons including hormonal imbalance, unhygienic parturition procedure.
  • Cervical cancer occurs in the cervix part of uterus, often due to human papilloma virus. Excessive lower abdominal pain, pain on urination and fowl odoured vaginal discharge are the signs.
  • Ovarian cancers begin in the epithelial lining of the ovaries. They majorly go unnoticed, unless they spread to the pelvic region. A very high level of hormonal imbalance is encountered in such females which if go untreated may prove fatal.
  • Prostrate/penile/testicular cancer: Occurs in the male population, often treated with surgical approach.
  • Prostrate cancer is the most commonly occuring cancer in the prostrate gland of men. It can be cured if it goes noticed in the early stages. Painful urination and loss of urinary sensation are the most common symptoms.
  • Renal cell carcinoma: It infects the urinary bladder, kidneys, urethra or ureter. Painful urination, little or almost passing out and blood in urine are symptoms in the advanced stage.
  • Skin : These include melanomas, multiple myeloma, basal cell carcinomas and non melanomas. Mostly occur due to excessive UV radiation, exposure to carcinogenic chemicals.
  • Haematologic: These include blood, lymph and bone marrow cancers such as leukemia and lymphomas. Leukemia causes excessive production of the white blood cells. The progenitor cells in the bone marrow are triggered by cancer signals to multiply rapidly into WBCs. In myeloid leukemia there is increased production of myeloblasts, platelets and red blood cells. Quite a dangerous form of cancer, proves fatal if untreated at the correct stage.

Commonly encountered leukemia are:

  1. Acute myeloid leukemia
  2. Chronic lymphocytic leukemia
  3. B cell polymorphocytic leukemia
  4. Hairy cell leukemia
  5. Mast cell leukemia

Commonly encountered lymphomas are:

  1. Burkitt’s lymphoma
  2. Follicular lymphoma
  3. Hodgkin’s lymphoma
  4. Primary effusion lymphoma

Treatment Of Cancer:

Radiation therapy RT: 

It is a branch of medicine that aims at killing cancer cells in the early stages, routinely recommended for various types of tumors including breast, lung, cervical cancer & lymphoma. In curative RT, ionizing radiation beams are targeted towards the nucleus of the abnormal cells which bring about disintegration of its DNA. As a result they undergo apoptosis i.e cellular death & the division eventually stops. It is a fairly painless procedure. Adjunctive RT is used along with chemotherapy sessions or post surgical removal. The palliative type does not aim at curing the cancer, it only provides symptomatic relief. The number of radiation therapies & the dose per appointment is decided by the oncologist as per the tumor stage. Total duration may last from anytime between 2-3 months to 10-12 years depending upon the aggressiveness of the cancer & response of the patient.

Chemotherapy:

It is a treatment strategy which uses anticancer drugs instead of radiation. These drugs interfere with the metabolism of the cancerous cells & prolong the cellular division. They reduce the availability of nutrients from the surrounding environment which these cells may require for multiplication. Also they prevent spreading or migration of the tumor mass into the adjacent spaces. Reduction or shrinkage of the cancer mass may also be achieved with chemo sessions It may be the only choice of treatment for certain cancers e.g leukemia or used along with RT & surgery as in cases of colon cancer.. The frequency of chemo & type of drug to be used along with its dosage is a collective decision of the oncologist & chemotherapist. 

  • Surgical Management:
  • In simpler terms, it implies removal or resection of the cancer mass. Multiple types of surgical interventions are done depending upon the severity of the metastasis including:
  • Curative: It involves complete removal of the localized mass followed by sessions of RT or chemotherapy. In breast cancer surgery, the cancerous tissues are removed in tote; mastectomy i.e complete removal of one or both the breasts may also be done followed by mammary reconstruction. In cases of oral cancer, resection of the infected tissue is carried out & reconstruction done with artificial prosthesis. Removal of tumor mass from eosophagus is also commonly done. It is also a routine protocol to remove lymph nodes in extreme cases of lymphoma. Prostrate cancers are also treated best with this type of approach.
  • Preventive: It includes removal of precancerous masses which in future may develop into a tumor. These include removal of fibroids from breast region, intestinal polyps in the colonic region.
  • Palliative: It aims at providing relief from symptoms & does not involve any major resections as such.
  •  Cryosurgery: One of the recent advances in the field of oncology, it is a bloodless procedure using extremely cold temperatures to kill the cancer cells. It is used for the treatment of skin & colon cancers. Liquid nitrogen has proven to be an effective & excellent chemical for this use.
  • Cancer Drugs:

As such there isn’t a particular drug which cures all types of cancer. Neither is there a drug available aimed at curing a single type of tumor. Nevertheless anticancer drugs are still used along with RT, chemo & surgery to provide relief from symptoms & suppress the multiplication activity of the tumor cells.

  • Immunotherapy:

It is a methodology in which the individual’s immune system is boosted to fight against cancer. Leucocytes, macrophages, C & T cells, platelets etc bring about the natural defense of the human body. However, they become weak/exhausted during cancer stages. Hence they are administered into the body to shoot up the immunity. Biologic proteins & CAR T cells are used for this purpose. They multiply rapidly within the host upon injection & prevent the progress of cancer division. Immunotherapy can be adopted as a late resort after RT & chemo sessions are completed.

Complications & Risk Factors Associated With Cancer:

  • Although RT & chemotherapy both are painless procedures, certain sensitive areas may feel mild pain or loss of sensation. Radiation beam may target the normal tissues if the angle of beam is not proper. Thus, a few healthy cells may also get killed in the process. The most commonly encountered side effects include
  • Hair loss
  • Skin irritation
  • Nausea & vomiting
  • Soreness of throat
  • Thyroid dysfunction may occur as a result of RT in the head & neck region.
  • Infertility or impotence may occur as a result of high RT to the reproductive organs e.g in cases of prostrate, ovarian or cervical cancer.
  • Complications also occur commonly with chemo sessions since the drug administered travels throughout the body, causing a mild to severe damage to the normal cells. These include:
  • Hampering with the blood forming cells in the bone marrow, hair follicles leading to hair loss.
  • Erosion of the oral, respiratory & alimentary track leading to soreness.
  • Uneasiness, lethargy, skin irritation, diarrhea, easy bleeding/bruising

Success Rate Of Cancer Treatment:

The success rate for benign tumors in the early stages using RT and chemo ranges from 70-75%. There may be chances of recurrence. Only 10% of metastatic tumors show success rate. Survival rate can be prolonged with palliative approaches, though untimely death can occur because of pre existing conditions.

Why MedcureIndia?

Team MedcureIndia is known for its versatility and efficiency in providing a platform for the treatment and cure of multiple diseases, and cancer is no way an option to dispose. In today’s era where cancer is on such a rise, we at MedcureIndia aim at reaching out to our clients with the best treatment options available in our knowledge at best affordable prices.