Health Essays - Understanding Cancer - Diagnosis and Treatment

Cancer wreaks havoc in almost every part of the human body. Tumors strike the brain and the gut, muscles and bones.

Some grow slowly; others are more aggressive and expand quickly. Their presence in human tissues signals chaos and a breakdown of normal function. Cancer brings unwelcome change to a biological machine that is perfect, marvelously beautiful, and complex beyond measure. Wherever tumors appear, they take on the appearance of alien life forms, invaders that enter the body through stealth and begin their programs of destruction from within.

But appearances deceive: The truth is much more subtle and endlessly interesting.

The introductory quotation (Weinberg, 1999), in vividly describing cancer, suggests that cancer is not a simple phenomenon. In fact, not only is cancer complex, but its origins, diagnosis, and treatment choices are also complex. This essay will support this thesis by exploring the conventional understanding of cancer, its origins, diagnosis, and treatment choices. In conclusion, conventional and alternative treatment approaches will be briefly compared, and a possible future approach to meeting the challenges of this disease will be suggested.

Cancer is a common term for neoplasms, or tumors, that are malignant. These malignancies are comprised of undifferentiated, unspecialized cells with atypical cell structures which function differently from the normal cells in the body organ in which they originate. Almost all of the body's organs are vulnerable to cancer. (The Columbia Encyclopedia, 2005) Unlike normal cells, cancer cells do not possess controlled growth patterns. They typically invade and destroy normal cells and spread to various parts of the body through the bloodstream and lymph system. (The Mosby Medical Encyclopedia, 1996) Two characteristics of cancer cells include invasiveness, or the spread to surrounding tissues, and metastasis, or the spread through the blood or lymphs. Cancer cells compete for nutrients with normal cells until the normal cells die. (The Columbia Encyclopedia, 2005)

The understanding of cancer has evolved over many centuries. Huff and Tomatis (2001) write: In ancient times etiology and prevention of cancer were entirely included within the concept of this feared disease being equivalent to divine punishment, adding that traces of such belief are still with us. Between the seventeenth and eighteenth centuries cancers were thought to be transmissible, and patients were isolated in a manner similar to patients with leprosy (Ackerknecht, 1965, cited in Huff and Tomatis, 2001). Other theories have included Virchow's cell irritation theory and Conheim's cell rest theory which proposed that cells that did not mature caused cancer (Conheim, 1889; Triolo, 1964; Ackerknecht, 1965; Triolo, 1965, cited in Huff and Tomatis, 2001).

In more modern times, a rivalry arose between those experts who attributed cancer to chemical causes and those who attributed it to viral (and, later, microbiological) causes (Huff and Tomatis, 2001). Today, experts are focusing on cancer research involving genes. Cancer Research UK (January 7, 2005) contends that [t]he driving forces behind the development of cancer are damaged genes. Haney (1998) states: Twenty years of research into the origins of malignancy jell into one profound insight: Cancer is a disease of genes gone bad. Larson (1999) confirms this in a similar statement: Decades of cancer research have revealed a simple but potent fact: Cancer is a case of good genes gone bad, adding that [r]esearchers probing the genetic basis of cancer in the early 1980s discovered that certain mutated genes cause cell division to go haywire and that [t]hey named these genes 'oncogenes' from the Greek onkos, meaning 'mass'.

More than 200 types of cancer have been identified and various different causes have been discovered. Cancers have been found to develop because of a complicated interaction between our genes, our environment, and chance. (Cancer Research UK, January 7, 2005). Weinberg (1999) writes:

Tumors are not foreign invaders. They arise from the same material used by the body to construct its own tissues. Tumors use the same componentshuman cellsto form the jumbled masses that disrupt biological order and function and, if left unchecked, to bring the whole complex, lifesustaining edifice that is the human body crashing down.

Weinberg (1999) continues by contending that both normal and malignant cells know how to build, that each type has its own agenda directing its growth, division, and aggregation yet there is no overseeing master builder to ensure proper development. He writes that [m]ost human tumors comprise a billion or more cells before we become aware of them and stresses that these malignancies grow, not quickly, but rather slowly over a period of decades.

A cancer is typically named for the site of its origin thus indicating that there are many origins for cancer. Even when a cancer spreads to other parts of the body, it carries the name of the site of its origin (e.g. a cancer that spreads from the lung to the stomach is called metastatic lung cancer). (The Columbia Encyclopedia, 2005) The initial site of a cancer is often called the primary cancer. If the cancer spreads to other locations in the body, those locations are frequently referred to as secondary cancers. (The Mosby Medical Encyclopedia, 1996)

The most common types of cancer are those originating in the in the lung, breast, bowel, and prostate. These comprise over one-half of new cases. Among the least common are certain blood cancers that comprise less than one percent of new cases. Among the more than two hundred other forms of cancer are acute leukaemia, chronic leukaemia, bladder cancer, bone cancer, brain cancer, cervical cancer, gullet cancer, Hodgkin's lymphoma, non-Hodgkin's lymphoma, kidney cancer, live cancer, mesothelioma, multiple myeloma, ovarian cancer, pancreatic cancer, penile cancer, melanoma skin cancer, non-melanoma skin cancer, soft tissue sarcoma, stomach cancer, testicular cancer, thyroid cancer, and endometrial cancer. (Cancer Research UK, October 23, 2003)

Just as there are many different types of cancermore than 200 as presented earlierthere are different symptoms and treatment choices (Cancer Research UK, January 7, 2005). In terms of diagnosis, for example, the following approaches are recommended to detect abnormalities (The World Almanac and Book of Facts 2000, 1999):

Cancer-related screenings are recommended every three years for everyone between the ages of twenty and forty then each year for people over forty years of age. The specifics of the screening would depend on the person's age and sex, but could include checks for cancers of the thyroid, oral cavity, skin, lymph nodes, testes, and ovaries.
Monthly breast cancer self-examinations are recommended for women starting at twenty years of age. Clinical breast examinations are suggested for women ages twenty to thirty-nine each three years and, for women forty and over, yearly examinations and mammographies are recommended.
Annual pap tests are suggested for cervical cancer for sexually-active women and for those over the age of eighteen.
Colorectal screenings are recommended for women and men starting at the age of fifty. Different testing methods are suggested at various time periods.
Based on risk, periodic post-menopausal endometrial samplings are recommended for women at high risk of developing endometrial cancer.
Regular oral cancer checks by dentists and physicians are recommended.
Annual prostate cancer examinations are recommended for men at age fifty and above and for younger men who are at high risk. Both prostate-specific antigen (PSA) examinations and digital rectal examinations (DRE) are suggested.
Regular self-examinations for suspicious lesions on the skin should be conducted by all adults.

Choices available for treatment of cancer are as diverse as the diagnostics just presented. Developments in the treatment of cancer have led to greatly improved survival and quality of life for cancer patients in the past three decades. Conventional treatments for cancer have emphasized chemotherapy; radiation; and surgery, which is still the primary treatment choice for most types of cancer especially for those that have not spread. Victims of cancer, with the assistance of their physicians, often choose surgery accompanied by chemotherapy, radiation, or both. More recently, immunotherapy has been used, and new drugs are constantly being introduced to fight cancer. These include antiangiogenic agents, which suppress the outgrowth of tumors; genetically-engineered monoclonal antibodies, which (unlike substances used in chemotherapy) kill only specific types of cancer cells; and vaccine agents, which stimulate the immune system. (The Columbia Encyclopedia, 2005) Finally, there are now drugs, such as Herceptin, that victims can choose to target cancer at its genetic roots, according to Larson (1999).

In additional to conventional treatments, there are alternative treatments that cancer victims are choosing with anecdotal reports of various degrees of success. Spowers (2002) lists several of these including:

an organic and raw vegetable regimen offered by Danish doctor Kristine Nolfi;
a wheatgrass juice combined with an organic vegetarian diet promoted by Ann Wigmore;
a diet similar to Wigmore's but with an emphasis on potassium from the skins of root vegetables, combined with pancreatin, freeze-dried thyroid, niacin, Royal Jelly and B12 injections with raw liver juice suggested by Dr. Max Gerson;
a raw food regimen combined with pancreatic enzymes and coffee enemas recommended by Dr. W. D. Kelly; and
the use of specific vitamins, minerals, and herbs in conjunction with colonic cleansing, meditation and spiritual healing promoted by the Bristol Cancer Help Centre in Britain.

In addition to the foregoing traditional and alternative treatments, cancer victims can choose biofeedback, acupuncture, meditation, and use of narcotics to treat the pain that frequently accompanies cancer (The Columbia Encyclopedia, 2005). According to Sikora (1998), progress has also been made in alleviating the sickness associated with chemotherapy and in eliminating infections that frequently accompany cancer.

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Cancer is one of the most serious diseases affecting humankind. Cancer Research UK (January 7, 2005) claims: In Britain, the lifetime risk of developing cancer is more than one in three, and that [d]ifferent cancers affect people at different ages, but the risk of getting the disease rises significantly as we get older. Not surprisingly, [f]or most people, the word cancer provokes fear and they have a negative attitude towards it, conjuring up images of a relentless disease (Martocchio, 1985, cited in Casey and Langton, 2000, 44).

Larson (1999) writes that [i]n the end, there may be no single 'magic bullet' that cures cancer. Both conventional and alternative approaches seem to have their places in the treatment of cancer and may well, in combination, provide improved results. There is a wealth of data to support conventional treatments, but there is still no treatment that guarantees successful results in all cases. Regarding the success of alternative treatments, Spowers (2002) writes: The efficacy of alternative treatments for cancer [has] been supported by numerous well-documented cases from around the globe.

Aside from conventional treatments and the alternative treatments already presented, the ultimate cancer treatment may actually lie substantially in prevention. Weinberg (1999) writes:

[O]ur recently gained knowledge of genes and proteins should take us far in conquering this disease. But cancer's ultimate causes really begin far outside the individual cell, in our environment, in the food we ingest and the smoke we inhale. We must address these ultimate roots of cancer before we make substantial reductions in cancer incidence. Genes and proteins will help us little here.

The precedent set by other major diseases over the past two centuries is clear: Reductions in mortality have come from improvements in personal sanitation, nutrition, access to clean water, and immunization. By extension, the big decreases in cancer deaths will likewise come from preventing disease rather than discovering new cures.

In exploring the conventional understanding of cancer, the origins of cancer, the diagnosis of cancer and treatment choices, this essay has supported the thesis that cancer is a complex disease and that its origins and diagnosis are, likewise, quite complex, as are treatments for cancer that, to be most effective, may involve the choice of a combination of conventional and alternative treatment choices.

Ackerknecht, E. H. (1965). History and Geography of the Most Important Diseases. New York: Hafner Publishing Company, 1965. Cited in Huff, James and Tomatis, Lorenzo (2001).

Cancer Research UK (2005) What is cancer: CancerA complex disease, January 7, 2005. Available from: http://www.cancerresearchuk.org/aboutcancer/whatiscancer/. Accessed: July 19, 2005.

Cancer Research UK (2005) Specific cancers: The most common cancers, October 23, 2003. Available from: http://www.cancerresearchuk.org/aboutcancer/specificcancers/ Accessed: July 20, 2005.

Casey, Anne and Langton, Helen (2000) The child with cancer: Family-centred care in practice. Edinburgh: Balliere Tindall, 2000, 44.

Conheim, J. (1889) Lectures on general pathology.: A handbook for practicians and students. London: The New Sydenham Society, 1889. Cited in Huff, James and Tomatis, Lorenzo (2001).

Haney, Daniel Q. (1998) Basic discoveries into genetic roots of cancer begin to pay off. AP Online, June 27, 1998.

Huff, James and Tomatis, Lorenzo (2001) Evolution of cancer etiology and primary prevention: Primary prevention aimed at avoiding or drastically reducing exposures will be the most efficient way to prevent environmentally associated cancers. Environmental Health Perspectives 109:10, 2001.

Larson, Ruth (1999) Cancer cure is elusive, but therapies hold hope. Insight on the News 15:30, August 16, 1999.

Martocchio, B. (1985) Family coping: Helping families help themselves. Seminars in Oncology Nursing, 1 (4), 292-297. Cited in Casey, Anne and Langton, Helen (2000), 44.

Sikora, Karol (1998) Cancer: The hype, the hope, the facts. Sunday Mirror, July 12, 1998.

Spowers, Rory (2002) Cancer: The ultimate price of progress. Geographical 74:10, October 2002.

Triolo, V. A. (1964) Nineteenth century foundations of cancer research: Origins of experimental research. Cancer Research 24:4-27, 1964. Cited in Huff, James and Tomatis, Lorenzo (2001).

Triolo, V. A. (1965) Nineteenth century foundations of cancer research: Advances in tumor pathology, nomenclature and theories of oncogenesis. Cancer Research 25:75-106, 1965. Cited in Huff, James and Tomatis, Lorenzo (2001).

Weinberg, Robert A. (1999) One renegade cell: How cancer cegins. New York: Basic Books, 1999.

(The) World Almanac and Book of Facts 2000 (1999) Health: Cancer-detection guidelines, January 1, 1999.

Please note: The above essays and dissertations were written by students and then submitted to us to display and help others. Thanks to all the students who have submitted their work to us.