Frequently asked questions (FAQ)
Q: What is cancer?
A: Cancer is an abnormal growth of cells. Cancer cells rapidly reproduce despite restriction of space, nutrients, or signals sent from the body to stop reproduction. Cancer cells are often shaped differently from healthy cells, do not function properly, and can spread to many areas of the body. Tumors, abnormal growths of tissue, are clusters of cells that are capable of growing and dividing uncontrollably; their growth is not regulated.
Q: What is the difference between cancer and oncology?
A: Oncology is the branch of medicine concerned with the diagnosis and treatment of cancer.
Q: What do the terms benign and malignant mean?
A:Tumors can be benign (noncancerous) or malignant (cancerous). Benign tumors tend to grow slowly and do not spread. Malignant tumors can grow rapidly, invade and destroy nearby normal tissues, and spread throughout the body.
Q: How is each cancer type named?
A:Cancer is named after the part of the body where it originated. When cancer spreads, it keeps this same name. For example, if kidney cancer spreads to the lungs, it is still kidney cancer, not lung cancer. (The cancer in the lung would be an example of a secondary tumor.) Staging is the process of determining whether cancer has spread and, if so, how far. There is more than one system used for staging cancer, and the definition of each stage will depend on the type of cancer.
Q: What causes cancer?
A:There is no one single cause for cancer. Scientists believe that it is the interaction of many factors together that produces cancer. The factors involved may be genetic, environmental, or lifestyle characteristics of the individual.
Q: Why do some people get cancer and not others?
A: In a few cancers, there seems to be an inherited factor that we can (partly) identify. In most cancers, we assume that a person’s cells have a low threshold for becoming malignant, and thus that he or she will develop a cancer with relatively less prompting by a trigger (such as cigarettes or the sun) than another person whose cells have a higher threshold and who may be able to tolerate more exposure to a trigger without developing a cancer.
Q: Can cancer be prevented?
A: We think a lot of it can. The established preventive methods (including refraining from smoking, avoiding sun damage, sensible sexual behavior, eating a high-fiber, low-fat diet, having regular Pap tests) would reduce the incidence of cancer dramatically. We could probably prevent more if we knew more, so research is very active in this field.
Q: Why isn’t there a simple, universal test for cancer?
A: Because cancer cells are very similar to normal cells, and a cancer begins with a very small number of cells. In a small number of cancers, certain tests can detect early changes: the best example is cancer of the cervix (the Pap test).
Q: Why do people with the same cancer get different treatment and have different problems?
A: A lot depends on the stage of the disease and on the particular individual. For instance, in breast cancer with involved lymph nodes, if you are postmenopausal the best treatment may be a hormone tablet; if you are premenopausal it may be chemotherapy.
Q: Does conventional treatment work?
A: In many cases, yes. Surgery is an often successful conventional treatment, as are radiotherapy (after or instead of surgery) and chemotherapy. In addition, conventional treatment can produce remissions in a proportion of cases when cure is not possible. So in some cases it works, and in other cases it does not, and your doctor will be able to explain whether the chance of it working in your own case is high or low or in between. That is why the discussions you have with your doctor about your particular case are so important.
Q: Why is the treatment so awful?
A: Treatment is so awful mostly because cancer cells are only slightly different from normal cells. In this respect, cancers are totally different from, say, bacterial infections such as pneumonia or tuberculosis. Because bacteria are completely different from our body’s cells, antibiotics can kill them and not affect us very much. But because cancer cells are very like our normal cells, in order to kill them we (usually) risk doing considerable damage to normal cells or tissues.
Q: How can I ask my family to help me?
A: This may be one of the hardest things to do. Most family members want to help and are just waiting to do something. Often they feel helpless, and afraid to ask if they help. By being very specific about what you would like them to do, it will make it much easier for them to help. Sometimes, a family meeting is a good way to tell family what is going on, and to organize the tasks and activities. A family meeting may also be helpful when family members may not understand that fatigue is a real problem related to cancer and its treatment. Your doctor, nurse or a social worker can help with this, too.
Q: How can I get the best from my doctor?
A: Doctor-patient relationships are similar in some respects to marriages: some are good and some are bad, and a lot depends on the people involved. The key to getting the best from your medical team is to present your problems as clearly and accurately as you can and clarify exactly what it is you want to know and what you need.
Q: Why are we all so frightened of cancer?
A: Probably because the other major threats to our health have faded somewhat. Until the 1940s we used to be afraid of syphilis and tuberculosis; before that it was cholera and smallpox. Currently, cancer and the infectious disease AIDS are occupying the roles of humankind’s bogeyman diseases. Cancer has not changed very much, but our perception of it has.
Q: Can attitudes or stress cause cancer?
A: Not as far as we know. In fact, the idea that the cancer "personality” or a bad attitude contributes to the cause of cancer may be part of the ancient human habit of blaming the patient for the disease.
Q: Will there ever be a cure for cancer?
A: Probably not a cure. It is quite likely that we will make some further advances in some cancers. The biggest changes in cancer may come from prevention or from other directions, such as treatments or vaccines to prevent spread after the primary cancer has been removed. Obviously nobody knows what is going to happen, but a single, sudden breakthrough that produces a universal miracle cure is very unlikely.
Q: Can our species ever be free of cancer?
A: Probably not. It is likely that our human species evolved with a design that was quite satisfactory if the individual lived for three, four, or perhaps five decades. Our problem, so to speak, is that we are now quite good at dealing with the forces that, centuries ago, used to kill us off before we were sixty. Now that many more of us are living into our sixties, seventies, and beyond, cancer is a flaw that appears with increasing frequency as cells do more and more multiplying and get older. It is possible that we can devise ways of stopping this flaw from appearing, but it is equally possible that cancer is not eradicable in the way smallpox was.
Q: Should everyone get a second opinion?
A: Many people with cancer get a second opinion from another doctor. There are many reasons to get a second opinion, including if the person is not comfortable with the treatment decision, if the type of cancer is rare, if there are different ways to treat the cancer, or if the person is not able to see a cancer expert.
Q: How can someone get a second opinion?
A: There are many ways to get a second opinion:
The person’s primary doctor may be able to recommend a specialist such as a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or programs.
The Cancer Information Service (800-4-CANCER) informs callers about treatment facilities, including cancer centers and other programs supported by the National Cancer Institute.
Patients can get names of doctors from their local medical society, a nearby hospital, a medical school, or local cancer advocacy groups, as well as from other people who have had that type of cancer.
Consult the Official ABMS Directory of Board Certified Medical Specialists. This reference book lists doctors by state. It gives their specialty, background, and training. It is available at most public libraries.
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