Cancer is a global issue that impacts everyone. This is regardless of their age, gender, where they live, or how much money they have.

In 2023, around the world, there were about 20 million new cases of cancer. Approximately, 10 million people died from cancer.

Have you undergone unexplained weight loss, or experienced fatigue all of a sudden?

Have you ever worried that you might have cancer? Or does someone in your family have it?

Sometimes, if people in your family have had cancer before, you might be more likely to get it too.

This blog from Karetrip can help you learn about the signs of cancer and when you should talk to a doctor for help.

What is Cancer?

Cancer basically means unregulated growth of abnormal cells. There are over a 100 types of cancers. Where do they arise from?

Well, our body has about a trillion cells. Each organ has its own kind of a cell to perform a function specific to it.

Most cells in the body undergo controlled cell division. Like cops, certain cells regulate the division and differentiation of these cells.

Older cells die and are then replenished by new cells via cell division as and when needed.

• Any errors in this process can cause cancer. Damage to DNA by environmental factors like UV rays, tobacco, alcohol can also lead to cancer. Cancer can also be hereditary.

• Not all cancers are malignant. Cancer is either benign or malignant. As the name suggests benign tumours are non invasive and do not spread to other tissues.

Malignant tumours are invasive and can spread to other tissues. This process is called metastasis. Metastasis occurs mainly through 3 ways :

• Direct spread: Direct invasion of adjacent tissues

• Hematogenous spread: Blood vessels act as pipes connecting the malignant site to the rest of the body. Such metastasis affects vital organs such as bone, lung, liver and brain.

• Lymphatic spread: Lymphatic channels are alternate channels for spread of tumour. This spread causes the symptoms of lymphadenopathy. This is used to assess the degree of spread of tumour.

Once the cancer metastasises, it becomes very difficult to treat the cancer. These cancers are more likely to be fatal.

Types of Cancer

As mentioned there are different types of cancer based on different types of cells. Broadly based on the type of cell, cancers are of 5 types :

1. Carcinoma – This is the most prevalent type of cancer. This type of cancer starts either in the skin or in the tissues that cover organs inside the body.

Again, this could be benign or malignant. The malignant ones are called carcinomas.

There are various subtypes depending on the type of lining. These are adenocarcinoma, basal cell carcinoma, squamous cell carcinoma, and transitional cell carcinoma.

2. Sarcoma – This type begins in the connective or supportive tissues.

This is of 2 types:

• Bone Sarcomas
• Soft tissue Sarcomas : This includes cancers arising from muscles, tendons, fibrous supporting tissue and blood vessels.

3. Leukaemia – In this cancer,white blood cells are involved. These cells are produced in the bone marrow. These are broadly of 2 types :

• Lymphoid leukaemia
• Myeloid leukaemia

They make up 3% of cancers worldwide. They are the most common cancer type in children.

4. Lymphoma and Myeloma – Cancer of cells of the immune system. It involves the lymphatic system which is responsible for fighting infections.

• Lymphoma : Hodgkin’s and Non-Hodgkin's are the 2 main types of Lymphomas.

• Myeloma : Cancer of plasma cells. These are cells in the bone marrow and blood which produce antibodies. Antibodies are required for fighting off the infections.

5. Brain and Spinal Cord cancers – they are the central nervous system cancers.

• Brain tumours : There are different types of brain tumours affecting all ages. The symptoms of these vary due to the location of the tumour. It can vary from movement disorder to memory and cognitive impairment.

• Spinal Tumours : They are extremely rare tumours but terrorising tumours. They cause severe impairment as it directly affects the spinal cord.

Both of these tumours are worrying because they impair the quality of life. What makes treatment more challenging is that it can cause collateral damage to the nearby structures.

Symptoms of Cancer

There are over a 100 different types of cancer. Depending on location, size, type of cancer, the symptoms vary.

Some signs common to most cancers are listed below

• Fatigue
• Weight loss
• Appetite loss
• Night sweats
• Fever - on and off
• Pain (based on location)
• Mass/ lumps maybe be present (based on location)
• Cough

Prevention

Prevention is the most cost-effective way to control cancer in the long run. Between 30% and 50% of cancer deaths could be stopped by changing or avoiding certain key factors. These risk factors are :

• Don't use tobacco, including cigarettes or chewing tobacco.
• Limit the use of alcohol.
• Weight loss.
• Eat lots of fruits and vegetables and have a healthy diet. Limit processed meats.
• Exercise regularly. Physical activity of 15 - 300 mins is recommended weekly.
• Safe sex practices.
• Get vaccinated against hepatitis B and HPV (human papillomavirus).
• Protect yourself from the sun's UV rays. Avoid tanning beds as well.
• Try to avoid unnecessary exposure to radiation, like from X-rays. Monitoring radiation exposure and regular health checkups in case of occupational exposure.
• Stay away from urban air pollution and indoor smoke from burning solid fuels.
• Get regular check-ups from your doctor. This is especially important if you have a family history of cancer.
• Some long-lasting infections (eg : HPV, Hepatitis B, Hepatitis C) can also increase your risk of cancer, especially in low- and middle-income countries.

It's also possible to reduce the burden of cancer by finding it early. Prompt treatment gives better results by reducing the spread of the cancer. This is where screening procedures come into play.

• Cervical cancer is screened using pap smear.
• Prostate cancer screenings are included in routine check-ups.
• Lung cancer screenings are suggested for those with specific risk factors.
• The American Cancer Society suggests regular colorectal cancer screenings starting at age 45. This is often done through a colonoscopy. Some at-home testing kits can also detect certain types of colorectal cancer.
• Mammograms for breast cancer are recommended for women aged 45 and older. For those at higher risk, screenings might be advised earlier.

Treatment modalities

As mentioned, not all cancers are malignant. Benign growths are removed by a simple excision surgery, or may sometimes be left as it is.

Malignant tumours need aggressive therapy. Based on the grade and stage of the tumour the treatment modality is chosen by your doctor. A multi-modal approach is usually chosen for maximum benefit.

Main modalities of cancer management are :

• Surgery : This is first line management for most tumours. The goal is to remove as much tumour as possible. The rest of the tumour is targeted with chemotherapy or radiation therapy.
• Chemotherapy and Radiotherapy : this is used as adjuvant therapy to surgery. Chemotherapy is used as the first line treatment modality in leukemias and lymphomas.
• Immunotherapy : The body immune cells are used to target cancer cells.
• Bone Marrow transplant : This is used commonly to treat leukemias.
• Hormone therapy : Used in breast and prostate cancer
• Targeted therapy based on genetic studies
• Clinical trial : This is recommended to those patients wherein the traditional treatment strategies have been unsuccessful.
• Palliative care : Improves your quality of life. This focuses on pain management. Has no role to reduce mortality.