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Learn about Cancer
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Frequently Asked Questions
Cancer is the name given to a collection of related diseases1. It’s a disease caused by an uncontrolled division of abnormal cells in a part of the body. Some cancers may eventually spread into other tissues2. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected3.
Cancer is a genetic disease—that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide. Cancer can start almost anywhere in the human body. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place1.
When Cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors1.
Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemias, generally do not form solid tumors.
Cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system and form new tumors far from the original tumor1.
Unlike malignant tumors, benign tumors do not spread into, or invade, nearby tissues. Benign tumors can sometimes be quite large, however. When removed, they usually don’t grow back, whereas malignant tumors sometimes do. Unlike most benign tumors elsewhere in the body, benign brain tumors can be life threatening1
Lumps that could be Cancer might be found by imaging tests or felt as lumps during a physical exam, but they still must be sampled and looked at under a microscope to find out what they really are. Not all lumps are Cancer. In fact, most tumors are not Cancer9. Tests of cells and tissues can find many other kinds of diseases, too. For instance, if doctors are not sure a lump is Cancer; they may take out a small piece of it and have it tested for Cancer and for infections or other problems that can cause growths that may look like Cancer.
From 2001-2005, Ibandan recorded Breast Cancer as its most common Cancer incidence in both sex with a total of 1612, followed by Cervix having 1246, Prostate having 544, Colo-rectal having 226, Liver having 182 and NHL having 89.
From 1995-2004, Kano recorded Cervix Cancer as the most common Cancer incidence in both sex having a sum of 226, followed by breast having 193, followed by Prostate having 165, followed by Colo-rectal having 127, followed by NHL having 75 and Liver 32.
From 2004-2006, Calabar recorded Prostate Cancer as the most common Cancer incidence in both sex with a total of 204, followed by Breast having a sum of 174, Cervix having 48, Liver having 13, Colo-rectal having 12 and NHL having 8.
From 1995-2002, Jos recorded Breast Cancer as the most common Cancer incidence in both sex with a sum of 528, followed by Cervix 524, followed by Prostate having 225, followed by NHL having 208, Liver having 203 and Colo-rectal having 158.
From 1980-1999, Benin recorded Cervix as its most common Cancer incidence in both sex with a sum of 465, followed by breast having 412, Prostrate having 161, Colo-rectal having 129, Liver having 75 and NHL having 634.
Thus, data from various parts of the country show that cancer incidence is increasing with female Cancers leading (Breast Cancer), changing pattern has also been noticed from all the regions of the country. Increasing incidence has been attributed to poor awareness about the risk factors, changes in lifestyle4.
The six most common Cancers in Nigeria in descending order of frequency are;
Liver cancer and
Presently in Nigeria, Cancer incidences are common. No week passes that you do not hear that a Nigerian has died of Cancer. Hundreds of thousands are dying silently. Not much appears to have been done to stem the tide of deaths5.
The former minister of Health, Professor Onyebuchi Chukwu disclosed that data collected from 11 Federal tertiary hospitals by the National System of Cancer Registries showed 7,000 new documented cases of Cancer which also corresponded with the average estimated 100,000 new cases of Cancer reported in Nigeria annually. From the data, 60 per cent of cancers occur in women and 39.8 per cent in men5.
Breast Cancer accounts for 40 per cent of women Cancers, closely followed by Cervical Cancer of 17.9 per cent, lymphomas and ovarian cancer are next. “Whereas in men, the commonest reported Cancer is prostate Cancer which accounts for 29.2 per cent of male Cancers, closely followed by colorectal Cancer and lymphomas5.
Observers say these deaths are unnecessary and untimely. The World Health Organisation, WHO, projects that about 84 million people may die by 2015 if urgent strategies are not implemented to arrest the cancer scourge. Less than three years to 2015, it is indeed worthy of concern and should not be taken for granted by a country like Nigeria5.
In an article tagged: “The Sad Truth about Cancer in Nigeria” Prof. Remi Ajekigbe, Consultant Radiotherapist and Oncologist, Lagos University Teaching Hospital, Idi-Araba, was quoted to have said that 2 million Cancer cases are recorded in Nigeria and out of the figure, 10 percent or about 200,000 have access to hospitals with radiotherapy facilities. About 5 percent of this number i.e. 10,000 have resources to go abroad where they pay between $10,000 – $15,000 per patient for a 3-5weeks course of radiotherapy5.
He also observed that Nigeria’s mortality and morbidity statistics for Cancer are high, due to the ‘late presentation syndrome’ involving 83-87 percent of Cancer patients, running up bills of N150,000 to N350,000 every three weeks, for as long as the patient survives.
Experts have predicted that by 2020, the number of Cancer patients in Nigeria is going to rise from 24 million to 42 million as speculated 21 years ago. It is also feared that by same 2020, death rates from Cancer in Nigerian males and females may reach 72.7/100,000 and 76/100,000 respectively5.
Cancer is a common disease, so most families will have some members who have had cancer but that does not mean the Cancer in that family is hereditary. We don’t know the cause of most Cancer, but experts believe that about 10% of most cancer types are due to inherited gene changes. Cancer that does not appear to be caused by inherited genes is called “sporadic Cancer.” It is believed that most – perhaps 90% – of all Cancers are sporadic. This means even if Cancer does not run in a family, a family member can still be at risk for some type of cancer in his or her lifetime6.
Sporadic Cancer and hereditary Cancer differ in several ways that may affect health care decisions6:
Hereditary Cancer often occur earlier than the sporadic form of the same Cancer, so experts often recommend different screening, at a younger age for people with hereditary cancer in their family.
Hereditary Cancers are caused in part by gene changes passed on from parents to their children. Other blood relatives may share these same gene changes. Sporadic Cancers are believed to arise from gene damage acquired from environmental exposures, dietary factors, hormones, normal aging, and other influences. Most acquired gene changes are not shared among relatives or passed on to children.
Individuals who have inherited a gene change may be at a higher risk for more than one type of cancer. For Cancer survivors, this may affect Cancer treatment options or follow-up care.
Cancers that may be caused by an inherited faulty gene and may seem to run in families include2:
Some virus infections can cause Cancer, though the disease often appears several decades afterwards. For example, Cancer of the cervix is linked to infection with the human papilloma virus (HPV) that causes genital warts. In this case, the DNA in the virus mixes with the cell’s DNA, triggering changes that make the cell grow and multiply. From 2009, girls in the UK have had access to vaccine that prevents infection with HPV and thus protect them from developing Cervical Cancer as result7. HPVs also have a role in causing some Cancers of the penis, anus, vagina, and vulva. They are linked to some cancers of the mouth and throat, too. Again, although HPVs have been linked to these Cancers, most people infected with HPV never develop these Cancers.
Smoking, which is also linked with these Cancers, may work with HPV to increase Cancer risk. Other genital infections may also increase the risk that HPV will cause Cancer9.
The year 2011 marks the centenary of Francis Peyton Rous’s landmark experiments on an avian Cancer virus. Since then, seven human viruses have been found to cause 10–15% of human Cancers worldwide. Viruses have been central to modern Cancer research and provide profound insights into both infectious and non-infectious Cancer causes. This diverse group of viruses reveals unexpected connections between innate immunity, immune sensors and tumour suppressor signaling that control both viral infection and cancer8.[/vc_toggle][vc_toggle title=”Is Radiation a cause for Cancer?” open=”false”]When most people think of radiation, they think of manufactured devices such as the nuclear bomb or Cancer treatments, which emit high doses of radiation. In reality, however, radiation takes many forms and is always around us. Some types are much more dangerous than others10.
Most researchers agree that there is no such thing as a dose of ionizing radiation that is so low that it will not have some effect on our body, such as damaging cells. Usually, the damage is small enough that one dose does not lead to any health problems. It is likely that the increased risk of Cancer from low doses of radiation is so low that studies in the general population can’t detect it10. It is important to note that each exposure to radiation builds up in our body and the risk of Cancer increases with each radiation exposure. So even though a single source of exposure to radiation is unlikely to cause cancer by itself, the combined exposures add up throughout our lifetime and increase our risk of Cancer over time. This is why it is important to limit unnecessary exposures to radiation. Radiation exposure during certain sensitive times of development, such as during childhood and puberty, also has more health risks than the same exposures in adults10.
Since radiation is always around us, we cannot avoid all radiation, but we can try to limit our exposures.
Background radiation refers to radiation that naturally occurs in our environment and does not come from any manufactured devices. Radiation is emitted from the earth, sun, our galaxy, and other galaxies. Even the human body naturally contains some radioactive elements10. People who receive few or no high-dose radiation medical tests usually get more exposure to radiation from the natural environment than from any manufactured device.
The risk of developing Cancer from a lifetime exposure of background radiation is about 1 in 100, or 1% of the population. It is impossible to avoid all background radiation, but the best ways to limit unnecessary exposure to radiation from the environment is to prevent your exposure to radon and repeated unprotected sun exposure.[/vc_toggle][vc_toggle title=”How is Cancer Diagnosed?” open=”false”]Cancer is nearly always diagnosed by an expert who has looked at cell or tissue samples under a microscope. In some cases, tests done on the cells’ proteins, DNA, and RNA can help tell doctors if there’s cancer. These test results are very important when choosing the best treatment options9.
In most cases, doctors need to do a biopsy to make a diagnosis of Cancer. A biopsy is a procedure in which the doctor removes a sample of tissue. A pathologist then looks at the tissue under a microscope to see if it is Cancer1. The sample may be removed in several ways:
With a needle: The doctor uses a needle to withdraw tissue or fluid.
With an endoscope: The doctor looks at areas inside the body using a thin, lighted tube called an endoscope. The scope is inserted through a natural opening, such as the mouth. Then, the doctor uses a special tool to remove tissue or cells through the tube.
With surgery: Surgery may be excisional or incisional.
In an excisional biopsy, the surgeon removes the entire tumor. Often some of the normal tissue around the tumor also is removed.
In an incisional biopsy, the surgeon removes just part of the tumor.[/vc_toggle][vc_toggle title=”How is an early cancer detected?” open=”false”]Early detection of cancer greatly increases the chances for successful treatment. There are two major components of early detection of Cancer: education to promote early diagnosis and screening11.
Recognizing possible warning signs of Cancer and taking prompt action leads to early diagnosis. Increased awareness of possible warning signs of Cancer, among physicians, nurses and other health care providers as well as among the general public, can have a great impact on the disease. Some early signs of Cancer include lumps, sores that fail to heal, abnormal bleeding, persistent indigestion, and chronic hoarseness. Early diagnosis is particularly relevant for Cancers of the breast, cervix, mouth, larynx, colon and rectum, and skin11.
Regular screening already detects some cancer in their early stages- for example smear tests for Cervical Cancer and mammograms for breast cancer. In the future, a simple blood or urine test could detect many other Cancers very early. Lifestyle changes or medicines could then help prevent serious problems later in life. Couples who have a history of inherited cancer are already screening potential embryos to ensure they have a child without the high-risk gene7.
Cancer that’s diagnosed at an early stage, before it’s had the chance to get too big or spread is more likely to be treated successfully. If the cancer has spread, treatment becomes more difficult, and generally a person’s chances of surviving are much lower.
Below are some examples of how spotting Cancer early can make a real difference2:
- Bowel Cancer
More than 9 in 10 bowel Cancer patients will survive the disease for more than 5 years if diagnosed at the earliest stage.
- Breast Cancer
More than 90% of women diagnosed with Breast Cancer at the earliest stage survive their disease for at least 5 years compared to around 15% for women diagnosed with the most advanced stage of disease.
- Ovarian Cancer
More than 90% of women diagnosed with the earliest stage Ovarian Cancer survive their disease for at least 5 years compared to around 5% for women diagnosed with the most advanced stage of disease.
- Lung cancer
Around 70% of lung Cancer patients will survive for at least a year if diagnosed at the earliest stage compared to around 15% for people diagnosed with the most advanced stage of disease.
Early diagnosis can increase chances of survival. But improving survival rates is not just down to earlier diagnosis – ensuring patients receive the most effective and appropriate treatment for them is also an important part of the jigsaw.
Preventing Cancer doesn’t work in the same way as preventing infectious diseases with vaccines.
‘Healthy living’ is not a cast-iron guarantee against Cancer. But it stacks the odds in your favour, by reducing the risk of developing the disease2.
Experts estimate that more than 4 in 10 cancer cases could be prevented by lifestyle changes, such as:
- not smoking
- keeping a healthy bodyweight
- cutting back on alcohol
- eating a healthy, balanced diet
- keeping active
- avoiding certain infections (such as HPV)
- enjoying the sun safely
- occupation (avoiding cancer risks in the workplace)
|Warning Signs||What to look for|
|Unusual bleeding/discharge||– Blood in urine or stools
– Discharge from any parts of your body, for example nipples, penis, etc.
|A sore which does not heal||Sores that:
– don’t seem to be getting better over time
– are getting bigger
– getting more painful
– are starting to bleed
|Change in bowel or bladder habits||– Changes in the colour, consistency, size, or shape of stools. (diarrhoea, constipated)
– Blood present in urine or stool
|Lump in breast or other part of the body||– Any lump found in the breast when doing a self examination.
– Any lump in the scrotum when doing a self exam.
– Other lumps found on the body.
|Nagging cough||– Change in voice/hoarseness
– Cough that does not go away
– Sputum with blood
|Obvious change in moles||Use the ABCD RULE
– Asymmetry: Does the mole look the same in all parts or are there differences?
– Border: Are the borders sharp or ragged?
– Colour: What are the colours seen in the mole?
– Diameter: Is the mole bigger than a pencil eraser (6mm)?
|Difficulty in swallowing||– Feeling of pressure in throat or chest which makes swallowing uncomfortable
– Feeling full without food or with a small amount of food
There are many types of Cancer treatment. The types of treatment that you receive will depend on the type of Cancer you have and how advanced it is1.
The main types of Cancer treatment include:
- Surgery: A procedure in which a doctor with special training, called a surgeon, removes Cancer from your body.
- Radiation Therapy: Uses high dosesof radiation to kill Cancer cells and shrink tumors.
- Chemotherapy: Uses drugs to kill Cancer cells.
- Immunotherapy: Helps your immune systemfight Cancer.
- Targeted Therapy: This involves the use of targated agaents (monoclonal antibodies) that targets the changes in Cancer cells that help them grow, divide, and spread.
- Hormone Therapy: Slows or stops the growth of Cancer that uses hormonesto grow.
- Stem Cell Transplant: Procedures that restore blood-forming stem cellsin people who have had theirs destroyed by high doses of Cancer treatments, such as chemotherapy and radiation therapy.
Some people with Cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy.
- National Cancer Institute. What is Cancer? Accessed at http://www.cancer.gov/about-cancer/what-is-cancer on July 15, 2015.
- Cancer Research UK. What is Cancer? Accessed at http://www.cancerresearchuk.org/about-cancer/what-is-cancer on July 15, 2015.
- Medical News Today. Cancer: Types, Symptoms and Causes. Accessed athttp://www.medicalnewstoday.com/info/cancer-oncology/ on July 15, 2015.
- Abdulkareem, F. (2009). Epidemiology of common Cancer in Nigeria. Survey, 21-23
- Is Nigeria winning the war against Cancer? Accessed at http://www.vanguardngr.com/2012/11/is-nigeria-winning-the-war-against-cancer/ on July 15, 2015.
- Facing Our Risk of Cancer Empowered. Hereditary Cancer and Genetics. Accessed athttp://www.facingourrisk.org/understanding-brca-and-hboc/information/hereditary-cancer/hereditary-genetics/basics/what-is-hereditary-cancer.php#text on July 15, 2015.
- Science museum. Who am I? Accessed athttp://www.sciencemuseum.org.uk/WhoAmI/FindOutMore/Yourbody/Whatiscancer/Whatcausescancer/Howcanvirusescausecancer.aspx on July 15, 2015.
- National Center Biotechnology Information. Why do viruses cause cancer? Highlights of the first century of human tumour virology. Accessed athttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3718018/ on July, 2015.
- American Cancer Society. Viruses that can lead to Cancer. Accessed athttp://www.cancer.org/cancer/cancercauses/othercarcinogens/infectiousagents/infectiousagentsandcancer/infectious-agents-and-cancer-viruses on July, 2015.
- Cancer Prevention and Trust Fund. Everything you need to know about Radiation and Cancer. Accessed at http://www.stopcancerfund.org/pz-environmental-exposures/everything-you-ever-wanted-to-know-about-radiation-and-cancer-but-were-afraid-to-ask-2/ on July 15, 2015.
- World Health Organization. Cancer Detection. Accessed at http://www.who.int/cancer/detection/en/1 on July 15, 2015.