This is the first of a three part series exploring cancer. Part one focuses on the basics of cancer from a Western perspective while part two and three will focus on Ayurvedic knowledge of Cancer and its herbal, nutritional and holistic management.
By far, cancer is the most feared of all disease. Taunting humanity with the threat of a slow and painful death, it is often the first disease people think they have when they experience pain or feel a lump in their bodies and the last they want to talk about. Going to the doctor, patients wait with baited breath for the phone call that tells them “yes” or “no”. That one phone call either brings tremendous relief, exhilaration, and an appreciation for life; or it brings shock and despair. While cancer is a devastating disease, the likelihood of dying of cancer is much less than dying from cardiovascular disease (heart attacks and strokes). Cardiovascular disease remains the number one killer, and is responsible for three times as many deaths as all cancers combined. Still, approximately one in five people will develop some form of malignant cancer at some time in their life.
What is Cancer?
Cancer is a proliferation of cells in the body which undergo unregulated growth. These cells often spread by seeding themselves though out the body. Typically growing in the form of tumors, new tumors emerge as cells take root and grow in different parts of the body. Death occurs when the body’s life support functions are compromised due to the cellular damage.
When cancer is discussed, what is really meant is a malignant tumor. A malignant tumor is one with the tendency to grow and invade surrounding tissues. Benign tumors, while still cancerous, pose a much lesser threat. They are encapsulated and are much less likely to spread. Often, they can be removed surgically and no additional treatment is required. Metastatic tumors are malignancies which have already spread. Metastatic cancers are generally the most dangerous.
Determining the Prognosis
The prognosis for a cancer patient decreases significantly with metastasis. This is the main reason the medical profession encourages routine tests for early detection. A patient’s prognosis also decreases with the extent of metastasis. The more sites, the less likely recovery is. Another factor in the prognosis is the exact location of the tumor. A tumor located in a vital organ or near a vital function of the body is more difficult to treat. Finally, the type of cell involved in the cancer can indicate how aggressive the cancer will tend to be.
The Many Causes of Cancer
While most people will never have cancer, every body produces cancerous cells. Every day, even in healthy people, malignant cells are formed and circulate. In a normal, healthy body, these cells are destroyed by the body’s immune system. In patients who develop cancer, something has compromised the body’s ability to effectively deal with these cells.
Developing cancer is dependent upon many factors. Most certainly, one of these is genetic. The body has certain genes called “oncogenes.” Oncogenes are mutated genes which regulate cell growth. Proteins in these genes signal the cell to divide when it is not suppose to. Exposure to environmental carcinogens and viruses are responsible for converting regular genes to oncogenes.
Our bodies are designed to deal with this threat. Additional genes called “tumor repressor genes” normally suppress or regulate growth. Mutations, however, can cause these genes to fail and unrestricted growth occurs. Chromosomal abnormalities have been linked to a large number of cancers, including leukemia and lymphoma.
Viruses appear to play an important role in the onset of cancer. A virus is a strand of genetic material that is able to insert itself into the DNA of its host and then replicate, thereby altering the functions of the host. While often the body’s defenses can rid itself of the aggressive intruder, other times the intruder imbeds itself deep inside the DNA and the body appears defenseless against it. Altering the bodies DNA, these mutations can be passed down from generation to generation. Viruses are the closest physical evidence that there is to support something akin to the idea of possession. Common viruses known to cause cancer include HPV (Human papillomavirus), CMV (Cytomegalovirus), EBV (Epstein-Barr virus) and Hepatitis B. In addition, any pathogen that causes chronic inflammation increases the risk of cancer.
Environmental contamination is often blamed for causing cancer. Indeed, environmental contaminants have been proven to increase cancer risk. Chemical carcinogens cause cells to mutate through a series of stages. These stages of mutations are often dependent upon contact with ordinary chemicals which by themselves are not a threat, but when combined with a carcinogen trigger mutation. These chemicals are called “co- carcinogens. The list of common chemicals known to cause cancer is very long and includes many pesticides, diesel exhaust, lead based paint fumes, formaldehyde, and a variety of hair dyes.
The cause of cancer is complex. There are many factors that contribute. In additional to genetic tendencies, viruses and environmental contaminates, ultraviolet light, radiation from x-rays, nuclear power plants, nuclear weapons testing and the use of immunosuppressive drugs all are important factors. In addition, people with a history of autoimmune diseases–whose immune systems are clearly not functioning properly–are also at higher risk.
The Red Flag Signs and Symptoms
Early signs and symptoms of cancer are not often present. Cancer often develops in the body for quite some time before the body’s functions are compromised and symptoms are noticeable. This is one more reason why early detection through non invasive testing is so important. Patients who experience unexplained weight loss, night sweats, unexplained pain (especially at night) and abnormal bleeding from any orifice should seek a complete examination as soon as possible.
The Major Cancers
Lung Cancer is the most common form of cancer and is the leading cause of all cancer deaths. Bronchogenic carcinoma, responsible for 90% of all lung cancers, is very aggressive. Eighty seven percent of these cancers are attributed to cigarette smoking.
Colorectal Cancer is the second most common cancer. It tends to affect adults over the age of 40. Scientists accept that a diet low in fiber and high in animal protein contributes to this condition. A vegetarian diet that includes whole grains should significantly reduce the risk. A simple blood test is available for screening called CEA (carcinoembryonic antigen).
Breast Cancer affects 13% of woman by age 95. This is the most common form of cancer in woman. While many middle aged woman develop breast cancer, risk increases dramatically after age 75. Eighty percent are first discovered by the patient as a lump. By the time they are discovered, many have metastasized into surrounding lymph. Early detection through daily breast examinations and mammograms offers the possibility of finding the cancer prior to metastasis and greatly improves prognosis. Studies show that annual mammograms reduce the mortality rate of breast cancer by 25 – 30%. While there are risks of radiation exposure from mammograms, most medical professionals believe that the potential benefits outweigh the risks. Breast cancer is responsible for 3.5% of all deaths in woman. A woman who is free of cancer in her lymph nodes following therapy has a 10 year survival rate of 80%
Woman with a family history of breast cancer and those who have taken birth control pills are at higher risk. Other factors that increase risk include becoming pregnant after age 30, early start of menses, late occurrence of menopause, radiation exposure, and hormone replacement therapy.
Prostate Cancer is the most common malignancy in men over age 50. Some studies have shown that a majority of men will develop prostate cancer if they live long enough. While generally a slow growing, mildly aggressive cancer; it does have the ability to metastasize and kill. Blood tests (Prostatic-Specific Antigen (PSA) test) can reveal the presence of prostate cancer. While a positive test indicates cancer a negative test can not rule it out. The value of all blood screening tests for cancer is controversial.
Endometrial Cancer is the 4th most common malignancy in woman. Risk increases dramatically after age 40 and peaks between ages 50 – 60. The greatest correlated risk factor is obesity. Other important risk factors include: estrogen replacement therapy, the choice to have or the inability to have children (nulliparity), ovulatory disorders, and late menopause. The condition has also been correlated with high estrogen levels in the body in comparison to progesterone. Most cases present with abnormal vaginal bleeding as the first sign.
Cervical Uterine Cancer is the result of sexually transmitted pathogens and is less common than endometrial cancer. Risk increases with the number of sexual partners a woman has had and with the early loss of one’s virginity. Human Papillomavirus (HPV) clearly plays a role. HPV is the cause of genital warts. Cigarette smoking also increases the risk.
Ovarian Cancer affects one in 70 women, and one of every one hundred woman dies of it. Its incidence increases around menopause and in post menopausal woman. Surprisingly, the risk of developing ovarian cancer decreases with oral contraceptive use. Known risk factors include obesity, nulliparity, infertility, late childbearing and late menopause. A blood test is available for screening. The test is called CA-125. The accuracy of all blood screening tests is controversial.
Malignant Melanoma is the most aggressive form of skin cancer. While the condition is very aggressive and very often fatal when diagnosed in its late stages, early diagnosis leads to a nearly 100% cure rate. Other skin cancers, such as basal cell carcinoma and squamous cell carcinoma, are less aggressive with lower rates of metastasis. Medical treatment of these cancers is quite effective.
American Cancer Society’s Recommended Screening Procedures
Self Breast Exam (Screen for breast cancer)
Monthly after age 18
Breast Exam by a professional (Screen for breast cancer)
Every 3 years age 18 – 40. Every year after age 40
Pap Smear Test (screens for endometrial cancer )
Yearly age 18 – 65 and then at the doctors discretion
Pelvic Examination (Screen for multiple cancers of the female reproductive system)
Every 1-3 years, age 18 – 40, then yearly
Chest X-ray (Screen for lung cancer)
Only if there is high risk
Sputum Cytology (Screen for lung cancer)
Only if there is high risk
Rectal Exam (Screen for prostate cancer)
Yearly after age 40
Blood PSA (Screen for prostate cancer)
Yearly after age 50
Stool exam for occult blood (Screen for colorectal cancer)
Yearly after age 50
Sigmoidoscopy (Screen for colorectal cancer)
Every 3 – 5 years beginning age 50
Traditional Cancer Therapy
Traditional cancer therapies are based on two simple principles. Remove the cancerous cells when possible, and destroy any cells that remain. To accomplish these goals, surgery is utilized when a malignant cancer is found that has not metastasized. Surgery may also be performed if there is metastasis if the removal of a tumor will increase the quality of life or if all surrounding lymph nodes are easily accessible.
Radiation therapies are employed in addition to or as an alternative to surgery. These therapies utilize gamma, neutron, proton, and electron radiation to destroy localized tumors. For some cancers, such as prostatic cancer and certain brain cancers, a radioactive seed may be implanted into the tumor to destroy it from the inside out. Radiation may also be employed as an isotope and be injected into the blood if the cancer has a tendency to pick up the isotopes from the blood stream. This is common with thyroid cancers. While radiation damages or kills malignant cells, it also causes damage to nearby healthy cells.
Chemotherapy is the use of drugs to destroy cancer cells. Drugs are non specific and are spread throughout the entire body. These drugs are highly toxic and destroy both healthy and cancerous cells. As crude as it sounds, the success is dependent upon the ability of the drug to kill the cancerous cells before it kills the patient. Common side effects of chemotherapy include vomiting, mouth sores, hair loss, and loss of appetite.
Endocrine therapies are somewhat effective for some cancers. Endocrine therapies involve altering levels of hormones in the body. In the management of prostate cancer, an orchietomy (removal of the testes) may be performed to decrease testosterone levels. In addition, estrogen may be administered. By decreasing testosterone and increasing estrogen, the growth of prostatic cancer cells is slowed. Other cancers such as breast cancer respond positively to lower estrogen levels. A drug called tamoxifen is sometimes used as a part of the treatment for breast cancer. It works by lowering estrogen levels. In addition, the ovaries are often removed to further reduce estrogen levels.
Biological Therapies are employed in the treatment of certain blood and lymph cancers. Interferon and Interleukins are anti-viral drugs that slow down the progression of leukemia and lymphomas, and in some cases leads to cure.
The Western approach to managing Cancer brings both opportunities for cure as well as great challenges. With early detection, prior to metastasis, Western Medicine can often offer patients excellent results. However, the long term prognosis for cancers that have metastasized is much less optimistic. In part two of this series, the Ayurvedic knowledge and approach to cancer will be explored, as well as important nutritional and herbal therapies.