MEDICAL ONCOLOGY UNIT, KHYBER TEACHING HOSPITAL, PESHAWAR

Frequently Asked Question

What is cancer and how does it develop?
Cancer is a disease in which abnormal (malignant) cells grow out of proportion and results in a lump or tumor. They may invade the local tissues and spread (metastasize). There is an alteration (mutation) in the genes that control normal cell growth and death (either hereditary or due to environmental/acquired factors). Thus abnormal/cancer cells get out of control of the cell regulatory mechanisms and keep on dividing and do not die, resulting in a tumor.

Are some people predisposed to cancer?
Close (first-degree) relatives of patients with certain types of cancers are predisposed to these cancers. They include cancers of the skin (melanoma), breast, ovary, colon, prostate and eye cancer (Retinoblastoma). Genetic defects have been found in these people. They need to have regular check-ups and certain tests to detect cancer in its early stage.

What factors predispose to cancer?
These risk factors include tobacco/pollution (lung/bladder cancer), snuff/chewable tobacco (naswaar, paan used in Pakistan), ultraviolet radiation from the sun (skin cancer), prolonged x-ray exposure (skin and blood cancers), chemicals/certain industrial pollutants and dyes (asbestos, benzene, certain pesticides etc), alcohol (cancers of the liver, stomach etc), certain viruses causing cervix cancer and lymphomas (human papilloma virus (HPV), Epstein-Barr Virus (EBV) etc), artificial sweeteners/additives in food etc.

What are the signs of cancer?
These include (a) Unexplained weight loss. (b) Lumps in the neck, armpits, groins etc. (c) Unexplained fever not responding to medication. (d) Unexplained bleeding or discharge. (e) Non-healing sore. (f) Hoarseness or severe cough with blood stained sputum. (g) Changes or itching in a mole. (h) Lump in the breast. (i) Change in bowel/bladder habits etc. These are some of the signs of cancer but they do not always mean that a person has a cancer. A doctor must be consulted in such cases.

How is cancer diagnosed?
Cancer can be diagnosed by (1) Blood or urine tests (2) X-rays/Scans (3) Tissue biopsy.

Is there a cure for cancer?
Yes, certain types of cancers such as Acute Lymphocytic Leukemia, Hodgkin’s lymphoma, Choriocarcinoma, Kidney tumors in children etc can be cured with modern medicines. In most of other cases in early stages, life can be prolonged by many years with proper cancer treatment.

How is cancer treated?
Cancer can be treated by (1) Surgery to remove the tumor. (2) Radiation in which high energy rays are used to kill the cells. It is usually given five days a week for 30-45 days. (3) Chemotherapy in which medicines are used to kill cancer cells. This may be the only form of treatment for certain cancers. It is usually given in injectable forms at three weekly intervals. Can be given orally, in the muscles, in the veins or via catheters. Some cancers respond to radiation while others to medicines so usually the patient will either be treated with radiation or chemotherapy but a "combination" of the two may also be used in certain cancers.

What is chemotherapy?
The use of medicines for treatment of cancers is known as chemotherapy. These may be oral or injectables. These drugs stop the abnormal growth of cancer cells and kill cancer cells.

What are the side-effects of cancer chemotherapy?
Side effects of chemotherapy include nausea, vomiting, hair loss, diarrhea, mouth sores, fatigue, fever, chills, sleep disorders. These can usually be controlled with medication and occur rarely except hair loss. If these side-effects do occur, the treating oncologist must be contacted immediately. Certain drugs may cause infertility. Discuss this with your oncologist before treatment starts.

Can these side-effects be controlled?
Yes, most of these side-effects can be controlled with medicines and good hygiene.

Is it important to stick to the appointment dates?
It is extremely important to stick to your chemotherapy dates since irregular cycles will result in disease resistance and a very poor outcome.

How do I find an Oncologist or get more information about cancer/particular cancers and their treatments?
Please see our section of Related Links

How is cancer staged?
Staging of cancer is as follows:

STAGE I: Small, localized cancer (which has not spread to or invaded the local tissues/ not metastasized).

STAGE II: Small lump with local spread only in the organ involved and its draining lymph nodes.

STAGE III: Cancer cells invade the neighboring tissues as well as lymph nodes.

STAGE IV: Cancers cells have spread to distant tissues in different parts of the body (liver, lungs, bones, brain etc).