EDP column by Dr Ketan Dhatariya

“I have recently been diagnosed with cancer. The doctors were very good and explained the treatments and the likely outcomes to me. But what is cancer?"

Normally, cells are produced by a very controlled process called cell division. A cell will divide and produce two ‘daughter’ cells. Each of the daughter cells will then go on to divide and produce 2 daughter cells each, a total of 4. This process continues, producing 16 cells, then 32, 64, and so on.  Cells have within then a part of their genetic makeup that tells them when to stop dividing. Indeed, many cells also have within them, instruction about how to die off when they are too old – the technical term for this is ‘apoptosis’ or ‘programmed cell death’. Cancer occurs when this process goes wrong and the cells do not stop dividing or die off.

Many things may predispose to cancer, such as exposure to cancer causing chemicals – smoking is the best example, or genetics causes with some childhood cancers.

There are dozens of different type of cancer, and they are often named after the tissues from which they are derived. Any kind of tissue can be affected. An example of this is if the cancer arises from the layer of cells that cover an organ – the epithelium, then it is known as a carcinoma.  If the cancer arises from the bone or muscles, then it is known as a sarcoma. For each type of cancer there are often subtypes, for example, a cancer of the white cells of the blood is called leukaemia, but there are several kinds of white cells, and each could be affected.

Cancer can differ in how aggressive it is. Some cancers are associated with almost no long term problems at all, whilst others, can be very nasty indeed. These are all things that your doctors will explain to you in great detail.

Often cancer cells can spread. They do this by either ‘direct invasion’ – that is they spread into the tissues next to it, or they can spread by the blood stream or lymphatic system. It is important to try and diagnose and treat cancer early to try and prevent it spreading, because that can often make treatment more difficult and less successful.

Because of how many different types there are, the treatments also differ greatly. These can be surgery, radiotherapy, chemotherapy, and so on. Treatment is based on what has been shown to work in clinical trials. It is often very difficult to decide what to give to whom. Your doctor or specialist will be the best people to explain things to you. Again, if they use words or phrases that you not understand, ask them to explain things to you in a way that you can.

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