No. Of course not. Over the past decade the survival rate from cancer has increased dramatically for the common cancers detected in early stages. Some are now deemed as curable diseases.

But cancer is a difficult disease to treat for more than one reason. First, it is a chronic disease that tends to linger and recur, for which is required expert and prolonged treatment. The treatment might not be available everywhere and the treatment is often expensive. And lastly, since cancer treatment often involves loss of an organ, long absence from the place of work, and continued medical supervision, it causes a great deal of disturbances in personal and family life. It is therefore necessary for the patient and relatives to have some idea about the disease and its possible outcome so that they can plan their response to the disease. The success of cancer treatment depends a great deal on proper planning. It is a multi step procedure where every step has to logically and sequentially follow one another.

The cancer cells can break away from the primary tumor and enter the bloodstream or lymphatic system (which carry nutrients and drain tissue fluids to and from every part of the body) and through them can reach other parts of the body and form secondary tumors there. So even after a good excision of the primary tumor, there is often an outside chance that the break away cells will cause a further growth at a later date near or away from the primary tumor. When these secondary growths occur in distant organs they are called metastasis. It is because of this capacity of cancer to reappear in indifferent parts of the body even after successful treatment of the primary growth, it at times becomes difficult to cure a cancer patient.

As we have seen, cancer is essentially caused by alterations or mutations in genes that control the growth and death of cells. The altered genes might be inherited or they might get altered due to continuous abuses by lifestyle and environmental factors, principal amongst which are tobacco, alcohol, rich diet, exposure to chemical and radiation injuries, and infection by certain viruses like human papilloma virus (HPV), hepatitis B and C, and human immunodeficiency virus (HIV).

No. No one can catch cancer from another person. But these cancer causing viruses can be transmitted from one person to another by close body contact.

Yes, to a great extent. The two major cancers that affect Indian population like oral cancer caused by pan and tobacco and uterine cervical cancer caused by HPV viruses are both preventable. Good and healthy life style, avoidance of known cancer causing substances like tobacco, rich food etc. can prevent cancer to some extent. Now some preventive drugs like tamoxifen for breast cancer, aspirins for colon cancer, vitamin A derivatives for oral cancer and vaccines to prevent cervical cancer and liver cancer are now available.

Cancer that are caused by faulty inherited genes cannot be prevented now, but soon they too will become preventable by genetic engineering as we now know what defects in which genes cause what cancers.

For the present, the most important thing is prevention by early detection. This is done by having regular check ups and screening examinations like pap test of cervical smears, mammography, occult blood test of stool, colonoscopy, etc so that the disease is caught in an early stage when a cure is possible.

Cancer can cause a variety of symptoms and signs and that depends on the organ or organs it has affected. Breast cancer typically presents with a lump. A colon cancer will cause passage of blood with stool. A kidney cancer might simply cause anemia or low grade unexplained fever. A brain tumor might cause change in behavior. Often the symptoms and signs are very minimal till the advanced stage of the disease and contrary to popular belief many cancers often do not start with loss of general health and do not cause pain until a very late stage of the disease.

1) New thickening or lump in any part of the body, particularly breast and also neck and lower part of the face
2) A new mole or change in an existing wart or mole
3) a sore that does not heal
4) Nagging cough or hoarseness
5) changes in bowel or bladder habits
6) persistent indigestion or difficulty in swallowing
7) unusual bleeding or discharge.

Unexplained change in weight is also an important symptom. In short, any illness that persists even after treatment for sometime should be investigated. A qualified doctor must be consulted, necessary investigations done and if required a biopsy must be performed. Biopsy is the only way to know for certain whether cancer is present. There is no particular danger attached to it.

The doctor now determines the stage of the disease by a few other tests like x-rays, CT scans, blood tests, which show how far the disease has progressed in the body. The stage of the disease finally decides the intent and nature of the treatment. There are internationally set and accepted rules of staging a cancerous disease and as of now the TNM system devised by UICC is universally followed so that patterns of treatment and the results can be standardized and followed all over the world. The TNM staging system is based on the extent of the tumor (T), spread to lymph nodes (N), and metastasis i.e. spread to other parts of the body (M).The three factors are combined to describe basically five stages of progression i.e. stage 0 to stage IV. According to the disease and the organ involved these stages are then divided into further sub stages where it has been found important. For example a T3 N0 M0 tumor in breast will mean a tumor of more than 5cm in size but which has not spread to the regional nodes or to any distant organ. Stage 0 means carcinoma in situ or when the cancer is still confined within the layer of cells where it incepted. For blood cancers and lymphomas different staging systems are used. If the tumor is operated then after operation a detailed pathological and other tests are done to asses the aggressiveness (like grade) of the tumor and also its biological nature to help guide subsequent treatment like radiotherapy and chemotherapy.

It absolutely depends on the type of cancer and the stage of the disease in which it has been diagnosed and also on the patient’s physical condition. A stage IV breast cancer will require an entirely different approach from a stage II colon cancer. But basically all cancers are treated by surgery, radiation, and chemotherapy, either singly or in combination. To them, can be added hormone therapy and biological therapy which target the very process of the cancer formation itself and not the tumor alone. To date, for most of the early stage common cancers that affect the solid organs (as opposed to the blood and blood forming organs) surgery is generally employed to get rid of the primary tumor and then if required to follow up with other methods of treatment. (See fact sheet on surgical oncology). The two other most commonly used therapies are radiotherapy and chemotherapy both of which act using the same biological principles that destroy the cancer cells’ ability to survive and multiply. Radiotherapy acts locally, only to the tumor bearing part of the body where the radioactive rays are targeted while chemotherapy, which means administration of cytotoxic drugs, acts through out the body. Both can harm normally dividing cells and thus cause some serious side effects. It is these side effects that limit the use of radiotherapy and chemotherapy to their fullest extent. Often radiotherapy and chemotherapy are concurrently used to help the action of each other. The side effects are usually reversible and go away when the therapies are over. Hormone therapy is used to treat cancers that are hormone dependant like breast, ovary and prostate cancers. Biological therapy and targeted therapies use the body’s immune system and the biochemical factors present inside a patient’s body that promote and sustain a cancerous growth rather than the cancer itself.

Relaxation and meditation certainly helps, not in curing the disease but in helping to cope with the psychological trauma and tolerating the side effects of prolonged and toxic treatment. Supportive treatment with specialized diet have also been found to be helpful but there is not enough evidence to prescribe or recommend any particular dietary formula except to say that a bland non toxic easily digestible diet rich in vitamins, anti oxidants, and fibers, and low in fat is best. Amongst the ingredients of an average Indian diet fish, turmeric, tomato, garlic and lemon have been found to be having anti cancer properties. Beside these general supportive measures, the established scientific agencies all over the world have so far not found any alternative therapy or drug which had been scientifically proven to be effective.

We often hear about grand discoveries or miracle drugs from the practitioners of alternative medicine but none so far have stood the test of time. Most of the sensational discoveries from this world have later been proved to be plain hoaxes. The world of alternative therapy is a very wild and unregulated one where, without the oversight of a regulatory authority, it is very difficult to know the charlatan from the serious practitioners. But from the current medical knowledge about cancer it can be said that there will never be one single drug that will cure cancers of all types and stages because it is not one single disease.

Not always. It again depends on which body parts are affected. A growth that involves bone and nerve tissues causes more pain than a cancer growing within the body cavity. The perception of pain also depends a great deal on the personality of the patient. However cancer pain can be treated satisfactorily and no patient should suffer from pain. That is a major goal for any cancer treatment.