We have created a question & answer bank on the basis of the information our patients have frequently sought from us. However, it is possible that your question does not find place here. If so please do not hesitate to contact us. Our panel of experts will send you a reply as soon as possible and we will add your query to the bank, if we find that it is of common relevance.
"A neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after cessation of the stimuli which evoke the change." - Willis, 1952.
Cancer cells differ from normal cells in that they have the ability to infiltrate surrounding normal tissue. Small clumps of cancer cells may break off from the parent growth and be carried by the blood or lymphatic flow to other parts of the body and become established as secondary growths, known as metastatic deposits.
There is no single causal relationship for cancer. In experimental animals many agents, including chemicals, hormones, viruses and radiation, have produced cancer. There is a casual relationship between tobacco consumption and head and neck cancers. According to the W.H.O., 90% of the people who suffer from head and neck cancers have used tobacco in some form or the other.
Nicotine absorption is faster in presence of alcohol. The severity of the ill effects is of a greater degree if tobacco and alcohol are consumed together. French epidemiologists have shown that the combined use of alcohol and tobacco can cause cancers of the larynx and pharynx.
Tobacco is associated with increased incidence of head and neck cancers. In India, the very high incidence of cancers of the mouth is due to the rampant tobacco chewing habits. Poor oral hygiene may also play a role. A sharp edge of a tooth can, over a long period of time, cause dangerous ulcers on the inner lining of the cheek, the buccal mucosa.
Many researchers believe that some viruses may play an important role in causing cancer. Specific epidemiological data is available for nasopharyngeal and cervical cancers.
No. Cancer does not spread by direct or indirect contact with another person.
No. Injury, such as pathological fractures, may, however, make cancers noticeable.
There are three basic mechanisms of its spread:
- By direct extension to surrounding structures.
- Through blood circulation
- By lymphatic flow
- There is a wide variation in rate of growth of tumour at different sites.
- Different types of cancers will behave differently.
- Individual host factors may also be responsible for slow or fast growth.
According to some, the number of new cancer cases diagnosed each year, per thousand of our population, is slowly increasing. Some say that it may be because of increased life spans and better diagnostic facilities.
Yes. Though relatively rare, children can have cancer. Leukemia is the most common cancer in children.
No. The word "tumor" means swelling or lump caused by localized growth of cells. Those tumours, which do not have the potential to spread to other organs are harmless and are termed "benign". Tumours that spread to other organs of the body are called "malignant or cancerous".
No. In fact, often it is not an early symptom. In some cases cancer can cause pain at a late stage, when it invades the bone or compresses nerves. A painless lump warrants further investigation. Cancerous lumps in the breast can be painless to begin with. However, remember that all lumps need not be cancerous.
There are no sure symptoms and signs of early cancer. In the early stages, cancer and other illnesses cause a number of problems that may be similar. However it is important to seek medical advice if the following symptoms persist for more than two weeks
- Altered voice, persistent cough, hoarseness
- Difficulty in swallowing that is gradually increasing
- Change in bladder or bowel habits, blood in the urine or stools
- Lump any where in the body, often increasing in size
- Unusual bleeding or discharge, post-menopausal bleeding
- Non healing sores
- Obvious change in the size or pigmentation of a wart or mole. Melanomas are aggressive cancers.
- Unexplained weight loss.
We encourage monthly self-mouth examination in high-risk population, particularly tobacco users. It is important and relatively easy to detect oral cancers early. Treatment is more effective in the early stages, before the disease has spread to other organs.
Mouth self-examination means looking in a mirror to check for:
- A sore in the mouth that does not heal
- A lump or thickening in the mouth
- A pearly white patch or a red patch on the gums, tongue or buccal mucosa
Other symptoms are:
- Soreness or choking sensation in the throat
- Difficulty in chewing or swallowing
- Difficulty in tongue movements
It is important to see a specialist if the symptoms last for more than two weeks.
For breast cancer, self-breast examination and mammography are recommended as methods for early detection.
Cancer of the uterine cervix can be detected early if women of the reproductive age group undergo periodic gynaecological examination and a Pap test is done on a yearly basis.
Cancer can be treated by
- biological therapy (immunotherapy).
The doctor may use any one method or a combination of them. The choice of treatment depends on the
Type of cancer
- Location of the tumor
- Stage of the disease, patient's age, general health and a number of other factors.
The life of an untreated patient is shorter than that of a treated patient. The quality of life is also very poor.
A small piece is surgically removed from the affected tissue and is examined under a microscope to determine if it is cancer. Pre-cancerous conditions of the oral cavity such as leucoplakia can also be detected by a biopsy.
It depends on the procedure selected for the biopsy. A proliferative growth of the buccal mucosa can be biopsied in seconds. If the patient requires a surgical procedure like an endoscopy, for e. g. a direct laryngoscopy, or an examination under anesthesia or an open surgical procedure then more time will be required.
A biopsy may be performed under local anesthesia, while the patient is awake, or under general anesthesia, as per the area from where the biopsy is to be taken, doctor's discretion and sometimes the patient's preference.
Once the diagnosis is made, one should immediately contact an oncologist.
A head and neck cancer surgery involves removal of the affected part and lymph glands in the neck, and the surgical procedure is extensive. In the immediate post surgical period there may be a swelling over the operated part. It takes about two weeks for the immediate problems to settle down.
Yes. For a few weeks, there might be some trouble in eating solid food and the patient may have to be on a special diet.
This will depend on the initial extent of surgery. If the volume of tissue to be removed is large then there might be a permanent change in appearance.
All patients do not require plastic surgery. Only if a surgical defect is anticipated, does the operating team consider the option of reconstructive plastic surgery. The aim of reconstructive surgery is not only cosmetic but also functional recovery.
Speech may get affected if a patient is operated for cancer of the tongue or larynx and s/he would require post-operative speech therapy.
If patient undergoes surgery and receives adjuvant radiotherapy, s/he may be back to normal work in three months.
Radiotherapy is the use of radiation in the treatment of cancer. Radiation does not hurt. There is nothing to see or feel. The patient is positioned on a couch and the machine, which produces x-rays, gamma rays or electrons, is directed precisely onto the tumour bearing area. The entire session takes one or two minutes.
Cancer cells are vulnerable and are easily damaged and slowly decrease in number. The normal cells sustain radiation over a period of time and recover to their healthy form. Therefore, repeated daily treatments are prescribed.
Yes. The chances of local recurrence are reduced with adjuvant radiotherapy. However, it is better to let your oncologist take the decision.
Daily treatment takes only one or two minutes. And overall treatment time may extend from six to seven weeks.
The duration depends on the aim of the radiotherapy. If the aim is curative, then one has to receive therapy for six to seven weeks. Palliative radiotherapy is usually of a shorter duration. Accelerated fractionation of radiotherapy may conclude therapy in a shorter span and will also cure cancers in specific cases.
It is a convention to give radiotherapy for five days a week with two rest days for recovery of normal tissue.
Depending on the site of irradiation some side effects may be encountered. A radiation oncologist is able to help the patient get over these side effects.
Today, radiotherapy is safer than ever before.
Acute side effects are temporary and usually subside within a few weeks. By and large radiation reactions persist till the end of therapy and some time there after and can be minimized with the use of proper medication .
In addition to these acute reactions, there are some late effects of radiotherapy. These reduce over a period of time and often disappear completely.
Please consult your radiation oncologist for detailed information.
There may be a temporary or permanent loss of hair in the irradiated area. Color of the skin might change a little bit. There will be dryness of mouth.
There are various preventive methods to deal with dryness of mouth after irradiation.
- shielding of the parotid glands as much as possible without compromising the treatment of the tumour.
- Judicious use of medicines to prevent dryness of mouth.
- Gene therapy- selective protection of parotid gland.
Rehabilitation is a very important part of treatment for patients with head and neck cancers. Every effort is made to help the patient return to normal activity as soon as possible.
- Dietary counseling
- Dental prosthesis
- Speech therapy & other services, which are a part of physical rehabilitation
Learning to live with the changes brought about by extensive surgery for cancer of larynx is a special challenge and requires a high level of self-motivation.
Today, the focus is on genetic research.
There should not be a gap or an unnecessary delay between the biopsy and initiation of cancer treatment.
Please consult your doctor for information.
Yes. But, the probability is low.
Help line service of the Indore Cancer Foundation