The magnitude of the cancer problem may be appreciated by these few statistics. One in four Americans will develop cancer during his or her lifetime. More than 400,000 Americans died of cancer in 1990. Not only is cancer a momentous health problem, but the management and care of these patients is frequently quite complex and heartrending.

The much-feared word, cancer, is a term used to characterize an aberrant growth of cells, which ultimately results either in the invasion of normal tissues, or the spread to other organs, called metastasis. The degree of threat or malignancy (from the Latin roots malignus, and genus, meaning, “engendering harm”) of a particular cancer is based upon the propensity of its abnormal cells to invade surrounding tissues or spread to other organs.

Cancer is not one disease. There are more than one hundred distinct forms of cancer with differing biological behavior and clinical manifestations. The natural course of some kinds progresses rapidly, and takes the life of the victim within weeks to months. Others are very slow growing and may metastasize to distant areas, spread rapidly, or extend the tumor locally and invade the surrounding tissues.

Some types of cancer are quite predictable in their behavior, while others are just the opposite. The factors that allow aberrant cancer cells to invade tissues are not well understood. Some individuals appear to be resistant to the invasion of cancer. Not only do they resist the disease, but also if they have a malignant growth they may undergo spontaneous remission leading to a complete cure.

Some of the basic types of cancer have general features that characterize their behavior. Carcinomas are cancers involving glandular or covering tissues, such as the intestinal tract, lungs, or skin. These are more apt to spread by invasion of the lymph vessels, initially involving the nearest lymph node.

This is why the lymph nodes are carefully examined in the diagnosis and treatment of breast cancer, for example. Sarcomas, on the other hand, are cancers of connective tissue, such as muscle, cartilage, or bone. These characteristically spread via the blood stream, and distant metastases to the lungs or brain are common.

Two properties of tumor cells probably contribute to their spread to distant sites. One is decreased “adhesiveness” of tumor cells to each other with the resulting ability of these clumps of cells to break off and enter the lymphatics of blood stream and to lodge in other tissues.

The second is the elaboration of a “tissue angiogenesis factor,” which results in rapid development of local blood vessels, thereby feeding the growing tumor cell mass and hastening its development.

Common symptoms that are seen with most malignancies are those of weight loss, loss of appetite, and unexplained bleeding. The American Cancer Society has popularized the seven danger signals, which although helpful in early detection, at times show up too late for an actual cure by surgical removal.

The change in a wart or mole, unexplained bleeding, difficulty swallowing, loss of appetite, a persistent cough, particularly with the production of blood, a lump developing in some part of the body, and a change in bowel habits these are the signs that should alert one to seek comprehensive investigation for the possibility of cancer.

Many causes of cancer have been suggested. A great deal of evidence has accumulated in recent years. For a long time, it was known that certain hereditary disorders might increase the risk of cancer. For example, if a relative of a patient has breast cancer, the risk increases 3-5 times in females. Individuals with multiple polyps in the colon, or other hereditary disorders, such as Down’s syndrome, have increased risk of developing certain cancers.

Viruses can cause development of cancer in almost every mammal, as well as fish, frogs, and other species. Some may be transmitted to humans through meat eating, milk, or eggs. These tumor viruses transform cells, but occasionally may lie dormant for many years without producing disease.

It is felt today that many cases of breast cancer, leukemia, and other cancers of the lymph organs (lymphomas) are caused by viruses. One of these is the Epstein- Barr virus known to cause infectious mononucleosis.

Lung cancer is much more common today, caused by one or more of the dozens of cancer-producing chemicals present in mainstream tobacco smoke. People working in occupations where dusts are inhaled, as asbestos workers and coal miners, and some who in painting the luminous dials of watches exposed themselves to radium, —all can develop cancer from these environmental agents.

In fact, radiation in any form, as well as numerous drugs have been unequivocally shown to be associated with the induction of cancer. The survivors of the atomic bombing of Hiroshima and Nagasaki showed an increased incidence of acute and chronic leukemia that reached a peak approximately seven years after their exposure to radiation.

As this research points up, it is right to minimize ones exposure to radiation and x-rays. Drugs are also capable of interacting with cells to form various types of cancer. Radioactive isotopes and immune suppressive agents, as well as some hormones have been known to cause cancer. Exposure to estrogens has increased the incidence of cancer of the womb.

Arsenic exposure has been associated with skin cancer. Many other common drugs, such as coal tar ointments are being related to skin cancer. Amphetamines, male hormones, and in fact, practically all of the anticancer chemotherapy drugs can in susceptible individuals produce malignancy.

More recent research has focused on the role of diet in possibly causing (called the etiology) certain cancers. We know, for example, that in undeveloped nations where the fiber intake is high the incidence of cancer of the colon is exceptionally low. Cancer of the stomach, as well as the colon has been related to certain Oriental food patterns.

Meat intake is being implicated more and more as a possible cause of cancer. Evidence supporting this assertion indicates a higher rate of cancer in the northern United States and New Zealand where beef consumption is high. In fact, colon cancer risk seems directly proportional to the amount of meat taken by a given population.

Nursing a baby appears to protect a mother against developing breast cancer later in life. Some additives in foods, such as the artificial sweeteners, saccharine and cyclamate, have been related to cancer of the bladder in experimental animals. So you can see that our environment may contain many agents with malignant potential.

This makes it mandatory to guard your personal health and fortify your body’ s resistance to disease with the purest air and water, and the most natural sources of food that you can find. Certain examinations should always be carried out in high-risk patients for early detection of possible cancer.

Probably the most valuable screening test is the chest x-ray, a must in smokers. Preferably, in tobacco users a chest x-ray should be taken every three to six months. For the general population, an annual chest x-ray can determine the earliest presence of most lung cancers, as well as tuberculosis and several other pulmonary diseases.

Routine annual x-rays of the breasts (called a mammogram) should be performed especially in ladies with unusually large breasts, fibrocystic disease, or with a strong family history of breast disorders or cancer. The cumulative radiation exposure makes mammography’s routine use unadvisable for women without any risk factors or symptoms.

The complete blood count is the best screening procedure for leukemia and many other diseases involving the blood. Urine tests can be done to evaluate the kidneys, bladder, and urinary tract for bleeding or other suspicious abnormalities. Many other blood tests and x-ray procedures, as well as the actual obtaining of tissues through a biopsy can diagnose with certainty most specific types of cancer.