CANCER . . . basics and overview

This is the 2nd of two blog entries about cancer. Last month included the warning signs as well as other information to begin this discussion. This entry will expand on details of diagnosis and treatment.

When there are changes in an individual's health status, the physician will initially perform a physical exam, evaluating the skin, any changes in or abnormalities of lumps or skin changes, as well as a firm palpation of abdomen to feel the contour of internal organs for normal or abnormal surfaces there. If there are noted changes, the physician will commonly have some testing done to identify whether the symptoms are resulting from cancer. Cancer screening procedures will often reveal cancer at its earliest stage which provides the best chance for cure or reasonable control. Blood and urine tests reflect variations in health also.

The presence of abnormalities prompts biopsy, or xray, scan, or electronic imaging to help identify the status of the area of the body under suspicion for disease. When cancer is confirmed or strongly indicated, the primary care physician will likely refer the patient to a cancer specialist, known as an oncologist. The medical specialty of oncology may be further identified by physicians who specialize in particular types of cancer such as blood cancers, skin cancers, lung, gastric, bone cancer, for example.

When a cancer is identified and confirmed usually by a biopsy, further diagnostic testing is done to determine whether the initial cancerous tumor has spread to another part of the body., When there are distant tumors, the cancer is then termed metastatic, or the distant (within the body) tumor is referred to as metastasis. The biopsy results contribute to the identification of a particular stage of cancer, otherwise known as the severity of the disease. Stage I is the earliest stage of cancer, with greatest chance of successful treatment. Stage IV is the most advanced stage of the disease, with a rather guarded prognosis. The biopsy results provide detailed information about the configuration of abnormal cells, which are categorized by what types of tissue they affect, which, in turn, determines the prognosis and the most effective course of treatment.

Treatment options for most types of cancer include one or more of the following: surgery, radiation, chemotherapy, hormone therapy, targeted drug therapy, stem cell transplant, and clinical trials. Not all of those treatments are used for one specific cancer; the treatment is tailored to the specific cell type of the cancer as noted in the report of the pathologist. The pathologist is a medical doctor who specializes in the identification of cell-types from a biopsy; the tissue is examined under a microscope for extent and severity of the cancer specimen. The extent of the treatment is determined by how the cancer responds to treatment, and whether the treatment will improve the prognosis or length of life in the setting of the particular cancer status.

A cancer diagnosis can be a life-changing event in an emotional, physical, and spiritual way. Often it is difficult to know what to do first. It takes time to gather medical information, evaluate options, and partner with your physician to explore the best treatment option. As the patient, or as a family member of a patient, learn enough about the specific cancer to make decisions about the care that is best for you. Keep family and trusted friends close, and closely informed. Keeping personal relationships strong provides support when you may feel overwhelmed by the situation. Find someone to talk with, someone who is a good listener and who knows your situation. Seek out support groups affiliated with hospital or clinic.

Much additional information is available through the National Cancer Institute and the American Cancer Society.