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1. What is cancer?
2. What are some of the common signs and symptoms of cancer?
3. Is there a blood test to check for cancer?
4. How long has my cancer been present?
5. What is chemotherapy?
6. How is chemotherapy given?
7. How will chemotherapy effect me?
8. What is adjuvant therapy?
9. How many treatments will I receive?
10. How long will my treatments last?
11. How often will I be treated?
12. Can I eat in the office while I am getting my chemotherapy treatments?
13. Can I drive to and from the office after receiving my treatment?
14. Will I need an IV access device?
15. Can I work during treatment?
16. Will chemotherapy make me sick?
17. Will chemotherapy make me lose my hair?
18. Can I color or perm my hair?
19. Will chemotherapy interfere with my sexual activity?
20. Can I take vitamins?
21. What does a fingerstick blood test check?
22. What causes cancer?
23. Can injuries cause cancer?
24. Can stress cause cancer?
25. Is cancer contagious?
26. Can cancer be prevented?
27. How many people alive today have ever had cancer?
28. How is cancer treated?
29. What are the side effects of cancer treatment?
30. Is cancer treatment worse than cancer?
31. How many people alive today have ever had cancer?
32. How is cancer treated?
33. What are the side effects of cancer treatment?
34. What are some of the common signs and symptoms of cancer?
35. Are clinical trials (research studies) available?
36. Where can people get more information about clinical trials?
37. Does cancer always cause pain?

1. What is cancer?
Cancer is an abnormal growth of cells. Normally, human cells grow and divide as needed by the body. Cancer cells have the ability to divide without control and often invade surrounding tissue or spread to other parts of the body. Sometimes these cells collect and form masses called tumors. Tumors may be benign (noncancerous) or malignant (cancerous). The type of treatment depends on the type, stage and location of the cancer, whether the disease has spread, the patient's age, general overall health, and other factors.

Cancer is a generic term for a group of more than 100 diseases that can affect any part of the body. Other terms used are malignant tumours and neoplasms. One defining feature of cancer is the rapid creation of abnormal cells which grow beyond their usual boundaries, and which can invade adjoining parts of the body and spread to other organs, a process referred to as metastasis. Metastases are the major cause of death from cancer.

2. What are some of the common signs and symptoms of cancer?
Following is a list of signs and symptoms that may indicate cancer; however, this list is by no means all inclusive. If you experience any of these symptoms, it is recommended that you see a physician.

Thickening or lump in the breast or any other part of the body

Obvious change in a wart or mole

A sore that does not heal

Persistent cough or hoarseness in voice

Changes in bowel or bladder habits

Indigestion or difficulty swallowing

Unexplained changes in weight or change in appetite

Unusual bleeding or discharge

Unexplained pain or discomfort

3. Is there a blood test to check for cancer?
There is no specific blood test to check to see if a person has cancer. Certain types of cancers can cause blood disorders. However, a diagnosis of cancer would not be made on these blood tests alone, since conditions other than cancer can also cause similar disorders in the blood.

4. How long has my cancer been present?
Cancer cells divide at different rates. It is difficult to establish exactly how long your cancer has been present. However, treatment is likely to be more effective when cancer is detected in its early stages.

5. What is chemotherapy?
Chemotherapy is a group of medications given to attack rapidly dividing cells. The type of chemotherapy drugs given is based on the disease or cellular make up. One chemotherapy drug may work well with breast cancer cells while another works well with colon cancer cells. However, chemotherapy drugs also effect normal healthy cells in this process.

6. How is chemotherapy given?
Chemotherapy can be taken as a pill, or more commonly, given as an injection or infusion through your veins. The way your treatment is given as well as the type of chemotherapy drugs selected for you by your physician depends on the type, location, and stage of your specific disease.

7. How will chemotherapy effect me?
Not all chemotherapy medications have the same side effects. You will receive specialized teaching regarding the chemotherapy drugs you will be given. Your questions about side effects, when to call the doctor, the length of your treatment, and many more questions will be answered during your teaching session.

8. What is adjuvant therapy?
Adjuvant therapy is the use of additional treatment after your primary therapy to eradicate unseen cancer cells.

9. How many treatments will I receive?
The number of treatments you will receive depends on the type, location and stage of cancer being treated, how well you are responding to the treatment, and how well you are tolerating the therapy. Your doctor will decide what method is best to use to treat your cancer. Often, one or more methods are used. Surgery, chemotherapy, radiation or any combination of these therapies may be used.

10. How long will my treatments last?
Your treatment can take from a few minutes to several hours depending on what medications are being administered. Your doctor or nursing staff can give you a better idea of the length of time it will take for your specific treatment.

11. How often will I be treated?
Treatment schedules depend on the disease being treated. Some schedules involve daily treatments and some may be only once a month.

12. Can I eat in the office while I am getting my chemotherapy treatments?
Depending on the type of chemotherapy drugs you will be receiving, you may be in our office for several hours. You may bring a light lunch with you.

13. Can I drive to and from the office after receiving my treatment?
It is recommended that you do not drive the day you are getting your treatments. Sometimes you are given medications that may cause drowsiness. For your safety, we recommend you have a friend or family member drive for you. If you do not have transportation, we can make arrangements with the American Cancer Society's Volunteer Driving Program to assist you.

14. Will I need an IV access device?
The term IV means use of the veins for treatment, typically veins in the arm. Port-a-caths or ports are devices surgically inserted into the chest wall when the veins in the arms cannot be easily used. Your doctor or nurse will determine the need for a port-a-cath. Port-a-caths are frequently recommended for patients undergoing treatment on a daily basis or if the patient has poor venous access ("bad veins").

15. Can I work during treatment?
Most patients reduce their work schedule or do not work at all during treatment. Some patients, however, continue to work if their job is not physically demanding.

16. Will chemotherapy make me sick?
Not all chemotherapy causes nausea. There are now several medications called antiemetics that will prevent nausea caused by certain chemotherapy medications. Your doctor will prescribe the appropriate antiemetic for you before your treatment. If necessary, antiemetic medications will be given to you to take home.

17. Will chemotherapy make me lose my hair?
There are certain chemotherapy drugs that will cause you to lose your hair completely or cause hair thinning. You will be told, if you are receiving a chemotherapy drug that causes hair loss. Once you have finished your treatments, your hair should begin to grow again. However, not all chemotherapy drugs cause you to lose your hair.

18. Can I color or perm my hair?
It is recommended that you do not color or perm your hair while receiving chemotherapy treatment. The chemicals may interact with the chemotherapy drugs and cause damage to the hair roots.

19. Will chemotherapy interfere with my sexual activity?
Some patients experience fatigue related to their chemotherapy. This may temporarily interfere with both your desire and ability to have sex. There are medications, which help with this fatigue. It is important to tell your doctor or nurse if this becomes a problem for you.

20. Can I take vitamins?
It is okay to take a multivitamin during your treatment. Maintaining good nutrition and a healthy diet is extremely important. However, you need to tell your doctor if you are taking vitamins and any herbal medication. Some vitamins and herbs can interact with the chemotherapy medication you are given.

21. What does a fingerstick blood test check?
A fingerstick blood test is a small sample of blood taken from your finger at each visit. This test evaluates your red blood cells (oxygen carrying), white blood cells (infection fighting), and platelets (cells that allows your blood to clot when needed). This test is a valuable tool that the doctor uses to see how your blood cells are tolerating your treatment.

Cancer is a leading cause of death worldwide. From a total of 58 million deaths worldwide in 2005, cancer accounts for 7.6 million (or 13%) of all deaths. The main types of cancer leading to overall cancer mortality are:

The most frequent cancer types world wide are:

Among men (in order of number of global deaths): lung, stomach, liver, colorectal, oesophagus and prostate.

Among women (in order of number of global deaths): breast, lung, stomach, colorectal and cervical.

40% of cancer can be prevented (by a healthy diet, physical activity and not using tobacco).
Tobacco use is the single largest preventable cause of cancer in the world. Tobacco use causes cancer of the lung, throat, mouth, pancreas, bladder, stomach, liver, kidney and other types; Environmental tobacco smoke (passive smoking) causes lung cancer.
One-fifth of cancers worldwide are due to chronic infections, mainly from hepatitis B viruses HBV (causing liver), human papilloma viruses HPV (causing cervix), Helicobacter pylori (causing stomach), schistosomes (causing bladder), the liver fluke (bile duct) and human immunodeficiency virus HIV (Kaposi sarcoma and lymphomas).

What causes cancer?


Cancer occurs because of changes of the genes responsible for cell growth and repair. These changes are the result of the interaction between genetic host factors and external agents which can be categorized as:

physical carcinogens such as ultraviolet (UV) and ionizing radiation
chemical carcinogens such a asbestos and tobacco smoke
biological carcinogens such as
infections by virus (Hepatitis B Virus and liver cancer, Human Papilloma Virus (HPV) and cervical cancer) and bacteria (Helicobater pylori and gastric cancer) and parasites (schistosomiasis and bladder cancer)
contamination of food by mycotoxins such as aflatoxins (products of Aspergillus fungi) causing liver cancer.

Tobacco use is the single most important risk factor for cancer and causes a large variety of cancer types such as lung, larynx, oesophagus, stomach, bladder, oral cavity and others . Although there are still some open questions, there is sufficient evidence that dietary factors also play an important role in causing cancer. This applies to obesity as a compound risk factor per se as well as to the composition of the diet such as lack of fruit and vegetables and high salt intake. Lack of physical activity has a distinct role as risk factor for cancer. There is solid evidence about alcohol causing several cancer types such as oesophagus, pharynx, larynx, liver, breast, and other cancer types.

How does cancer develop?

Cancer arises from one single cell. The transformation from a normal cell into a tumour cell is a multistage process, typically a progression from a pre-cancerous lesion to malignant tumours. The development of cancer may be initiated by external agents and inherited genetic factors. Ageing is another fundamental factor for the development of cancer. The incidence of cancer rises dramatically with age, most likely due to risk accumulation over the life course combined with the tendency for cellular repair mechanisms to be less effective as a person grows older.

How can the burden of cancer be reduced?

The existing body of knowledge about the causes of cancer and about interventions to prevent and manage cancer is extensive. Cancer control is understood as public health actions which are aimed at translating this knowledge into practice. It includes the systematic and equitable implementation of evidence-based strategies for cancer prevention, early detection of cancer and management of patients with cancer.

Up to one third of the cancer burden could be reduced by implementing cancer preventing strategies which are aimed at reducing the exposure to cancer risk mainly by:
changes in tobacco and alcohol use, and dietary and physical activity patterns
immunization against HPV infection
the control of occupational hazards
reducing exposure to sunlight
Another third of the cancer burden could be cured if detected early and treated adequately.
Early detection of cancer is based on the observation that treatment is more effective when cancer is detected earlier. The aim is to detect the cancer when it is localized. There are two components of early detection programmes for cancer:

+ Education to promote early diagnosis by recognizing early signs of cancer such as: lumps, sores, persistent indigestion, persistent coughing, and bleeding from the body's orifices; and the importance of seeking prompt medical attention for these symptoms.

+ Screening is the identification by means of tests of people with early cancer or pre-cancer before signs are detectable. Screening tests are available for breast cancer (Mammography) and Cervical cancer (Cytology tests).

Treatment of cancer is aimed at curing, prolonging life and improving quality of life of patients with cancer. Some of the most common cancer types such as breast cancer, cervical cancer and colorectal cancer have a high cure rate when detected early and treated according to best evidence. The principal methods of treatment are surgery, radiotherapy and chemotherapy. Fundamental for adequate treatment is an accurate diagnosis by means of investigations involving imaging technology (ultrasound, endoscopy, radiography) and laboratory (pathology).

Relief from pain and other problems can be achieved in over 90% of all cancer patients by means of palliative care. Effective strategies exist for the provision of palliative care services for cancer patients and their families, even in low resource settings.

People-centered: the ultimate goal is to improve the well-being of the people, communities, families and individuals.

Equity: the strategy focuses on the needs of low-and middle-income countries and of vulnerable and marginalized populations.

Sustainability: the strategy emphasizes the need for national governments and partners collectively strive for financial and technical self-reliance, to ensure the continuation of benefits from established programmes after major assistance has been completed.

Integration: the strategy is embedded within the overall framework of chronic disease prevention and control and other related areas (such as environmental health, communicable diseases, etc).

Stepwise approach: the strategy considers the implementation of interventions, at a national or sub-national level, in a sequential manner.

Evidence-based: the strategy is based on research results, programme evaluation, economic analysis, best practice, and lessons from countries.

Advocacy and political commitment for cancer prevention and control
Generation of new knowledge and dissemination and diffusion of existing knowledge to facilitate the application and programme delivery of evidence-based approaches to cancer control
Development of standards and tools for guiding effective cancer control planning and implementation of evidence-interventions for prevention, early detection, treatment and palliative care
Facilitating the development of multisectoral networks of cancer control partners at the global, regional and national levels
Building capacity for developing and implementing effective policies and programmes and strengthening health systems
Provision of technical assistance for the rapid, effective and efficient translation of evidence-based cancer control interventions into public health policies and programs