Cancer - OOKINFO
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6/06/2019

Cancer

Cancer is a disease characterized by uncontrolled cell growth, which has the ability to infiltrate and damage healthy cells in the body.

Each body cell has a control center called the nucleus. The nucleus consists of a series of DNA chains that function as a regulator of the nature and workings of each cell, including to divide.


Normally, the cell will divide according to a predetermined time and with genetic traits in normal cells. But in the event of a mutation in the cell, the cell's genetic information in the DNA chain is damaged, double-printed or even lost, during the process of cell division. In cancer, there is a mutation in which cells will divide too much to form tumor tissue.

Based on the type of cell that is attacked, cancer can be divided into 5 groups, namely:

  • Carcinoma, cancer that originates from the skin tissue or the outer tissue of the internal organs. Carcinoma is divided into several subtypes including adenocarcinoma, basal cell cancer, squamous cell cancer, and transitional cell cancer.
  • Sarcomas, cancers that originate from connective tissue such as bone tissue, cartilage tissue, fat tissue, muscle tissue, and blood vessel tissue.
  • Leukemia, cancer that originates from blood-forming tissues such as the bone marrow. This type of cancer causes excessive blood cell production which will then be released into the bloodstream.
  • Lymphoma and myeloma, cancers that originate from cells in the immune system.
  • Cancer in the brain and spinal cord, namely cancer originating from central nervous system tissue.

In addition to these groups, cancer is also divided according to the organ from which the cancerous tissue originates such as lung cancer or breast cancer.

Causes of cancer

The main cause of cancer is the mutation of DNA in cells, so cells break down at speeds exceeding normal. Finally, there is a buildup of new cells that are not needed by the body. These new cells will continue to grow into adulthood and then divide again, and so on.

In addition, mutations also occur in genes responsible for repairing DNA damage. Normally, this gene serves to see what abnormalities occur in the cell's DNA, then fix them. Because the gene is mutated, this gene is not able to repair the abnormalities that exist in cells until eventually, the cells become malignant.

There are several factors that can cause mutations in normal cells, and can originate both inside and outside the cell.
Mutations originating from cells are generally obtained genetically from parents. While the causal factors from outside the cell, the most common is exposure by substances that can trigger mutations (mutagen).

Some substances included in the class of mutagens include:

  • Cigarettes
  • Radiation
  • Virus
  • Carcinogenic chemicals
  • Hormone

Mutations due to external factors can also be caused by other factors such as obesity, chronic inflammation and lack of physical activity. In general, external factors are more risky to cause cells to mutate compared to internal factors.
Risk factors that can increase a person's chances of getting cancer are as follows:

  • Age. The development of cancer in a person can occur in a very long time, therefore most cancer sufferers are elderly people over the age of 65 years. Even so, cancer can also be experienced by anyone regardless of age.
  • Family history. Genetic mutations can be inherited from parents. If someone has a family member who has cancer, there is a possibility that the person is at risk of getting the same condition. It is recommended for people who have a history of cancer in the family to undergo genetic testing to check for genetic mutations inherited in that person.
  • Chronic health conditions. Some chronic diseases can increase the risk of cancer. Such as ulcerative colitis can increase the risk of colon cancer in a person.
  • Environment. Environmental factors can increase a person's risk of cancer. Examples are dangerous chemical compounds such as asbestos or benzene. Smoking also increases the risk of cancer, especially lung cancer.
  • Infection. Some viruses can cause or increase the risk of cancer. Examples are hepatitis B and C viruses which can cause liver cancer. In addition, infection with the HPV virus ( human papilloma virus ) in women can cause cervical cancer.
  • Immune system disorders. People with immune system disorders or people with weak immune systems are more susceptible to cancer than healthy people. Immune system disorders can originate from infections such as HIV / AIDS or drugs that suppress the immune system
 

    Symptoms of cancer


    Symptoms that arise due to cancer vary greatly depending on the type of cancer that is experienced and the organs affected by cancer. Some of the common symptoms experienced by cancer patients are:

    • Fatigue and feeling weak.
    • Changes in body weight without being desired can be a decrease or increase in body weight.
    • The appearance of a lump or thickening felt under the skin.
    • Changes to the skin, such as yellowing, darkening, or redness. It can also be a disorder or wound that is painful and does not go away.
    • Long-term fever and night sweats.
    • Bleeding and bruising are not clear why.

    If you experience these symptoms, especially symptoms that persist for a long time, it is recommended to immediately consult a doctor. Risk factors and a history of cancer in the family also need to be consulted so that routine screening checks can be carried out so that cancer can be diagnosed early.

    Cancer Diagnosis and Distribution


    The earlier the cancer is diagnosed, the greater the chance of recovery for the sufferer. Because it is highly recommended for people who are at risk of developing cancer to consult a doctor regarding their risk factors. Some of the cancer diagnosis steps that doctors generally make are:

    • Physical examination. Physical examination performed to show signs of cancer can include examining lumps under the skin, changes in skin color, and swelling of organs.
    • Laboratory test. Blood and urine tests can be done to check for abnormal body conditions. An example is in cases of leukemia , where doctors can do laboratory tests in the form of calculating the complete number of blood cells to diagnose the number of leukocyte cells that increase abnormally.
    • Imaging test (imaging test). This test serves to map internal organs and bones without surgery. The imaging tests performed can be CT scans, bone scans, MRI, PET scans, ultrasound examinations, X-ray photos, and others.
    • Biopsy. This examination is done by taking tissue samples that are thought to have cancer to be observed using a microscope in the laboratory. Through a microscope, the structure of the tissue sample can be observed more clearly. Normal cells are usually seen as cells that are uniform in size and neatly arranged. Whereas in cancer cells, the size will look different and the arrangement is not neat. The biopsy is the most accurate examination in determining whether a person has cancer or not.

    After the tests are done and the patient is confirmed to have cancer, the doctor will determine the level (stage) of cancer. In general, the division of cancer stages is as follows:

    • Stage 1. It indicates that the cancer is small and still exists in the organ where cancer begins.
    • Stage 2. It indicates that cancer has not spread to the surrounding tissue, but the size of the cancer is greater than stage 1. In some types of cancer, stage 2 means that cancer cells have spread to the lymph nodes closest to the cancerous organ.
    • Stage 3. The size of the cancer is larger than stage 2 and the cancer cells have begun to spread to other tissues or organs, as well as to the lymph nodes around cancer.
    • Stage 4. It indicates that cancer has spread to other organs or tissues.

    In addition to the stage level system, also known as the TNM level system, the details are as follows:

    • T (Tumor). Describes the size of the cancer and the spread of cancer to surrounding tissues. To describe the size of the cancer used numbers 1, 2, 3, 4, with number 1 which indicates the smallest size and the 4 largest.
    • N (node). Describes the spread of cancer to lymph nodes (lymph nodes) around the cancer. To describe the spread of cancer numbers 0, 1, 2, 3 with 0 indicate that the cancer has not spread to the lymph nodes and 3 indicates that many lymph nodes have cancer.
    • M (Metastasis). Describes the spread of cancer to other organs. Number 0 indicates cancer has not spread to other organs and number 1 indicates that cancer has spread to other organs.

    In cases of cancer diagnosed at an early stage, a condition can be found in the form of an abnormal collection of cells in the body. The collection of cells can develop into cancer in the future, but it is too small to form a tumor. This condition is called dysplasia or carcinoma in situ which in the division of the level of cancer is called stage 0 cancer.

    Some doctors call this condition a non-invasive cancer. Carcinoma in situ is generally difficult to detect due to its very small size, except in places that are easily visible (for example on the skin). Several types of screening tests can also detect carcinoma in situ in the breast or cervix.

    Determination of the level of malignancy and the spread of cancer is a very important part of the diagnosis of cancer because it will determine the type of treatment that is most effective for patients.

    Cancer Treatment


    Various types of cancer treatments have been found and are used for cancer patients. The type of treatment that the doctor will apply depends on several things, such as the type of cancer, the stage of cancer, the location of cancer, the general health condition of the patient, and the patient's request. The doctor will give consideration regarding the advantages and risks of each treatment.

    The main goals of cancer treatment are as follows:

    • Healing patients. Healing is the main goal of various cancer treatments carried out. Achieving this goal or not depends on many factors, such as the type and level of cancer malignancy and the general condition of the patient.
    • Primary treatment. The purpose of primary treatment is to remove or kill cancer tissue that is in the body as a whole without any cells left behind. Various types of treatment can be used so that cancer cells can be removed from the patient, but surgery is commonly used. If the cancer type of patient has a sensitivity to radiotherapy or chemotherapy, both types of treatment can be used as primary treatment.
    • Ad Juan / additional treatment . The aim of adjuvant treatment is to remove the remnants of cancer cells that are still inside the patient's body after primary treatment. Adjuvant treatment can also be done to prevent cancer from reappearing in patients. Adjuvant treatment that is commonly used is chemotherapy , radiotherapy and hormone therapy.
    • Palliative treatment. The aim of palliative treatment is to relieve the symptoms and side effects of primary and adjuvant treatment, not to cure.

    There are various methods of cancer treatment, which are chosen based on the type and level of cancer malignancy suffered by the patient. The commonly used methods are as follows:

    • Surgery. The purpose of surgery is to remove cancerous tissue that is in the body as much as possible.
    • Chemotherapy. It is a cancer treatment using chemical compounds in the form of drugs.
    • Radiotherapy. Is a cancer treatment by using high-energy rays to kill cancer cells. Radiotherapy can use radiation from outside the body (external siner radiation) or planted in the patient's body (brachytherapy).
    • Stem cell transplantation. Stem cell transplants are also called bone marrow grafts that play a role in producing blood cells. Transplanted stem cells can come from patients or from stem cell donors. In addition to being done to replace bone marrow that has abnormalities or malignancy, stem cell transplantation can also be done to provide an opportunity for doctors to use chemotherapy with higher doses of other types of cancer.
    • Immunotherapy . Immunotherapy is also known as a biological therapy that aims to help the immune system recognize cancer cells and then kill them. Cancer cells if not combated by the immune system can spread uncontrollably and endanger patients.
    • Hormone therapy. Some types of cancer can appear triggered by hormones such as breast and prostate cancer. Reducing or eliminating levels of this hormone in the body can stop the growth of cancerous tissue.
    • Targeted drug therapy. Provision of drugs that can kill only abnormal cells, without attacking healthy cells.

    Both cancer and cancer treatment can weaken a person's immune system. Cancer can weaken the immune system if cancer cells spread to the bone marrow where white blood cells are produced. Generally, leukemia and lymphoma cancers can weaken the immune system but some other types of cancer can also contribute to weakening the immune system.

    Like the treatment of other diseases, cancer treatment has side effects on the body. One side effect is lowering the number of blood cells in the body and slowing down blood production.

    At the beginning of treatment, the number of white blood cells will decrease. Under normal conditions, white blood cells that experience death will be replaced with new white blood cells for a week or two.

    However, a cancer treatment that is being undertaken can slow down the regeneration process of white blood cells. This condition can weaken the patient's immune system so that patients are more susceptible to secondary infections due to the weak immune system.

    Red blood cells normally have an age of about three months so that the process of regenerating red blood cells is slower than white blood cells. Cancer treatment, especially chemotherapy can reduce the number of red blood cells so that people who do not have the risk of anemia can get anemia. If the number of red blood cells is very small, blood transfusions can be performed for the patient.

    Platelets (platelets) can also decrease due to cancer treatment. Symptoms of decreased blood platelets can be observed from the occurrence of nosebleeds, bruises or red rashes on the skin. These side effects can be overcome by giving platelet transfusions to patients. Generally, after the patient has received chemotherapy in the long term, platelets take longer to increase to normal amounts than other blood cells.

    How Cancer Can Reappear (Relapse)


    Cancer can reappear to someone after treatment in cancer patients. Some of the recurrences of cancer are explained as follows:

    • Relapse after surgery. Cancer can reappear in cancer patients who have undergone surgical treatment due to the following:
      • Some cancer cells are still left in the body after the removal of cancer tissue.
      • Cancer cells have spread from the original organ of cancer before surgery is done.

    The surgeon who performs cancer removal in the patient will make every effort to eliminate all cancer cells. But there is still a possibility that a small percentage of cancer cells are left in the patient so that they can reappear and cause relapse. To overcome this, doctors will recommend additional treatment after surgery so that all cancer cells can be killed. Additional treatment can be in the form of chemotherapy, radiotherapy, immunotherapy, and hormone therapy.
    • Relapse after chemotherapy. The working principle of chemotherapy is to kill cells that are in the phase of cell division. Chemotherapy is given regularly with the aim of killing all cancer cells in patients even though they have different cleavage times.

    However, like surgical removal of cancer, chemotherapy cannot completely kill cancer cells. A small percentage of cancer cells will be left behind after the last chemotherapy so there is a possibility that the cancer will recur. To overcome this possibility the doctor will try as much as possible so that some cancer cells can be killed through chemotherapy. The rest of the cancer cells will be killed through the patient's immune system or will die automatically.
    • Relapse after radiotherapy. During radiotherapy, healthy cells around the cancer tissue will also suffer damage even though they will return to their own health. The same thing happens with cancer cells, especially if there are several cells that are not killed through radiotherapy.
    • Relapse after biological therapy. Some types of biological therapy function to kill cancer cells but some only shrink the size of cancer without killing it. Like other therapies, biological therapy can also leave a small portion of post-treatment cancer cells that can grow and reappear in the future.

    In order for cancer treatment given to patients to kill cancer cells as much as possible, patients will generally be given a combination of several therapies.

    In some cases, cancer cells can be resistant to the treatment of cancer making it more difficult to treat. Cancer cell resistance arises due to mutations that occur in cancer cells continuously so that the cell's genetic properties change. If this happens, the doctor will provide several types of treatment combinations to the patient. In some rare cases, after a combination of treatments cancer still has resistance. This condition is called multi drug resistance.

    Cancer Prevention


    Some things that can be done to prevent cancer are as follows:

    • Stop smoking. Smoking can increase a person's risk of developing various types of cancer, especially lung cancer.
    • Avoid excessive sunburn. Harmful ultraviolet light from the sun can increase the risk of developing skin cancer. Avoid sunburn by staying in the shade, using closed clothes, or using sunscreen.
    • Regulate a healthy diet. Expand to eat fruits, vegetables, whole grains (such as wheat), and foods that are rich in protein.
    • Exercise regularly every week. Regular exercise has an effect on reducing a person's risk of cancer.
    • Maintain weight. Experiencing a condition of obesity or being overweight can increase a person's risk of cancer. To maintain weight so that it can remain ideal through maintaining a healthy diet and regular exercise.
    • Reduce and stop drinking alcohol. If you actively consume alcohol, limit the amount of consumption to 1-2 times every day.
    • Schedule routine cancer screening checks.
    • Vaccination consultation with a doctor. Some types of cancer are caused by viruses so that they can be avoided by vaccination. Examples of cancers that can be avoided by vaccination are cervical cancer caused by HPV infection and liver cancer caused by viral hepatitis infection.

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