What is Cancer?
Sometimes, this cycle is broken, too many cells are formed beyond the body's control, or old cells do not die when they should. The tissue mass formed due to the uncontrolled growth of these abnormal cells is called a tumor. Tumors can be benign or malignant. Malignant ones, namely cancers, seriously threaten life; sometimes they can be removed from the body but can regrow, meaning they can recur.
Cancer cells can spread to and damage neighboring organs and tissues. They can jump to neighboring and distant organs and form new tumors.
Causes of Cancer (Risk of Cancer)
What Factors Cause Cancer?
Cancer development occurs after a very complex set of mechanisms. Today, it is accepted that cancer is a genetic disease. This means that cancer can't develop without changes in the genetic makeup of a normal cell. The development of cancer is the result of successive carcinogenic effects. Different defense mechanisms correct each of the disorders observed in cancer development, and our immune system also plays an active role in recognizing and eliminating such disorders. However, cancer can still develop despite these. The main reasons for this are the ineffective defense mechanisms and deficiencies in the immune system. As a result, cells that have gained the quality of cancer find the opportunity to multiply in excessive amounts and cause the disease tables we know as cancer.
Scientific studies show that factors such as the following increase the risk of developing cancer.
External Factors (85%): Smoking, alcohol, chemicals, radiation, some infections, unhealthy diet, air pollution, lack of activity and being overweight
Internal Factors (15%): Hereditary causes, changes, immune deficiencies, hormonal and metabolic disorders.
These factors can initiate cancer formation by acting together or sequentially.
Cancer Stages
Cancer Staging
In light of the results of many scientific studies, various stagings have been made in cancer diseases as it is essential to know whether cancer patients will receive treatment or not, to determine the most effective treatment methods they will receive treatment, to obtain information about the possible expected life expectancy of cancer patients.
In cancer, staging is done in solid organ cancers as stages 1-2-3-4 according to tumor characteristics such as tumor diameter, called TNM for short, lymph node involvement, M= distant metastasis, and staging as four stages and subgroups. In addition to this staging, another staging system called the FIGO staging system is also used in gynecological cancers.
In addition to staging in solid organ cancers, another essential form of tumor grading is grading from 0 to 4 according to the tumor's degree of differentiation (differentiation) from the best to the worst. Patients with good grade (0-1 grade) tumor types in this type of evaluation and stage 1-2 early-stage cancer in TNM staging have a much higher rate of cure with treatments, and the survival time and rates of these early-stage cancer patients are also very high.
Surgery or sometimes radiotherapy alone is sufficient for most early-stage cancers. Chemotherapy is often added to treatments in intermediate and advanced cancers with stage 3-4 and grade 2-4 cancers. The treatment of these moderate-advanced cancer patients is more complex, and their survival rates and rates seem to be lower than those with early-stage cancer.
The Ann Arbor Staging system is used for lymph node cancers, and the World Health Organization (WHO) staging system, often called WHO, is used for blood cancers. According to the stages in these systems, the disease is evaluated as early, moderate, or advanced, and treatment planning is made accordingly.
In addition, brain cancers are graded from first to fourth degree, and according to the grade of the tumor, radiotherapy and chemotherapy treatments are planned in addition to surgery.
As a result, staging in cancer is a critical process for planning the treatments for cancer disease, estimating the survival times brought by the disease, and evaluating cancer most accurately by all relevant physicians in a multidisciplinary manner and making the most accurate decisions.
In cancer patients, the most crucial action that an oncologist should do at the time of cancer diagnosis should be the staging evaluation.
Cancer in Turkey and the World
Cancer is the most common cause of death after cardiovascular diseases in Turkey and in the world. Lung cancer in men and breast cancer in women are the most common cancers worldwide. Certain cancers are more prominent in different geographies of the world. An increase in cancer types such as stomach cancer in East Asian communities, HPV-related cervical cancer in South Asia, hepatitis, HIV, HPV, etc. virus-related cancers in African communities, and breast and colon cancers in developed Western societies have been detected. There is an increasing trend in stomach, colon, and breast cancers all over the world and in Turkey. When we look at the frequency of cancer in Turkey, lung-bronchial and prostate cancers are observed most frequently in men, while breast and thyroid cancers are prominent in women. Prostate and colon cancers, which are increasing in developed Western societies, have started to be an increasing type of cancer in our country. Differences in the incidence of cancer types have been revealed in the world and Turkey according to the increase in life expectancy, diet, exposure to environmental carcinogenic substances, and the frequency of cancer-related virus infections.
What is Oncology?
The branch of medicine that studies tumors is called Oncology. It is an idiom formed by combining the Latin words oncos (= swelling) and logos ().
What are the Disciplines Dealing with Oncology?
These are surgical oncology, medical oncology, and radiation oncology. Joint work allows for more careful monitoring of patients' treatment and follow-up. Surgical oncology is very effective in diagnosing the disease and removing the patient's existing tumor.
This group includes many surgical disciplines (General Surgery, Otorhinolaryngology, Neurosurgery, Thoracic Surgery, orthopedics, etc.). Treatment is continued with cancer drugs and radiotherapy in patients who are diagnosed after surgical treatment or in those who have a disease that has spread beyond surgery. Medical oncology carries out drug treatment of cancer diseases (Pediatric Oncology for children), and Radiation Oncology performs radiotherapy. From all these processes, cancer requires more than one medical discipline to work together.
Frequently Asked Questions
What should I do when cancer is suspected or diagnosed?
A medical oncology specialist specializing in the follow-up and treatment management of cancer patients should be consulted.
There are so many recommendations; how should I decide on my treatment?
When it comes to a severe disease such as cancer, the suggestions coming from other patients can be very diverse and confusing, even demoralizing. Getting a second opinion from another specialist physician may help increase treatment accuracy and comfort.
What will happen to me in cancer treatment?
Patients may encounter surgery, radiotherapy, chemotherapy, radioactive drug treatments, or some interventional radiological methods during the treatment process.
What are the units involved in cancer treatment?
Surgical branches include organ-specific tumor surgery units (e.g., gynecological and surgical oncology), radiation oncology, and medical oncology.
Is it necessary to apply surgery, radiotherapy, and chemotherapy?
No. The treatment method that should be applied varies according to the organ where the cancer originates, the cell type, and the stage of the disease.
Is it dangerous to have surgery to treat cancer?
Contrary to this famous saying, surgery cures the disease if expert and experienced surgeons do it.
How is the order of treatment determined?
The current treatment for oncology patients, as well as the treatment methods to be applied and their order, are decided using a multidisciplinary approach organized with the participation of the relevant branches in the oncology councils formed in the appropriate centers.
Is chemotherapy necessary?
It would not be correct to say that it is necessary. As mentioned before, the methods to be applied for the patient vary according to the organ, cell type, and cancer stage. Some cancer types cannot be treated without chemotherapy (for example, leukemia and lymphoma).
When and how should the surgery be performed?
Surgery is the curative treatment option for some types of cancer in the early stages (for example, breast cancer, colon cancer, etc.). However, surgical treatment can be applied in some advanced cancers if certain conditions are met.
What is radiotherapy, and how is it applied?
The tumor uses it in a region by using some radioactive elements and directing the generated radiation to generate dangerous areas through throughs.
How can I use integrative medicine, i.e., complementary therapies?
Since this subject is a field that is prone to abuse, it is recommended to apply to medical doctors who are certified in the field of integrative medicine, i.e., complementary medicine, and who have knowledge and experience in this field.
What do smart drugs mean, and how is their application decided?
With the increase in molecular discoveries in recent years, molecular targets have been found in some cancer types. As a result of long research, drugs targeting these molecular points have been developed, and new ones are added to them every day. Thus, targeted drugs that hit cancer more precisely are designed for different types of cancer. Cancer cells must have these targets (biomarkers) for them to be used. These biomarkers should be examined during the pathological examination of cancer cells by unique staining methods or by subjecting them to special genetic examinations.
Why is genetic testing done for treatment, and at what stage is it necessary?
The previous question also explained the reason for using genetic tests. These genetic tests are required before administering systemic chemotherapy to the patient.
