10.(14-15) Cancer Prevention/Treatment Continues

Physician's Notebooks 10 - http://physiciansnotebook.blogspot.com - See Homepage
Update 22 Septr 2021.
 The following descending column of contents in order of appearance in text is for chapters 14 and 15 as noted. Use it as guide and for finding a subject.

Cancer Treatment and Risk Factor

A cancer's development from single cell

Immune Surveillance

 A virus causes cancer because it affects DNA

Things that Affect Risk Factors

Age range of high risk affects precautions

Heredity

Exposure to home and other environmental carcinogen

The question of estrogen causing breast and uterine cancer

Principle of Surveillance for Early Stage

A cancer's development from single cell allows estimate of time between cell divisions and size from 1 cell to an X-centimeter diameter lump. For most cancers it is several years from first cell to tumor first felt. The shorter the time to reach a specified size lump, the more malignant the cancer. For much of this time the slower growing cancers could be cured by removal of the lump. This gives a principle of early cancer screening to pick up cancer early as possible in the hope it is curable.

Immune Surveillance comes in here. We each have an immune system whereby our immune cells look for cancer mutation and, if they find it and can get at it, will destroy it. Its being imperfect is shown by the success of cancer cells to kill its human host but it explains why an early clump of cancer does not quickly spread and kill rapidly. And it shows the importance of a good immune system. Person with weakened immune system (AIDS, effect of radiation on body, medications like cortisone and for anti-immune organ transplant) gets cancer more easily, more frequently and more malignantly. So good nutrition, avoiding infection, avoiding unnecessary radiation, and keeping organs in top shape is important.

   A virus causes cancer because it affects DNA. This is a complex area for prevention. With Epstein-Barr virus of infectious mononucleosis, it is good for a child to catch the virus early because the infected individual develops cancer-preventing immunity against the virus. But in other (herpes virus of sexual transmitted disease), it is good to get rid of the infectious virus quickly, or never catch it, and get immunized if a vaccine exists. So one needs to keep informed on a virus-by-virus basis.

Things that Affect Risk Factors: Knowing you may pass through an age range of high risk affects precautions. For example, brain cancer has 2 age peaks: as a child and after age 60. So this example shows the importance of being aware of cancer epidemiology. (Age and geographical connections to cancer risk.)

Heredity: Some well known connections are ovary and breast cancer in mother and daughter and a type of eye cancer in child. One can do early detection and avoid other risk factor. In 2021, cancer-causing gene arrays can be tested. So be alert to cancers in family members as possible markers for your risk.

X-ray and gamma-radiation: Here one makes effort from childhood to avoid radiation.

Exposure to home and other environmental carcinogen: Here one has to use knowledge and common sense to protect against the cancer-paranoia that may limit life. Before you make changes in what you eat and how you live, be sure to research it and make well informed and expert-assisted decision.

   Smoking cigarette (and anything else including marijuana) or any amount and even secondhand smoke will up the risk of cancer. High alcohol drink intake and hepatitis-B virus ups the risk for liver cancer (Get Hep B immunization!) as do birth control pill correlated with estrogen level; also steroid taken by sport hero. Also chronic drinking of hot beverage is risk factor of esophagus cancer.

The question of estrogen causing breast and uterine cancer, and androgen causing prostate cancer, and both causing liver cancer looms large because estrogen and androgen may be hyped or used as hormone therapy. This is area where the dosage, the reason for use, the method of administration, and the protection against risk come together. To say No! to hormone anti-aging therapy in women or men there should be balanced risk-benefit reason. But always say No! to sex steroids when they are taken merely for body appearance.

15. Cancer – Principle of Surveillance for Early Stage –

is realized in cytology, e.g., Pap smear. It is an idea that the earlier you discover cancer the easier and simpler is cure. It is correct so long as not carried out mindlessly. Each screening test has an agreed-upon interval for re-check based on the screening data, risk factor exposure, and previous normality in the tested tissue. What is often not emphasized is that, when one has accumulated consecutive normal or negative tests, the risk of the cancer screened-for becomes so low as not to justify a frequency of testing. For each type of test there is different advice based on the screening experience-data and I just want a reader to know the concept; then, she or he can research literature, ask experts, and have seminar on when to stop repeatedly normal testing and what is correct interval, given specific risk and age and past history of screening result.

   For women, important are Pap smear, breast screening, and pelvic ultrasound for ovarian tumor; and for men, blood test for prostate specific antigen (PSA), cyto smear on urine, digital rectal and ultrasound for prostate cancer after age 45, monthly self palpation of testes and inspection of penis uncircumcised tip. For any adult, other screening depends on risk. A smoker should have yearly chest x-ray (better to stop smoking) and sputum Cyto smear; an over-65 person should have an MRI brain-scan. Then there is GI-tract screen; start age 40 and continue on 5-yr and includes upper and lower GI tract scope and the ultrasound exam of abdomen that should cover kidneys, liver and gallbladder, pancreas and spleen and may be done as frequently as needed. But most screening may be tapered off and stopped by age 80 in healthy persons.

   Concerning skin cancer, the big risk factor is too much exposure to sunlight and any use of UV lamp; also fair complexion. (Albino at highest risk) The policy should be: If in doubt cut it out!  Or, in the original German, besser aus.

 END OF CHAPTER. To read next click 10.16 Secrets of Good Breast Cancer Survival