Cancer Overview

Diagnosis of cancer can cause a great load of stress on you and your family, but Güven Hospital is ready to help you.

We would like to inform you broadly on what the cancer is, symptoms to be considered for diagnosis, how it is detected, relevant treatments and the care process following the treatment.
What is Cancer?
Cancer is among the most feared diseases in the world. It is perfectly normal to go through intense emotions and be scared after this condition is diagnosed for you or your loved ones.

Diagnosis of cancer can cause a great deal of stress for you and your loved ones. Güven Hospital is ready to make best efforts to have you regain your health in an easy and comfortable way. Learning as much as you can about your diagnosis and treatment processes and sharing everything with your physician throughout the treatment process will help you cope with the disease.

As a definition, cancer develops after body cells start to grow more rapidly than needed for the body in an extraordinary pattern or rate. Rapidly growing cells transform into a formation, called tumor. Tumors may be benign or malignant.

What do stages of cancer imply?
Metastasis – spread of the tumor from the original site to other body parts – is one of the major source for anxiety and resultant questions. Your physician will designate a number to the tumor (From I to IV). The higher the number is, the more extensive the spread of cancer. Your treatment processes and plans may be modified depending on these stages.

Why does cancer occur?
There are various underlying reasons for cancer. Although you do not have control over hereditary factors (other family members with the disease), there are numerous controllable causes that are related to your lifestyle.

For example, smoking is one of the major causes, especially in the case of lung cancer. Smoking and other tobacco products or exposure to them may lead to cancer in mouth and larynx, esophagus and throat as well as various other body parts.

Other major causes of cancer:
• Diet/Nutrition: One should always maintain a balanced diet to be healthy. Eating a fatty and imbalanced diet constantly increases the risk of colon and prostate cancer. Excess weight and sedentary lifestyle may lead to a wide range of cancer, including but not limited to breast, uterus, ovaries, prostate and colon.

• Environmental Factors: Exposure to pesticides (a poison more commonly seen in agricultural products), asbestos and similar chemicals for a period of time may trigger a cancer. Paying attention to how and what we eat and where we live is crucial for our quality of life and health.

• Exposure to radiation While the sun is the source of life, overexposure (ultraviolet radiation) may lead to skin cancer. Also, heavy exposure to X-ray and radiotherapy (as a part of cancer treatment) are risk factors for cancer.

• Hormone therapy: Postmenopausal women may receive various hormone therapies. However, hormone medications can increase the risk of breast cancer when not used under medical supervision or not regularly taken.

What are symptoms of cancer?
The most obvious symptoms of cancer are:

An unusual lump in any part of the body.
Wounds that do not heal.
Pyrexia (fever).
Change in character of warts or moles.
Severe pain.
Persistent cough/hoarseness.
Weight loss with no identifiable cause
Solid and immobile lumps in breasts, arm pits or other body parts
Unusual weight loss
Changes in skin, more remarkably in moles and warts
Changes in bowel movements or urinary habits
Heavy gingival bleeding
Extraordinary bleeding or discharge in various body parts.
Coughing up blood and chronic cough
Indigestion or problems with swallowing.
Vaginal bleeding at unusual times
Blood in stool and long-standing defecation problems
Blood in urine (hematuria) and change in frequency of urination
Please remember that the above mentioned symptoms do not necessarily mean you have cancer. However, it is rational to visit your doctor, if you recognize any one of the symptoms.

How is cancer diagnosed?
If your physician suspects a cancer in the light of physical examination, he or she will order certain tests:

Blood tests and urinalysis
Imaging tests (Computed Tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, ultrasound, etc.)
Biopsy (Examining a small specimen of the tumor under microscope).
What are treatment options for cancer?
The type of treatment will vary depending on location and stage (whether metastasis is present) of cancer and overall condition of your body.

• Chemotherapy: This treatment modality uses potent drugs that destroy cancerous cells. Medicines are taken by mouth or they are administered into a vein.

• Radiation: It is based on the principle of killing cancer cells with radiation. Note: In certain cases, radiotherapy and chemotherapy can be combined.

• Surgery: The tumor and its surrounding area are removed by a surgeon (can be performed on selected patients).

• Hormone therapy: Various hormones may be administered in order to block the hormones that cause a cancer. Hormones may be administered to suppress secretion of certain hormones that cause prostate and breast cancer.

• Biological therapies: Biological therapies use natural or synthetic medications for reconstructing the natural defense of the body against cancer. Biological therapies include immunotherapy, gene therapy, vaccines, monoclonal antibody therapy and certain targeted treatments. (Monoclonal antibodies are developed at laboratories to function like natural antibodies, which are produced by the immune system in order to fight off the diseases. Monoclonal antibodies represent a member of immunotherapy modalities that is most commonly introduced to the clinical practice. The targeted cancers are mainly breast cancer, colon cancer and a number of blood cancers.)

• Immunotherapy: It is a type of biological therapy that utilizes certain substances affecting the immune system in order to help the body fight cancer, infection and other diseases. While immunotherapy can help an immune response to tumors through the substances used in immunotherapy, native body cells can also create this response. Certain types of immunotherapy target only specific cells of the immune system. Survival rates improve significantly when they are combined with conventional cancer treatments. Types of immunotherapy include Monoclonal Antibodies, Adoptive Immunotherapy, Cytokines and other therapies that support the Immune System.

• Stem cell transplantation: Stem cells (immature cells from which all blood cells originate) are collected from circulating blood or bone marrow of the patient and they may be directly administered into circulatory system through an intravenous route in order to replace the damaged or lost cells and repair tissues or organs; or may be directly injected into the tissue or organ intended to be repaired.

What are the side effects of cancer treatments?
• Chemotherapy: Hair loss, tiredness, nausea, vomiting.
• Radiation: Tiredness, hair loss and skin problems (dark discoloration, dryness, itching).
• Surgery: Pain and fatigue, other probable surgery-specific side effects.
• Hormone therapy: Tiredness, swelling, hot flashes, impotence, and blood clots.
• Biological therapies / immunotherapy: Flu (fever, shivering, muscle pain, etc.), skin rashes, swelling, cyanosis or increased tendency to bleeding.
• Stem cell transplantation: Nausea, vomiting, symptoms similar to flu and higher risk of infection.
What could happen after my cancer treatment is completed?
It is crucial to attend medical follow up visits regularly after the cancer treatment is completed. These controls may involve blood tests, overall health check-up or other investigations to detect any problems secondary to cancer treatment.

Regular and comprehensive care in post-treatment period is crucial for increasing the quality of life. Lifelong communication with your oncologist and strict compliance to his/her recommendations will help you overcome the problems you may face in any period of your life more easily.

Questions frequently asked in post-treatment period
You will find answers to the following questions following completion of your treatment but we are ready to answer any and all questions you may have.

• How long will it take me to recover and feel better?

• Which doctors should I visit for my follow up care and how frequently? 

• Which symptoms should I observe?

• Which work up should I have after treatment is completed and how frequently?

• What are the health problems I may face as a result of my cancer treatment?

• How likely is it for cancer to recur?

• Which records should I save regarding my treatment?

• What can I do to take better care of myself and be as healthy as possible?

Your post-treatment care schedule
Individualized care programs may be followed for each patient. These are determined according to:

• Type of your cancer.

• Type of your treatment.

• Potential problems related to the treatment and your overall health.

As a rule of thumb, you will be asked to visit your physician every three – four months for the first two to three years and once or twice a year thereafter following your treatment. You can also have the interviews online. Your physician may recommend other tests should they are deemed necessary.

What should you share with your physicians at follow up visits following the treatment?
It is crucial to openly discuss all physical and emotional problems with your physician. You do not have to spend your life anxiously monitoring all symptoms; although it is normal to be scared of any type of pain and ache; kindly remember that all you have to do is to share them with your physician.

Symptoms that you should notify your doctor:

• Physical problems that affect your daily activities, such as tiredness; urinary bladder, intestinal or sexual disorders; attention deficits; impaired memory; sleeping disorders; weight loss or gain.

• All medications, vitamins, medicinal herbs or food supplements that you started to take recently 

• Changes in medical history of your family.

• All emotional problems, such as anxiety or depression.

Your treatment summary
Your physician will provide you with a written summary of your treatment. It is rational to keep the summary with you in all doctor visits.

Summary of your treatment includes:

• Date of your diagnosis.

• Type of cancer

• Pathology report(s) describing type and stage of the cancer in detail

• Treatment reports.

• Contact details of all healthcare professionals who took a role in your treatment.

• Problems occurred during and after your treatment.

• All supportive care you received throughout your treatment (anti-depressants or anxiety medication; emotional support and food supplements, etc.).

Teaming up actively with your physician and receiving aid from other members of healthcare team are the preliminary steps of the treatment. Being aware of what to expect following your treatment will help you and your family for planning ahead, lifestyle changes and making important decisions.

For a healthy lifestyle following cancer treatment 
Remember that you will need to have certain priorities for a healthier and happier life following cancer treatment.

Quit smoking. Smoking after cancer treatment may increase the risk of cancer at the same or any other part of your body.

Quit alcohol consumption. Alcohol consumption increases your risk of cancer.

Body weight management. Well-balanced diet and an active lifestyle contribute in achieving a healthy body weight and overall health. You can discuss special nutritional needs with your physician and dietician.

Exercise and stay active. Research show that an active life after diagnosis of cancer decreases the risk of relapse. With moderate daily exercises for 30 minutes (walking, cycling and swimming), you can:

• Alleviate your anxiety and depression,

• Improve your mood and boost self-confidence,

• Relieve tiredness, nausea, pain and diarrhea.

In certain cases, you may require to take additional precautions while exercising. You should contact your physician before starting any exercising schedule and it is rational to be supervised by a professional.