- Papilloma - A projecting mass on the skin (for example, a wart)
- Adenoma - A tumor that grows in and around the glands
- Lipoma - A tumor in fatty tissue
- Osteoma - A tumor originating in the bones
- Myoma - A tumor of muscle tissue
- Angioma - A tumor usually composed of small blood or lymph vessels
(for example, a birthmark)
- Nevus - A small skin tumor of one variety of tissues (for example, a mole).
- Carcinomas. These cancers originate in the epithelium. The epithelium is the lining cells of an organ. Carcinomas are the most common type of cancer. Common sites of carcinomas are the skin, mouth, lung, breast, stomach, colon and uterus.
- Sarcomas. Sarcomas are cancers of connective and supportive tissue (soft tissues) of all kinds. Sarcomas can be found anywhere in the body, and they often form secondary growths in the lungs.
- unaccountable weight loss
- unusual bleeding or discharge
- persistent indigestion
- the presence of white patches inside the mouth or white spots on the tongue
- Self-exams
- Biopsy (the removal of living tissue for the purpose of microscopic
examination of cells)
- Ultrasound (the use of reflected high-frequency sound waves to differentiate
various kinds of tissue)
- Computed tomography (CT) (the use of x-rays to produce a cross-sectional
picture of body parts)
- Magnetic resonance imaging (MRI) (the use of magnetic fields and radio waves to show changes in soft tissues without the use of x-rays).
- Reduce or avoid exposure to known or suspected carcinogens or cancer-promoting
agents, including cigarettes and sun exposure.
- Eat a balanced diet that includes vegetables, fresh fruit, whole grains,
and adequate amounts of fiber.
- Reduce the amount of fat and preservatives in the diet, including
smoked and salt-cured meats.
- Participate in regular exercise.
- Obtain adequate, consistent periods of rest (at least 6 to 8 hours
per night).
- Eliminate or reduce stress and enhance the ability to effectively
cope with stress.
- Go to annual health check-ups.
- Enjoy consistent periods of relaxation and leisure.
- Learn to practice self-examination (breast and testicular).
- Seek immediate medical care if cancer is suspected.
- unusual mass or swelling
- unexplained paleness
- loss of energy
- sudden tendency to bruise
- persistent, localized pain or limping
- prolonged, unexplained fever or illness
- frequent headaches, often with vomiting
- sudden eye or vision changes
- excessive, rapid weight loss.
Overview
Cancer is not a single disease. It is a group of more than 200 different diseases. Cancer can be generally described as an uncontrolled growth and spread of abnormal cells in the body. Cells are basic units of life. All organisms are composed of one or more cells. Normally, cells divide to produce more cells only when the body needs them.
Sometimes cells keep dividing and thus creating more cells even when they are not needed. When this happens, a mass of tissue forms. This mass of extra tissue is called a tumor. Tumors are found in all kinds of tissue, and can be benign or malignant.
Tumors
Benign
Benign tumors are not cancer. They usually can be removed and, in most cases, they do not come back. Most important, cells from benign tumors do not spread to other parts of the body. Cells from benign tumors stay together and often they are surrounded by a containing membrane. Benign tumors are not usually a threat to life.
Examples of Benign TumorsMalignant
Malignant tumors are cancer. Cancer cells can invade and damage tissues and organs near the tumor. Cancer cells also can break away from a malignant tumor and enter the lymphatic system or the bloodstream, which is how cancer can spread to other parts of the body. The characteristic feature of cancer is the cell's ability to grow rapidly, uncontrollably, and independently from the tissue where it started. The spread of cancer to other sites or organs in the body through the blood stream or lymphatic system is called metastasis.
Malignant tumors generally can be classified in two categories.
Characteristics of Benign and Malignant Tumors
| Characteristic | Benign | Malignant |
| Differentiation | Tumor cells resemble the original mature cells | Tumor cells might not resemble the original mature cells |
| Growth Rate | Slow; might stop or regress | Rapid, autonomous; usually does not stop or regress |
| Type of Growth | Expand and displace | Invade, destroy, and replace |
| Metastasis | No | Yes |
| Health Effect | Usually does not cause death | May cause death if not diagnosed and treated |
Some Causes of
Cancer
Different types of cancer have different causes and are likely
to depend on many factors. Some cancers are more common than others, and
chances for survival vary among different types. Most cancers do not have
known causes from a chemical, environmental, genetic, immunologic, or
viral origin. Cancers also can arise spontaneously from causes that are
thus far unexplained.
The causes of cancer are very complex, involving both the cell and factors in the environment. Much progress has been made in identifying possible causes of cancer, including:
Chemicals and other substances. Being exposed to substances such as certain chemicals, metals, or pesticides can increase the risk of cancer. Any chemical that is known to cause cancer is called a carcinogen. Asbestos, nickel, cadmium, uranium, radon, vinyl chloride, benzidene, and benzene are examples of well-known carcinogens. These may act alone or along with another carcinogen, such as cigarette smoke, to increase the risk of cancer. For example, inhaling asbestos fibers increases the risk of lung diseases, including cancer, and the cancer risk is especially high for asbestos workers who smoke.
Tobacco. The most common carcinogens in our society are those
present in cigarette smoke. Tobacco smoke is known to contain at least
60 carcinogens and 6 developmental toxicants. In addition to being responsible
for 80 to 90 percent of lung cancers, cigarette smoking is also associated
with cancers of the mouth, pharynx, larynx, esophagus, pancreas, kidney,
and bladder.
Avoiding tobacco products is one way to decrease a person's risk of cancer.
Ionizing radiation. Certain types of radiation, such as x-rays, rays from radioactive substances, and ultraviolet rays from exposure to the sun, can produce damage to the DNA of cells, which might lead to cancer.
Heredity. Certain types of cancer occur more frequently in some families than in others, indicating some inherited predisposition to the development of cancer. Even in these cases, however, environment plays a part in the development of cancer.
How Cancer Develops
Cancer can develop in people of all ages, but it is more common in people
over 60 years old. One of every three people will develop cancer at some
point in their lives. Because people are living longer, the risk of developing
cancer is increasing.
The development of cancer is a long process that usually starts with genetic changes in the cells, and continues in the growth of these cells over time. The time from genetic change to development of cancer is called the latency period. The latency period can be as long as 30 years or more. This means that some cancers diagnosed today may be due to genetic changes that occurred in the cells a long time ago.
Theoretically, the body develops cancer cells continuously, but the immune system recognizes them as foreign cells and destroys them. The body's ability to protect itself from cancer can be impaired by some drugs and viral infections.
Symptoms of Cancer
Everyone should be familiar with certain signs that may indicate early
cancer. It is important to report them immediately, before the condition
spreads. It is unfortunate that early stages of cancer are typically painless;
because they are painless, diagnosis and treatment are often delayed.
Early symptoms can include
Detection of Cancer
Early detection and prompt treatment are directly responsible for increased
survival rates.
Tools for cancer detection include
Risk Factors for Cancer
Because cancer is not a single disease, it does not have a single cause.
Many causes or risk factors can contribute to a person's chance of getting
cancer. Risk factors are different with each type of cancer. It is important
to remember that 1 in 3 people will develop a cancer during their lifetime.
Risk factors can include such things as age, race, sex, genetic factors, diet, and exposure to chemicals, radiation, and tobacco.
Genetics play a large role for many cancers, such as breast and colon cancer. This means that a family's health history can be a risk factor for some types of cancers.
Lifestyle Factors
Personal choices we make about the way we live our lives can increase
our chance of developing cancer. These choices are called lifestyle factors,
and they include smoking, heavy drinking, and eating foods that have excess
calories, high fat, and low fiber. Other factors that increase risk are
related to sexual contact and sunlight exposure.
Tobacco
Thirty percent of all cancers are attributed to smoking or chewing tobacco.
Cigarette smoking is also associated with cancers of the mouth, pharynx,
larynx, esophagus, pancreas, kidney, and bladder.
Diet
Researchers found that different types of food you eat affect your risk
of developing cancer. Approximately 30% of cancers are related to diet.
Infectious Agents
Some viruses have the ability to transform cells into cancer. Examples
include (a) human papilloma virus (HPV) and cervical cancer, and (b) Epstein-Barr
virus and lymphoma.
Occupational Exposure
Occupational exposure includes high-risk occupations such as uranium miners,
asbestos factory workers, certain chemical plant workers, and workers
in nuclear power plants.
Reproductive Factors
The reproductive factors category refers mostly to women's risk factors.
For example, the risk of breast cancer goes up if a woman does not have
children before the age of 30. Sexually transmitted diseases also increase
the risk of cervical cancer.
Sedentary Lifestyle
Not moving around much during the day may increase the risk of cancer.
The body's own defenses work better when you exercise and maintain an
ideal weight. Moderate exercise such as walking or climbing a flight of
stairs can help.
Alcohol/Drugs
Alcohol contributes to the risk of developing cancer. People who drink
too much or abuse drugs may not eat well or take care of themselves, which
will increase their overall risk of cancer.
Pollution
Although people think environmental pollution is a major of cancer, in
fact few cancers have been found to be caused by pollution, but research
is still ongoing. The cause of many cancers is not known. Other factors
that interact to increase the risk of cancer are age, hormonal balance,
response to stress, and status of the immune system.
Risk and Protective Factors in the Development of Cancer
| Protective Factors | Risk Factors | ||||||
|---|---|---|---|---|---|---|---|
| Type of Cancer |
Vegetables | Fruits | Physical Activity |
Alcohol | Obesity | Tobacco Use |
Environmental Exposure |
| Lung | GL | SL | ML | MR | HR | SR | |
| Colon/Rectum | GL | GL | SR | MR | MR | ||
| Breast |
SL | SL | ML | SR | SR | ||
| Prostate |
ML | MR | |||||
| Stomach |
GL | GL | MR | ||||
| Oral/Pharynx |
GL | GL | MR | HR | MR | ||
| Kidney | ML | SR | MR | ||||
| Ovary |
ML | ML | |||||
| Pancreas |
SL | SL | HR | ||||
| Liver |
ML | HR | MR | ||||
| Cervix |
ML | ML | HR | ||||
| Bladder |
SL | SL | HR | SR | |||
| Esophagus | GL | GL | HR | HR | MR | ||
| Larynx |
SL | SL | HR | HR | MR | ||
| Thyroid |
ML | ML | SR | ||||
| Uterus |
ML | ML | HR | ||||
| Gallbladder |
MR | ||||||
| Nasopharynx | SR | MR | |||||
GL = Greatly lowers your risk
SL = Somewhat lowers your risk
ML = Might lower your risk
SR = Somewhat raises your risk
MR = Might raise your risk
HR = Highly raises your risk
Adapted from: Westcott S. A Journey Into Cancer's Causes. Anchorage (AK): Alaska Native Health Board; 1999. p. 11.
Cancer and Children
It can be especially difficult to understand and accept when a child develops cancer. The most common cancers in children are leukemia, brain tumors, and lymphomas. Nearly 1 in 450 children will be diagnosed with cancer before the age of 15.
Many pediatric cancers occur very early in life and many parents want to know why. The cause of most childhood cancers is not known, although some of these cancers are the result of genetic predisposition (cancer runs in the family). Radiation exposure also contributes to certain types of childhood cancers. Other factors that have been implicated in childhood cancers include infectious diseases, prenatal conditions, environmental pollutants, electromagnetic fields, and use of medications.
Unlike most cancers of adults, childhood cancers are not significantly related to lifestyle risk factors such as tobacco or alcohol use, poor diet, or not enough physical activity. Many organ systems in children are undergoing rapid growth and development in the first years of life. These systems are especially vulnerable to injury during these periods of development.
The types of cancer that occur in children vary greatly from those seen in adults.
Most Common Cancers in Children and Adults
| Children | Adults |
|---|---|
| Leukemias: acute lymphocytic (lymphoblastic) | Lung |
| Brain and Other nervous system tumor: neuroblastoma | Breast (carcinoma) |
| Lymph-node cancers (lymphomas) | Colorectal |
| Bone (osteosarcoma) | Prostate |
| Soft-tissue sarcomas: rhabdomyosarcoma | Skin (melanoma) |
| Kidney: Wilms tumor | |
| Eye: retinoblastoma | |
| Adrenal gland (adrenocortical carcinoma) |
This information on children and cancer was compiled from "Childhood Cancer-General Statement", published by the American Cancer Society.
Acute lymphocytic leukemia (ALL) is the most common childhood malignancy. ALL accounts for almost one-third of all childhood cancers.
Brain and spinal cord cancers are the second most common cancers
in children. Most brain cancers of children involve the cerebellum or
brain stem. Adults are more likely to develop cancers in different parts
of the brain -- usually the cerebral hemispheres. Spinal cord tumors are
less common than brain tumors in both children and adults.
Bone cancer is uncommon. The incidence of primary bone cancer (cancer
starting in bones) is highest in children and adolescents. Cancer that
spreads to the bones is more common than primary bone cancer in all age
groups. Osteosarcoma is the most common type of primary bone cancer in
children and young adults. Ewing sarcoma is a less common primary bone
cancer that occurs mostly in children and adolescents.
Detecting Cancer
in Children
Cancers in children are often difficult to recognize. Parents should take
their children to regular medical checkups and should be alert to any
unusual signs or symptoms that persist. It is important to report unusual
signs or symptoms to a health care provider.
What About Chemicals in the Environment?
"All substances are poisons: there is none which is not a poison. The right dose differentiates a poison and a remedy."
Environmental pollutants are only one of the many connections between cancer and our lives. Not all contaminants are deadly or even cause disease.
The amount of a contaminant a person is exposed to
plus the length of time that person is exposed
plus how many times that person is exposed
plus how the person was exposed
equals whether a person will experience negative health effects from an
exposure.
Exposures to some chemicals in the environment, at home, and at work
may contribute to an individual's risk of developing cancer. Toxic substances
such as benzene, asbestos, vinyl chloride, and arsenic can increase the
risk of cancer in those exposed to them. The International Agency for
Research on Cancer (IARC) classified these substances as known human carcinogens
because studies showed a link in humans between exposure to these substances
and cancer.
Some chemicals have been shown to cause cancer in animals, but there is
not enough evidence to show that these chemicals also cause cancer in
humans. These chemicals are classified by IARC as possibly or probably
carcinogenic to humans. Chloroform, DDT, formaldehyde, and polychlorinated
biphenyls are examples of such chemicals.
Most of what we know about chemicals and cancer in humans comes from scientists' observation of workers. The most significant exposures to cancer-causing chemicals have occurred in workplaces where large amounts of toxic chemicals have been used regularly.
The amount of toxic chemicals found in food, air, and drinking water are typically much lower than those in the work environment. Therefore, cancer risk from environmental exposures is thought to be lower compared to the risk in occupational settings. In fact, the cancer risk from environmental exposures is often difficult to measure.
Environmental Toxicants
Environmental toxicants are classified by the National Toxicology Program as (a) known human carcinogens and (b) reasonably anticipated to be (suspected) human carcinogens to differentiate the level of evidence available to support the carcinogenicity of a probable toxicant. Carcinogens include a wide diversity of synthetic and naturally occurring substances, including hormones, immunosuppressants, organic and inorganic chemicals, and cytotoxins.
It is difficult to study populations living near a hazardous waste site and determine if their cancers are associated with exposures. A major difficulty for those studying these populations is not knowing the exact level of individual exposure to a carcinogenic agent. Waste sites often contain more than one chemical, which makes it difficult to associate health outcomes to a single exposure. Often other variables must be accounted for before making any associations of the disease outcome to a given exposure from the site.
Because of the long latency period of cancer development and the type
of behavioral risk factors associated with cancers (such as tobacco use,
alcohol consumption, and diet), it is difficult to collect information
about environmental exposures that occurred years ago.
A List of Known and Suspected Human Carcinogenic Agents by Organ
Human Carcinogenic Agent |
||
| Organ | Known | Suspected |
|---|---|---|
| Lung | Arsenic Asbestos Benzo(a)pyrene bis(Chloromethyl)ether Chromium Nickel subsulfide Zinc chromate Tobacco smoking Mustard gas Uranium |
Acrylonitrile Beryllium Cadmium 1,2-Dibromo-3-chloropropane Polyclic aromatic hydrocarbons (PAHs) |
| Kidney | Coke oven emissions Zinc chromate |
Tetrachloroethylene |
| Bladder | Benzidine Tetrachloroethylene Cyclophosphamide 4-Aminodiphenyl Tobacco smoking Chloraphazine |
Tetrachloroethylene |
| Stomach | Zinc chromate | Ethylene oxide |
| Skin | Arsenic Benzo(a)pyrene Overexposure to the sun |
PAHs Tetrachloroethylene |
| Liver | Vinyl chloride Aflatoxin Alcoholic drinks |
|
| Mouth, pharynx, larynx, esophagus |
Alcoholic drinks Tobacco smoking Tobacco chewing (mouth only) Mustard gas (larynx) |
|
| Prostate | Cadmium | |
Source: Lybarger JA, Spengler RF, DeRosa CT, editors. Priority health conditions: an integrated strategy to evaluate the relationship between illness and exposure to hazardous substances. Atlanta: Agency for Toxic Substances and Disease Registry; 1993. p. 61.
For more information about Cancer:
Contact your Health Care Provider
Your local American Cancer Society Chapter
or visit the following sites on the Internet:
http://cancernet.nci.nih.gov
http://www.yourcancerrisk.harvard.edu/
http://www.cdc.gov/cancer
http://www.acor.org
http://www.pbs.org/wgbh/nova/cancer
References
Mosby's Patient Teaching Guide, Editor, Harrison, Alison (1995), Mosby Year Book, Inc.
Medical/Surgical Nursing, 5th Edition, (2000), Lewis, Sharon; Heitkemper, Margaret; Dirksen, Shannon; Mosby.
A Journey Into Cancer's Causes, Wescott, Siobhan, (2001),, Alaska Native Health Board
Professional Guide to Diseases, (1995), 5th Edition, Springhouse Corporation
The Human Body in Health and Disease, 7th Edition,(2000) Memmler, R.; Wood, D.; Lippincott Williams & Wilkins
Memmler's Structure and Function of the Human Body, 7th Edition (2000); Cohen, B.; Wood; D; Lippincott, Williams & Wilkins
What You Need to know about Cancer of the Cervix, (1994), National Institutes of Health, National Cancer Institute
Priority Health Conditions: An Integrated strategy to Evaluate the Relationship Between Illness and Exposure to Hazardous Substances; (1993); Lybarger, J.; Spengler, R.; DeRosa, C.; Agency for Toxic Substances and Disease Registry
Cancer Warrior, NOVA On-Line, (2001); www.pbs.org/wgbh/nova/cancer
Cancer Source Book for Nurses, 7th Edition; (1997); American Cancer Society
Cancer Facts and Figures 2001; (2001); American Cancer Society
Childhood Cancers; (2001); Pediatric Oncology Resource Center, www.acor.org.diseases/ped-onc/diseases/diseases.html
NCI Fact Sheet: National Cancer Institute Research on Causes of Cancers
in Children; (1999);
www.oncolink.upenn.edu/pdq_html
Cancer Information Service; www.fhcrc.org/cipr/pnwcis
For more information,
contact ATSDR's toll-free information line:
(888) 42-ATSDR. . .(888) 422-8737
Agency for Toxic Substances and Disease Registry, 1825 Century Blvd, Atlanta, GA 30345
Contact CDC: 800-232-4636 / TTY: 888-232-6348
