Cancer can start anywhere in the body. They are a group of large cells that invades the organ or tissue and start growing aggressively if not controlled in time can lead to spreading to other parts of the body. Cancer is the second leading cause of death globally, accounting for an estimated 9.6 million deaths, or one in six deaths, in 2018.

Breast cancer is cancer that develops in the cells of the breast. Lobules are the glands that produce milk and ducts are the pathways that bring the milk from the glands of the nipples. The cancer cells are generally formed in these glands but they can also form in the fatty tissue or the connective tissue within your breast.

The lymph nodes are the general pathway that helps the cancer cells spread to the rest of the body parts. The unchecked cancer cells invade their way to healthy cells then can travel through lymph nodes under the arms.

Breast cancer cells can develop in both males and females, but it is most commonly diagnosed in females. It is the most common type of cancer. As per the American Society of clinical oncology 1 in 29 females develop breast cancer in India.

Breast Cancer Symptoms

In the early stages, it is difficult to detect breast cancer as it may not have any clear symptoms, sometimes the lump could be small making it hard to know. However, a mammogram could detect any abnormality.

The first symptom would a lump under your arms or on your breast that was not there before.

Other symptoms of Breast cancer are:

• Pain in the breast
• Rash around the nipples
• Inverted nipples
• Bloody discharge from the nipples
• Redness and pit around the breasts
• Change in the size and shape of the breast
• Any change of appearance of the skin on the breast or nipples

All lumps are not cancerous it could also be a benign cyst but if there is any lump or other symptoms it is ideal to visit a doctor to exam further.

Key steps to prevent developing Breast Cancer in the future.

There is no way one could prevent breast cancer. But certain lifestyle decisions in one’s life can decrease the risk of breast cancer.

1. Be active and maintain a healthy weight

It is necessary to have a healthy weight to prevent cancer. Hormone receptors can cause breast cancer cells to grow and develop. An increase in Hormone receptors can be caused due to excess fat in the body.

If you have a healthy weight maintaining it is very important as it decreases the chances of developing breast cancer. If you have an unhealthy try to get it under control through your diet. Adults should aim for at least 150 minutes a week of moderate activity.

2. Avoid alcohol and smoking

There are pieces of evidence that show a strong link between smoking and breast cancer. Smoking is unhealthy and is linked to several cancers including lung cancer. Based on research it is advised to take not more than one glass of alcohol per day as having alcohol at a small amount still puts one at risk.

The more you drink or smoke the higher the chance of developing breast cancer.

3. Regular visits to gynecologists and mammograms

It is ideal for women above the age of 40 to visit a gynecologist for an annual mammogram. Mammograms are effective to detect any abnormality and catching signs of cancer. Additional to regular visits and annual mammograms women should also self-examine their breasts as it will help to notice any changes in size and shape. Regular mammograms would not prevent cancer but help it detect at an early stage. If you detect any breast cancer symptoms it is important to communicate them to a doctor.

4. Hereditary Factor.

Few women are at a higher risk of developing breast cancer due to hereditary factors. If a close relative in one’s family has or had breast cancer then the person’s chance increase. Women who carry certain mutations in the BRCA1 and BRCA2 genes are genes that produce a protein that repairs damaged DNA. Everyone has two copies of this gene that we inherit from our parents. They are also called tumor suppressor genes as they have certain changes that are harmful (pathogenic) variants (mutation) that can also have a higher chance of developing it. You may need to do a DNA test and to diagnose this mutation.

5. Limitation in hormonal therapy

Discuss with your doctor the risks and benefits of hormonal therapy if you are taking it for menopause and chronic diseases. Combination hormonal therapy may put people at higher risk. That is why it is important to study and talk to your doctor regarding alternative medication and treatment.  If at all there is no substitute then consult your doctor and limit the dosage of medication.

Breast Cancer Treatment

Breast cancer treatment includes:

• Surgery

There are two types of surgery depending on the size of the tumor.

1. Lumpectomy- The tumor and small amount of healthy tissue around the tumor along with tissues under your arms are removed.
2. Mastectomy- The surgical removal of the entire breast.

• Chemotherapy

Chemotherapy is drugs used to destroy the cancer cells keeping the cancer cells from growing and multiplying.

It can be suggested to be given before surgery if the tumor is larger. As it will help it to shrink a bit making surgery go easier.

May also be given after surgery to reduce the risk of recurrence.

• Radiation

The use of high x-ray particles to destroy cancer cells.

After lumpectomy radiation therapy is advised 3-4 times per week that is if the cancer cells have not spread to lymph nodes.

After a mastectomy, it is usually given 5 days a week.

The length of your radiation therapy depends upon the tumor and spread of cancer cells.

Following few steps and adding them to your lifestyle could be lifesaving. Be vigilant regarding any changes that are unusual and consult your doctor.

Today, Cancer is one of the most enigmatic topics in the field of medicine. Even though we know cancer as one of the most dreadful diseases, there’s more to it. To beat or prevent cancer, it is important to know its significance inside out. To put some light on Cancer treatment and its diagnosis, Dr Abhinav Deshpande (MBBS, MS, Mch Oncology, FIAGES), a well-known Cancer Surgeon from Nagpur, specialized in surgical oncology and a fellowship in Robotic surgery shares his experience and knowledge about Cancer via AMTL – Add more to Life’s Facebook LIVE conducted on the topic- Understanding Cancer: Diagnosis and Treatment on 11^th February 2021 at 12 PM.

Here’s what Dr Abhinav Deshpande has got to say about the diagnosis and treatment of Cancer:

What is Cancer?

Very few people know the significance of the term ‘Cancer’. Cancer is derived from the Greek word Carcinos. Carcinos in layman’s term stands for ‘crab’. It is derived from this term because a crab has one main mass and its limbs spread in its underlying region. This formation of crab can be linked to Cancer. Because the swollen veins around a tumour mass resemble the limbs of a crab.

Cancer is not one particular disease. It is a group of diseases which involves the uncontrolled growth of abnormal cells.

 There are 3 important aspects to be considered while talking about Cancer.

–          Uncontrolled growth

–          Abnormal cells

–          Potential to spread or invade

Cancer is also known as ‘neoplasm’ or ‘malignant tumour’. This is very different from benign tumour- comparatively harmless.

Cancer in Numbers

Cancer is the second leading cause of death in the entire world. And globally, according to WHO, one in six deaths is unfortunately because of Cancer. According to the Indian Council of Medical Research, in India, one woman is dying of cervical cancer every 8 minutes. For every two females diagnosed with breast cancer, one woman dies of it in India. Now, due to tobacco, more than 3.5k people are affected in India, every day.

If we consider these and more such scenarios, there will be more than 15 lakhs cases of Cancer in India by 2025. That means 1 out of 10 Indians will suffer from Cancer and 1 out of 15 will lose their battle to cancer – according to WHO.

The best news is that if we are aware of this and if we receive the treatment early, it can be cured.

Beating Cancer

When surgeons try to treat cancer, there are 3 questions to be answered.

–          What are we trying to target?

–          Why are we trying to use the system?

–          How are we going to target it?

It’s like hitting the bull’s eye. Cancer has evolved over some time and undergoes different mechanics to escape the conventional mode of cancer treatment. This is one of the reasons why it is difficult to beat Cancer.

Risk factors
Various factors lead to certain types of cancers. These factors can be divided into 3 types.
–          Vulnerable factors
–          Contributing factors
–          Direct factors
Taking an example of Breast Cancer, here are various risk factors that can cause the disease in a woman.
Vulnerable factor – Early menses or late menopause
Contributing factors – Lack of exercise, excess of alcoholism, injection of pesticide or chemicals
Direct factors – Radiation, inherent mutations. If the genes are present already, these can be considered as direct factors.
These are the various factors that increase the chances of having breast cancer in a woman.  

Diagnosing Cancer

Diagnosing Cancer is major classified in steps. These are as follows.

Good clinical examination

Conventionally, a good clinical examination is the best possible way Cancer can be picked up and diagnosed at an early stage. It includes a general examination, followed by identifying the symptoms and confirming the underlying problem.

Pathological testing

After a good clinical examination, a pathological test is conducted, where a particular body part will be tested. Blood and urine test are usually put down on the list to detect Cancer. But apart from that, it also includes microscopic testing – which involves testing tissues using the needle test that helps is detecting Cancer and its types.

Radiology If after pathological testing, the results are positive, doctors need to understand the stage of cancer. Depending on that, the treatment will be subjected to patients which will include different radiology tests and nuclear.

How doctors all over the globe are coming together to fight cancer?

Due to advancement in technology, cancer specialists, cancer fighters, as well as cancer caregivers all over the world, has adopted ‘team-approach against this illness. Surgical oncologists may tackle this illness with surgery, medical oncologists will take care through chemo-therapy, immune-therapy, targeted-therapy or hormonal treatment, Radiation-oncologist may try to kill cancer via radiation protocols and radiation beams. According to literature, it is observed that more than 30-50% of patients have a significant amount of pain in Cancer. So, the pain-management teams help patients to tackle and minimize pain. Once Radiologists are specialized in finding out important parts affected by cancer through radiology. Another branch of the team consists of onco-pathologists that carry out the molecular diagnostics and genetic testing of Cancer. Oncoplastic surgeons, reconstructive surgeons, nursing staff, rehabilitation, physiotherapy department, nutritionists, etc all form an important part of this team approach.

There are times when cancer has already spread to various body parts of the patient. Such palliative cases are handled by palliative care experts who take care of the patient by trying to minimize his agony in the best possible way. Undergoing cancer treatment is a tremendous emotional turmoil for the patient. To aid the patient to live a normal life post-surgery and cope up with the situation, psychological and Physiatrist counsellors play an important role.

medicines scans. There are different types of radiological tests. For example, X-ray for lung, mammography for breast, CT Scan, MRI, thyroid scan, etc.

Once these steps are covered, the stage and the type of cancer is diagnosed.

This team-approach of the care-givers and doctors all around the world work as a multidisciplinary team to fight against Cancer.

Three important treatments

When it comes to treating cancer, three main options are available:

·         Surgical oncology

It deals with the surgical aspects of treating Cancer- ‘How do you remove cancer from the body through operations?’.  This process takes care of the parts affected with cancer as well as the potential organs where the disease might spread.

·         Medical oncology

This treatment deals with treating Cancer through medical processes like Chemotherapy.  targeted therapy, and Immunotherapy

Targeted therapy is very precise and targets only cancer cells minimizing any other side effects, unlike chemotherapy. In Immunotherapy, the body’s immune system fights against the cancer cell.

·         Radiation Oncology

It involves radiation therapy to target cancer tumours- the extremely focussed radiation branches like image-guided radiation therapy or immuno-guided radiation therapy reduces to treat cancer that prevents side effects on the surrounding organs and maximizes the effect on cancer cells.

How treatment patterns have changed in recent times?

With the advancement in technology, treatment options have evolved over some time. Following are a few patterns and what do they stand for:

Oncological clearance – It removes cancer and does not spread throughout the body.

Cosmesis of the patient – Cosmesis stands for preservation, restoration, or bestowing of body part’s structure affected with cancer.

Organ preservation – Normal organ function is safeguarded while tackling cancer.

Quality of life – An idea of improved lifestyle post-surgery for patients.

Can Cancer be prevented?

Yes. It can be prevented. Frequent tobacco smoking is one of the most important causes of cancer. If the person does not smoke, cancer can be prevented at an early stage. Other factors like alcohol consumption, excess body weight, obesity may also lead to cancer. Being physically active can help one to avoid cancer.

Certain vaccines like hepatitis B and hepatitis C can also help to prevent cancer.

Progression in Cancer Treatment

Knowing the basic cause of Cancer or knowing how to identify the basic symptoms can save a million lives. For example, if your immediate relatives have cancer or many people from one side of the family have some type of cancer, consult a doctor for genetic counselling. Self-examination in-case of breast cancer or even pap smear test for cervical cancer should be encouraged after a particular age group.

To conclude on a positive note, robotic surgery, personalized oncology, immune therapy, liquid-biopsy, and much more advancements are happening in the cancer treatments that boost self-esteem in cancer patients.

When it comes to the wellbeing of  COVID-19 and Cancer patients- one has to be more cautious and follow the hygiene guidelines applicable to everyone. Wash your hands frequently, maintain social distance and use an alcohol-based hand rub to stay safe.

It is important to look forward to optimistic survivors as Cancer awareness is a paramount step to fight and defeat cancer.

If you have been recently diagnosed with cancer then there must be a lot going in your mind. It can put you in shock and make you feel out of control and overwhelmed.  From treatment to actual success rate to life after any cancer treatment, there’s a lot of anxiousness and nervousness attached to every possible aspect related to the disease. By staying informed can help you alleviate these feelings. 

It is important to know that not all cancers require emergency treatment and you may have time to learn and understand in detail about your diagnosis and treatment options, ask for answers and get a second opinion. Cancer is one of the deadliest causes of death worldwide and hence it shouldn’t be taken for granted at any cost. With multiple treatment options available, cancer if detected at an early stage can surely be cured. Usually, when suggested a Chemotherapy or radiotherapy, many unpleasant thoughts are created in your mind but as the journey of survival begins and the final output is picturized then there are more than a few reasons to be happy with it.  And, for all those who are not completely aware of the treatment options available especially when it comes to cancer surgery, we will help you learn more about the treatment and what to expect afterward.

Cancer treatment:

Cancer surgery is the first option considered in the treatment of many firm malignant tumors. It helps in removing the cancerous tumor and the healthy tissue surrounding it to prevent the spread further. In simple words, the objective of any cancer surgery is to get rid of the cancerous cells from the body. But, it depends on the doctor who is diagnosing it to whether suggest you surgery or any other standard procedure considering the seriousness of the disease.

Tumors that cannot be treated with other treatments like radiation or chemotherapy are removed through surgeries. The cancer cells that produce blood-borne factors, responsible for stimulating the growth of cancer in distant body parts, are removed by surgery. Surgery alone can completely remove cancer cells that are confined in a small restricted area, which eliminates the need for any other treatment. But in some cases, surgery does not aim at removing the entire tumor because of the location of the tumor. If the tumor mass is sizeable then surgery is suggested to diminish the size of the tumor so that it is eliminated with the help of other treatment options like chemotherapy or radiotherapy. Surgery enables one to examine the cancerous tumor for deciding the most suitable treatment option for each patient based on the pathology. It can also guide the future course of treatment and also helps to analyze the treatment response. Above all, it is comparatively convenient to the patient, as it needs to be performed in a day and lasts only a few hours.

Benefits of Cancer surgery

Out of all the above-discussed treatment options available to treat cancer, surgery is by far the most common treatment for treating cancer.  As mentioned earlier it eliminates the cancerous cells that help in increasing life expectancy. It also helps in reducing the pain, symptoms and problems with digestion. Cancer surgery can tackle existing weight issues effectively and support the human body to respond better to other medical conditions. Sometimes, surgery may be used to help with body functions, such as breathing and getting enough nutrition. On the other hand, it surely gives a boost to the self-esteem of the patient. Most importantly, a surge in energy levels is observed post cancer surgery. Patients have a better sleep cycle and a positive attitude in life.

The success rate of cancer surgery

The rate of success of cancer surgery is directly dependent upon the extent and type of tumor along with the overall health status of the patient. Many other factors influence survival in addition to cancer type, including age and stage at diagnosis, treatment, insurance status, competing for health conditions, and financial resources. Cancer treatment can be more challenging and complex for older adults. This is because older adults are more likely to have chronic health conditions, such as blood pressure, diabetes, etc.  The success, failure and survival rates for cancer patients vary for each individual depending on the changing traits of each patient including tumor location and tumor type. Physician and patient factors, including never give up attitudes, beliefs, preferences, and implicit or explicit biases, also influence treatment recommendations and delivery and likely contribute to the survivorship of a person. As per multiple surveys, tumor surgeries carry a greater chance of success in the younger patient subgroup as they are more fit physically.

Similarly, access to high-quality cancer care defines the outcome of the treatment. It increases the chances of survival and is directly proportional to the patient’s improved quality of life.

To conclude, cancer surgery is a part of the cancer treatment plan and may be used along with other cancer treatment options such as chemotherapy and radiation. Surgery can be used to prevent cancer, removing cancer, diagnosing the stage of cancer, relieving symptoms, support other treatment and body functions. Also with recent advancements in medical technology, the success rate of cancer surgery is improving day by day and patients have seen a drastic improvement in their quality of life. Cancer surgery has surely given a new lease of life to a million people worldwide.

Cancer is to a large extent avoidable. Some of them can be detected at their initial stage of growth, treated and cured. Even the last stage of cancer’s progression can be slowed and the pain can be reduced. Though cancer remains the world’s second leading cause of death, there are still many treatment options and drugs available to treat cancer, with many more being studied. The types of treatment chosen depends on the type of cancer one has and how radical it is. Few types will have only one treatment option available. But most people get a combination of treatments. Some are local treatments like surgery and radiation therapy, which are used to treat a specific tumor or area of the body. And, drug treatments such as chemotherapy, immunotherapy, or targeted therapy are often called “systemic” treatments because they can affect the entire body. It completely depends on your doctor to make a reasonable treatment decision, depending upon the type of your cancer and its stage.  At the same time, every patient needs to follow some ground rules like acceptance, realistic expectations, beliefs and attitude towards the disease before exploring treatment options. Let’s now dig in deep and learn about the effectiveness and risks associated with surgical cancer treatment.

Surgery is the conventional form of treating cancer. It is very effective in removing the majority of cancer types before their spread to lymph nodes or distant sites, referred to as metastasis. Surgery may be used alone or in combination with other treatments such as chemotherapy or radiation. Surgery may cure cancer if it has not spread to distant locations in the body. But, it is highly impossible to predict every time whether cancer has spread or not with complete surety. Hence, surgeons frequently remove the lymph nodes surrounding the tumor (sentinel nodes) to confirm whether cancer has spread.

The primary aim of surgery in cancer treatment is to eliminate the cancerous tumor from a specific area of the body. Hence, surgery is considered to be highly effective at complete removal of cancer in its initial stage, which is restricted to its area of origin and hasn’t spread to other adjacent or distant parts of the body (Solid Tumors). However, surgery can also be performed to treat cancer that has spread from the primary site or primary tumor to other parts of the body. Typically, a surgery to remove a cancerous tumor lasts 3 to 6 hours depending on multiple factors such as tumor size, tumor location and access to the tumor, surrounding organs, presence of nerves and blood vessels around the tumor, co-morbid conditions and the number of procedures being performed in a single session.

Risks and side effects of cancer surgery

Risk is a part of any surgery. Though technology has made surgery a safe and authentic treatment option, there are always some potential risks or side effects.

Cancer surgery, like any other treatment option, is associated with benefits as well as side effects. However, the type and extent of side effects differ for each patient, depending on the type and cancer location, surgery type, involvement of concomitant treatment like chemotherapy or radiation and the patient’s general health. In many cases, however, the positive effects outweigh the risks or side effects. 

Common side effects of surgical treatment of cancer include:

• Pain: It is common to have some pain after surgery. 
• Tiredness: Most people feel tired after undergoing surgery, particularly when it involves the chest or abdomen. 

• Loss of Appetite: The patient may feel a loss of appetite after surgery. It may be associated with temporary weight loss.
• Swelling surrounding the surgical site: It is natural to experience some swelling as the body’s natural response to injury is inflammation. 
• Drainage from the surgical site: In some cases, the fluid that formed at the surgery site drains through surgical wounds. The patient should contact their surgeon if they develop signs of infection like drainage that smells bad, fever, and redness around the wound.
• Bruising surrounding the surgical incision: Bruising is a common occurrence after surgery caused due to some blood leakage from small blood vessels under the skin.
• Numbness at the incision site: Commonly, numbness is because the nerves in the skin are cut at the time of surgery.
• Bleeding: Mostly, when a patient undergoes surgery, they lose some blood which is usually very little and does not affect the body.
• Surgical site infection: It is common to have infections at the surgical site, but it can also occur elsewhere in the body.
• Lymphedema: Collection of lymph in areas around the excised lymph nodes.
• Organ Dysfunction: It happens most commonly when the surgery is done in certain areas such as the abdomen and chest.
• Concerns related to diet causing GI problems like constipation and decreased ability to absorb nutrients from food.
• Change of body image due to the distorted appearance of the body due to the removal of a certain body part.
• Depression: It is a common experience one can feel after surgery.
• Decreased sexual drive especially if surgery is performed for colorectal, prostate or bladder cancers.
• Fertility: It sometimes affects a woman’s ability to maintain a pregnancy and a man’s ability to father a child.

It should be your first call before you decide to have any surgery or any other treatment, that you utterly understand the risks and side effects associated with it. As any type of medical treatment has its risks and side effects. Be sure, you discuss the details of your case with your physician or surgeon before undergoing any treatment so that you can have a better idea about what your risks might be. The most important thing one should consider that the expected positive effects of the surgery outweigh the possible risks.