Cancerous cells can occur in any part of the body. When the normal process of cell division is hindered, that is, when the cell is old or damaged and dies, new cells are formed. But in the case of cancer cells, the abnormal or damaged cells multiply when they should not.
Cancers can be classified as benign or malignant. Benign cancers or benign tumors are slowly growing masses of solid tumors that do not spread to other parts of the body. Malignant tumors, on the other hand, rapidly grow and spread to the other parts quickly. The spread of the cancerous tumors to other organs or parts of the body is termed metastasis.
Metastasis, also known as metastatic cancer, occurs when the cancer cells begin to spread from the original site to other parts of the body via the hematogenous spread (via blood) or lymphatic spread (via lymph nodes). Hence, benign tumors are not metastatic, but malignant tumors are.
Stages of Cancer
Cancer patients are diagnosed on the basis of stages of cancer. Mostly, all cancers have 4 stages.
- Stage 1: The cancer cells are localized to one area and don’t spread to the proximal or distant lymph nodes.
- Stage 2: The cancer cells have grown but haven’t spread.
- Stage 3: The cancer cells have grown larger and possibly spread to lymph nodes.
- Stage 4 cancer: The cancer cells have spread to other organs and parts of the body.
Is Stage 4 Cancer Curable?
Stage IV cancer is the most advanced stage of cancer. By the time cancer reaches stage 4 cancer, the cancer’s growth and spread are unavoidable and nonpreventable.
Cancer symptoms will differ from different types of cancer. But the common symptoms of Stage 4 cancer are:
- Dyspnea or shortness of breath
- Unexplained fatigue
- Unexplained weight loss
- Abdominal swelling in case of liver involvement.
- Dizziness, confusion, seizures in case of brain cancer.
- In cases of bone involvement, pathological fractures are quite common.
1. Breast cancer
Metastatic breast cancer is one of the most common cancers in women. The cells in the breast start growing abnormally. Cancerous cells can occur in any part of the breast, even in the duct or lobes.
The different types of cancers are:
- Invasive ductal carcinoma
- Invasive lobar carcinoma
- Ductal carcinoma in situ (confined to the duct)
- Lobar carcinoma in situ (confined to the lobe)
The rare cancer types are:
- Paget’s disease of the breast
- Inflammatory breast cancer
The common symptoms of cancer, as listed above, remain the same. The common symptoms of breast cancer are:
- Lump in the breast or thickening of the skin
- Change in size and shape of the breast
- Dimpling of the skin
- Orange peel appearance of the skin- redness, and pitting over the skin of the breast
- Inverted nipple
- Abnormal discharges from the nipple
The causes of breast cancer are usually idiopathic, hereditary, or inherited. The other causes of advanced cancer may depend on the risk factors.
People who are chronic smokers or chronic alcoholics, have an unhealthy lifestyle or a sedentary lifestyle, have a history of consuming birth control pills for more than 5 years, are prone to develop breast cancer in their lifetime.
Breast cancer can be diagnosed by:
- Breast examination. This can be done by a clinician or by doing a self-examination.
- Mammogram. X-ray of the breast. There are 2 types: screening mammograms and diagnostic mammograms. If breast cancer is detected in the screening mammogram, the patient is advised to get a diagnostic mammogram.
- Breast Ultrasound
- Breast MRI
Hormone receptor-positive or hormone receptor-negative cancers
After a cancer diagnosis is done, the prognosis for the same has to be carried out. The prognosis also helps in knowing the reoccurrence relative survival rate of that cancer.
The test is carried out while getting a biopsy done. A biopsy is a procedure to remove cells or tissues for cancer diagnosis.
The test can have either of the two results:
Hormone receptor-positive cancers
For breast cancer, hormone receptors are the proteins that can be found on the most advanced breast cancer cells. These terminal and advanced cancer cells pick up the signals for the estrogen and progesterone hormones and promote cancer cell growth if they contain the receptors for these hormones.
Breast cancers may be positive for progesterone receptors (PR+), estrogen receptors (ER+), or both hormones (PR/ER+)
Hormone receptor tests help in planning the treatment and hormonal therapy of the patient. These patients can be given estrogen blockers or drugs that lower their estrogen levels.
Hormone receptor-negative cancers
In the case of breast cancer, hormone receptors are absent; that is, there are no estrogen receptors or progesterone receptors. Hormone therapy is not available as one of the treatment options.
These advanced cancers tend to grow faster than hormone receptor-positive cancers. HR- cancers are more common in women who have not undergone menopause yet.
HER 2 Positive breast cancer is a type of breast cancer that tests positive for the protein human epidermal growth factor receptor 2. This protein promotes the growth of cancer cells.
This type of cancer is more aggressive compared to the other types of breast cancer.
The different treatment options for treatment of breast cancer are:
- Surgical interventions like Lumpectomy, which is the removal of the tumor and a small margin of the healthy tissue around the tumor. The rest of the breast remains. There is also Mastectomy, which is the surgical removal of the entire breast.
- Radiation therapy is given when surgical intervention is not possible. It is one of the best treatment options for regional breast cancer recurrence.
- Chemotherapy, targeted therapy, or hormone therapy is the main treatment option or may follow surgery or radiation therapy.
2. Lung Cancer
Lung cancer begins in the lungs and is another leading cause of death worldwide. People who smoke are at the greatest risk of developing lung cancer. The people who are non-smokers can also develop the same.
The 2 types of lung cancers, according to the American Cancer Society, are:
a. Non-small cell lung cancer (NSCLC)
- Adenocarcinoma: Adenocarcinomas start in the cells which secrete substances such as mucus. It is more commonly seen in women than in men. It is found in the outer parts of the lungs and is more likely to be found in the earlier stages.
- Squamous cell carcinoma: SCC starts in the squamous cells. They are found in the central part of the lungs, near the main airway.
- Large cell (undifferentiated) carcinoma: It can appear in any part of the lung. It grows and spreads quickly; hence, it is difficult to treat.
b. Small cell lung cancer (SCLC)
It is also called Oat Cell Cancer. These cancers tend to grow and spread faster as compared to NSCLC. By the time diagnosis of the cancer is done, the cancer has already spread beyond the lungs.
- Cough, which gets worse.
- Rust colored sputum.
- Chest pain which worsens with breathing or coughing.
- Shortness of breath- Dyspnea
- New onset of wheezing
- Infections like bronchitis don’t go away.
Lung cancer can be diagnosed with the help of certain tests that the physician may perform to rule out the possibility of other diseases.
- Imaging Tests
- Sputum cytology
Staging of cancer can be done on the basis of PET scan, CT Scan, and MRI Scan.
- Imaging Tests: An imaging Test is similar to an X-ray, where the presence of mass or nodules is confirmed. The X-Ray test is done to see if the tumor cells present have spread or are localized.
- Sputum cytology: To confirm the presence of cancer cells, the sputum is checked under the microscope.
- Biopsy: The tissue cells are removed to check for any abnormality or presence of tumor cells.
Lung cancer in the later stages, like seen in stage 4 colon cancer, is incurable due to metastasis. The spread of cancer cells to different parts of the body makes it difficult to treat the disease; hence, the physician starts to treat symptoms.
The practice involves chemotherapy, where only the symptoms of an advanced stage of cancer are treated, which is known as Palliative care. Palliative care is aggressive treatment given to patients diagnosed with stage 4 cancer, usually.
Hence, if the cancer patient is diagnosed in the earlier stages, in the primary cancer stages, there are a couple of treatments available for the patient’s recovery from the primary tumor.
Treatment for Cancer
- Chemotherapy: Chemotherapy is a drug therapy used in the treatment of cancer.
- Radiation therapy: In radiation therapy, high beam radiations are given to the part affected. The radiation kills the cancer cells. The drawback is that it also kills the healthy cells surrounding it.
- Surgery: Surgically, the cancer cells can be excised. If the lymph nodes around the affected cells have metastasized, the lymph nodes are removed, too.
- Immunotherapy: Immunotherapy uses the body’s immune system to fight cancer. It helps the body to identify cancer and attack it.
- Hormone therapy: Also known as endocrine therapy. In cases of prostate cancer and breast cancer, hormone therapy is the choice of treatment. Cancer treatment is done by blocking the hormones causing the symptoms or blocking their effect entirely.
- Cryoablation: This treatment option kills the cancer cells by using cold. A cryoprobe (a wand-like needle) is inserted, and a cold gas is used to kill cancer cells. This is an invasive method of treatment.
According to the National Cancer Research Institute, targeted therapy is defined as the cancer treatment that targets proteins that control how cancer cells grow, divide, and spread.
The mechanism of how targeted therapy works against cancer cells is as follows:
- Similar to immunotherapy, it helps the immune system to fight cancer.
- Stops cancer cells from growing and spreading.
- Stop signals that promote angiogenesis.
- It causes apoptosis in cancer cells, which normal cells perform once they’re worn out.
Targeted therapies have a high success rate, nearly equal to 80%, which in comparison to chemotherapy immunotherapy is very high. This is because chemotherapy offers a 40% success rate in most of the cancer cases.
Palliative care focuses on treating the symptoms and not treating the cancer. It is given to improve their quality of living and not improve their condition. The primary goal of palliative care is to reduce the dependence on mobility and self-care activities and give them the confidence to perform activities of daily living by themselves.
Palliative care is also given when patients start to lose hope, and a lot of times, their mental health starts to deteriorate. In order to help them overcome depression, anxiety, or fear and to fight the disease with ease, palliative care is given.
The patients start feeling like a burden to their family members and the health care providers, and to make them feel otherwise, these caregivers are present.
With proper treatment options available and the correct diagnosis, stage 4 cancer can be curable. The process can be slow and traumatizing, but with the right resources and help, the hassles are easier to clear. If the treatments are not helping, there is always the option to improve the quality of life and provide palliative care to the patients.
There is a very strong saying that it will not make any difference to cancer, but the will give the patient the courage to fight it.
“There is CAN in CANCER, because we CAN beat it.” -Anonymous.