1. 1 I.IntroductionCancer is fundamentally a disease of failure of regulation of tissue growth. Inorder for a normal cell to transform into a cancer cell, the genes which regulate cellgrowth and differentiation must be altered. It Cancer has a reputation as a deadlydisease. Taken as a whole, about half of people receiving treatment for invasivecancer (excluding carcinoma in situ and non-melanoma skin cancers) die from canceror its treatment. Survival is worse in the developing world. However, the survivalrates vary dramatically by type of cancer, with the range running from basically allpeople surviving to almost no one surviving.Those who survive cancer are at increased risk of developing a second primary cancerat about twice the rate of those never diagnosed with cancer. The increased risk isbelieved to be primarily due to the same risk factors that produced the first cancer,partly due to the treatment for the first cancer, and potentially related to bettercompliance with screening. It is a deadly disease that kills over a million of peoplenot only here in the Philippines but also around the world.Cancer is one disease which has not been stopped or checked by any boundaries. Itcan victimize people of all ages and all genders and it can take over any part of yourbody at any time. This is one thing nobody can escape without the aid of God andmiracles. There have been many new viruses and diseases which came to light agesafter cancer was recognized. But till date cancer remains one of the few diseaseswhich does not have complete assured cure.

2. 2Background of the StudyThis paper deals with the alarming percentage increase of cancer patients in thecountry and also worldwide and if these kind of disease is still curable; and also tofind out that if the measures done in the hospitals are enough to stop or even lessenthe high percentage of death caused by the said disease. 3. 3Importance of the StudyIn view of the importance of this study will be a great accomplishment andsignificance to the entire concerned individual.The findings of this study may be used to 1. Serve as an eye-opener for the government, NGOs and families to affect thenecessary measures to look for answers to resolve or to look for cure in thisproblem. 2. Stress some points that will lead to the planning of an effective program thatwill serve the needs of the parents and most especially for the good of ourpatients. 3. Serve as basis in examining the situations that possibly leads towards thedevelopment of programs that is primarily support the lives of individualswho encounter this family problem. 4. Imply the cause of massive increase of patients having the said disease. 5. Encourage further studies and investigations concerning to this physical healthphenomenon. 6. Arouse the interest of persons to get involved with advocacies emphasizedtheir responsibilities as members of the society.Purpose of the Study 4. 4The purpose of this study is to serve as a guide and also find out why there areincreasing number cancer patients in the Philippines and also how to prevent this kindof deadly disease. This can be a useful guide for the students learning about theproblem.Statement of the ProblemThis study is seeks to answer why many people encounter this kind of disease and atthe same time is to contribute on looking for some ways to prevent and resolve theabove mentioned statement.Definition of TermsCancer- known medically as a malignant neoplasm, is a broad group ofvarious diseases. Carcinoma: Cancers derived from epithelial cells. This group includes manyof the most common cancers, particularly in the aged, and include nearly all thosedeveloping in the breast, prostate, lung, pancreas, and colon. Sarcoma:Cancers arisingfrom connectivetissue (i.e. bone, cartilage, fat, nerve), each of which develop from cellsoriginating inmesenchymal cells outside the bone marrow. Lymphoma and leukemia: These two classes of cancer arise fromhematopoietic (blood-forming) cells that leave the marrow and tend to mature inthe lymph nodes and blood, respectively. Leukemia is the most common typeof cancer in children accounting for about 30%.[44]Germ cell tumor: Cancers derived from pluripotent cells, most oftenpresenting in the testicle or the ovary (seminoma and dysgerminoma,respectively). Blastoma: Cancers derived from immature "precursor" cells or embryonictissue. Blastomas are more common in children than in older adults. Benign tumors (which are not cancers) are named using -oma as a suffix withthe organ name as the root. For example, a benign tumor of smooth muscle cells 5. 5is called aleiomyoma (the common name of this frequently occurring benigntumor in the uterus is fibroid). Confusingly, some types of cancer use the -noma suffix, examples including melanoma and seminoma. Palliative care refers to treatment which attempts to make the patient feelbetter and may or may not be combined with an attempt to attack the cancer.Palliative care includes action to reduce the physical, emotional, spiritual, andpsycho-social distress experienced by people with cancer. Unlike treatment that isaimed at directly killing cancer cells, the primary goal of palliative care is toimprove the patients quality of life.II.Content Cancer- known medically as a malignant neoplasm, is a broad group ofvarious diseases, all involving unregulated cell growth. In cancer, cells divide andgrow uncontrollably, forming malignant tumors, and invade nearby parts of the body.The cancer may also spread to more distant parts of the body through the lymphaticsystem or bloodstream. Not all tumors are cancerous. Benign tumors do not growuncontrollably, do not invade neighboring tissues, and do not spread throughout thebody. There are over 200 different known cancers that afflict humans. Determining what causes cancer is complex. Many things are known toincrease the risk of cancer, including tobacco use, certain infections, radiation, lack ofphysical activity, obesity, and environmental pollutants. These can directly damagegenes or combine with existing genetic faults within cells to cause the disease.Approximately five to ten percent of cancers are entirely hereditary.Cancer can be detected in a number of ways, including the presence ofcertain signs and symptoms, screening tests, or medical imaging. Once a possiblecancer is detected it is diagnosed by microscopic examination of a tissue sample.Cancer is usually treated with chemotherapy, radiation therapy and surgery. Thechances of surviving the disease vary greatly by the type and location of the cancerand the extent of disease at the start of treatment. While cancer can affect people ofall ages, and a few types of cancer are more common in children, the risk ofdeveloping cancer generally increases with age. In 2007, cancer caused about 13%of all human deaths worldwide (7.9 million). Rates are rising as more people live toan old age and as mass lifestyle changes occur in the developing world. 6. 6What causes CANCER?Cancers are primarily an environmental disease with 9095% of cases attributedto environmental factors and 510% due to genetics. Environmental, as used bycancer researchers, means any cause that is not inherited genetically, not merelypollution. Common environmental factors that contribute to cancer deathinclude tobacco (2530%),diet and obesity (3035%), infections (1520%), radiation (both ionizing and non-ionizing, up to 10%), stress, lack of physicalactivity, and environmental pollutants.It is nearly impossible to prove what caused a cancer in any individual, because mostcancers have multiple possible causes. For example, if a person who uses tobaccoheavily develops lung cancer, then it was probably caused by the tobacco use, butsince everyone has a small chance of developing lung cancer as a result of airpollution or radiation, then there is a small chance that the cancer developed becauseof air pollution or radiation. 1. Is cancer a hereditary disease?The vast majority of cancers are non-hereditary ("sporadic cancers"). Hereditarycancers are primarily caused by an inherited genetic defect. Less than 0.3% of thepopulation are carriers of a genetic mutation which has a large effect on cancer riskand these cause less than 310% of all cancer.Some of these syndromes include:certain inherited mutations in the genes BRCA1 and BRCA2 with a more than 75%risk of breast cancer and ovarian cancer, and hereditary nonpolyposis colorectalcancer (HNPCC or Lynch syndrome) which is present in about 3% of peoplewith colorectal cancer,among others. 2. What are some physical agents that cause CANCER? A prominent example of this is prolonged exposure to asbestos, naturally occurring mineral fibers which are a major cause of mesothelioma, a type of cancer of the serous membrane. Other substances in this category, including both naturally occurring andsynthetic asbestos-likefiberssuch as wollastonite, attapulgite, glass wool, and rock wool, are believed to have similar effects.Nonfibrous particulate materials that cause cancer include powderedmetallic cobalt and nickel, and crystalline silica (quartz, cristobalite, and tridymite).Usually, physical carcinogens must get inside the body (such as through inhaling tinypieces) and require years of exposure to develop cancer. 7. 7Physical trauma resulting in cancer is relatively rare. Claims that breaking boneresulted in bone cancer, for example, have never been proven Similarly, physicaltrauma is not accepted as a cause for cervical cancer, breast cancer, or brain cancer.One accepted source is frequent, long-term application of hot objects to the body. It ispossible that repeated burns on the same part of the body, such as those producedbykanger and kairo heaters (charcoal hand warmers), may produce skin cancer,especially if carcinogenic chemicals are also present. Frequently drinking scaldinghot tea may produce esophageal cancer.Generally, it is believed that the cancer arises, or a pre-existing cancer is encouraged,during the process of repairing the trauma, rather than the cancer being causeddirectly by the trauma. However, repeated injuries to the same tissues might promoteexcessive cell proliferation, which could then increase the odds of a cancerousmutation. There is no evidence that inflammation itself causes cancer 3. What are the Cancer causing deaths in the Philippines? 1. Breast cancer- In 2010, breast cancer became the most common cancer inthe country with 16 percent of a total of 50,000 cases resulting in death.The disease has also become the leading cause of cancerfor Filipino women. Doctors advise women about constant self-breastexamination to detect abnormal growth in the breasts so that the cancercan be treated during its early stages. Meanwhile, the Philippine CancerSociety has pledged to provide more free mammography services, fineneedle aspiration biopsy, and education campaigns to help more Filipinasin combating the disease. 2. Lung cancer is the leading cause of cancer for Filipino men. It was theleading cause of cancer deaths in the country before it was replaced bybreast cancer. Meanwhile, the Philippine Cancer Society expressedconcern over the rise in lung cancer incidences among Filipino women.Experts advise the public to refrain from cigarette smoking as nine out often smokers die from lung cancer. Non-smokers also become prone oflung cancer through second-hand and third-hand smoke. 3. Liver cancer is the eight most common cancers in the world. However, itappears that the disease is more common in the Philippines compared tothe lesser number of incidences in the United States. Doctors attribute thisto the fact that chronic hepatitis B affects 10 to 12 percent of all Filipinos.Chronic hepatitis B causes cirrhosis of the liver which is a major riskfactor of liver cancer. 4. Cervical cancer It is estimated that 12 Filipinas die of cervicalcancer each day with 6,000 cases being diagnosed each year. This type of 8. 8 cancer is common among women from age 30 to 55. Twenty-two in 100,000 women will get cervical cancer and only 44% of this number will survive the disease. Thus, doctors are urging women to be screened three years after their first sexual contact. They also strongly recommend administering the cervical cancer vaccine to Filipinas age ten years and above. 5. Colon cancer occurs when abnormal cells develop in the large intestine. It is best detected early through fecal occult blood test and colonoscopy. It is then treated through surgery which entails removing the affected part of the colon. Among Filipino personalities who died of the disease are Corazon C. Aquino, Chat Silayan, Rio Diaz, Helen Vela, and veteran actor Charlie Davao in August 2010. 6. Thyroid cancer is more common in women than in men. In fact, it is the most common cancer for women at age 15 to 24. Risk factors include family history, exposure to radiation, and not having enough iodine in the diet. It is highly curable by surgery alone. 7. Rectal cancer is caused by cancer cells that grow in the last 15 centimeters of the colon. These cancer cells become deadly once they travel through the bloodstream and into the other internal organs such as the liver. A diet rich in red meat and processed meats, lack of exercise, obesity, smoking, type-2 diabetes, and alcoholism is found to cause the disease. 8. Ovarian cancer as the 5th most common cancer among women. It is considered a silent killer as it is usually detected when the cancer cells have already spread to other organs such as the lungs and the liver. In March 2010, the mother of actress Francine Prieto succumbed to Stage 3 ovarian cancer. 9. Prostate cancer is the most common cancer for men. According to Enrique Ona of the National Kidney and Transplant Institute, prostate cancer develops in 19.3 out of every 100,000 Filipinos. The Department of Health has already recognized this alarming number and declared June of every year as Prostate Cancer Awareness Month. 10. Lymphoma is a type of cancer that affects the lymphoid tissues such as the lymph nodes or the spleen. It is considered as the most common type of blood cancer in the United States. Meanwhile, non-Hodgkins lymphoma is a type of lymphoma that commonly affects adults. Patients with non-Hodgkins lymphoma have a lower survival rate (63%) compared to patients with Hodgkins lymphoma (90%).4. How hormones affect the increase of cancer cells in the body? 9. 9 Hormones play a role in the development of cancer by promoting cell proliferation. Hormones are important agents in sex-related cancers such as cancer of the breast, endometrium, prostate, ovary, and testis, and also of thyroid cancer and bone cancer. An individuals hormone levels are mostly determined genetically, so this may at least partly explains the presence of some cancers that run in families that do not seem to have any cancer-causing genes. For example, the daughters of womenwhohavebreast cancer have significantlyhigher levels of estrogen and progesterone than the daughters of women without breast cancer. These higher hormone levels may explain why these women have higher risk of breast cancer, even in the absence of a breast-cancer gene. Similarly, men of African ancestry have significantly higher levels of testosterone than men of European ancestry, and have a correspondingly much higher level of prostate cancer. Men of Asian ancestry, with the lowest levels of testosterone-activating androstanediol glucuronide, have the lowest levels of prostate cancer. However, non-genetic factors are also relevant: obese people have higher levels of some hormones associated with cancer and a higher rate of those cancers. Women who takehormone replacement therapy have a higher risk of developing cancers associated with those hormones. On the other hand, people who exercise far more than average have lower levels of these hormones, and lower risk of cancer. Osteosarcoma may be promotedby growth hormones. Sometreatmentsand prevention approaches leverage this cause by artificially reducing hormone levels, and thus discouraging hormone-sensitive cancers.5. The relationship of Pathopysiology to Cancer: 10. 10Cancer is fundamentally a disease of failure of regulation of tissue growth. Inorder for a normal cell to transform into a cancer cell, the genes which regulate cellgrowth and differentiation must be altered.The affected genes are divided into two broad categories. Oncogenes are genes whichpromote cell growth and reproduction. Tumor suppressor genes are genes whichinhibit cell division and survival. Malignant transformation can occur through theformation of novel oncogenes, the inappropriate over-expression of normaloncogenes, or by the under-expression or disabling of tumor suppressor genes.Typically, changes in manygenes are required to transform a normal cell into a cancercell.Genetic changes can occur at different levels and by different mechanisms. The gainor loss of an entire chromosome can occur through errors inmitosis. More commonare mutations, which are changes in the nucleotide sequence of genomic DNA.Large-scale mutations involve the deletion or gain of a portion of achromosome. Genomic amplification occurs when a cell gains many copies (often 20or more) of a small chromosomal locus, usually containing one or more oncogenesand adjacent genetic material. Translocation occurs when two separate chromosomalregions become abnormally fused, often at a characteristic location. A well-knownexample of this is the Philadelphia chromosome, or translocation of chromosomes 9and 22, which occurs in chronic myelogenous leukemia, and results in production ofthe BCR-ablfusion protein, an oncogenic tyrosine kinase.Small-scale mutations include point mutations, deletions, and insertions, which mayoccur in the promoter region of a gene and affect itsexpression, or may occur in thegenes coding sequence and alter the function or stability of its protein product.Disruption of a single gene may also result from integration of genomic material froma DNA virus or retrovirus, and resulting in the expression of viral oncogenes in theaffected cell and its descendants. 11. 11Replication of the enormous amount of data contained within the DNA of living cellswill probabilistically result in some errors (mutations). Complex error correction andprevention is built into the process, and safeguards the cell against cancer. Ifsignificant error occurs, the damaged cell can "self-destruct" through programmedcell death, termed apoptosis. If the error control processes fail, then the mutations willsurvive and be passed along to daughter cells.Some environments make errors more likely to arise and propagate. Suchenvironments can include the presence of disruptive substances calledcarcinogens,repeated physical injury, heat, ionising radiation, or hypoxia III.How to diagnose CANCER? Most cancers are initially recognized either because of the appearance of signs or symptoms or through screening. Neither of these led to a definitive diagnosis, which requires the examination of a tissue sample by a pathologist. People with suspected cancer are investigated with medical tests. These commonly include blood tests, X-rays, CT scans and endoscopy. CANCER PREVENTION: Cancer prevention is defined as active measures to decrease the risk of cancer. The vast majority of cancer cases are due to environmental risk factors, and many, but not all, of these environmental factors are controllable lifestyle choices. Thus, cancer is considered a largely preventable disease. Greater than 30% of cancer deaths could be prevented by avoiding risk factors including: tobacco, overweight / obesity, an insufficientdiet, physical inactivity, alcohol, sexually transmitted infections, and air pollution. Not all environmental causes are controllable, such as naturally occurring background radiation, and other cases of cancer are caused through hereditary genetic disorders, and thus it is not possible to prevent all cases of cancer.Dietary 12. 12 While many dietary recommendations have been proposed to reduce the riskof cancer, few have significant supporting scientific evidence. The primary dietaryfactors that increase risk are obesity and alcohol consumption; with a diet low infruits and vegetables and high in red meat being implicated but notconfirmed. Consumption of coffee is associated with a reduced risk of livercancer. Studies have linked consumption of red or processed meat to an increased riskof breast cancer, colon cancer, and pancreatic cancer, a phenomenon which could bedue to the presence of carcinogens in meats cooked at high temperatures. Dietaryrecommendations for cancer prevention typically include an emphasis on vegetables,fruit, whole grains, and fish, and an avoidance of red meat, animal fats and refinedcarbohydrates. However, these recommendations are based on relatively limitedevidence.MedicationThe concept that medications can be used to prevent cancer is attractive, and evidencesupportstheir use ina fewdefinedcircumstances. Inthe generalpopulation NSAIDsreduce the risk of colorectal cancer however due to thecardiovascular and gastrointestinal side effects they cause overall harm when used forprevention. Aspirin has been found to reduce the risk of death from cancer by about7%. COX-2 inhibitor may decrease the rate of polyp formation in people with familialadenomatous polyposis however are associated with the same adverse effects asNSAIDs. Daily use of tamoxifen or raloxifene has been demonstrated to reduce therisk of developing breast cancer in high-risk women. The benefit verses harm for 5-alpha-reductase inhibitor such as finasteride is not clear.Vitamins have not been found to be effective at preventing cancer, although lowblood levels of vitamin D are correlated with increased cancer risk.[61][62] Whetherthis relationship is causal and vitamin D supplementation is protective is notdetermined. Beta-carotene supplementation has beenfound to increase lungcancer rates in those who are high risk.[64]Folic acid supplementation has not beenfound effective in preventing colon cancer and may increase colon polyps. 13. 13VaccinationVaccines have been developed that prevent some infection by some viruses. Humanpapillomavirusvaccine (Gardasil and Cervarix)decreases therisk ofdeveloping cervical cancer. The hepatitis B vaccine prevents infection with hepatitisB virus and thus decreases the risk of liver cancer.ScreeningUnlike diagnosis efforts prompted by symptoms and medical signs, cancer screeninginvolves efforts to detect cancer after it has formed, but before any noticeablesymptoms appear. This may involve physical examination, blood or urine tests,or medical imaging.Cancer screening is currently not possible for many types of cancers, and even whentests are available, they may not be recommended for everyone. Universalscreening or massscreening involvesscreening everyone. Selectivescreening identifies people who are known to be at higher risk of developing cancer,such as people with a family history of cancer. Several factors are considered todetermine whether the benefits of screening outweigh the risks and the costs ofscreening. These factors include: Possible harms from the screening test: for example,X-ray images involve exposure to potentially harmful ionizing radiation.The likelihood of the test correctly identifying cancer.The likelihood of cancer being present: Screening is not normally useful forrare cancers.Possible harms from follow-up procedures.Whether suitable treatment is available.Whether early detection improves treatment outcomes.Whether the cancer will ever need treatment. 14. 14Whether the test is acceptable to the people: If a screening test is tooburdensome (for example, being extremely painful), then people will refuse toparticipate.Genetic testing: Genetic testing for individuals at high-risk of certaincancers isrecommended. Carriers of these mutations may than undergo enhanced surveillance,chemoprevention, or preventative surgery to reduce their subsequent riskPalliative carePalliative care refers to treatment which attempts to make the patient feel better andmay or may not be combined with an attempt to attack the cancer. Palliative careincludes action to reduce the physical, emotional, spiritual, and psycho-social distressexperienced by people with cancer. Unlike treatment that is aimed at directly killingcancer cells, the primary goal of palliative care is to improve the patients quality oflife.Patients at all stages of cancer treatment need some kind of palliative care to comfortthem. In some cases, medical specialty professional organizations recommend thatpatients and physicians respond to cancer only with palliative care and not withcancer-directed therapy. Those cases have the following characteristics:1. patient has low performance status, corresponding with limited ability to carefor oneself2. patient received no benefit from prior evidence-based treatments3. patient is ineligible to participate in any appropriate clinical trial4. the physician sees no strong evidence that treatment would be effectivePalliative care is often confused with hospice and therefore only involved whenpeople approach end of life. Like hospice care, palliative care attempts to help theperson cope with the immediate needs and to increase the persons comfort. Unlike 15. 15hospice care, palliative care does not require people to stop treatment aimed atprolonging their lives or curing the cancer.Multiple national medical guidelines recommend early palliative care for peoplewhose cancer has produced distressing symptoms (pain, shortness of breath, fatigue,nausea) or who need help coping with their illness. In people who have metastaticdisease when first diagnosed, oncologists should consider a palliative care consultimmediately. Additionally, an oncologist should consider a palliative care consult inany patient they feel has a prognosis of less than 12 months even if continuingaggressive treatment.SurgerySurgery is the primary method of treatment of most isolated solid cancers and mayplay a role in palliation and prolongation of survival. It is typically an important partof making the definitive diagnosis and staging the tumor as biopsies are usuallyrequired. In localized cancer surgery typically attempts to remove the entire massalong with, in certain cases, thelymph nodes in the area. For some types of cancer thisis all that is needed to eliminate the cancer.ChemotherapyChemotherapy in addition to surgery has proven useful in a number of differentcancer types including: breast cancer, colorectal cancer, pancreatic cancer, osteogenicsarcoma,testicular cancer, ovarian cancer, and certain lung cancers. The effectivenessof chemotherapy is often limited by toxicity to other tissues in the body.RadiationRadiation therapy involves the use of ionizing radiation in an attempt to either cure orimprove the symptoms of cancer. It is used in about half of all cases and the radiationcan be from either internal sources in the form of brachytherapy or external sources.Radiation is typically used in addition to surgery and or chemotherapy but for certaintypes of cancer such as early head and neck cancer may be used alone. Forpainful bone metastasis it has been found to be effective in about 70% of people. 16. 16Alternative treatmentsComplementary and alternative cancer treatments are a diverse group of health caresystems, practices, and products that are not part of conventional medicine."Complementary medicine" refers to methods and substances used along withconventional medicine, while "alternative medicine" refers to compounds usedinstead of conventional medicine. Most complementary and alternative medicines forcancer have not been rigorously studied or tested. Some alternative treatments havebeen investigated and shown to be ineffective but still continue to be marketed andpromoted. IV.Cancer to society and CultureThough many diseases (such as heart failure) may have a worse prognosis than mostcases of cancer, cancer is the subject of widespread fear and taboos. The euphemism,"after a long illness" is still commonly used (2012), reflecting an apparent stigma.This deep belief that cancer is necessarily a difficult and usually deadly disease isreflected in the systems chosen by society to compile cancer statistics: the mostcommon form of cancernon-melanoma skin cancers, accounting for about one-thirdof all cancer cases worldwide, but very few deathsare excluded from cancerstatistics specifically because they are easily treated and almost always cured, often ina single, short, outpatient procedure.Cancer is regarded as a disease that must be "fought" to end the "civil insurrection";a War on Cancer has been declared. Military metaphors are particularly common indescriptions of cancers human effects, and they emphasize both the parlous state ofthe affected individuals health and the need for the individual to take immediate,decisive actions himself, rather than to delay, to ignore, or to rely entirely on otherscaring for him. The military metaphors also help rationalize radical, destructivetreatments.In the 1970s, a relatively popular alternative cancer treatment was a specialized formof talk therapy, based on the idea that cancer was caused by a bad attitude. Peoplewith a "cancer personality"depressed, repressed, self-loathing, and afraid to expresstheir emotionswere believed to have manifested cancer through subconsciousdesire. Some psychotherapists said that treatment to change the patients outlook onlife would cure the cancer. Among other effects, this belief allows society to blame 17. 17the victim for having caused the cancer (by "wanting" it) or having prevented its cure(by not becoming a sufficiently happy, fearless, and loving person). It also increasespatients anxiety, as they incorrectly believe that natural emotions of sadness, anger orfear shorten their lives. The idea was excoriated by the notoriously outspoken SusanSontag, who published Illness as Metaphor while recovering from treatment for breastcancer in 1978. Although the original idea is now generally regarded as nonsense, theidea partly persists in a reduced form with a widespread, but incorrect, belief thatdeliberately cultivating a habit of positive thinking will increase survival. This notionis particularly strong in breast cancer culture.In 2007, the overall costs of cancer in the U.S. including treatment and indirectmortality expenses (such as lost productivity in the workplace) was estimated to be$226.8 billion. In 2009, 32% of Hispanics and 10% of children 17 years old oryounger lacked health insurance; "uninsured patients and those from ethnic minoritiesare substantially more likely to be diagnosed with cancer at a later stage, whentreatment can be more extensive and more costly." V.Advocacy against CANCERBecause cancer is a class of diseases, it is unlikely that there will ever be a single"cure for cancer" any more than there will be a single treatment for all infectiousdiseases. Angiogenesis inhibitors were once thought to have potential as a "silverbullet" treatment applicable to many types of cancer, but this has not been the case inpractice.Experimental cancer treatments are treatments that are being studied to see whetherthey work. Typically, these are studied in clinical trials to compare the proposedtreatment to the best existing treatment. They may be entirely new treatments, or theymay be treatments that have been used successfully in one type of cancer, and arenow being tested to see whether they are effective in another type. More and more,such treatments are being developed alongside companion diagnostic tests to targetthe right drugs to the right patients, based on their individual biology.Cancer research is the intense scientific effort to understand disease processes anddiscover possible therapies.Research about cancer causes focuses on the following issues: 18. 18 Agents (e.g. viruses) and events (e.g. mutations) which cause or facilitategenetic changes in cells destined to become cancer. The precise nature of the genetic damage, and the genes which are affected byit. The consequences of those genetic changes on the biology of the cell, both ingenerating the defining properties of a cancer cell, and in facilitating additionalgenetic events which lead to further progression of the cancer.The improved understanding of molecular biology and cellular biology due to cancerresearch has led to a number of new treatments for cancer since U.S. President Nixondeclared the "War on Cancer" in 1971. Since then, the U.S. has spent over $200billion on cancer research, including resources from the public and private sectors andfoundations. During that time, the country has seen a five percent decrease in thecancer death rate (adjusting for size and age of the population) between 1950 and2005.VI. Effect of cancer to pregnancyBecause cancer is largely a disease of older adults, it is not common in pregnantwomen. Cancer affects approximately 1 in 1,000 pregnant women. The most commoncancers found during pregnancy are the same as the most common cancers found innon-pregnant women during childbearing ages: breast cancer, cervical cancer,leukemia, lymphoma, melanoma, ovarian cancer, and colorectal cancer.Diagnosing a new cancer in a pregnant woman is difficult, in part because anysymptoms are commonly assumed to be a normal discomfort associated withpregnancy. As a result, cancer is typically discovered at a somewhat later stage thanaverage in many pregnant or recently pregnant women. Some imaging procedures,such as MRIs (magneticresonanceimaging), CTscans,ultrasounds,and mammograms with fetal shielding are considered safe during pregnancy; someothers, such as PET scans are not.Treatment is generally the same as for non-pregnant women. However, radiation andradioactive drugs are normally avoided during pregnancy, especially if the fetal dosemight exceed 100 cGy. In some cases, some or all treatments are postponed until afterbirth if the cancer is diagnosed late in the pregnancy. Early deliveries to speed the 19. 19start of treatment are not uncommon. Surgery is generally safe, but pelvic surgeriesduring the first trimester may cause miscarriage. Some treatments, especially certainchemotherapy drugs given during the first trimester, increase the risk of birthdefects and pregnancy loss (spontaneous abortions and stillbirths).Elective abortions are not required and, for the most common forms and stages ofcancer, do not improve the likelihood of the mother surviving or being cured. In a fewinstances, such as advanced uterine cancer, the pregnancy cannot be continued, and inothers, such as an acute leukemia discovered early in pregnancy, the pregnant womanmay choose to have abortion so that she can begin aggressive chemotherapy withoutworrying about birth defects.Some treatments may interfere with the mothers ability to give birth vaginally or tobreastfeed her baby. Cervical cancer may require birth by Caesarean section.Radiation to the breast reduces the ability of that breast to produce milk and increasesthe risk of mastitis. Also, when chemotherapy is being given after birth, many of thedrugs pass through breast milk to the baby, which could harm the baby. VII.Summary of FindingsCancer has a reputation as a deadly disease. Taken as a whole, about half of peoplereceiving treatment for invasive cancer (excluding carcinoma in situ and non-melanoma skin cancers) die from cancer or its treatment. Survival is worse in thedeveloping world. However, the survival rates vary dramatically by type of cancer,with the range running from basically all people surviving to almost no one surviving.Those who survive cancer are at increased risk of developing a second primary cancerat about twice the rate of those never diagnosed with cancer. The increased risk isbelieved to be primarily due to the same risk factors that produced the first cancer,partly due to the treatment for the first cancer, and potentially related to bettercompliance with screening.Predicting either short-term or long-term survival is difficult and depends on manyfactors. The most important factors are the particular kind of cancer and the patientsage and overall health. People who are frail with many other health problems havelower survival rates than otherwise healthy people. A centenarian is unlikely to 20. 20survive for five years even if the treatment is successful. People who report a higherquality of life tend to survive longer. People with lower quality of life may beaffected by major depressive disorder and other complications from cancer treatmentand/or disease progression that both impairs their quality of life and reduces theirquantity of life. Additionally, patients with worse prognoses may be depressed orreport a lower quality of life directly because they correctly perceive that theircondition is likely to be fatal.Cancer is usually treated with chemotherapy, radiation therapy and surgery. Thechances of surviving the disease vary greatly by the type and location of the cancerand the extent of disease at the start of treatment. While cancer can affect people ofall ages, and a few types of cancer are more common in children, the risk ofdeveloping cancer generally increases with age. 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