Cancer

Definition
Cancer is not just one disease, but a large group of almost 100 diseases. It is a genetic disease, with two main characteristics of uncontrolled growth of the cells in the human body and the ability of those cells to migrate from the original site and spread to distant sites.

Description

One out of every four deaths in the United States is from cancer. It is second only to heart disease as a cause of death in the United States. About 1.2 million Americans are expected to be diagnosed with cancer each year, of which more than 500,000 are diagnosed as terminally ill. Cancer can attack anyone. Since the occurrence of cancer increases as people age, most cases are seen in adults, middle-aged or older. The most common cancers are skin cancer, lung cancer, colon cancer, breast cancer (in women), and prostate cancer (in men). In addition, cancer of the kidneys, ovaries, uterus, pancreas, bladder, rectum, blood (leukemia), and lymph nodes (lymphoma) are also included among the 12 major cancers that affect most Americans.

Cancer, by definition, is a disease of the genes. A gene is a small part of DNA, which is the master molecule of the cell. Genes make proteins, which are the ultimate workhorses of the cells. It is these proteins, along with other substances, that allow our bodies to carry out the many processes that permit people to breathe, think, move, etc. Many genes produce proteins that are involved in controlling the processes of cell growth and division. An alteration, or mutation, to the DNA molecule can disrupt the genes and produce faulty proteins. This causes the cell to become abnormal and lose its restraints on growth. The abnormal cell begins to divide uncontrollably and eventually forms a new growth known as a tumor or neoplasm (medical term for cancer meaning "new growth"). In a healthy individual, the immune system can recognize the neoplastic cells and destroy them before they get a chance to divide. However, some mutant cells may escape immune detection and survive to become tumors or cancers.

Tumors are of two types, benign or malignant. A benign tumor is slow growing, does not spread or invade surrounding tissue, and once removed, it does not usually recur. A malignant tumor, on the other hand, invades surrounding tissue and has the capacity to spread to other parts of the body. If the cancer cells have spread to the surrounding tissues, then, even after the primary malignant tumor is removed, it generally recurs either locally or to a distant site. A majority of cancers are caused by changes in the cell's DNA because of damage due to the cell's environment. Environmental factors that are responsible for causing the initial mutation in the DNA are called carcinogens, and there are many types. Some cancers also have a genetic basis. In other words, an individual could inherit faulty DNA from a patient's parents, which could predispose the patient to getting cancer. There is also the two "hit" theory, where there is a combination of a genetic mutation and a stimulation of cell division and/or replication, due to environmental circumstances. While this scientific evidence points to both factors (environmental and genetic) playing a role, less than 10% of all cancers are purely hereditary. Cancers that are known to have a hereditary link are breast cancer, colon cancer, ovarian cancer, and uterine cancer. In late 2001, scientists took one step closer to identifying genetic markers that indicate cancer susceptibility. Called "low penetrance genes," these markers are believed to combine to increase risk for cancer.

There are several different types of cancers. Carcinomas are cancers that arise in the epithelium (the layer of cells covering the body's surface and lining the internal organs and various glands). Ninety percent of human cancers fall into this category. Melanomas are cancers that originate in the skin, usually in the pigment cells (melanocytes). Sarcomas are cancers of the supporting tissues of the body, such as bone, muscle, and blood vessels. Cancers of the blood and lymph glands are called leukemias and lymphomas respectively. Gliomas are cancers of the nerve tissue.

Causes & Risk Factors
The major risk factors for cancer are: tobacco, alcohol, diet, sexual and reproductive behavior, infectious agents, family history, occupation, environment, and pollution. According to the estimates of the American Cancer Society (ACS), approximately 40% of the cancer deaths in 2003 were due to tobacco and excessive alcohol use. An additional one-third of the deaths were related to diet and nutrition. Many of the one million skin cancer cases were due to overexposure to ultraviolet light from the sun's rays. It should be noted that medical science has not been able to pinpoint many of the exact causes of cancer, but has been able to estimate risk factors and occurrence associated with various agents.

Tobacco
Eighty to ninety percent of lung cancer cases occur in smokers. Smoking has also been shown to be a contributory factor in cancers of the upper respiratory tract, esophagus, larynx, bladder, pancreas, and probably liver, stomach, breast, and kidney, as well. Recently, scientists have also shown that second-hand smoke (or passive smoking) can increase one's risk of developing cancer.


Alcohol 
Excessive consumption of alcohol is a risk factor in certain cancers, such as liver cancer. Alcohol, in combination with tobacco, significantly increases the chances that an individual will develop mouth, pharynx, larynx, and esophageal cancers.


Diet
Thirty five percent of all cancers are estimated to be due to dietary causes. Excessive intake of fat leading to obesity has been associated with cancers of the breast, colon, rectum, pancreas, prostate, gall bladder, ovaries, and uterus.


Infectious agents. In the last 20 years, scientists have obtained evidence to estimate that 15% of the world's cancer deaths may be traced to viruses, bacteria, or parasites.

Family history. Certain cancers like breast, colon, ovarian, and uterine cancer, recur generation after generation in some families. A few cancers, such as the eye cancer "retinoblastoma," a type of colon cancer, and a type of breast cancer known as "early-onset breast cancer," have been shown to be linked to certain genes that can be tracked within a family. It is therefore possible that inheriting particular genes makes a person susceptible to certain cancers.
Occupational hazards. There is evidence to estimate that certain occupational hazards account for 4% of all cancer deaths. For example, asbestos workers have an increased incidence of lung cancer. Similarly, a higher likelihood of getting bladder cancer is associated with dye, rubber, and gas workers; skin and lung cancer with smelters, gold miners, and arsenic workers; leukemia with glue and varnish workers; liver cancer with PVC manufacturers; and lung, bone, and bone marrow cancer with radiologists and uranium miners.

Environmental radiation. Exposure is believed to cause 1–2% of all cancer deaths. Ultra-violet radiation from the sun accounts for a majority of melanoma deaths. Other sources of radiation are x rays, radon gas, and ionizing radiation from nuclear material.
Pollution. Several studies have shown that there is a well established link between asbestos and cancer. Chlorination of water may account for a small rise in cancer risk. Studies released in 2003 showed that cadmium, a natural metal found in food, water, and cigarette smoke, disturbs a system in our cells essential to preventing cancer. The main danger from pollution occurs when dangerous chemicals from the industries escape into the surrounding environment. It has been estimated that 1% of cancer deaths are due to air, land, and water pollution.

Alternative medicine tends to disagree with conventional medicine about the causes of cancer, claiming that environmental pollution and emotional and psychological factors are major influences upon the disease. Samuel S. Epstein, a professor of Occupational and Environmental Medicine at the University of Illinois and the chairman of the Cancer Prevention Coalition, is one of the strongest critics of the National Cancer Institute and the American Cancer Society (ACS). Epstein tends to echo many of the beliefs of alternative practitioners. He claims that mainstream medicine, driven by politics, profits, and pharmaceutical sales, is not discussing or sufficiently researching some major factors behind cancer, or researching ways of preventing those causes. Epstein asserts that a primary cause of cancer is the massive pollution of the air, water, food, and workplace. For instance, since the 1940s over 100,000 new chemicals have been added to the environment, and each year in the United States alone, over 10 lb (4.5 kg) of pesticides and herbicides per person are used on the food supply, chemicals that are proven to be carcinogenic. Epstein believes that the human immune system simply cannot handle all the new carcinogens and stresses in the environment, and cancer represents this breakdown of the immune system. He is also a critic of some conventional cancer therapies like radiation and chemotherapy, claiming that the therapies themselves are highly carcinogenic and are often responsible for recurrent cancer. Epstein points out that despite the "war on cancer" by mainstream medicine, mortality rates have not been significantly improved by its methods, and more research needs to be dedicated to preventative and alternative measures instead of pharmaceuticals and invasive treatments.

Symptoms
Cancer is a progressive disease, and goes through several stages with varying symptoms. Some symptoms are produced early and may occur due to a tumor that is growing within an organ or a gland. As the tumor grows, it may press on the nearby nerves, organs, and blood vessels.
This causes pain and some pressure that may be the earliest warning signs of cancer. Despite the fact that there are several hundred different types of cancers, producing very different symptoms, the ACS has established the following seven symptoms as possible warning signals of cancer:
•    changes in the size, color, or shape of a wart or a mole
•    a sore that does not heal
•    persistent cough, hoarseness, or sore throat
•    a lump or thickening in the breast or elsewhere
•    unusual bleeding or discharge
•    chronic indigestion or difficulty in swallowing
•    any change in bowel or bladder habits
Many other diseases besides cancer, could produce the same symptoms. However, it is important to have these symptoms checked as soon as possible, especially if they linger. The earlier a cancer is diagnosed and treated, the better the chance of it being cured. Many cancers, such as breast cancer, may not have any early symptoms. Therefore, it is important to undergo routine screening tests, such as breast self-exams and mammograms.

Diagnosis

Diagnosis begins with a thorough physical examination and a complete medical history. The doctor will ob serve, feel, and palpate (apply pressure by touch) different parts of the body in order to identify any variations from the normal size, feel, and texture of the organ or tissue. As part of the physical exam, the doctor will inspect the oral cavity, or the mouth. By focusing a light into the mouth, he or she will look for abnormalities in color, moisture, surface texture, or presence of any thickening or soreness in the lips, tongue, gums, the hard palate on the roof of the mouth, and the throat.
To detect thyroid cancer, the doctor will observe the front of the neck for swelling. He may gently manipulate the neck and palpate the front and side surfaces of the thyroid gland (located at the base of the neck) to detect any nodules or tenderness. As part of the physical examination, the doctor will also palpate the lymph nodes in the neck, under the arms, and in the groin. Many illnesses and cancers cause a swelling of the lymph nodes.
The doctor may conduct a thorough examination of the skin to look for sores that have been present for more than three weeks and that bleed, ooze, or crust; irritated patches that may itch or hurt, and any change in the size of a wart or a mole. Examination of the female pelvis is used to detect cancers of the ovaries, uterus, cervix, and vagina. In the visual examination, the doctor looks for abnormal discharges or the presence of sores. Then, using gloved hands the physician palpates the internal pelvic organs such as the uterus and ovaries to detect any abnormal masses. Breast examination includes visual observation where the doctor looks for any discharge, unevenness, discoloration, or scaling. The doctor palpates both breasts to feel for masses or lumps. For males, inspection of the rectum and the prostate is also included in the physical examination. The doctor inserts a gloved finger into the rectum and rotates it slowly to feel for any growths, tumors, or other abnormalities. The doctor also conducts an examination of the testes, where the doctor observes the genital area and looks for swelling or other abnormalities. The testicles are palpated to identify any lumps, thickening, or differences in the size, weight, and firmness.
If the doctor detects an abnormality on physical examination, or the patient has some symptom that could be indicative of cancer, the doctor may order diagnostic tests. Laboratory studies of sputum (sputum cytology), blood, urine, and stool can detect abnormalities that may indicate cancer. Sputum cytology is a test where the phlegm that is coughed up from the lungs is microscopically examined. It is often used to detect lung cancer.
A blood test for cancer is easy to perform, usually inexpensive and risk-free. Blood tests can be either specific or nonspecific. Often times, in certain cancers, the cancer cells release particular proteins (called tumor markers) and blood tests can be used to detect the presence of these tumor markers. However, with a few exceptions, tumor markers are not used for routine screening of cancers, because several noncancerous conditions also produce positive results. Blood tests are generally more useful in monitoring the effectiveness of the treatment, or in following the course of the disease and detecting recurrent disease.
Imaging tests such as computed tomography scans (CT scans), magnetic resonance imaging (MRI), ultra-sound, and fiberoptic scope examinations help doctors determine the location of the tumor even if it is deep within the body. Conventional x rays are often used for initial evaluation, because they are relatively cheap, painless, and easily accessible. In order to increase the information obtained from a conventional x ray, air or a dye (such as barium or iodine) may be used as a contrast medium to outline or highlight parts of the body.

The most definitive diagnostic test is the biopsy, wherein a piece of tissue is surgically removed for microscope examination. Besides confirming a cancer, the biopsy also provides information about the type of cancer, the stage it has reached, the aggressiveness of the cancer, and the extent of its spread. Since a biopsy provides the most accurate analysis, it is considered the gold standard of diagnostic tests. Screening examinations, conducted regularly by healthcare professionals, can result in the detection of cancers of the breast, colon, rectum, cervix, prostate, testes, tongue, mouth, and skin at early stages, when treatment is more likely to be successful. Some of the routine screening tests recommended by the ACS are sigmoidoscopy (for colorectal cancer), mammography (for breast cancer), pap smear (for cervical cancer), and the PSA test (for prostate cancer). Self-examinations for cancers of the breast, testes, mouth, and skin can also help in detecting the tumors before the symptoms become serious.
Diagnosis in alternative treatment often relies on conventional diagnostic tools for determining the type and stage of cancer, but will supplement those tools with diagnostic techniques that strive to evaluate the overall health of a person, in order to treat a person holistically. For instance, Ayurvedic medicine and traditional Chinese medicine place high priorities during diagnosis on the patient's emotional and psychological history, as well as considerations like lifestyle, relationships, and the degree of social and spiritual support, in order to have insight into the cause and proper treatment of a particular cancer. These alternative practices also have highly developed diagnostic techniques for the body, including pulse diagnosis; methods of analyzing the tongue, eyes, skin, hair, and fingernails; palpating and finding problems in the organs and abdomen; and listening to the breath for clues to the internal environment.

Treatment
Choosing an Alternative Cancer Treatment
There are a multitude of alternative treatments available to help a person with cancer. They are usually integrated with allopathic treatments like surgery, chemotherapy, and radiation therapy, where only an estimated 4% exclusively use alternative medicine. Chemotherapy and radiation treatments are some of the most painful and toxic of conventional treatments, and often have unpredictable results. As a rule, alternative treatments are less invasive, nontoxic, and have minimal side effects. When used as adjuncts to conventional treatment, some alternative treatments have been shown to decrease pain and side effects, aid in the recovery process, and improve the quality of life of cancer patients.

Alternative treatment of cancer is a complicated arena and choosing one from the many can seem a difficult task, as can choosing an alternative practitioner. Patients should consult as many trained health practitioners as feasible when choosing alternative therapies. If patients are willing to ask questions and thoroughly re-search their options, they can increase their chances of getting the best possible alternative support for the difficult task of treating cancer.
When choosing alternative treatment, individuals should evaluate practitioners, therapies, and services delivered by clinics or practitioners, as well as the extent of documentation and published literature regarding these concerns. When looking for practitioners, patients should evaluate their training and credentials and their reputations in the healing community. Referrals from other patients should be requested. Furthermore, they should seek practitioners who are knowledgeable and familiar with a broad spectrum of options of treating cancer, including those used by conventional medicine, and who are willing to work in conjunction with conventional doctors if the patient and treatment requires it. Conversely, if patients choose a physician who employs and recommends conventional, allopathic methods, that physician should be willing to communicate with patients, as well as communicate with an alternate provider. Another major consideration when choosing a practitioner is whether he or she seems trustworthy, ethical, and compassionate.

Patients should also evaluate the particular therapy offered by a practitioner or clinic. They should find out exactly how the therapy works and the principles behind it; whether it is harmless or potentially damaging, and the positive benefits it offers; what literature and scientific studies exist for the therapy; and what other patients say about the treatment.

Finally, patients should evaluate the quality of service that the practitioner or clinic offers. Cost, reputation, quality of support personnel, and attention to individual needs are important considerations when evaluating the service dimension of a treatment.

Types of Alternative Treatment
Alternative medicine generally views cancer as a holistic problem. That is, cancer represents a problem with the body's overall health and immunity. As such, treatment is holistic as well, striving to strengthen and heal the physical, mental, and spiritual aspects of patients. Alternative cancer treatments may emphasize different basic approaches, which include traditional medicines, psychological approaches, nutritional and dietary approaches, physical approaches, integrated approaches, and experimental programs.

TRADITIONAL MEDICINES. Traditional Chinese medicine uses acupuncture, acupressure massage, herbal remedies, and movement therapies like t'ai chi and qigong to treat cancer. Traditional Chinese herbal remedies have already contributed a significant number of anticancer drugs, as studies have shown their anti-cancer properties and immune stimulants. A 2001 report noted that the ancient compound artemisinin (worm-wood) appears surprisingly effective in targeting certain cancer cells and helping to destroy them. The therapy is much less expensive than many traditional options, but further study was underway. Acupuncture has been shown to reduce some tumors and significantly reduce pain and improve immune system activity.
Ayurvedic medicine utilizes detoxification, herbal remedies, massage, exercise, yoga, breathing techniques, and meditation as part of its cancer treatment. Panchakarma is an extensive detoxification and strengthening program that is recommended for cancer sufferers and those undergoing chemotherapy and radiation. Panchakarma uses fasting, special vegetarian diets, enemas, massage, herbal medicines, and other techniques to rid the body of excess toxins that are believed to contribute to chronic diseases like cancer, and to strengthen the immune system. Ayurvedic herbs are also being demonstrated to have significant anticancer properties.

Naturopathy and homeopathy are traditional Western healing systems using herbal medicines and other techniques to strengthen the immune system and reduce the pain of cancer treatment. Western herbalism is also beginning to compile studies of many herbs that have anticancer and immune strengthening properties.
PSYCHOLOGICAL APPROACHES. Alternative treatments that seek to help patients with the mental and spiritual challenges that cancer poses include psychotherapy, support groups, guided imagery, meditation, biofeedback, and hypnosis.
Psychological approaches work with the idea that the mind and emotions can profoundly influence the health of the body and diseases like cancer. Many studies have acknowledged that mind and emotions play a key role in cancer and immune functioning, and psychological approaches are being used by many conventional programs, including Harvard Medical School. A new field of academic medicine called psychoneuroimmunology has begun that studies the interactions between mental states and immune response.

Studies have shown that patients who approach their cancer with positive attitudes and peaceful acceptance have higher survival rates than those patients who react with negative emotions, like depression, cynicism, or helplessness. Alternative treatments use psychological approaches to help patients overcome the mental and emotional barriers to healing.

PHYSICAL APPROACHES. Physical approaches to cancer include exercise; massage therapies; movement therapies like yoga, t'ai chi and qigong; breathing techniques; and relaxation techniques. These therapies strive to increase immune system response, promote relaxation and stress reduction, and reduce side effects of conventional treatments such as pain, nausea, weakness, and physical immobility.

NUTRITIONAL AND DIETARY APPROACHES. Diet is now recognized by scientists to play a major role in reducing the risk of some cancers. A 1992 report in Oncology claimed that nutritional factors may account for up to 70% of avoidable cancer mortality in this country. Many nutritionists also state that cancer patients have heightened needs for diets free of toxic chemicals and full of cancer-fighting nutrients. Diet and nutrition can improve both a cancer patient's chances for recovery and quality of life during treatment. In laboratory studies, vitamins such as A, C, and E, as well as compounds such as isothiocyanates and dithiolthiones found in broccoli, cauliflower, and cabbage, and the antioxidant beta-carotene found in carrots, have been shown to protect against cancer. Additionally, bioflavonoids and lycophene found in green tea help in the prevention of cancer.
Dietary approaches for cancer include vegetarianism, raw food diets, macrobiotics, the Gerson diet, and the Livingston-Wheeler nutritional program, discussed below. Cancer diets generally emphasize fresh fruits, vegetables, whole grains, and legumes, and restrict intake of fat, meat, dairy products, sugar, processed foods, and other foods believed to tax cancer patients. Nutritional approaches to cancer include antioxidant and vitamin supplementation and the use of numerous herbal extracts. There are many herbs that have been shown to have anticancer, immune enhancing, and symptom reducing properties, and patients are recommended to consult competent herbalists for herbal support.

INTEGRATED APPROACHES. Keith Block is a conventional physician and oncologist who is integrating many alternative practices into his cancer treatment center affiliated with the Chicago Medical School in Illinois. His program seeks to provide individualized cancer treatment using conventional therapies while integrating alternative healing techniques. Block advocates a special diet (based on vegetarianism and macrobiotics), exercise, psychological support, and herbal and nutritional supplements. Block's program has received acclaim for both treatment success and satisfaction of patients.
EXPERIMENTAL PROGRAMS.Antineoplaston therapy was developed by Stanislaw Burzynski, a Polish physician who began practicing in Houston, Texas. Burzynski has isolated a chemical, deficient in those with cancer, which he believes stops cancer growth, and his treatment has shown some promise.
Dr. Joseph Gold, the director of the Syracuse Cancer Research Institute, discovered that the chemical hydrazine sulfate has many positive effects in cancer patients, including stopping weight loss, shrinking tumors, and increasing survival rates.

The Livingston therapy was developed by the late Dr. Virginia Livingston, an American physician. She asserted that cancer is caused by certain bacteria that she claimed are present in all tumors. She advocated a detoxification program and special diet that emphasized raw or lightly cooked and primarily vegetarian foods, with special vitamin and nutritional supplements.

The Gerson therapy was for years the best known nutritional therapy for cancer. It is available in two clinics in California and Mexico. It consists of a basic vegetarian diet low in salt and fat, with high doses of particular nutrients using raw fruit and vegetable juices. The Gerson therapy also requires patients to drink raw calf's liver juice, believed to aid the liver, and advocates frequent coffee enemas, which are claimed to help the body evacuate toxins.

Allopathic Treatment

The aim of allopathic (conventional) cancer treatment is to remove all or as much of the tumor as possible and to prevent the recurrence or spread of the primary tumor. While devising a conventional treatment plan for cancer, the likelihood of curing the cancer has to be weighed against the side effects of the treatment. If the cancer is very aggressive and a cure is not possible, then the treatment should be aimed at relieving symptoms and controlling the cancer for as long as possible. Cancer treatment can take many different forms, and it is always tailored to the individual patient. The decision on which type of treatment is the most appropriate depends on the type and location of cancer, the extent to which it has already spread, the patient's age, sex, general health status, and personal treatment preferences. The major types of treatment are: surgery, radiation, chemotherapy, immunotherapy, hormone therapy, and bone marrow transplantation.

Surgery
Surgery is the removal of a visible tumor and is the most frequently used cancer treatment. It is most effective when a cancer is small and confined to one area of the body. Surgery can be used for many purposes. Treatment of cancer by surgery involves removal of the tumor to cure the disease. Along with the cancer, some part of the normal surrounding tissue may also be removed to ensure that no cancer cells remain in the area. Since cancer usually spreads via the lymphatic system, adjoining lymph nodes may be examined and sometimes removed, as well. Preventive or prophylactic surgery involves removal of an abnormal looking area that is likely to become malignant over time. The most definitive tool for diagnosing cancer is a biopsy. Sometimes a biopsy can be performed by inserting a needle through the skin. However, at other times, the only way to obtain tissue sample for biopsy is by performing a surgical operation.

Radiation
Radiation kills tumor cells. Radiation is used alone in cases where a tumor is unsuitable for surgery. More often, it is used in conjunction with surgery and chemotherapy. Radiation can be either external or internal. In the external form, the radiation is aimed at the tumor from outside the body. In internal radiation (also known as brachytherapy), a radioactive substance in the form of pellets or liquid is placed at the cancerous site by means of a pill, injection, or insertion in a sealed container.

Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. It destroys the hard-to-detect cancer cells that have spread and are circulating in the body. Chemotherapeutic drugs can be taken either orally or intravenously, and may be given alone or in conjunction with surgery, radiation, or both. The toxic effects of chemotherapy are severe. In 2003, a new technique was developed to streamline identification of drug compounds that are toxic to cancerous cells but not to healthy cells. The technique identified nine drugs, one of which had never before been identified for use in cancer treatment. Researchers began looking into developing the new drug for possible use. In addition, it may make the body less tolerant to the side effects of other treatments that follow, such as radiation therapy. The more common use of chemotherapy is adjuvant therapy, which is given to enhance the effectiveness of other treatments. For example, after surgery, adjuvant chemotherapy is given to destroy any cancerous cells that still remain in the body.




Immunotherapy
Immunotherapy uses the body's own immune system to destroy cancer cells. This form of treatment is being intensively studied in clinical trials and is not yet widely available to most cancer patients. The various immunological agents being tested include substances produced by the body (such as the interferons, interleukins, and growth factors), monoclonal antibodies, and vaccines. Unlike traditional vaccines, cancer vaccines do not prevent cancer. Instead, they are designed to treat people who already have the disease. Cancer vaccines work by boosting the body's immune system and training the immune cells to specifically destroy cancer cells.

Hormone Therapy

Hormone therapy is standard treatment for some types of cancers that are hormone-dependent and grow faster in the presence of particular hormones. These include cancer of the prostate, breast, and uterus. Hormone therapy involves blocking the production or action of these hormones. As a result, the growth of the tumor slows down and survival may be extended for several months or years. However, in 2003, the Women's Health Initiative found that even relatively short-term use of estrogen plus progestin is associated with increased risk of breast cancer, diagnosis at a more advanced stage of the disease, and a higher number of abnormal mammograms. The longer a woman used HRT, the more her risk increased. This contradicted earlier beliefs that HRT could prevent breast cancer. So checking with a physician for the latest information is advised.

Bone Marrow Transplantation

The bone marrow is the tissue within the bone cavities that contains blood-forming cells. Healthy bone marrow tissue constantly replenishes the blood supply and is essential to life. Sometimes, the amount of drugs or radiation needed to destroy cancer cells also unfortunately destroys bone marrow. Replacing the bone marrow with healthy cells counteracts this adverse effect. A bone marrow transplant is the removal of marrow from one person and the transplant of the blood-forming cells either to the same person or to someone else. Bone marrow transplantation, while not a therapy in itself, is often used to rescue a patient, by allowing those with cancer to undergo very aggressive therapy.

In 2001, interest grew in adding hyperthermia to conventional therapy such as radiation. By raising tumors to high fever temperatures, the performance of certain cancer drugs was noted. Hyperthermia is thought to destroy cancer cells much the same way that the body uses fever to naturally combat other forms of disease.
Many different specialists generally work together as a team to treat cancer patients. An oncologist is a physician who specializes in cancer care. The oncologist provides chemotherapy, hormone therapy, and any other non-surgical treatment that does not involve radiation. The oncologist often serves as the primary physician and coordinates the patient's treatment plan. There are many other specialists involved in cancer treatment, and virtually any type of medical or surgical specialist may become involved with care of the cancer patient, should it become necessary.

Expected Results
Lifetime risk is the term that cancer researchers use to refer to the probability that an individual, over the course of a lifetime, will develop cancer or die from it. In the United States, men have a one in two lifetime risk of developing cancer, and for women the risk is one in three. Overall, African Americans are more likely to develop cancer than Caucasians. African Americans are also 30% more likely to die of cancer than Caucasians. Many cancers are curable if detected and treated at their early stages. A cancer patient's prognosis is affected by many factors, particularly the type of cancer the patient has, the stage of the cancer, the extent to which it has metastasized, and the aggressiveness of the cancer. In addition, the patient's age, general health status, and the effectiveness of the treatment being pursued are also important factors. To help predict the future course and outcome of the disease and the likelihood of recovery from the disease, doctors often use statistics. The five-year survival rates are the most common measures used. The number refers to the proportion of people with cancer who are expected to be alive five years after initial diagnosis, compared with a similar population that is free of cancer. It is important to note that while statistics can give some information about the average survival experience of cancer patients in a given population, they cannot be used to indicate individual prognosis, because no two patients or cancers are exactly alike. The unpredictability of cancer can be seen as positive, as well as negative—some patients have experienced recoveries in cases that were deemed incurable.

Alternative medicine rarely claims to be able to cure cancer on a regular basis, but many treatments seem to help with controlling symptoms, controlling the pain and side effects of conventional treatments, and increasing the quality of life for cancer sufferers. Alternative therapies have also shown unexpected results and cures. Alternative therapies may be strongest as preventative measures, before major problems like cancer occur in the body.

Prevention
Most practitioners agree that the best treatment for cancer is prevention. Having sound physical and mental health can significantly reduce the chances of getting cancer. The following guidelines are generally recommended by doctors, nutritionists, and alternative practitioners for cancer prevention and recovery:
•    Refraining from smoking.
•    Not drinking alcohol excessively.
•    Exercising regularly, at least 20 minutes per day, preferably outdoors in the fresh air.
•    Avoiding exposure to radiation. This includes avoiding unnecessary x rays, not residing near sources of natural or human-made radiation, and avoiding occupational exposure to radiation.
•    Avoiding exposure to harmful chemicals in food, the home, and workplace.
•    Maintaining proper body weight, particularly avoiding obesity.
•    Practicing safe sex.
•    Protecting the skin from overexposure to sunlight. Avoiding the midday sun between 11 A.M. and 3 P.M. and never allowing the skin to become sunburned help with prevention.
•    Eating a healthy diet. Becoming educated on and practicing dietary principles reduces the risk of cancer. These principles include eating plenty of fresh fruits, vegetables, beans, and whole grains and consuming organically grown foods when possible. Minimizing overeating and reducing intake of meat and dairy products while increasing fiber are recommended. Avoiding processed and canned foods, including soft drinks, and avoiding sugar and refined starch products like white flour also helps. Reducing the intake of fat, avoiding hydrogenated vegetable oils like margarine and shortening, and drinking filtered or spring water have been recommended.
•    Striving to maintain sound mental and emotional health is believed to help prevent cancer. Learning a technique like yoga, t'ai chi, meditation, or others can reduce stress and promote relaxation. Maintaining healthy relationships and social support systems also relieves stress.