ACS :: General Questions and Answers

Cancer is not just one disease but rather a group of diseases. Cancer develops when cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because of out-of-control growth of abnormal cells.

Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person's life, normal cells divide more rapidly until the person becomes an adult. After that, cells in most parts of the body divide only to replace worn-out or dying cells and to repair injuries.

Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to form new abnormal cells.

Cancer cells develop because of damage to DNA. This substance is in every cell and directs all its activities. Most of the time when DNA becomes damaged the body is able to repair it. In cancer cells, the damaged DNA is not repaired. People can inherit damaged DNA, which accounts for inherited cancers. Many times though, a person’s DNA becomes damaged by exposure to something in the environment, like smoking.

Cancer usually forms as a tumor. Some cancers, like leukemia, do not form tumors. Instead, these cancer cells involve the blood and blood-forming organs and circulate through other tissues where they grow.

Often, cancer cells travel to other parts of the body, where they begin to grow and replace normal tissue. This process is called metastasis. Regardless of where a cancer may spread, however, it is always named for the place it began. For instance, breast cancer that spreads to the liver is still called breast cancer, not liver cancer.

Not all tumors are cancerous. Benign (non-cancerous) tumors do not spread (metastasize) to other parts of the body and, with very rare exceptions, are not life threatening.

Different types of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. That is why people with cancer need treatment that is aimed at their particular kind of cancer.

Cancer is the second leading cause of death in the United States. Nearly half of all men and a little over one-third of all women in the United States will develop cancer during their lifetimes. Today, millions of people are living with cancer or have had cancer. The risk of developing most types of cancer can be reduced by changes in a person's lifestyle, for example, by quitting smoking and eating a better diet. The sooner a cancer is found and treatment begins, the better are the chances for living for many years.

No, cancer is not contagious. In the past, people often avoided those who had cancer. They feared diseases of all kinds, and didn't know enough about illness to understand that they were in no danger. Even today, families, friends, and co-workers of people with cancer sometimes shy away from them when they learn about the disease. As a result, people with cancer often say they feel isolated and alone. You don't have to stay away from someone with cancer -- you cannot catch it from them. In fact, that person could probably use your company even more.

Researchers have done many studies to see if there is a link between personality, stress, and cancer. No scientific evidence has shown that someone's personality can increase their cancer risk. Although findings do not always agree, the feeling of being stressed does not appear to be a strong predictor of cancer. Major life stressors, such as divorce or the death of a loved one, may raise cancer risk slightly. Also, poverty is linked to higher cancer risk, but this may be more related to health behaviors and poor access to medical care than to poverty itself. Of interest, several studies have shown that people who are socially isolated are more likely to die of all causes, including cancer. Whether this is true for people who have already been diagnosed with cancer is not known.

We do know that social support and practical help improves the quality of life of people with cancer. It also helps them cope better with their diagnosis, treatment, and recovery. If one of your co-workers has cancer, offering your emotional support and assistance is a key step toward helping that person manage the effects of their cancer.

Pain is one of the reasons people fear cancer. If someone you know has cancer, it is normal to be worried about seeing him or her in pain. But there are some cancers which cause no physical pain at all. When a person with cancer does have pain it can be caused by a number of things. Some people have pain because of the growth of the tumor or as a result of advanced cancer, while others may have pain as a result of surgery or the side effects of treatment.

You should also know that the cancer care team can treat and manage almost any kind of pain. A great deal of progress has been made in pain control, so pain can be reduced or relieved in almost all cases. Even patients with advanced disease can be kept comfortable.

If you work with someone being treated for cancer pain, you may also wonder if they will become addicted to the pain medicine. But the evidence shows that people who take prescribed drugs for cancer pain in general do not become addicted. For more on this, please see our information, Pain Control: A Guide for Those with Cancer and Their Loved Ones.

No, absolutely not. The most recent available data shows that 60% of people diagnosed with cancer are still alive 10 years later. Among those who are not cured of cancer, many can still go on living for some years, even though there will be changes in their lives. For these people, cancer is much like diabetes or heart disease -- a chronic illness that is mostly controlled with treatment.

If someone you work with has cancer, it's especially important for you to realize that cancer is not a death sentence. If you believe that they are beyond hope or help, you may not offer them your support. The truth is that they may be living with a disease that can be treated. Keep in mind that cancer is often treatable, even curable. This will help you focus on supporting that person as they learn to live with cancer. So remember the good news: there are more than 11 million Americans alive today who have had cancer, and the survival rate is improving all the time.

If someone you work with is being treated for cancer, you may want to learn more about what they are going through. Surgery, chemotherapy, and radiation are the main types of cancer treatment.

Surgery is often the first treatment option if the tumor can be removed from the body. Sometimes only part of the tumor can be removed. Radiation, chemotherapy, or a combination of both might be used to shrink the tumor before or after surgery. For more information, please see our document, Surgery.

Doctors use chemotherapy to kill cancer cells. The term chemotherapy (often shortened to chemo) refers to the use of drugs to kill cancer cells. Usually, the drugs are given intravenously (into a vein) or taken by mouth. Chemo drugs then travel through the body in the bloodstream, reaching cancer cells that may have spread (metastasized) from the tumor to other places in the body. For more information, please see, Understanding Chemotherapy: A Guide for Patients and Families.

Radiation therapy uses treatment with high energy rays (such as x-rays) to kill cancer cells and shrink tumors. The radiation may come from outside the body (external radiation) or from radioactive materials placed directly in the tumor (internal or implant radiation). The procedure for getting external radiation is much like getting an x-ray. The radiation itself is painless, although tissue damage may cause side effects. For more information, please see the ACS document, Understanding Radiation Therapy: A Guide for Patients and Families.

Other, newer kinds of treatment you might hear about include hormone therapy, stem cell or bone marrow transplant, immunotherapy, and targeted therapy. Hormone therapy is sometimes used to treat certain kinds of prostate and breast cancers. Immunotherapy is treatment that can boost the cancer patient's own immune system to help fight the cancer. Targeted therapy is treatment that targets the cancer cells and causes less damage to healthy cells. Please call us or visit our Web site if you would like to learn more about these types of cancer treatment.

You might know someone else being treated for a similar type of cancer, but don't assume that 2 people will respond the same way to treatment. Each cancer is different, and each person's response to treatment is unique. It is best not to compare one person's treatment to another's.

The type of treatment a person gets will depend on the type and stage (how far the cancer has spread) of cancer, the age of the patient, and other medical problems and treatments the person has had. Each drug or treatment plan has different side effects. It is hard to predict what side effects will happen, even when patients get the same treatment. Some effects can be severe and others fairly mild. Although it is true that some people have a tough time with cancer treatment, there are also many who manage fairly well and are able to work during treatment. But sometimes working during treatment requires changing work schedules, since many cancer treatments are only given during the day.

Short-term (and often treatable) side effects of chemo can include nausea and vomiting, loss of appetite, hair loss, and mouth sores. Because chemo can damage the blood-producing cells of the bone marrow, patients may have low blood cell counts. Low blood counts can cause certain side effects, such as:

For these reasons, cancer care teams watch for and manage chemotherapy's side effects carefully.

Because everyone's body is different, each person responds differently to chemo. Most of the side effects of chemo will go away after treatment ends. For example, hair lost during treatment nearly always grows back after treatment. In the meantime, most patients are able to use wigs, scarves, or hats to cover, warm, or protect their heads.

Radiation treatments are much like x-rays and are not painful. The most common side effects are skin irritation and severe tiredness called fatigue. Fatigue is especially common when treatments go on for several weeks. It is a feeling of extreme tiredness and low energy which often does not get better with rest. People also report fatigue caused by the daily trips to the hospital to get their radiation treatments.

Many people work throughout the course of their radiation treatments, though it is also common for them to adjust their schedules or work fewer hours until they feel better. Sometimes people are not able to keep working during treatment because of the extreme fatigue or other side effects. One of the most important things you can do for a co-worker with cancer is to help them maintain a flexible schedule. Cancer treatment and its side effects can be unpredictable; expect your co-worker to have good days and bad days.

This is a common myth that can shorten lives. People who believe that cancer treatment is worse than cancer itself might not follow important treatment recommendations that can prolong life or even cure their cancer.

It is easy to understand the source of this myth. Often people diagnosed with cancer have never had any symptoms or pain. For others, the symptoms have just started and are not yet severe. But once the treatment starts, they often begin to feel pretty sick. It is true that chemo, radiation, and surgery can cause distressing and sometimes serious side effects. But most of them can be treated and will go away after treatment ends, and cancer treatment can be life-saving.

There are times when every cancer patient questions their commitment to the difficult journey of treatment and its side effects. Sometimes they can get discouraged by the uncertainty of treatment, and wonder if it's worth it. This is normal. It may help to remember that every year cancer treatments get more and more effective, and doctors keep learning better ways to control treatment side effects.

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