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The more you learn about cancer, the more you will be able to take control of your experience. An ancient Chinese general once observed that knowing your enemy is the first step to true victory. That's certainly true in the battle against cancer.

Q: What is cancer?

A: Cancer is not just one disease but a group of more than 100 diseases that share a common trait — they all start when abnormal cells live longer than they should and grow out of control. As they continue dividing, abnormal cancer cells usually form a lump or mass called a tumor. Tumors can be benign (non-cancerous) or malignant (cancerous). Benign tumors grow locally and can be removed. They do not spread to other areas in the body. Malignant tumors, however, are composed of cancerous cells that can break away and travel through the blood stream or lymph system to other parts of the body. This is called metastasis. Most cancers are named for the organ or type of cell in which they start, and they continue to be called by that name even if they spread from their original location to another organ or region of the body.

Q: What causes cancer?

A: Researchers are continuing to look into the precise reasons that some people get cancer, but we can say with certainty there are two types of factors that contribute to it. One is a tendency or predisposition in some people to develop cancer, and the other is exposure to the triggers that set it off, such as smoking and sun exposure. People with cells that have a low threshold for becoming malignant may develop cancer with less exposure to a trigger than people with higher thresholds. Also, a few cancers seem to have a genetic inheritance factor.

Q: What types of cancer are there?

A: Although there are many types of cancer, they can be grouped into broad categories. The main categories include:

Carcinoma, cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma, cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia, cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and myeloma, cancers that begin in the cells of the immune system. Central nervous system cancers, cancers that begin in the tissues of the brain and spinal cord.

Q: How is cancer treated?

A: Most cancer treatment plans consist of a combination of therapies, the most common of which are the use of cancer drugs, radiation, and surgery. Your physician will discuss the best treatment option for you based on the type of cancer, its stage, and your overall health status. The treatment options include:

Chemotherapy, the use of drugs to destroy cancer cells or slow the spread of cancer. Radiation therapy, the use X-rays or other high-energy rays to kill cancer cells and shrink tumors. Surgery, a common method for treating certain kinds of cancer that appear to be locally contained. It involves the removal of a tumor and nearby tissue that may contain cancer cells. Hormone therapy, which alters the levels of hormones in the body. Immunotherapy, or biologic response modifier therapy, the use of the body's natural immune system to help fight cancer. Bone marrow and stem cell transplants, used mostly for cancers of the blood and lymph system (leukemia and lymphoma) and some solid tumors (breast and ovarian). If your doctor feels you are a candidate for a transplant, you will be referred to a transplant treatment center.

Q: What are the stages of cancer?

A: Cancer stages describe the extent of the disease in a given individual. "Staging" a cancer is important to the care team because it helps doctors to plan a person's treatment, estimate the person's prognosis (likely outcome or course of the disease), and identify clinical trials (research studies) that may be suitable for a particular patient. Although there are finer designations within each stage, here are the basic stages:

Stage 0 — Early cancer that is present only in the layer of cells in which it began.

Stage I, Stage II, and Stage III — Higher numbers indicate more extensive disease: greater tumor size, and/or spread of the cancer to nearby lymph nodes and/or organs adjacent to the primary tumor.

Stage IV — The cancer has spread to another organ.

Q: Will there ever be a universal cure for cancer?

A: A universal miracle cure is unlikely, but advances are being made continually that increase the odds of surviving cancer. At the present time, more than half of the people who are diagnosed with some form of cancer have a good chance of long-term survival. It is quite likely that medical science will make further advances in some cancers.

Q: Does the Tunnell Cancer Center participate in clinical trials of new treatments and drugs?

A: Clinical trials are research studies in which people help doctors find ways to improve health and healthcare. The Tunnell Cancer Center has a clinical affiliation agreement with Christiana Care's Helen F. Graham Cancer Center to participate in the Community Clinical Oncology Program. This partnership enables Beebe Healthcare patients to take part in National Cancer Institute research protocols and clinical trials.

Q: What is genetic counseling?

A: Talking with a genetic counselor at the Tunnell Cancer Center may help you better understand how and if genetics played a role in your cancer. Some people inherit changes in a cancer-associated gene from their parents. Since the DNA of a number of genes must be altered for a cell to become cancerous, just one alteration won't cause cancer by itself. But an inherited DNA change means people who have it are at higher-than-average risk for certain types of cancer.

People want to know their cancer risk for many different reasons:

Understand the risk of cancer for themselves or their children. Discover if inheritance played a role in the development of their cancer or a family member's cancer. Obtain information about cancer screening tests, such as mammography or colonoscopy and how often the tests should be done. Make decisions about the use of hormone replacement therapy or preventive surgery. Investigate the feasibility of genetic (DNA) testing for cancer-predisposing genes.