1. CANCER

2. What is Cancer?
Cancer is a condition in which body cells become abnormal and grow uncontrollably within the body

3. Normally, cells die as they grow old or become damaged
Normally, cells die as they grow old or become damaged. The dead cells are replaced by new cells. Cancer develops when the old or damaged cells fail to die and continue to survive.

4. These are examples of old cells that are replaced by new ones.
The green cells are the bad cells that do not die and continue to divide. They have the potential to become cancer.

5. The bad cells continue to grow until they form a mass called a “tumor” or “neoplasm”.
The tumor continues to divide until it eventually forms a lump and disrupts the normal organization of a body part

6. Tumors or neoplasms refer to “new growths”
Tumors or neoplasms refer to “new growths”. Not all of them are malignant or cancerous
Benign tumors, rarely, if at all, cause patients to die from the disease.
Benign tumors remain within the original part of the body where they started to grow

7. Malignant tumors or cancers are capable of invading the blood vessels, migrate and grow in other parts of the body.
This process is known as “metastasis”

8. Example, if breast cancer cells start to grow in the bone, how do we name these cancers now? Will they be called bone cancer?

9. The breast cancer cells growing in the bone is now called Metastatic Breast Cancer NOT bone cancer.
The cancer cells that metastasize share the name of the original tumor

10. Why is cancer dangerous?
Cancer is dangerous because it can grow in other parts of the body and disrupt
the functions
of these
other organs

11. Do all patients diagnosed with cancer die from their disease?

12. SOME cancers that are detected early can be cured
SOME cancers that are detected early can be cured. Generally, these are cancers that have not yet metastasized (“transferred”) to other parts of the body

13. Unfortunately, not all cancers have symptoms, especially if the cancer is at an early stage.
Some cancers have symptoms only when they have already metastasized to other parts of the body

14. How will I know if I have cancer?

15. If cancer spreads, symptoms may appear in different parts of the body
The signs and symptoms of cancer will depend on where the cancer is, its size and how it affects other organs or structures.
A symptom is an indication of disease. It may be felt or noticed by a person but may not be easily noticed by anyone else.
A sign is defined as an observation made by a doctor, nurse, or other health care professional
If cancer spreads, symptoms may appear in different parts of the body
Examples (signs & symptoms): chest pain may be a symptom of a heart attack; fever and rapid breathing are signs of pneumonia

16. The Signs & Symptoms of Cancer are not specific

17. That is why it is important to undergo “screening” for some cancers especially if the person has “risk factors”

18. What is Screening?
Screening refers to testing persons for cancer in the absence of signs or symptoms
Screening methods are designed to check for cancer in people with no signs or symptoms

19. Detecting the cancer early through screening allows doctors to detect the cancer when it is small and less likely to have spread to other parts of the body. This also increases the chances of successful treatment or cure

20. What are risk factors?
Risk factors are those things that increase a person’s chances of developing cancer
Examples of risk factors
Cigarette smoking
Family history
Dietary habits
Exposure to chemicals

21. If a person undergoes screening, does it mean that he will not develop cancer?

22. There is no test that can detect all kinds of cancer
Screening tests are only available for:
Breast cancer
Cervical cancer
Colon & rectal cancer
Prostate cancer
Lung cancer

23. What are the Signs & Symptoms of Cancer?

24. There are no signs or symptoms that exclusively indicate presence of cancer. However, the following are conditions that MUST prompt a person to consult a doctor.

25. These symptoms must not be neglected especially if they have been present for a long time or are getting worse

26. Possible Signs & Symptoms of Cancer
Weight loss, night sweats & fever
Fatigue
Unexplained (unintentional) weight loss of 10 pounds or more may be the first sign of cancer

27. Possible Signs & Symptoms of Cancer
Persistent cough or
blood-tinged saliva
Unexplained anemia or
low blood count

28. Possible Signs & Symptoms of Cancer
Blood in the stool
Change in bowel habits

29. Possible Signs & Symptoms of Cancer
Breast lump

30. Possible Signs & Symptoms of Cancer
Breast discharge

31. Possible Signs & Symptoms of Cancer
Change in urination
Blood in the urine
Changes in urination may be a symptom of prostate cancer especially among elderly patients. Blood in the urine can signal kidney or urinary bladder cancer

32. Possible Signs & Symptoms of Cancer
Changes in wart or mole
Non-healing sores in the mouth
Any change in color or shape, loss of definite borders, or an increase in size of warts or mole should be reported to your doctor without delay.
A persistent sore in the mouth could be an oral cancer and should be dealt with promptly, especially in patients who smoke, chew tobacco, or frequently drink alcohol

33. Possible Signs & Symptoms of Cancer
Lump in the testicles

34. Possible Signs & Symptoms of Cancer
Persistent lump or swollen glands

35. Possible Signs & Symptoms of Cancer
Trouble swallowing
Hoarseness

36. The above conditions do not automatically indicate presence of cancer
The above conditions do not automatically indicate presence of cancer. These conditions can also be present in harmless situations but it would be best for the person to be seen by a doctor.

37. The Nine Warning Signs C Change in bowel or bladder habits. A U
A sore that does not heal.
Unusual bleeding or discharge.
Thickening of a lump in breast or elsewhere.
Indigestion or difficulty in swallowing.
Obvious change in a wart or mole.
Nine Warning Signs of Cancer: (examples)
Change in bowel or bladder habits – alternating constipation and diarrhea, hematochezia, melena, hematuria
A sore that does not heal – squamous cell carcinoma in sun exposed areas of the skin
Unusual bleeding or discharge – hemoptysis, vaginal bleeding in a menopausal female, hematochezia, hematuria, melena
Thickening of a lump in the breast or elsewhere – breast masses, palpable nodes, enlarging masses in the extremities
Indigestion or difficulty in swallowing – dysphagia, early satiety, gastric ulcer-like pain
Obvious change in a wart or mole – melanoma changes specially in sun exposed or frequently traumatized areas
Nagging cough or hoarseness – chronic cough specially in smokers, changes in the voice
Unexplained anemia – may be an early systemic manifestation of cancer
Sudden, unexplained weight loss – should always have cancer as a differential diagnosis.
Nagging cough or hoarseness.
Unexplained anemia.
Sudden, unexplained weight loss.

38. If you notice any major changes in the way your body functions or the way you feel, especially if they last for a long time or get worse, let your doctor know.

39. How can I prevent cancer?

40. Cancer Prevention Step 1
Don't use tobacco

41. Cancer Prevention Step 2
Eat your fruits & vegetables
Eat an abundance of foods from plant-based sources. Eat five or more servings of fruits and vegetables each day.

42. Cancer Prevention Step 3
Watch the meats you eat, choose low fat meats
Limit fat. Eat lighter and leaner by choosing fewer high-fat foods, particularly those from animal sources.

43. Cancer Prevention Step 4
Limit salt intake

44. Cancer Prevention Step 5
Limit cured, smoked & processed foods
Limit your intake of ham, longanisa, tocino, hotdogs, corned beef, tapa, tinapa, tuyo, daing

45. Cancer Prevention Step 6
Limit alcohol intake
Women should have no more than one drink a day, and men should have no more than two drinks a day.
One drink equals: 12 ounces of beer or 5 ounces of wine or 1.5 ounces of liquor

46. Cancer Prevention Step 7
Stay active and maintain a healthy weight
Try to be physically active for 30 minutes or more on most days of the week.

47. Cancer Prevention Step 8
Get immunized
Certain cancers are associated with viral infections that can be prevented with immunizations. Be immunized against:
Hepatitis B. Hepatitis B can increase your risk of developing liver cancer.
Human papillomavirus (HPV). HPV is a sexually transmitted virus that can lead to cervical cancer.

48. Cancer Prevention Step 9
Avoid risky behaviors
Reduce your risk of certain cancers by avoiding risky behaviors that can lead to infections that may increase your risk of cancer. Viruses transmitted sexually or by sharing contaminated needles include:
HPV. HPV increases your risk of cervical cancer or penis (penile) cancer. The more sexual partners you have in your lifetime, the more likely you are to have HPV.
Human immunodeficiency virus (HIV). People with HIV or AIDS have an increased risk of anal cancer, cervical cancer, liver cancer, lymphoma and Kaposi's sarcoma. People with multiple sexual partners and intravenous (IV) drug users who share needles have an increased risk of HIV.
Hepatitis B and C. Chronic hepatitis B or hepatitis C infection can increase your risk of liver cancer. Both forms of hepatitis can be passed through sexual contact with an infected person or sharing needles with an infected drug user.

49. Cancer Prevention Step 10
Get screened
Regular screening and self-examination for certain cancers may not prevent cancer, but it can increase your chances of discovering cancer early — when treatment is more likely to be successful.
Get screened for breast, cervical, prostate, colon, rectum/anus and lung cancer

50. Philippine Society of Medical Oncology
The Philippine College of Physicians wishes to acknowledge the following for their invaluable efforts in the preparation of this module
Denky dela Rosa, MD
Philippine Society of Medical Oncology