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What is cancer

Adriana Sandini Mioto
Dr. Alice Zelmanowicz

Known since the early history of medicine, cancer occupies a prominent place among the causes of death. In this interview, conducted with Dr. Alice Zelmanowicz, coordinator of the Department of Epidemiology and Prevention of Cancer Center of the Brotherhood of Santa Casa de Misericordia Porto Alegre, and author of several publications, we take this disease, its signs, symptoms and consequences, because ever since its discovery a lot of progress in knowledge and treatments.

Queen - What is cancer?

Alice Zelmanowicz - Cancer is a disease that happens when a group of cells lose their original features and is growing wildly. These cells multiply faster than the original tissue that gave rise to the organs and compress your back, giving signs and symptoms. Also, your cells, cancer cells have the ability to invade the tissues around and come off, enter the bloodstream or lymphatic and staying in a distant tissue, which is called metastasis. This loss of features and control over cell growth can occur in any tissue or organ of the body.

The way cancer will manifest depends basically on the type of cell that has undergone these changes and the place or organ of the body where it happened. Already metastases originate in one place and appear in another, but have characteristics similar to tumor cells that gave rise to them. For example, a breast cancer can metastasize to the lungs or brain, and these cells will look like, at the microscopic level, the breast tumor.

Queen - Why are people so afraid of this disease that in many cases they refer to it as one disease, avoiding pronounce his name?

Alice Zelmanowicz - cancer, for a long time in the history of medicine, has suffered a big taboo and caused great fear, because there was no technology for precise and early diagnosis. In addition, the treatment causes many side effects and suffering without a real change in the natural history of disease if I could. At that time, a person diagnosed with cancer was seen as someone who would suffer greatly from the treatment and symptoms of evolution disease and, ultimately, would die shrouded in so much pain and sadness. As long as with other diseases such as tuberculosis. But with the advancement of science, new tools to make the diagnosis and new treatment options have changed that reality, and today we live with people who have had cancer, did the necessary treatment and live as normal a life as others who have other chronic diseases.

Even today, people with cancer suffer with fear and sometimes discrimination against their neighbors. This is because many people still do not recognize as the treatment and prognosis of a person with cancer has changed. Seeing someone in a wig or that you're doing chemotherapy still cause much discomfort or penalty, although in most cases, the patient himself was not feeling so bad.

Queen - When you suspect that you are cancer?

Alice Zelmanowicz - Any person who notices something different in your body, like a lump, an abnormal bleeding or pain not explained by an identifiable reason should seek a doctor you trust to be examined. These symptoms are not necessarily related to cancer, but are what is called the warning signs and only a doctor can make the differential diagnosis. Thinning not expected or planned are also part of the warning signs.

People who have a first-degree relative with any type of cancer should be vigilant for possible signs or symptoms related to that type of cancer, since their chance of developing the same kind is always greater than that of others.

Persons exposed to known risk factors such as smoking, for example, should consult their doctor regularly and whenever they notice any unexplained changes in your body, since these factors can increase your risk of developing cancer.

Queen - All types are predictable, detectable early?

Alice Zelmanowicz - Early detection is that when a cancer is discovered before it causes a change in people in the form of signs or symptoms. Most cancers can be detected early, because there is no technology to do so. But the good news is that the most common cancers and causes more deaths can be prevented in some way. Breast cancer, colon and prostate can be detected early in many situations.

Queen - What kind of tests are used for that purpose?

Alice Zelmanowicz --

Each type of cancer is diagnosed in a specific way. Usually they are diagnosed early by physical examination by a doctor when you come on a routine or a change. If the doctor finds something that suggests a specific disease, called complementary tests to confirm his suspicion. If there is anything still seek imaging or laboratory should be performed periodically to detect precancerous lesions or cancers in their earliest stage. For breast cancer, this test is a screening mammogram. For colon cancer can be an endoscopy of lower digestive tract, such as colonoscopy or sigmoidoscopy.

Queen - If a cancer is detected early, the medicine has the means to change the course of the disease?

Alice Zelmanowicz - only you do tests for early detection of cancers that are treated early also cause less suffering and less death. Do not make a person know that she has cancer as early as possible if you can not offer a change in the natural history of this disease. While it may seem illogical, we do not have technical resources to change the evolution of all types of cancer.

Queen - Scientific studies have discovered who are more likely to develop any cancer?

The lice Zelmanowicz - Most are related to some known risk factors. They are: tobacco, alcohol, obesity, sedentary lifestyle and poor diet in foods of plant origin. People who have a lifestyle of these habits are those with the greatest chance of having cancer.

Queen - Is there a genetic predisposition?

Alice Zelmanowicz - Having had a close relative with any cancer gives the person a higher risk of having that type of cancer. This is called familial aggregation. This means that the cancer may run in families. This is partly because these cancers may have a genetic predisposition, but also in part by the lifestyle, habits and cultural features that are added in families. People exposed to similar risk factors may develop the same type of cancer.

Queen - What are the treatments available today? All types are treated equally?

Alice Zelmanowicz - The types of treatment for most common cancers are surgery, chemotherapy and radiotherapy. They are chosen depending on where the cancer started, what stage of evolution is, how it spread and what are the clinical conditions of the patient.

Queen - How is the development? He can be considered evil since the beginning?

Alice Zelmanowicz - Every person has cancer cells circulating in your body. The immune system clears the body of these cells, and these people will never have a tumor. However, in some, the immune system can not do this properly and cleaning the cells start to grow wildly. When all these cells is to invade surrounding tissue and cause some kind of symptom is that it says that she is a cancer. In some types of cancer can identify the early stages of these tumors. In such cases, there is talk in the pre-malignant. If nothing is done and the cells continue to grow, eventually becoming a cancer.

The time between a malignant cell is not identified by the immune system and gain the ability to continue to play wildly to become a cancer is likely to be different for each type of cancer and also for each type of person, depending on the risk factors that person is exposed and how your immune system.

Queen - What is metastasis?

Alice Zelmanowicz - Metastasis is a tumor that started in a tissue or organ and, through blood vessels or lymph nodes, was to stay in a place other than where they started.

Queen - Is there a cure for some kind? What are the most aggressive?

Alice Zelmanowicz - Several types of cancer when detected and treated early can be cured, such as skin cancer or uterus. Even when some found in a later stage can be cured, such as testicular cancer or some children. The types are more aggressive sarcomas and melanomas.

Queen - What determines whether a person will heal or not?

Alice Zelmanowicz - The chance of curing a person is related to the type of cancer she has and what stage is when you start treatment. In addition, for tumors in which the first treatment option is surgery, it is important to be able to remove all the tumor to increase the chance of cure. You must remember, however, that many people live with a good quality of life even if not completely cured. They control the cancer and are not necessarily affected in their day-to-day by the presence of tumor.

Queen - What are the main risk factors?

Alice Zelmanowicz - Smoke of any kind, use alcohol abusively, obesity, sedentary lifestyle, diet low in plant foods, sun exposure at a time and inadequate quantity and exposure to cancer-related infections such as hepatitis B and C, human papilloma virus (HPV) and human immunodeficiency virus (HIV).

Queen - To reduce the chances of developing cancer, what are your suggestions?

Alice Zelmanowicz - Looking for a healthy lifestyle. Avoid habits known to be related to the development of cancer. Visit your doctor regularly and do a consultation to identify where something changed in your body or have any symptoms.

Queen - What is the incidence of cancers in children? What are the most common and care that parents should have with their children to prevent or detect any abnormality early?

Alice Zelmanowicz - Cancer in children is very rare when compared with the incidence in adults. The data on childhood cancers are very difficult to be compiled. In Brazil, they probably do not represent the reality, and they are relatively old.

The most common cancers in children are leukemias that affect the white blood cells, tumors of the central nervous system lymphoma affecting the lymph nodes and lymphatic system. Also affect children neuroblastoma (tumor of sympathetic ganglia), Wilms tumor (kidney tumor), retinoblastoma (tumor of the retina of the eye), germ cell tumor (tumor cells that will give rise to the gonads), osteosarcoma (bone tumor) and sarcomas (soft tissue tumors).

According to the National Cancer Institute (Inca), is important for parents to know that some changes may be related to these tumors. For example:
In leukemias, the invasion of the bone marrow by abnormal cells, the child becomes susceptible to infections, is pale, you feel pain and bleeding bone.
In retinoblastoma, an important sign of manifestation is called the reflection of cat's eye, whitening of the pupil when exposed to light. Can also present with photophobia or strabismus. Usually affects children before the age of three. Sometimes, the parents noted a mass in the abdomen, but may, in this case too, a Wilms tumor or neuroblastoma. Solid tumors may manifest by the formation of a tumor, and be visible and cause pain in the limbs, a symptom, for example,
frequent in osteosarcoma (bone tumor growth), more common in adolescents.
Tumor of the central nervous system is like symptoms, headache, vomiting, motor abnormalities, cognitive dysfunction and nerve paralysis.
Child does not invent symptoms. If any abnormalities appear, parents should take their children to the pediatrician for an evaluation. However, it is very important to know that the very great majority of cases, these symptoms are related to common childhood illnesses rather than cancer. But that does not be a reason for not taking her to the doctor.

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