Oncology – A Diagnosis of Cancer
Looking Forward with Hope
As we live longer lives, more and more people are likely to get cancer. There are, however, millions of Americans who have been diagnosed and successfully treated for cancer. Today, they are alive and well.
Better, and regular, screening tests have helped detect cancer at its earliest and most treatable stages. Treatment methods have also improved over the years. As a result, many people go into remission and also become long-term survivors. About 60 percent of the 1.2 million people diagnosed with cancer this year will live cancer-free for five years or more. For many cancers, these people have the same life expectancy as people who never had cancer.
The American Institute for Cancer Research strongly believes that being an informed, involved patient is an important factor in overcoming cancer. In this section, we discuss the initial questions and emotions nearly all cancer patients face upon first learning that they may have cancer.
What is Cancer?
"What can I do to fight cancer?"
Although the term "cancer" is often used as if it were one disease, cancer is actually a group of over 100 different diseases affecting various parts of the body. They all have one common characteristic, however –– the uncontrolled growth and spread of abnormal cells that can invade and damage healthy body tissues and organs. Most cancers are named for the body tissue in which they begin, such as the breast, colon or skin.
Normally, cells divide to produce new cells only when the body needs them. If cells keep dividing when new cells are not needed, a mass of extra tissue, called a tumor, forms. Tumors can be benign, meaning noncancerous, or malignant, meaning cancerous. Cancer cells can break away from a malignant tumor and enter the bloodstream or lymphatic system. This is how cancer spreads, or metastasizes, to other parts of the body.
Scientists don’t know for sure why some people develop cancer and others don’t, but advancing age increases the risk of nearly all types of cancer. Cancer is rarely caused by a single factor; rather, it is the result of a complex interaction between carcinogens, or cancer-causing substances in the environment, and heredity.
The process begins with the many thousands of genes found in each cell of the human body. Made up of DNA, genes carry instructions for making the proteins that regulate all body processes, including how efficiently we process foods, metabolize toxins, and fight infections.
Genes are activated, or switched on and off, by signals in the body or by environmental influences. For instance, an unhealthy diet, cigarette smoke, too much sun, or high levels of certain chemicals, can damage the DNA and cause genes to mutate, or change. Most of the time, regulator genes in the cells can recognize when the DNA is damaged and fix the problem so that it is not copied into new "daughter" cells. When the repair mechanism doesn’t work properly, because of an inherited or environmentally-caused mutation, the damaged cell continues to grow and multiply abnormally, and can eventually lead to cancer.
It is generally believed that cancer is triggered by defective genes. However, most people who get cancer do not inherit altered, or mutated, genes. In fact, only about five to ten percent of all cancers are caused by an inherited "cancer gene." Even if there is a strong family history of a particular cancer, it does not mean that cancer is inevitable. Dietary and lifestyle factors can interact with the genes to influence whether a person at risk for cancer actually gets the disease.
Researchers are making great progress in their understanding of cancer and its causes. As they continue to find better ways to diagnose and treat cancer, the chances of recovery keep improving. Many individuals who have been successfully treated for cancer are able to lead normal, active lives.
The road to recovery begins with an understanding of your diagnosis and what it means to you and your family.
Understanding Your Diagnosis
It is very important to understand the diagnosis you are receiving from your doctor or health care provider. Powerful emotions are a natural response to even a potential diagnosis of cancer, but getting the facts about your situation will help you make the right decisions in the days ahead.
If you are nervous or don’t think you’ll remember what you are being told, then bring someone with you, ask your doctor to write out the information you need, or take notes yourself. Don’t be afraid to ask questions. Make sure you understand what the doctor is saying. If medical jargon is confusing you, then ask the doctor to explain the answer in a different way.
It’s in your best interest to be an involved and informed patient. So, let your doctor know you want to be an active participant in your health care. Try to build a relationship with your doctor and health care team. A good doctor will not only have exceptional medical knowledge about your condition, but will also offer support, listen to your concerns, and explain medical procedures and options to your satisfaction.
Below are some questions you’ll want answered, to help you take charge of your health and medical care.
Questions to Ask Your Physician and Other Health Care Providers About Your Diagnosis
- Exactly what type of cancer do I have?
- What stage is the cancer in? What does that mean?
- How does my stage affect what I am supposed to do?
- What other health professionals do I need to speak with? How can they help me?
- How was my diagnosis determined?
- What tests were taken and what did they show?
- Are more tests planned?
- What is my prognosis? (You should ask your doctor to give you an honest answer, neither minimizing nor maximizing your chances. How likely are you to survive? How likely are you to have a good quality of life?)
- What are the next steps to take? (If your doctor is not an oncologist, or cancer specialist, you should be advised to see one for further tests or for treatment. If your doctor is an oncologist, treatment options will be recommended.)
The Emotional Impact of a Cancer Diagnosis
Your Personal Reactions
Powerful feelings, both positive and negative, are part of living with cancer. For many people, the most intense emotional upheaval comes right after diagnosis. Feelings change rapidly in the first few days and weeks, and may include such emotions as denial, anger, fear, stress, loneliness and depression. Family members and friends may also go through similar feelings. Or, they may try to hide their sadness and worry, and "distance" themselves emotionally.
All these emotions are natural reactions to a diagnosis of cancer. Most are temporary. Cancer experts recommend confronting these feelings directly, although methods and timetables will differ from person to person.
- Denial. At first, denial can help soften the impact of the diagnosis and give you time to process the information. Denial can be a problem, however, if it keeps you from getting treatment. Most cancer patients are able to work through these feelings before they begin treatment.
- Anger. Once you accept the diagnosis, anger may set in. You might ask yourself, "Why me?" Being angry at the disease or at healthy people you know could be a way of expressing other feelings, like fear or helplessness. Letting your feelings known can help you accept the diagnosis.
- Fear. A cancer diagnosis frightens many people. It may be the fear of pain or dying, the physical effects and costs of treatment, or the burden it could place on your family. Not knowing what to expect can cause more fear than the facts. Learning as much as you can about your diagnosis and treatment may make you feel less afraid and more in control of the situation. Read through CancerResource for helpful information.
- Stress. The stress that comes from learning of your diagnosis can cause a variety of physical symptoms, including a faster heart rate, headaches, trembling, loss of appetite and sleeping problems. Stress may also affect your immune system and how well your body fights disease. To help reduce stress and anxiety, try to exercise, listen to relaxing music, talk about your feelings, and keep involved in activities you enjoy. Counseling or joining a support group may also help.
- Loneliness. Cancer patients may feel isolated when they don’t feel like socializing or if friends stay away because of the diagnosis. If you are lonely or feel like no one you know understands what you’re going through, try to get in touch with other cancer patients or a support group of people who are facing issues similar to yours.
- Depression. You may feel depressed about a cancer diagnosis. If symptoms become more serious, like strong feelings of sadness and despair, helplessness, and loss of interest or ability to do activities that were a normal part of your life, then let your doctor know, so you can get appropriate help or treatment.
- Hope. Once the shock of a cancer diagnosis passes, most people are able to look forward with a feeling of hope. Since each cancer case is unique, it is not possible to exactly predict the outcome of your cancer. However, improved treatment methods and knowing that so many cancer survivors are leading full, productive lives may help you and your family feel more optimistic about the future.
Often, people living with cancer find that support groups can help them cope with some of the emotions described above. If you are interested in joining a support group, check with your hospital or treatment center for information about groups in the community.
Handling Family Issues
"I’m so concerned about how my family will handle this cancer diagnosis."
A diagnosis of cancer can present new challenges and stresses for many families. Adjusting to new roles and responsibilities can cause upheavals in the way family members interact. Children may need special attention and guidance at times of disruption in their routine. They need to know that nothing they said or thought caused you to get cancer and that their help and support means so much to you and the family. Sharing your feelings and needs with your spouse or partner is also very important.
If family members are unable to help each other or are having difficulty adjusting to the diagnosis, check with your physician, hospital social services department or library for referrals to local support and service organizations that can help you cope with the emotional stresses of the disease.
Finding Emotional Support
"My friends and family were just so helpful."
People with cancer and their families often find a great deal of help and support by making contact with others who are in similar circumstances. Cancer support groups can be a wonderful source of strength, hope and practical ideas for everyday life. Attending a support group can give needed structure and focus to your week, as well as emotional support from individuals who can empathize with you.
Some patients find that the support of the medical social worker in a local hospital, local mental health or health care facility is invaluable. For others, it might be a member of the doctor’s staff, a relative who has experienced cancer therapy or a neighbor who can run a few errands if you’re feeling tired.