The organs and tissues of the body are made up of tiny building blocks called cells. Cells in different parts of the body may look and work differently but most reproduce themselves in the same way. Cells are constantly becoming old and dying, and new cells are produced to replace them. Normally, the division and growth of cells is orderly and controlled but if this process gets out of control for some reason, the cells will continue to divide and develop into a lump which is called a tumour. Tumours can either be benign or malignant. Cancer is the name given to a malignant tumour.
In a benign tumour the cells do not spread to other parts of the body and so are not cancerous. However, if they continue to grow at the original site, they may cause a problem by pressing on the surrounding organs.
It is important to realise that cancer is not a single disease with a single type of treatment. There are more than 200 different kinds of cancer, each with its own name and treatment.
Types of cancer
About 85% of cancers are carcinomas. They start in the epithelium, which is the covering (or lining) of organs and of the body (the skin).
These form in the connective tissues of the body such as muscle, bone and fatty tissue (6% of cancers).
These occur in the tissues where white blood cells (which fight infection in the body) are formed, i.e. the bone marrow, and lymphatic system (5%).
Others forms of cancer
Brain tumours and other rare forms of cancer make up the other 4% of cancers.
Who gets cancer?
1 in 3 people will develop cancer during their lifetime, but cancer is not common in children or young people – it mainly occurs in the later years of life. Cancers can occur at any age, but the risk of developing cancer increases with age. Over 70% of all newly diagnosed cancers occur in people aged 60 years or more.
Some cancers are very common and others are very rare. The most recent statistics for the UK show that for men the most common cancer is lung cancer (19%), followed by prostate cancer (17%), large bowel cancer (14%) and bladder cancer (7%). For women the figures are breast cancer (29%), large bowel cancer (12%), lung cancer (11%) and cancer of the ovary (5%).
Many people with cancer can be cured. Even if a cancer cannot be cured, it can often be controlled with treatment for months or years.
CancerBACUP has information on all the main types of cancer, and on some of the rarer cancers.
Why do cancers come back?
A cancerous (malignant) tumour consists of cancer cells which have the ability to spread beyond the original site. If left untreated they may invade and destroy surrounding tissues. Sometimes cells break away from the original (primary) cancer and spread to other organs in the body by travelling in the bloodstream or lymphatic system. When these cells reach a new area of the body they may go on dividing and form a new tumour, often referred to as a “secondary” or a “metastasis”.
How is it treated?
There are five main types of treatment for cancer and these are described below:-
Active surveillance (or watchful waiting)
Some types of cancer grow very slowly and may cause no problems for many years. In this situation you may not need to have any treatment for some time, but your doctor will monitor you closely so that if the cancer does start to grow you can be given treatment at that time.
An operation is done to remove the tumour. Surgery is often used if the cancer is only in one area of the body and has not spread. It may be used to remove lymph nodes if these are also affected by the cancer. It can sometimes be used to remove a cancer that has spread to another area of the body, but this is not common. The type of operation will depend on the area of the body affected by the cancer, and on the size and position of the tumour.
This is the use of high energy x-rays to destroy cancer cells, but cause as little harm as possible to normal cells. The radiotherapy is aimed at the affected area of the body and is very carefully planned. It can cause side effects and the most common is tiredness. The side effects will depend on the part of the body that is being treated.
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. There are more than 50 different chemotherapy drugs. Some are given as tablets or capsules but most are given by drip (infusion) into a vein. The drugs go into the bloodstream and travel throughout the body to treat the cancer cells wherever they are. Sometimes just one chemotherapy drug is used, but often a combination of two, three or more drugs is given.
Chemotherapy can cause side effects. The side effects will depend on which drug (or combination of drugs) is used. There are now very good ways of preventing or reducing the side effects of chemotherapy.
Hormonal therapies work by altering the levels of particular hormones in the body. Some cancers depend on certain hormones in order to divide and grow. By altering the level of hormones in the body, or blocking the hormones from attaching to the cancer cells the cancer can be controlled.
Other treatments can be used to cure or control a cancer. These include chemicals which stimulate the body’s immune system to attack the cancer cells. They are called biological therapies and include interferon and interleukin.
Monoclonal antibodies are drugs that can `recognise’ and find specific cells in the body. These drugs can be designed to find a particular type of cancer cell, attach itself to them and destroy them. They can be used alone, or a radioactive molecule can be attached to a monoclonal antibody, which then delivers radiation directly to the cancer cells.
Research is trying to see whether vaccines can be given to treat a cancer that has come back or has spread. Vaccines may also be able to reduce the chance of a cancer coming back, but this type of research is in the very early stages.
CancerBACUP has information on all the cancer treatments mentioned above and also on cancer research trials.
Understanding terms & statistics
It is not unusual when we are reading or being given information about cancer for it to include statistics. Unless our work involves dealing with them, generally in our daily lives, we won’t have had to understand what they mean.
For most of us a cancer diagnosis means that we have to learn and take in a great deal of information as well as coping with it. It is not easy to gain an understanding of statistics at the same time.
In this section there are a number of “Question and answers” to help you understand some of the terms that may be used.
I have a cervical wart. My husband and I have been married 15 years. Does this mean he has been having an affair? Can this be passed on by oral sex? Will I get cancer? What do I do?
Like all warts, cervical warts are caused by a virus, the human papilloma virus (HPV). There are over 100 types of HPV, some types cause common skin warts, and others genital warts. There are about 30 types which can infect the cervix. If the cervix is infected with the virus this may cause visible warts but in many women infection can be only detected microscopically by a smear test.
Genital HPV is usually spread though direct sexual contact, including
oral sex, but non-sexual infection, although rare, is also possible.
The virus can also lie dormant in the body for many years. It would be
wise not to assume anything about how you contracted the wart until you
have had a full discussion with your husband about this. When
transmission has occurred from an infected person, warts can take
anything from a few weeks up to several months to appear. Generally the
types of HPV that infect the skin of the hands and body don’t infect the
genital area, so it would be very unusual to contract cervical warts in
About half of the different types of HPV that can infect the cervix are associated with cervical cancer. The presence of the HPV infection in the cervix does increase the risk that mild abnormalities in the cervical tissue will progress to severe abnormalities and very occasionally to cervical cancer. However the overwhelming majority of HPV infections of the cervix never lead to cancer. Most HPV infections seem to go away by themselves, or with simple treatment from a specialist, without causing any cervical abnormalities. Cervical cancer can almost always be prevented by regular follow-up with cervical smears to detect and treat pre-cancerous changes before they go on to become invasive cervical cancer.
The most important thing to do now is to discuss the treatment and follow-up of the cervical wart with your specialist.
The short answer to your question is no, there is no link between sickle cell anaemia and cancer of any type.
Although sickle cell anaemia and cancer can both be serious illnesses, there is no link between the two conditions. Sickle cell anaemia never turns into cancer, and people with sickle cell disease are not at any greater risk than other people of developing cancer.
Hydroxyurea is a drug sometimes used to treat sickle cell disease. There are concerns that many years of treatment with hydroxurea can increase the risk of getting a ‘blood’ cancer but the risk is yet to be proven and appears to be small.
Sickle cell disease is due a faulty gene, which is inherited, so it runs in families. It occurs mainly in people of African-Caribbean descent, and in some parts of central Africa is very common indeed. It is also, much less commonly, found in people from parts of India, Saudi Arabia, Greece, Italy and North Africa.
If you inherit the sickle cell gene from just one parent then the condition is quite mild and usually causes no problems (this is called sickle cell trait), but if you inherit the gene from both your parents then this is sickle cell disease, which is much more serious. However, over the last 25 years the treatment of the condition has improved a great deal and the outlook is very much better now than it used to be.
For further information and support about sickle cell anaemia you may find it helpful to contact The Sickle cell society.
My husband has recently been diagnosed as having a lymphoma. We read about someone who has a Burkitt’s like lymphoma and the article said it was due to a virus. Is my husbands lymphoma also due to a virus?
It may help to answer your question by starting with an explanation about lymphomas in general.
Lymphomas are cancers of the lymphoid tissue which is part of our body’s immune system.
Our immune system protects us from infection. It is a complex system made up of the bone marrow, the thymus gland (which lies behind the breast bone), the spleen and the lymph nodes (or lymph glands).
One of the most important cells in our immune system is a type of white blood cell called a lymphocyte. There are two types of lymphocytes: ‘B-cells’ and ‘T-cells’. All lymphocytes are produced in the bone marrow and start life as young, immature cells called stem cells. Some lymphocytes continue their development in the bone marrow or lymph nodes and these are called B-cells but others move to the thymus gland and they are called T-cells.
Many years ago it was thought that lymphomas could be divided into just two conditions: Hodgkin’s disease (named after Thomas Hodgkin, the London doctor who first described it over 100 years ago) and non-Hodgkin’s lymphoma (NHL). With the passage of time it has become clear that NHL is not a single illness but includes a number of cancers, which behave very differently.
The description and classification of the various types of NHL has developed over the years as more has been learnt both about the immune system and the cancers themselves. The most recent classification still recognises the difference between Hodgkin’s disease and NHL but then goes on to divide NHL into some fifteen different tumour types.
The cause for the great majority of these different types of NHL remains a mystery but in three types of the disease, all of which are very rare in the UK, a link with viruses has been established. These are Burkitt’s lymphoma, Burkitt-like lymphoma and post-transplant lymphom
In 1956 a British surgeon called Dennis Burkitt was working in equatorial AfricH described an unusual type of lymphoma which was very common in children in that region. This became known as Burkitt’s lymphomLater research showed that B-lymphocytes in these children became infected with a virus, the Epstein-Barr virus, or E-B virus. Epstein-Barr virus infections are common and usually cause no problems but in central Africa many of the children had chronic malaria infections which reduced their resistance to the virus. In some cases this allowed the virus to change the infected B-lymphocytes into cancerous cells leading to the development of the lymphom
In recent years it has been recognised that in the western world there is one type of NHL where the tumour cells have very similar appearances under the microscope to those of Burkitt’s lymphoma. This rare condition has been called Burkitt’s-like lymphoma. Further research has shown that a high proportion of patients with Burkitt-like lymphoma (but not all) are HIV positive and many have AIDS. It seems that in this condition once again an Epstein-Barr virus infection occurs and because the HIV has reduced the patient’s immunity the Epstein-Barr virus is able to survive and ‘transform’ the normal B-lymphocytes to cancerous cells.
The same situation has been seen in some patients who have had organ transplants. Often after organ transplantation drugs are given for some time, often years, to suppress the patient’s immunity in order to reduce the risk of rejection of the grafted organ. Some of these patients appear to develop E-B virus infections and once again, as their resistance is reduced, this may lead to the development of a B-cell lymphom
All three of these virally-related types of NHL behave in a very aggressive way and need immediate treatment.
In the African children with Burkitt’s lymphoma chemotherapy gives a high cure rate but the Burkitt-like lymphoma and post-transplant lymphomas tend to be more resistant to treatment. Although a variety of different drug combinations have been used cure is not possible in the majority of people. This means that a number of clinical trials are in progress to try and improve the results of treatment.
In conclusion, the likelihood of your husband’s NHL being one of those types with a known viral cause is very, very remote. Almost certainly he has one of the forms of lymphoma for which no definite cause is known.
I had a hysterectomy for cervical cancer two years ago. My doctor has taken a smear from my vagina and says I have a wart virus. Does it mean I will develop another cancer? Is there anything I can do to get rid of this?
Wart virus (also known as human papillomavirus or HPV) is known to be associated with abnormalities in the cervix known as CIN which if untreated can sometimes develop into cancer of the cervix. It is much less commonly associated with similar changes in the cells of the vagina known as VAIN (vaginal intraepithelial neoplasia) but this only very rarely leads to vaginal cancer. So once the cervix has been surgically removed (as it will have been if you have had cervical cancer), then there is no risk of getting a new cervical cancer and the chances of getting vaginal cancer are very slim indeed. There is always a very small risk of a recurrence of the original cervical cancer, but there is absolutely no evidence that having the wart virus in the vagina will increase this risk.
Although wart virus is known to be one of the factors in the development of most cervical cancers, it is also found in many other women who will never develop cervical cancer. So having the wart virus certainly does not mean a woman will develop cervical cancer. In fact only a very small number of women who ever have a wart virus will develop cancer or even pre-cancerous areas on the cervix.
There are over 80 different types of the wart virus, and some of these types are more likely to be associated with cancer development than others. For example some types are commonly found in women with cervical cancers, whereas other types just cause common skin warts. There are also other factors that may contribute to the risk of cancer; these include number of sexual partners, age, heavy smoking, number of children and other genital infections.
At this stage there is no known method for getting rid of the virus. It is likely to just go way on its own accord with the help of your natural body’s defences. It is certainly important, however, that you continue to have regular smears and examinations as follow up after your cancer.
Cancer of the vulva is a rare cancer. It usually affects women between the ages of 55 and 75, but can occur in younger or older women.
The cause of most vulval cancers remains unknown but there are a number of conditions that can affect the vulva which will sometimes lead to cancer after many years. These are: n VIN (vulval intraepithelial neoplasia) which can occur in the skin of the vulva and is linked to infection by some types of wart virus, known as human papilloma virus (HPV). There are three levels of abnormality: VIN1, VIN2 and VIN3. VIN3 is the most abnormal and, in some women, can develop into cancer of the vulva if left untreated. n vulval lichen sclerosus and vulval lichen planus. These are two non-cancerous conditions which cause inflammation of the skin of the vulva and occasionally can lead to the development of a cancer after a number of years.
Also there is evidence that cigarette smoking may increase the risk of developing both VIN and vulval cancer. This may be because smoking depresses the immune system.