Scientifically speaking, what is cancer?

A tumor (swelling) is caused by uncontrolled growth of cells starting in a particular organ in the body. Almost all tumors arise from a single cell that has lost growth control and makes a colony or clone of cells that are initially identical.

There are two main categories of tumors: Benign and malignant. Benign tumors are less aggressive, usually don’t invade into tissues that are not their normal residence and don’t metastasize or spread to distant tissues or organs through the vascular systems (lymphatic and blood vessels). Malignant tumors are defined by their ability to invade and metastasize causing significant illness and death. They usually need treatment to remove or destroy them.

Cancer is a general, sometimes imprecise term for a malignant tumor. There are hundreds of different kinds of cancers, and each is a distinctive disease. Malignant tumors are characterized and classified by the location in the body where they start:

• Carcinomas are tumors of epithelium (more below)
• Sarcomas are tumors of supporting tissues (bone, connective tissue, fat, blood vessels, etc.)
• Leukemias are tumors of blood cells
• Lymphomas are tumors of lymph node or blood cells
• Central nervous system tumors originate in the brain.

Carcinomas are the most common tumors in adults (e.g., breast, colon, prostate, lung cancers), and start in the organs that are mostly made up of epithelial cells. These are cells of specialized function that define the organ (for example carcinomas of the skin are malignant tumors arising in the epithelium of the skin, or the epidermis – the covering that is the main functional part of the skin).

Cancers usually arise spontaneously or sporadically (“out of the blue”), but rarely an increased cancer risk can be inherited. The cause of most cancers is unknown, but some are caused by viruses (cervical cancer, liver carcinoma, and a few others). It is thought that exposure to certain chemicals, or excessive radiation can cause cancer, but in only a few instances are the exact causes understood (e.g. smoking is clearly a major cause of lung cancer and increases the risk for many other cancers).

Editor's Note: If you receive a diagnosis of cancer continue to talk with your doctor until what you are hearing makes sense to you. Don't be afraid to ask as many questions as you need to, regardless of how long it takes. Understanding your personal diagnosis is a powerful tool in your survivorship journey.

You might also like:

• Lynn's #1 lesson: There are no stupid questions
• Who is a cancer survivor? What's in a name?
• Free tool: Charting your family health history

4 obstacles to yoga defeated

The therapeutic benefits of yoga often take a back-seat to the obstacles we’ve set up in our mind. I often hear from students that they were scared to start doing yoga but now that they’ve started they couldn’t be happier with their personal growth.

Here are answers to some of the most common concerns I hear:

I’m not flexible.
Many people wrongly believe that you have to be flexible to begin doing yoga. The truth is you’re actually the perfect candidate for yoga. Yoga treats inflexibility in a natural and calming way.

I’m embarrassed.
Our yoga studio is a non-competitive, non-judgmental environment. You can wear whatever you want to class and if you’re still worried don’t be. Most yoga is done with our eyes closed. You’ll enjoy focusing inward on how your body feels with less emphasis on how you look.

It’s forbidden by my religion.
Some people have the misconception that yoga is a religion. It’s not. Yoga is a practice of self care. It is the application of Western medical science influenced by Eastern philosophy. Yoga is not trying to recruit you or change your beliefs. All people from all religions are welcome to attend, remember, yoga is non-judgmental.

It’s too expensive.
I can only speak for my studio but at Wild Grace Arts we offer many payment options which you can view on our website: http://www.wildgracearts.com/. It’s true that yoga does cost money, but I feel, when you consider the benefits, the cost becomes less important. Yoga is an investment in your health. A small price to pay for preventing stress related illness. You may find that after you have come to a few classes it’s something you want to do on your own, in which case we offer a cd that you can play for a similar “in-class” relaxation experience (call 360.754.3983 if you are interested in purchasing).

You might also like:

• What happens in a yoga class for cancer survivors?
• What is yoga and how can it help me?

Reader response: Changing your diet to recover some energy

In a recent post, “You don’t have to put with cancer-related fatigue” Barbara, a blog reader, generously shared with us how she changed her diet as part of the process to get her energy back. I thought it might be beneficial for our other readers if Iresponded to some of the key changes she made and why they worked. Thank you Barbara for getting this conversation started!

At this point I try to eat nothing out of a box.
Processed foods have less nutritional value than ‘whole foods’. What are whole foods? Foods that are not altered by preservatives and chemicals in the preparation process; whole foods are anything that is ‘made from scratch.’ Examples: cooking your own oatmeal from raw oats, adding your own spices, nuts, etc., and not using a package that you simply pour water over to make.

Try to eat five different colors of fruits and vegetables--5- 8 servings a day. I do eat a green salad daily.
Various colors of fruits and vegetables can assist in obtaining a variety of nutrients contained within. For instance: a lot of beta-carotene and Vitamin A is found in orange colored vegetables such as yam, squash, and carrots. Dark green leafy vegetables (chard, kale, spinach) are high in iron content. A green salad provides fresh food and roughage. This provides a good source of vitamins, minerals, nutrients, as well as helping to keep the digestive system moving along.

I am supposed to avoid baked goods, but don't always. This includes even whole grain breads.
Baked goods usually contain flour and sugar, which represent carbohydrates (sugars) once broken down through digestion. Because the human body needs fewer carbohydrates to maintain a healthy balance it makes sense to limit the consumption of baked goods. As a rare treat, this is okay. If at all possible, whole grain breads are best. Flour is processed from its whole grain form to create ‘white flour.’ The processed end product of white flour has far less nutritional value than a whole grain option.

I used to drink two glasses of milk a day, I now limit milk to a splash on my steel-cut soaked- overnight oatmeal--there go the Cheerios and bran flakes.
This recommendation is an excellent example of why there is no substitute for talking with your health care provider about your specific situation. For some cancer patients, the intake of milk could be very beneficial. I’m assuming that this recommendation was made to you to cut down your fat content but again, this should be handled on a case by case basis under the supervision of your provider.

The naturopath said to eat two cups of cooked whole grains a day.
Combining a whole grain with a protein such as beans (black or pinto) and legumes (lentils) results in a ‘perfect protein’ that contains all the essential amino acids necessary through proper nutrition which results in the building blocks of the nutrients needed by the human body.

Eggs, beans and nuts and yogurt are my main protein with some chicken, lamb, venison and a little cheese. I was told to limit red meat which I already did. A little protein with each meal.
Essentially, you are cutting down your fat content by selecting protein sources which are lower in fat. If at all possible go the extra step to select organic, free range eggs. If one is going to eat lean meats, try for a local source that is organically fed. I mention this, but it is a tricky issue, as this is more expensive. Red meat refers to beef, pork and lamb. The American Institute for Cancer Research recommends eating no more than 18 oz. per week of red meat.

Changing your diet is never easy. If anyone has other tips they would like to share we would love to hear them. Keep up the great work Barbara!

You might also like:

• A 2011 resolution: Exercise more to help your cancer treatment
• What can naturopathic care do for me?

8 questions to ask before every test your doctor runs

Sometimes it seems like the tests never end.

When your doctor tells you that you need another test it’s important for you to understand why. Next time you hear, “We need to run another test,” ask these eight questions, the answers should help you generate useful dialogue between you and your doctor. 

1. What is the purpose of this particular study or test?
2. What do the results mean?
3. How will the results influence my treatment?
4. Will I need any more tests or studies?
5. How frequently will I need a test or study done?
6. What would be the possible risks if I decide to limit the number of tests I have?
7. The potential benefits?
8. Are there any limitations or possible errors with this test or study?

To illustrate what this dialogue may sound like between you and your doctor I’ve provided two different scenarios. In the first scenario I have just told the patient that I have found a lump in her breast. The test I would like to run is a mammogram.

1. What is the purpose of this particular study or test?
   As your providers we need to further evaluate if what I found is a mass in your breast.
2. What do the results mean?
   Most of the time a mammogram will confirm a finding of a mass or lump.
3. How will the results influence my treatment?
   If we do find the mammogram is abnormal we will need to conduct a biopsy.
4. Will I need any more tests or studies?
   If the mammogram is inconclusive you may need to have more imaging/pictures taken through repeat mammogram or an ultrasound or MRI of your breast.
5. How frequently will I need a test or study done?
   We may need to repeat the mammogram in a few weeks or few months depending on the severity of the situation.
6. What would be the possible risks if I decide to limit the number of tests I have?
   If you decide to limit the number of tests you could potentially delay/miss diagnosis and treatment.
7. The potential benefits?
   Any early diagnosis typically means a better chance for a cure.
8. Are there any limitations or possible errors with this test or study?
   A small percentage of patients/cases could be missed despite extensive testing because there is always a limitation to certain tests/technology. The more complete the evaluation, the better chance to have the right diagnosis and prompt treatment.

If that same patient gets an “abnormal mammogram” I would then recommend to the patient that we biopsy the tissue.

1. What is the purpose of this particular study or test?
   A biopsy will tell us if the affected region is cancer or not cancer.
2. What do the results mean?
   The results will tell us whether the affected region is benign, suspicious, or cancer.
3. How will the results influence my treatment?
   In most cases a benign finding would need no more treatment; a suspicious finding would need either a repeat biopsy or close monitoring; a cancer or malignant finding would possibly need surgery. Sometimes, chemotherapy before surgery could also be considered depended on the size and location of the lump.
4. Will I need any more tests or studies?
   If there is an abnormal lymph node found either by physical exam or mammogram, further CT scan would also be considered.
5. How frequently will I need a test or study done?
   If we decide to repeat the biopsy due to a suspicious finding we would do so right away. If we decide to closely monitor you we will most likely recommend a mammogram or MRI in 1~3months or 3~6months pending level of suspicion.
6. What would be the possible risks if I decide to limit the number of tests I have?
   If you decide to limit the number of tests you could potentially delay/miss diagnosis and treatment.
7. The potential benefits?
   We will be able to initiate appropriate treatment in a timely fashion and best treat the disease which means a better chance for early diagnosis and cure.
8. Are there any limitations or possible errors with this test or study?
   At times a biopsy may not provide an adequate sample amount meaning we can miss the real diagnosis.

Remember, as the patient your understanding is the most important thing. If you don’t like the way a question was answered or you want more information, ask it again, as many times as you need to.

Editors Note: The examples provided in this post are fictional and do not reference an actual patient. If you find yourself undergoing the same tests be sure to ask your doctor about your specific situation.

Harmony and Hope: Free community event

We constantly hear from our patients how important they feel it is to find enjoyment in the small things. Lynn Davidson, one of our guest bloggers, says, “Life and all those things contained therein don’t stop with the diagnosis of cancer. We have to continue on … celebrating birthdays, planning vacations, looking forward to the spring planting and ... making the hard decisions. Cancer isn't our lives - just a part of them.”

We’re excited to present “Harmony and Hope: A musical celebration to recognize our patients and their families.”

Together we can enjoy the music of internationally acclaimed Cape Breton fiddlers Andrea Beaton & Glenn Graham and Bagpiper Colin Gemmell.

“We hope this night will be the first of many to come as we work to create an arts program that encourages our patients to interact with their care team and other patients on a non-medical level,” says Dr. James Lechner, medical director, Providence Regional Cancer System. “When people undergo treatment for a disease like cancer it’s incredibly beneficial to maintain a sense of self that doesn’t revolve around being a patient.”

The event is free and refreshments will be provided. And, if we're lucky, Dr. Lechner may even play his fiddle too!

Thursday, January 27, 6:30-8:30 p.m.
Providence Regional Cancer System and RadiantCare
4525 Third Avenue SE
Lacey, WA 98503
Get Directions

To RSVP, call 360.493.7768
For more information e-mail: Roy Olpin, PRCS Service Line Director

This event is brought to you by Providence Integrative Cancer Care, part of Providence Regional Cancer System and RadiantCare Radiant Oncology