What do you know about the cancer disease and chemotherapy, which are frequently seen in many countries around the world today and are referred to by frightening names in society?
1. What Does Cancer Mean?
Healthy body cells, except for muscle and nerve cells, have a limited ability to divide. A healthy cell divides in a controlled manner, as needed and in the required number, throughout its life. Cancer cells differ from these healthy cells by their uncontrolled division and proliferation characteristics. The cancer disease occurs as a result of the accumulation of these cells, which damage normal tissues in various ways.
2. What Are the Causes of Cancer?
There are many factors that lead to the formation of cancer in the body. Some of these are related to heredity, while others are related to the individual's lifestyle. Some external factors can also lead to cancer.
*Familial - genetic factors
*Smoking and alcohol consumption habits
*Prolonged exposure to the sun
*Unhealthy eating habits
*Viruses such as Hepatitis B and C, HPV (Human papillomavirus)
*Excessive exposure to X-ray radiation
*Exposure to radiation
*Chemical substances
*Air pollution
3. How Common Is Cancer in Our Country?
Cardiovascular diseases are the leading cause of death worldwide. Cancer is in second place. According to statistics, in Western societies, one in every 250 - 350 people is diagnosed with this disease each year. Cancer is more common in people over 60 years old. (4 - 5 out of every 300 people)
There are no definitive statistics on this issue in our country. According to estimates, the rates are around half of the above.
4. What Are the Most Common Types of Cancer?
As of 2016, the most diagnosed type of cancer worldwide is lung cancer, with a rate of 13%. It is followed by breast cancer at 11.9% and colon cancer at 9.7%.
Lung cancer is at the top of the list of cancers that lead to death. (19.4%) Following it are liver cancer (9.1%) and stomach cancer (8.8%).
According to 2010 data, the most common types of cancer in men are lung and prostate cancers. Men are more likely to develop cancers caused by tobacco use.
The most common type of cancer in women is breast cancer.
Professor Dr. Coşkun Tecimer ranked the most common types of cancer in our country in 2015 as follows:
1.Lung cancer
2.Prostate cancer
3.Breast cancer
4.Skin cancers
5.Stomach cancers
6.Bladder cancer
7.Colon cancer
8.Thyroid cancer
9.Uterine cancer
10.Women's ovarian cancer
5. What Are the Symptoms of Cancer?
*Abnormal bleeding from the uterus or rectum
*Swelling in the breast or other parts of the body
*Wounds that do not heal
*White or red plaques, hardness, masses in the mouth and lip
*Persistent sores in the mouth area (painful or painless)
*Growth, bleeding, or color change of moles or warts on the body
*Moles that change in size, shape, and color, ulcerate, or bleed easily
*Prolonged hoarseness and cough
*Foul-smelling and bloody sputum
*Difficulty swallowing, indigestion
*Changes in bowel movements
*Bloody urine
*Changes in the skin of the breast, such as thickening, retraction, or depression
*A mass felt in the breast when touched
*Clear or bloody discharge from the nipple
*Prolonged diarrhea or constipation
*Unexplained weight loss
*Menstrual irregularities, excessive or prolonged bleeding
*Bleeding between menstrual periods or after menopause
*Excessive vaginal discharge
*Bleeding after sexual intercourse
*Unexplained and prolonged fever
6. Where Should Tumor Treatment Be Done?
Tumor treatment, which is a team effort, should be performed in centers where all members of this team are present. This team should include;
*A specialist surgeon who is knowledgeable and experienced in tumor surgery,
*A radiation oncologist related to radiation therapy (Radiotherapy),
*Radiologist
*Pathologist
*A nurse knowledgeable about chemotherapy application,
*A medical oncologist knowledgeable about chemotherapy and patient care.
Expertise, experience, and technology are vital when it comes to cancer treatment. Planning should be done collaboratively by individuals specialized in different branches of medicine for treatment.
7. What Does Chemotherapy Mean?
Chemotherapy, which plays an important role in the cancer treatment process, is applied to kill cancer cells and slow their growth. During this process, chemical cancer drugs are used. These cytotoxic (causing toxic effects on cells, leading to their death or cessation of function) drugs should be administered in a dose that will be effective but will protect the patient from side effects. The drugs distributed throughout the body via the bloodstream prevent the uncontrolled growth of tumor cells.
Surgery and radiotherapy are local treatment methods applied directly to the area or wound where the disease is present. After these methods, systemic treatments such as chemotherapy and immunotherapy, which aim to treat the whole body, are applied.
7.1 How Is Chemotherapy Administered?
Chemotherapy drugs are mostly administered to the patient via intravenous route. Additionally, injections can be made into body cavities such as intramuscular, pleural space, subcutaneous, or the drugs can be taken orally in tablet form.
7.2 What Is the Purpose of Chemotherapy Application?
*To treat cancer
*To prevent its spread and transfer to other organs
*To reduce or eliminate the complaints and discomfort caused by cancer
*To slow the growth of the tumor
*If the disease has spread to other places, to destroy these diseased cells
7.3 Who Administers Chemotherapy Treatment?
This type of treatment, which requires special expertise, is administered by a medical oncologist (a specialist in internal medicine who specializes in tumor treatment).
7.4 What Are the Types of Chemotherapy Applications?
*Neo-Adjuvant Chemotherapy Treatment: Chemotherapy given to shrink the tumor and facilitate surgery when the tumor is limited and can be removed by surgical methods.
*Adjuvant Chemotherapy Treatment: Chemotherapy applied after the patient has undergone surgery, evaluated for the risk of recurrence of the disease, to prevent local recurrence and spread.
*Palliative Chemotherapy Treatment: Chemotherapy given to shrink or control the tumor or eliminate the symptoms caused by the tumor when the disease has spread throughout the body.
7.5 What Are the Side Effects of Chemotherapy?
Although the side effects of chemotherapy drugs used today have been significantly reduced thanks to advancements in medical technologies, the risk of affecting normal, healthy cells during treatment has not been completely eliminated.
Common side effects seen when chemotherapy is administered to patients include:
*Nausea
*Fatigue
*Loss of appetite
*Vomiting
*Diarrhea or constipation
*Hair loss
*Weakening of hearing and taste
*Widespread body aches
*Numbness in hands and feet
*Bone marrow suppression
-Fatigue caused by a decrease in red blood cells (Hemoglobin and hematocrit)
-Bleeding caused by a decrease in yellow blood cells (Platelets)
-Risk of infection caused by a decrease in white blood cells (Leukocytes and neutrophils)
The number of drugs used for chemotherapy treatment exceeds 50, and each has its own unique side effects. Not all of the side effects listed above occur simultaneously. The severity of these effects varies depending on which part of the body the disease affects, the stage of the disease, the patient's age and gender, whether there are other accompanying diseases, and the individual's constitution.
7.6 Can the Side Effects of Chemotherapy Be Prevented?
The side effects caused by chemotherapy usually start within 1 - 2 days and often decrease or disappear within 1 week - 10 days. However, this is not true for all; some may last longer. Although these side effects are bothersome, they are temporary, and one of the most important factors that ensure their short duration is the strength of the patient's immune system. The patient's optimism, calmness, and resilience help strengthen the immune system.
Patients experiencing nausea and vomiting after chemotherapy are given medications that suppress the brain's center for these symptoms.
Patients experiencing decreased appetite and weight loss are nourished with oral nutritional products.
Some drugs cause hair loss to begin from the first cycle. The lost hair grows back a few months after the chemotherapy ends. If possible, it is recommended to cut the hair before treatment begins.
Chemotherapy treatment can cause low red blood cell counts or yellow blood cell counts and bleeding, and depending on the patient's condition, red or yellow blood may be given.
For patients with low white blood cell counts and serious infection risks, drugs that stimulate the bone marrow are used. If the white blood cell count is low and there is no fever, oral antibiotic treatment is initiated as a precaution. If the white blood cell count is very low and fever develops (Febrile neutropenia), the risk of death for the patient is high. In this case, if possible, the source of infection should be identified, and the patient should be isolated in a single room for intravenous broad-spectrum antibiotic treatment.
7.7 Can You Work While Undergoing Chemotherapy?
Many cancer patients can go to work within the limits deemed appropriate by the doctor and continue their daily lives as long as they do not disrupt the treatment plan. However, some cancer patients may not be able to continue their working lives due to the type of disease, the extent of spread, the intensity of the treatment applied, and its side effects. For example, anti-nausea medications given after chemotherapy can cause drowsiness, making it unsafe to drive.
In general, patients are advised to continue their daily lives as much as possible during the chemotherapy process. If the treatment does not significantly affect the work being done, they can continue working with short breaks. The decision on this matter should be made in consultation with the doctor and in accordance with the doctor's recommendations.
7.8 Does Chemotherapy Affect Sexual Life?
It can lead to disturbances in the menstrual cycle in women. Menstrual bleeding can often be temporarily or sometimes permanently stopped, leading to infertility issues. Problems similar to menopausal issues, such as sweating, vaginal dryness, and hot flashes, may occur.
Chemotherapy can reduce sperm count in men and often cause temporary infertility, rarely leading to permanent infertility. Men of reproductive age who need to undergo chemotherapy due to issues such as testicular tumors can preserve their sperm by freezing it in sperm banks to be able to become fathers later.
7.9 Can You Go on Vacation While Undergoing Chemotherapy?
Yes, it can be done as long as the treatment plan is not disrupted. It is necessary to discuss with the doctor where and how to vacation and consider their recommendations. Some cancer drugs can cause side effects on the skin and may lead to an increase in skin lesions when exposed to sunlight. Before vacationing, a blood count should be done to check if there is any condition that would prevent swimming in a pool or the sea due to leukocyte and platelet values.
7.10 Is It Risky to Get Pregnant During or After Chemotherapy?
Women undergoing chemotherapy should use necessary birth control methods to avoid pregnancy. If pregnancy occurs during treatment, the likelihood of the child being born with disabilities is very high. Once chemotherapy is completed and the body's hormonal state returns to normal, if it is deemed unnecessary to continue treatment, pregnancy can be pursued under the supervision of a doctor.
Mothers who need to undergo chemotherapy after childbirth or who will undergo chemotherapy during breastfeeding due to cancer should not breastfeed their babies.
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