Human beings are made up of cells. A single cell is divided and forms multiple cells. These cells together then form a tissue, and tissues unite to form organs. A combination of organs creates a body.
According to sources, our body consists of approximately 37.2 trillion cells. Cancer occurs when there is a problem in the division of cells. At our cancer hospital, Vadodara; I’ve seen patients panic merely by the utterance of the disease name. Through this write-up, I, Dr. Dipayan Nandy will guide you about cancer. I’ve previously worked as an Onco-Surgeon with various hospitals and currently, I am working at Janvi Multispeciality hospital, the best cancer hospital in Vadodara.
So let’s begin to explore more about cancer.
How does Cancer Occur?
Cancer occurs only due to cells. Cell division is an intricate chemical dance that’s part individual and part community-driven. In a neighbourhood of 100 trillion cells sometimes things go wrong. Maybe an individual cell’s set of instructions or DNA gets a typo (what we call a mutation in technical terms). When a mutation occurs, most of the time the cell understands it and shuts itself down else our body eliminates it if it finds the cell to be troublesome.
But if such a mutated cell survives then it becomes a problem for the whole body. It further multiples into other cells with the wrong DNA structure. The new cells formed are defective and mutated.
| Cell shape | Uniform | Irregular |
| Nucleus | Spheroid shape, single nucleus | Irregular shape, multi-nucleation common |
| Chromatin | Fine, evenly distributed | Coarse, aggregated |
| Nucleolus | Single, inconspicuous nucleolus | Multiple, enlarged nucleoli |
| Cytoplasm | Large cytoplasmic volume | Small cytoplasmic volume |
| Growth | Controlled | Uncontrolled |
| Maturation | Mature into specialized cells | Remain immature and undifferentiated |
| Blood supply | Normal angiogenesis (occurs during development/ healing) | Tumor-induced angiogenesis |
| Oxygen | Favored (for aerobic respiration) but will undergo anaerobic respiration if required | Not required (thrive in hypoxic conditions), favour anaerobic respiration |
| Location | Remain in their intended location | Can spread to different locations in the body (metastasis) |
Once too many such mutated cells come together, we face the problems of lumps or other issues in our bodies. Further investigation reveals the incorrect growth of cells, which in technical terms is called cancer.
How is Cancer Detected?
Even a simple blood test can signal the presence of cancer in our bodies. Research indicates that an increase in platelet count which is exponentially high can be a warning sign of cancer. If the blood report reveals very high platelets then things need to be investigated more thoroughly. Once preliminary investigations point to the presence of cancerous cells, further tests are carried out which include:
Imaging (Radiology) Tests
As a cancer specialist in Vadodara, the first thing we check for after we’ve doubts regarding cancer is ‘imaging tests’.
Imaging tests take pictures of your body and can help us to find out the spread of cancer in the body. The various types of imaging tests that we conduct include:
- MRI
- CT Scan
- X-Ray and other Radiographic Tests
- Ultrasound
- Mammograms
- Nuclear Medicine Scans
- Radiology Tests for Cancer
Endoscopy Procedures
Endoscopy is an invasive procedure wherein the patient is given Anaesthesia and a tube-like instrument is passed inside the body to look inside the body. The various types of endoscopies that are needed to detect the presence of cancer include:
- Bronchoscopy
- Colonoscopy
- Cystoscopy
- Laparoscopy
- Laryngoscopy
- Mediastinoscopy
- Thoracoscopy
- Upper Endoscopy
Biopsy and Cytology Tests
Endoscopies and radiology tests can help us to judge the location of cancerous cells. But to judge how far they have spread we need to do a biopsy.
A biopsy is a test wherein the patient is sedated and then a sample of his/her tissue is collected through a needle. The instruments used to do this vary depending on the body organ involved. After the biopsy is done it is sent to a pathologist for clinical evaluation. Based on that, we can judge many things about cancer like,
- Its Spread
- The Organs it is Affecting
- Which kind of Treatment can be used to kill Cancerous Cells, etc.
How is Cancer Treated?
As a cancer hospital in Vadodara, we often base this judgement based on the spread of the Tumour. If the Tumour is slow-growing and in one place then surgery can be done to remove the cancerous cells/tissues.If the Tumour is fast-growing or invading nearby tissue then as a cancer specialist in Vadodara, I prefer surgery followed by radiation.
Radiation is needed even after the surgery because if even the smallest cancerous cell is left out after the surgery then it can again multiply itself. If cancer has spread in the whole body then as the best cancer hospital in Vadodara, we often recommend chemotherapy.
How do Radiation and Chemotherapy work?
Radiation and chemo both work by physically shredding the cell’s DNA or disrupting the copying machinery of the cell so that it is not able to mutate itself. It is necessary to understand that in both cases, we cannot specifically target the cancerous cells. Chemotherapy works on the principle of disrupting the process of cell division. An example will clear your doubts.
For e.g, if we consider liver cells, hair cells, and cancerous cells then we observe the following scenario:
- Healthy Liver Cells: The healthy liver cell divides only when it is stressed.
- Hair Cells: The healthy hair cells divide more frequently. Skin cells, blood cells, and gut cells also divide more frequently.
- Cancerous Cells: They divide even more frequently and recklessly.
What happens to them in the case of Chemotherapy?
Whenever the cells try to divide themselves and multiply further, a chemotherapeutic drug comes into play and disrupts the further division. But this applies to all cells and not only the cancerous cells.
Hence, as a result of chemotherapy patients feel:
- Nausea
- Hair Loss
- Loss of Appetite
- Fatigue
- Weight Loss
- Pain
- Vomiting
- Skin Rashes
After some time, the normal cells recover and grow again while the cancerous ones are destroyed. In extreme cases, if the healthy cells have lost their ability to replicate themselves, you need a bone marrow transplant.
How does Cancer spread through the Body?
As a cancer hospital, Vadodara, we face this question many times. The process of spreading cancerous cells in the body is known as metastasis. There are three ways in which they spread in your body.
- Transcoelomic- In this case, the malignant cells/cancerous cells penetrate the covering surfaces of cavities of our body. These surfaces are known as the peritoneal cavity.
- Lymphatic- In Lymphatic transmission, the cancerous cells travel to other parts of the body through the blood vessels. Finally, they travel to the lymph nodes in the body and attack the lymphatic system of the body.
- Hematogenous- In the case of hematogenous transmission, the malignant cells travel throughout the body through the blood vessels.
Why is it Difficult to Cure Cancer?
Cancerous cells multiply themselves quickly. Not only that, every time they multiply/mutate, they change their genetic mutations. This makes it very difficult even for the best cancer hospital in Vadodara like us, to deal with it. In medical terms, it is called ‘Clonal Heterogeneity’.
Not only that, the malignant cells suppress the immune system so that the immune system does not destroy them. In addition to that, it feeds itself from healthy blood vessels. The day we learn how to cut short these lines of communication, we’ll be able to get better control over cancer.
In addition to that, we need to eradicate cancer stem cells. A single stem cell that is left out in the body even after chemotherapy or radiation can again mutate itself and spread cancer in our body.
Cancerous cells are very adaptable. They adapt their cellular and molecular structure. When we try chemotherapy or radiation, some cancer cells make a protective shield for themselves and change their gene expression. This makes it very difficult even for the best cancer specialist in Vadodara to eliminate them.
How does Tobacco Cause Cancer?
Tobacco weakens the body’s immune system. This promotes the growth of cancerous cells in the body. Not only that, poison in tobacco damages the cell’s DNA. DNA is very crucial for cell mutation. Any wrong coding that gives rise to cancerous cells. Next time, do think twice before you consume tobacco in any form.
What is the Way Forward?
Due to the high adaptability of cancerous cells, and the ability to change the gene expressions, it is very difficult to get rid of them permanently. However, as science is progressing, we are developing new medicines and treatments to deal with them effectively. This is evident from the fact that the mortality rate due to cancer has dropped significantly. We can control mortality arising from cancer only if we can detect it in its early stages. To prevent cancer it is essential to follow a healthy lifestyle, avoid carcinogenic substances, avoid tobacco in all forms, and eat a balanced diet. Regular checkups can detect cancers timely and help us to save lives.
For preventive checkups, you can always come to our hospital. We are always there at your service. Lastly, I wish to say that cancer is not the end. You can fight against it if you start early. Don’t lose hope and continue to fight against it! Every time you feel demotivated, say to yourself, “Cancer may have started the fight, but I will finish it.”
About Dr. Dipayan Nandy: Dr. Dipayan Nandy is a Consultant Surgical Oncologist in Vadodara. His area of expertise is in a whole range of cancer surgeries with particular interest and acquired skills in conventional surgeries for hepatobiliary, Pancreatic Tumours, minimally invasive, and traditional surgeries for Gynaecological malignancies, and head and neck surgeries, peritonectomy for peritoneal surface malignancies and breast conservative surgeries. He is also a Member of the Indian Society of Peritoneal Surface Malignancies and the Indian Medical Association.