Cancer: Everything You Should Know About Cancer and KOL #1 Dr. Anne Marie Tjønneland

The term Cancer refers to a group of genetic conditions in which abnormal cells divide and multiply uncontrollably, infiltrating and damaging healthy tissues.

Cancer is a condition statistically growing; according to data from 2015 to 2017, around 39.5% of men and women will receive a cancer diagnosis at some point. The International Agency for Research and Diagnosis of Cancer reports that cancer is one of the leading causes of death in the world; in 2018, there were 18.1 million new cases and 9.1 million deaths from cancer, and by 2040, it is estimated that the number of people with cancer will reach figures of 29.8 million per year and the number of deaths from this cause is estimated to be 164 million. Likewise, the information from the International Agency indicates that the highest incidence rates of this disease are in countries with the best standard of living and development. However, the opposite is true for some types of cancer, such as cervical cancer; the highest rates are present in countries with fewer prevention and diagnostic measures.

Advances in the diagnosis and treatment of cancer and efforts to increase resources for research have contributed to the decrease in mortality rates in some types of cancer,  improving the quality of life of survivors and their follow-up.

This article generally describes cancer, from its definition to the different treatments.

What Is the ICD 10 Code for Cancer?

The ICD / ICD 10 code for Cancer is "C80.1" (Malignant (primary) neoplasm, unspecified).

Cancer: Definition of Cancer

In cancer, there is an increase in the number of abnormal cells in the affected tissue; these cells grow uncontrollably. The protein expression commanded by genes in the nucleus regulates cell formation. When this control is lost, there is no normal cell cycle in which others replace the cells that have already fulfilled their function, but rather an abnormal growth of cells with exaggerated longevity, giving rise to abnormal tissues seeded with cancer cells. Thus, these cells that grow abnormally and disorderly accumulate and give rise to tumors. These cells can migrate to other organs and affect them, leading to what is known as metastasis.

Tumors can be benign or malignant, and both types have essential differences. In the case of benign tumors, although some of them, due to their large size, can affect the functioning of the organ, once removed, the organ can recover its function. Brain tumors can be benign, but their location affects organ function and can be life-threatening. While malignant tumors generally affect organ function, despite being removed, other treatments are required to establish control of the disease.

What Is the ICD 10 Code for Cancer?

The ICD / ICD 10 code for Cancer is "C80.1" (Malignant (primary) neoplasm, unspecified).

Cancer: The Genetics of Cancer, Why Does It Occur?

Cancer is known to have a genetic origin. As previously mentioned, genes, DNA structures in the chromosomes of the cell nucleus, precisely regulate the synthesis of different cell proteins; the alteration in the genes that control the formation, structure, cell development, as well as the life of each cell, multiplication, and division, gives rise to the formation of defective proteins, which gives rise to defective and diseased cells that grow in a disorderly manner, causing cancer. The damage at the molecular level for cell alterations to occur and for cancer to originate are varied and numerous. These range from errors at the time cells multiply, causing defective cells, to errors in the formation of cells' substances, such as faulty proteins. These alterations occur at the level of deoxyribonucleic acid (DNA) caused by harmful agents present in the environment, such as chemicals in tobacco smoke and ultraviolet rays from the sun.

The human body destroys and eliminates cells that have damage to their genetic material (DNA) before they become cancer cells. However, with age, these cells can lose the ability to self-regulate and destroy themselves in the event of a defect, making the risk of cancer more significant as we age, in addition to more genetic changes taking place. As cancer grows, other changes occur within the same tumor since these cells may have genetic differences. Each person's cancer is a unique combination of genetic and environmental factors.

Cancer: What Genes Are Involved?

The genetic changes that contribute to cancer affect three main types of genes: proto-oncogenes, tumor suppressor genes, and DNA repair genes. These changes are sometimes called "onco-initiators" or oncogenic factors.

Proto-oncogenes are involved in the normal formation and multiplication of cells. But when there are specific changes in these genes or more activity than expected, they can become cancer-causing genes called oncogenes. Oncogenes cause the cells to multiply and survive in cases where they shouldn't.

Tumor suppressor genes also control the formation and multiplication of cells. Cells with specific changes in tumor suppressor genes could multiply out of control.

DNA repair genes fix damaged DNA. Cells with mutations in these genes tend to have more chromosome changes (such as missing or repeated sections of chromosomes). When both types of mutations come together, cells can become cancerous.

Cancer: What Symptoms Can a Person With Cancer Present?

There are several clinical manifestations related to cancer syndrome. However, it is essential to mention that cancer usually remains unmanifested or that there are subtle findings at the beginning. Once the tumor proliferates and grows, clinical manifestations begin, depending on the affected organ or system. It is increasingly important to carry out early diagnosis tests for the most prevalent cancers. Symptoms that may suggest a disease of this type are:

• Weight loss
• Night sweats
• Abnormal growth of lymph nodes in the affected area
• Palpable mass
• General weakness
• Fatigue
• Asthenia or adynamia
• Affected area pain

As mentioned, depending on the location of the tumor, the signs and symptoms will vary:

• Palpable mass (breast, intestinal, bone, and other cancers)
• Localized pain
• Pallor
• Digestive bleeding
• Jaundice (liver, pancreas, or bile duct cancer)
• Coughing up blood (lung cancer)
• Urine with blood
• Difficulty urinating

It is essential to note that the clinical manifestations will vary and that in the event of any of the symptoms mentioned above, you should immediately see your doctor to carry out appropriate evaluations and tests.

Cancer: What Are the Diagnostic Methods Used?

If any of the symptoms described above or any indication of cancer appears during a routine check-up, you should see your doctor immediately. The physician must investigate any suggestive symptom or sign in depth without underestimating. The doctor must analyze aspects such as predisposing family history and relevant personal history; if there is any suspicion, the doctor should request imaging studies. Initially, the least invasive and most economical study is an ultrasound of the suspicious area. The medical provider should ask for computed tomography or nuclear magnetic resonance if any relevant finding exists. There are also laboratory tests called tumor markers that guide the diagnosis; there are specific markers for certain types of cancer. These tumor markers are essential because they can function as diagnostic elements and monitor patients.

Cancer Diagnosis: Laboratory Tests

The concentrations of certain substances in the blood, urine, or other fluids can be altered in the presence of cancer due to their production by cells that grow disorderly; however, there are also cases where there are no relevant changes. Many of these substances are tumor markers detected in blood, tissue, and other fluids.

Cancer Diagnosis: Imaging Studies

Imaging studies have the benefit of reproducing body parts and showing the inside of organs; they detect most tumors and are a vital element in the research and protocolization of cancer patients.

Next, we present a brief explanation of the most used imaging studies.

Cancer Diagnosis: Computerized Axial Tomography (CAT Scan)

In this method, an x-ray machine makes multiple shots and cuts at different angles and projections that can then reproduce the organ's shape in 3D. Sometimes intravenous or oral contrast medium is used to delineate the structures.

Cancer Diagnosis: Nuclear Magnetic Resonance Imaging (MRI)

This method consists of a powerful magnet and radio waves that create pictures of the body in sections. The person is in a machine (closed or open), and cuts generate when the waves collide. This machine emits sounds and strong knocks on the body, thus producing an image of its entire structure. As in the tomography study, an intravenous dye or contrast medium can be injected.

Cancer Diagnosis: Nuclear Tomography

Also called scintigraphy, nuclear tomography uses radioactive material to draw or reproduce body parts. This material is injected into the bloodstream and captured by the machine that translates the image and draws the body, detecting tissues that capture the substance differently, making it possible to detect tumor growths or specific tissues.

Cancer Diagnosis: Positron Emission Tomography (PET)

A PET scan details images of the inside of the body where glucose uptake occurs; it is a scanner that creates 3D images. The reason for its use is that cancer cells use more glucose in their metabolism than normal cells. Therefore, as there are tissues with greater glucose uptake, they produce images that represent cancerous areas. During the exam, the patient is administered radioactive or labeled glucose intravenously, the exam is performed inside a scanner machine, and the patient lies on a table that moves to make the different cuts or scans.

Cancer Diagnosis: Bone Scan

Bone scintigraphic images are created using a radioactive contrast capable of marking the cancer cells in the bone; therefore, this test can detect bone cancer in either its metastatic form or primary bone cancer.

Cancer Diagnosis: Ultrasound

Ultrasound is beneficial at the beginning of the study of suspected cancer; it is a non-invasive method, does not use radiation, and is low-cost. Images suggestive of cancer can be seen, especially in solid organs such as the liver, kidneys, bile ducts, pancreas, mammary gland, bladder, and prostate.

The way it works is to impinge sound waves on the tissues and uses special equipment with transducers that pick up these waves back, translating them into an image on the screen.

Cancer Diagnosis: X-Rays

The patient is placed immobile in front of an X-ray machine, the beam is focused on the area to be studied, producing an image on a screen. Its usefulness in cancer is limited since it does not give many details about the tissues. However, it is performed at the beginning or in the follow-up of complications and treatments.

Cancer: Cancer Treatments

Before any therapy, a precise diagnosis must be made at the histological level to carry out the established protocols. Once cancer or tumor is detected, performing a biopsy or study of the tissue is essential. The techniques for taking biopsies are varied. Increasingly non-invasive studies and procedures have gained more strength and show significant advantages. Open surgery plus biopsy are used for specific cases and offer further benefits. The methods are sampling guided by ultrasound, laparoscopy, and endoscopies such as colonoscopy.

The physician must process the sample for biopsy by requesting different stains and markers. Its adequate and correct processing will give detailed cancer type and characteristics reports, ensuring successful treatment.

In general, the treatments are varied and will depend on the type and stage of cancer and the inherent characteristics of each patient, so individualization of each case is essential.

The pillars of treatment for cancer are:

Cancer Treatment: Surgery

If possible, surgery should be performed under safety measures to prevent dissemination. Surgery can be palliative or curative, depending on each case.

Cancer Treatment: Chemotherapy

Every time better mechanisms of action, doses, and side effects of drugs with action on tumor cells are known. Efficacy studies of these chemotherapeutic drugs detail the benefits of certain types of cancer. However, what often makes it more challenging to make these drugs available to patients is the costs, which is why government programs and health policies are open to the most vulnerable populations.

Cancer Treatment: Radiation Therapy

In radiotherapy, high doses of radiation directed at the tumor area are used to reduce them. The specific effect of radiotherapy is to destroy cancer cells since these high doses of radiation affect their DNA, preventing their division. This procedure makes it possible to reduce or make the tumor disappear; the cancer cells under the effect of radiotherapy die. Radiotherapy cannot treat all types of cancer; that is to be determined by the treating physician. The side effects of radiotherapy have to do with its intensity and are also related to the doses used. Radiotherapy has curative or palliative purposes; the latter is to reduce the clinical manifestations of cancer and provide a better quality of life for the patient.

Cancer Treatment: Immunotherapy

Immunotherapy stimulates the immune system to fight cancer. The immune system comprises white blood cells, red blood cells, and various chemicals capable of fighting disease.

Immunotherapy is a type of biological therapy. Biological therapy is a type of treatment that uses substances made by living organisms to treat cancer.

Monoclonal antibodies are a type of cancer immunotherapy. Under normal conditions, an antibody can mark cells and make them targets for the immune system to destroy. In the case of cancer, the monoclonal antibodies created can turn tumor cells into targets for the immune system to destroy them.

 

Dr. Anne Marie Tjønneland: KOL #1 for Cancer

According to KOL's technology, Dr. Anne Marie Tjønneland is the top ranking Key Opinion Leader (worldwide) for Cancer. You can see Dr. Anne Marie Tjønneland's KOL resume and other concepts for which they rank #1 worldwide.