12 causes of Cancer | Irradiation

12 causes of Cancer : Irradiation
Radiation is everywhere, be it from the sun, or from the electronic devices at our homes. But not all are harmful, and not all cause cancer. There are basically two types of radiations- ionizing and non ionizing. The ionizing radiation is the high frequency radiation which can potentially damage the DNA of the cells causing mutation. The Ionizing radiation is a known Carcinogen or cancer causing agent. The ionizing radiation includes the X rays , Atomic radiation, and high energy UV rays.

X rays-
Constant exposure to X rays causes certain cancers. This was a new finding when the X ray machine was still in its developing stage. The workers or technicians who manually held the X ray plates, developed certain Cancers , mostly affecting the skin of their hands.

avoid unnecessary X rays

Atomic Irradiation-
After the bombings at Hiroshima and Nagasaki in Japan, there was high incidence of Leukemia and thyroid cancer in the surviving population.
Also, the same was found after the accident in Chernobyl in 1986.

atomic irradiation in Japan

UV rays-
We discussed the role of UV rays in the previous article about Sunlight exposure.

Types of Cancers caused by ionizing radiation are-

• thyroid cancer
• leukemia
• multiple myeloma
• skin cancer
• breast cancer
• stomach cancer

Refer to the main article 12 causes of Cancer to see how Cancer develops.

Also read
5 reasons why you should study Oncology.
Cancer and surgery.
What is Radiation oncology?
What is Cancer-related fatigue?
What is psycho-oncology?
12 causes of cancer.
Cancer in 21st century.

12 causes of Cancer | Sunlight exposure

12 cause of Cancer : Sunlight exposure.

• The Ultra Violet or UV rays are responsible for most of the cases of Melanoma or skin cancer, especially in the western countries.
• Every person living on earth is more or less always exposed to sunlight. So why are only the people in the west mostly found to have skin cancers?
• There are 2 main reasons for this :

• The effect of sunlight exposure on the people is such that, it doesn't lead to more melanin production (like in dark skinned people), but it slowly alters the genetic constitution of the cells, and leads to mutations. A series of which results into skin cancer. 
• Increasing use of 'Tanning bed' which mainly emit UVA rays, which are responsible for causing Melanoma.

So, these are the 2 main causes of skin cancer which are again, preventable. And can be prevented by simple protective measures like covering the skin and use of a good sunscreen. Also, avoiding the use of 'Tanning beds' reduces the risk.

To know the mechanism of cause of Cancer, read 12 causes of Cancer.

Also read
5 reasons why you should study Oncology.
Cancer and surgery.
What is Radiation oncology?
What is Cancer-related fatigue?
What is psycho-oncology?
12 causes of cancer.
Cancer in 21st century.

12 causes of Cancer | Betel nut

12 causes of cancer : Betel nut-
Betel nut chewing is a very common cause of oral cancer in the South-East Asian countries, where it is locally produced and highly consumed.

betel nut

An interesting fact about betel  nut chewing is that, it's more of a cultivated habit, than being chewed because it is addictive.

In the rural areas, a mixture of betel nut, tobacco leaf and lime is widely used, which is highly carcinogenic.
This mixture is usually held in the cheek area inside the mouth. This stays in constant contact with the lining or buccal mucosa and is responsible for cancer.

mixture of betel nut, lime and tobacco

People start consuming the mixture even in  childhood, as early as 10 years of age.
This is one of the major causes of oral cancer in India.

To know HOW cancer is caused, see the main article 12 causes of Cancer

Also read
5 reasons why you should study Oncology.
Cancer and surgery.
What is Radiation oncology?
What is Cancer-related fatigue?
What is psycho-oncology?
12 causes of cancer.
Cancer in 21st century.

12 causes of Cancer | Alcohol

12 causes of Cancer : Alcohol

Firstly, alcohol consumption is directly associated with liver cancer in a way, that it causes liver cirrhosis which may turn into liver cancer later on.

liver cancer

Secondly, alcohol, if consumed along with tobacco smoking, HIGHLY increases the chances of developing:

• alimentary canal cancer
• pancreatic cancer
• cancer of colon, etc

smoking and drinking

These chances are lower in people who consume either alcohol or tobacco alone.
Esophageal cancer is associated with alcoholics who usually consume strong spirits.

Alcohol consumption is another risk factor which can be totally prevented.

To understand HOW cancer is caused, or to understand the basic pathway, see the main article
12 causes of cancer.

Also read
5 reasons why you should study Oncology.
Cancer and surgery.
What is Radiation oncology?
What is Cancer-related fatigue?
What is psycho-oncology?
12 causes of cancer.
Cancer in 21st century.

12 causes of Cancer | Smoking or tobacco chewing

12 causes of Cancer :smoking and tobacco chewing

Cigarette smoking:

• Smoking is the leading cause of not only cancer , but a myriad of other modern health problems too.
• It is obviously the highest preventable and controllable risk factor. 

cigarette and pipe smoking

Smoking may cause the following cancers :

• Lung cancer
• Oral cancer
• Cancer of larynx and throat
• Esophageal cancer
• Stomach cancer
• Pancreatic cancer
• Breast cancer
• Kidney cancer
• Bladder cancer
• Cancer of cervix and uterus

Tobacco Chewing:

• This causes the very dreadful and disfiguring oral cancer besides many other oral cavity problems.
• Again, this factor is highly controllable and preventable.

oral cancer

To understand HOW smoking and other facors cause Cancer, or to understand the basic pathway, see the main article 12 causes of Cancer.
For more information and latest statistics visit oral cancer causes / wikipedia

Also read
5 reasons why you should study Oncology.
Cancer and surgery.
What is Radiation oncology?
What is Cancer-related fatigue?
What is psycho-oncology?
12 causes of cancer.
Cancer in 21st century.

12 causes of Cancer.

How is Cancer caused?

We know that a complex disease like Cancer does not have 'one common cause' which is very simple, preventable, and easy to understand. For decades now,  researchers have been studying its cause , with a huge sum of money invested, using the best existing technology there is. And this has equipped us with the understanding of a  basic pathway that leads to Cancer. Let's have a look...

cancer cells spreading

Understanding basic pathway of cause of Cancer :
First of all, a single pathway for cause of cancer does not exist presently, and if it does, it's not yet found. But there are a few common sequential things that go wrong in and around a cell, which ultimately leads to cancer. So, lets take a look at those common factors.

• The one basic factor is, damage to the DNA or genetic blueprint of the cells, which causes mutation or sudden change.
• This change happens in the 2 genes that regulate the cell's multiplication as we discussed earlier, the proto-onco genes and the tumor suppressor genes.
• Now, not all types of damage to the DNA  will produce the same effect in these genes. That's how we get a variety of cancer types! 
• The specific thing that damages the DNA of a cell, often determines the type of Cancer. 
• For example, the damage caused to the cell because of carcinogen in tobacco and UV rays of the sun is very different. Each 'cause' or way of damage to a cell has a signature effect on the mutation of the cell, and hence produces a particular type of Cancer. The same applies to a virus that causes cancer as well.
• Now, is one mutation in one cell enough for producing cancer? No. It takes a series of mutations in that cell for it to undergo a cancerous change.
• This is the reason why Cancer does not happen after a year of smoking. It requires constant and long-term exposure to a carcinogen before cancer shows up. It waits for the body to become vulnerable and incapable of repairing the damage before it shows up!
• In case of familial cancers, they show up earlier than usual. The reason is that, the mutated genes are already present in that particular individual, inherited from the parents. So a little bit of exposure to the carcinogens is all it takes.

Apoptosis gone wrong :
Apoptosis is the self-regulation of cell growth, or a mechanism of natural cell death. Usually, when the cells are physically worn out, or genetically damaged, the undergo apoptosis, so that they are replaced by new normal healthy cells and the function of cells is not compromised. But when this process goes wrong, the genetically damaged cells continue to proliferate and become malignant.

Now that we have a basic understanding of what goes wrong, let's have a look at some common reasons WHY it does : 12 causes of cancer

1. Smoking or Tobacco chewing
2. Alcohol consumption
3. Betel nut
4. Sunlight exposure
5. Irradiation or radiation exposure
6. Irritants
7. Chemical Carcinogens
8. Hormonal imbalance
9. Viruses
10.Bacteria
11.Pre-existing genetic abnormalities
12.Faulty food habits

The 12 common causes of cancer will be discussed in detail in the further articles.

Also read
5 reasons why you should study Oncology.
Cancer and surgery.
What is Radiation oncology?
What is Cancer-related fatigue?
What is psycho-oncology?
12 causes of cancer.
Cancer in 21st century.

Cancer-related Fatigue | Evaluation (2)

Cancer and Fatigue : evaluation of fatigue

After the initial assessment with uni dimensional tool, a detailed assessment is necessary to evaluate and treat the fatigue.

Multi-dimensional scales:

These scales or tools are best suited for research purposes as they evaluate various aspects of fatigue.

Here's a few factors which should be evaluated in the initial assessment before using the tools:

• hemoglobin levels
• other medications
• pain intensity
• fever/infection
• psychological distress
• depression
• anxiety
• malnutrition or deficiencies

The patient's information should be updated on the evaluation sheet. The name, age and sex should be noted.
Having access to patient's treatment information is extremely important.
The following should be NOTED :

• Diagnosis- type and stage of cancer
• Current treatment- chemo/radio , drugs and dosage
• Relevant past treatment history( if any)
• Surgical history
• Hemoglobin levels

Then, further detailed evaluation can be made asking the following questions:

1. Do you experience fatigue or tiredness?

2. If yes, could you describe the pattern of fatigue, like when does it begin, how bad does it get, what relieves it, etc ?

3. How are you getting along with the treatment?

4. Are your sleeping habits and resting patterns changed? (time, duration, etc)

5. Has your appetite reduced?

6. Are you continuing your job/ work ?

Then, a complete physical examination should ideally be done mainly to assess-

•  muscle wasting
•  gait
•  posture changes
•  range of motion, etc

Then, one of the following available scales can be used to assess Cancer-related Fatigue.

1. Fatigue Symptom Inventory
This is a 14 point scale which is quite efficient and simple.
http://labpages.moffitt.org/jacobsenp/Copy/FSI%20English%20Version.pdf

2. Multidimensional Fatigue Symptom Inventory
This contains 30 statements and the most suitable answer has to be marked.
http://www.cas.usf.edu/~jacobsen/MFSI-SF%20English%20Version.pdf

3. Brief Fatigue Inventory
It is a short tool consisting of 4 questions and 6 sub-questions to the 4th one.

The above mentioned scales are easily available and can be used easily by translating into suitable languages for the patients.
Many other scales are also available like-

4. Piper Fatigue Self-Report Scale

5. The Schwartz Cancer Fatigue Scale

6. Lee's Visual Analog Scale for Fatigue

7. Cancer Fatigue Scale

8. The Functional Assessment of Cancer Therapy-Fatigue

9. The Functional Assessment of Cancer Therapy-Anemia

10.The Profile of Mood States of Fatigue?Inertia Subscale

Also, there are
Fatigue Intensity Scales
Fatigue/Function measures
The Fatigue Severity Scale

After collecting the data, correct interpretation should me made and the fatigue levels should be noted.
This is done by using the outcome measure methods that every individual scale has.

These scales are useful for the patients as well because it will help them self-assess their fatigue to a certain extent .
This will also help them understand the pattern of change in their fatigue levels.

Also read
5 reasons why you should study Oncology.
Cancer and surgery.
What is Radiation oncology?
What is Cancer-related fatigue?
What is psycho-oncology?
12 causes of cancer.
Cancer in 21st century.

Cancer-related Fatigue | Evaluation (1)

 Cancer and Fatigue: evaluation of fatigue

As I mentioned earlier, fatigue is a self-perceived state which is multi-dimensional in nature. Hence, it requires to be assessed using multi-dimensional tools or scales which evaluate all possible aspects of fatigue. This will help formulate a better treatment plan for every individual.

There are many scales available and appropriate for evaluation of Cancer-related Fatigue.

Uni-dimentional scales:
These simple scales can be used in busy clinical set-ups and also for quick follow-ups.
These scales do not evaluate every aspect of fatigue. However, they are used widely in clinical practice.

For example-

• Verbal rating scale (none, mild, moderate, severe)
• Linear analog scale assessment (LASA)
• Numerical rating scale

Numerical Rating Scale

• These scales can be useful in case of children.
• If the patient claims to have a very high level of fatigue then he/she can be evaluated for other factors like psychological distress, pain, co-morbidities, anemia, nutrition deficiency, sleep, etc.
• One of these scales can also be used as the 1st step of evaluation of fatigue which should be followed by a multi dimensional scale.

Also , a few simple questions regarding fatigue can be used. For example,

• Are you/ have you been experiencing fatigue?

• If yes, how severe has it been in the past week ? (use the numerical rating scale)

• Is the fatigue interfering in you activities of daily living, your ability to concentrate, your work, etc

Also read
 5 reasons why you should study Oncology.
Cancer and surgery.
What is Radiation oncology?
What is Cancer-related fatigue?
What is psycho-oncology?
12 causes of cancer.
Cancer in 21st century.