The plan is for me to write a series of blogs about cancer. You will read this small paragraph every time you read one of these blogs because it is an explanation and a disclaimer. First of all, why should I do this and what qualifies me to do so? The answer to the second question is that I am a cancer immunologist with a PhD from the University of Pennsylvania and have 30-years experience in not only research, but also in the experiences of cancer patients. I have published numerous articles and a book about immunity to cancer and have two other books about my experiences with research and cancer patients as well as a fictional account of the final cure for the disease. However, none of this experience allows me to give advice or otherwise tell people what to do if they have cancer. I can be viewed as a participant/observer who will be relaying current and past observations about this world called “cancer”, which many people do not understand. That’s the answer to the first question, which is why I should do this. The first step in overcoming anything is to understand it first. With that being said, here they are:
Number 1 The Symptoms and Diagnosis of Cancer
This aspect of cancer is the most innocuous of all. Many of the symptoms of this disease start out in a very benign way. It maybe just a pain somewhere or a bit of nausea, slight lightheadedness, blurred vision for a while. Occasionally there may be a rash or swollen glands, numbness, or vertigo. The list is extensive, but I think you get the idea, which is that many times the symptoms of cancer are masked in run-of-the-mill minor physical aches and pains we experience almost on a daily basis. What makes the symptoms of cancer different from the day-to-day aches and pains? The answer to this question is related to the nature of cancer itself. Cancer is the never-ending abnormal growth of previously normal cells in our bodies. The key words here are “never-ending abnormal growth”. So unlike those nagging day-to-day aches, pains, rashes, occasional dizzy spells, which come and go, but usually go, the symptoms related to cancer are persistent. They may lessen at times, but like cancer never go away and usually increase in intensity.
Some symptoms of cancer such as swollen glands and sweating with forms of leukemia are a direct effect of the growth of cancerous cells. In this case lymph nodes swell because the lymphocyte is the cancerous cell and expanding numbers of them take-up residence in their “home”, which is the lymphatic system containing the lymph nodes. The sweating is a natural by-product of rapid lymphocyte cell division. This occurs when we have viral or bacterial infections. However may other symptoms of cancer are secondary symptoms caused by the immune response to cancer. For instance with melanoma, which is a deadly form of skin cancer, the immune system attacks the cancer and as a consequence of this attack normal cells are damaged in the process. Melanoma cancer cells are derived from a normal cell called a melanocyte. These are pigment-producing cells that, after being stimulated with light, inject nearby skin cells with melanin, which is the pigment associated with a “tan”. Generally, the cells become cancerous through a series DNA repair mistakes and begin to grow out of control. The melanocyte is a unique cell because it is related to the cells of the nervous system. As these cells become malignant they retain some of normal proteins as well as the cancer proteins the immune cells recognize. Once a cellular immune response against the cancer is initiated some of these normal proteins are recognized as cancer proteins and as a result the immune system begins to attack normal cells as well. Therefore, some of the symptoms of melanoma are white patches forming in the skin, which is called vitiligo and a very painful symptom called peripheral neuropathy. These symptoms are called cancer-related “autoimmune episodes”. The vitiligo, which can be an autoimmune disease without the presence of melanoma, is caused by the immune system attacking and killing normal melanocytes. However peripheral neuropathy, which is nerve damage and the result of an anti-melanoma immune response is almost always associated with the occurrence of melanoma. Other indirect symptoms of cancer are the over secretion of normal cellular proteins, which are detected by blood test. The reason for this is what was mentioned above where the cancerous cell still possesses some normal functions, but now that the cells are growing at a rapid rate those normal functions are exaggerated. These are just some examples of the nature and cause of cancer symptoms, but how they are recognized and diagnosed as cancer symptoms is the most important aspect of this discussion.
Most people often have no idea that they have cancer prior to its diagnosis by a physician. Often what occurs is a change their health status or the identification of a known cancer-related symptom or event. An example of the latter would be a lump discovered during a routine breast self exam. This type of awareness of cancer is called “conscious detection” and the former, “passive detection”. The passive detection of cancer my include symptoms such as fatigue, nausea, pain, and a long list of other symptoms, which could be linked to a myriad of other health problems. However, it takes time to notice whether the symptoms are just passing or if they are persistent. This phase is referred to as an “appraisal delay”. Understanding and responding to these symptoms is in part based on an individual’s ability to determine if they are serious enough to decide to seek medical advice. This is another stage called “illness delay”. This is followed by another period where the individual must act upon the decision to seek medical care and is called a “behavioral delay”. There is a “scheduling delay” concerned with actually making the appointment to see the doctor. The final delay is the “treatment delay” and that is the period between the first doctor’s appointment and first treatment of the disease. The time between the initial recognition of cancer-related symptoms and treatment is a critical period in time. The above-mentioned delays often occur during periods of time where the cancer is at a stage that if detected early, can be successfully treated. However, as mentioned above, if these delays are prolonged the cancer may have an opportunity to spread (metastasize) throughout the body, which makes treatment that much more difficult. Because of this, the successful treatment of an initial cancer is dependent on two factors. The first is an increased public awareness of cancer and it’s symptoms and the second factor is an improvement in a physician’s ability to detect cancer in these patients
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