TYPES AND WARNING SIGNS OF CANCER

Knowing the warning signs and factors that increase the risk of developing different forms of cancer can save your life. The American Cancer Society estimates that of the 500 000 cancer deaths that occur in the United States, about one-third can be attributed to dietary factors, with another third being caused by cigarette smoking. Healthy lifestyle choices at any stage of life are a major step toward cancer prevention. Following are descriptions of some of the major types of cancer, including information about who is affected, what the symptoms are, how these can be detected and diagnosed, and what you can do to reduce your risk of contracting them.

BLADDER CANCER

Bladder cancer is the fourth most common cancer in males, eighth most common in females, and fifth leading cause of cancer deaths in the United States. It is four times more common in men than women, twice as common in Caucasians as in African-Americans, and is usually diagnosed later in life.

Causes and Risk Factors

The cause of bladder cancer is not known. Smoking is the number-one factor associated with bladder cancer. Also linked to bladder cancer are exposure to certain chemicals, such as benzidines, aniline dyes, naphthalenes; radiation exposure; heredity; possibly extremely high consumption of saccharin; a history of schistosomiasis (a tropical disease); chronic urinary tract infections or inflammation; and working in the dye, chemical, rubber, and leather industries.

Signs and Symptoms

Often symptoms do not appear in the early stages. The first warning sign is usually blood in the urine. Other symptoms can be pain and burning and urination, increased frequency of urination, and difficulty urinating.

Directions and Diagnosis

Bladder cancer can be detected by examining the bladder through a cytoscope, examining cells in the urine, or having intravenous pyelography (IVP, a special kidney x-ray) performed. Sometimes a large tumour can be detected through a rectal or vaginal exam. Researches are studying a new screening test that detects telomerase, an enzyme produced by bladder tumours.

Dietary and Nutritional Factors

Cruciferous vegetables such as broccoli, Brussels sprouts, cabbage, cauliflower, and kale have been credited with lowering the risk of bladder cancer due to their antioxidant and other cancer-fighting compounds. Eating the USDA recommended number of servings fruits such as apples, berries, cherries, oranges, pears, and tomatoes can reduce the risk by 45 percent. Drinking a lot of liquids, especially pure water, helps to dilute carcinogens and increase urination, lessening the time any carcinogens in the bladder have to do any damage.

Taking vitamin A, beta-carotene, vitamin C, and a multivitamin have show reductions in the risk of getting bladder cancer. Dimethylsulfoxide (DMSO) is an FDA-approved, non-toxic solvent that has been shown to aid in treatment.

BREAST CANCER

See BREAST CANCER in Part Two.

CERVICAL CANCER

Invasive cervical cancer is the second most common type of cancer in women and accounts for over 11 percent of all cancers around the world. The majority of cervical cancers grow gradually over several years with precancerous cells (dysplasia) existing previous to the cancer cells. If dysplasia is detected early enough and remove, cervical cancer can often be prevented.

Causes and Risk Factors

Most cervical cancers are associated with infection with human pallomaviruses (HPV), which can be transmitted sexually. Associated risk factors include having had more than five complete pregnancies; first intercourse before age eighteen; unprotected sex; sexually transmitted infections, including HIV, HPV, and genital herpes; early childbearing; multiple sex partners; infertility; low socio-economic status; smoking; and nutritional deficiencies.

Signs and Symptoms

Cervical cancer usually causes no symptoms until it is advance, which is why it is essential for women to have regular pelvic exams and Pap tests. It can cause bleeding between menstrual periods, bleeding after intercourse or douching, unusual discharge, painful menstrual periods, and heavy periods.

Detection and Diagnosis

The presence of abnormal cells can be detected by a Pap test, followed up with a biopsy. Women should begin having annual pelvic exams and Pap tests when sexual activity begins, or at age eighteen (after three or more normal exams, your doctor may recommend decreasing the frequency of the exams unless you have had dysplasia or are at increased risk for other reasons). Researchers are exploring the idea of screening for HPV as a method of early detection.

Dietary and Nutritional Factors

A diet low in fatty meats (especially pork), red meat, cheeses, and white bread, and high in soy products, fruits, dark green vegetables, tomatoes, whole grains, and yoghurt offers the best dietary protection. Shiitake mushrooms are also a good source of protection. If you do not consume 3-5 servings of fruits and vegetables daily, you should take vitamin C (500-1000 milligrams daily), E,A, and beta-carotene (25 000-50 000 international units daily) in supplemental form. Folic acid, one of the B vitamins (400-800 micrograms daily), can not only aid in prevention, but it has been know to reverse precancerous changes in cervical cells. Shark cartilage may also be helpful in fighting or preventing cervical cancer.

COLORECTAL CANCER

The large intestine is made up of the colon (the upper five to six feet) and the rectum (the last six to eight inches). This is where the last stage of digestion occurs and where solid waste is held until it is released. Colorectal cancer is second only to lung cancer among cancers that kill both men and women. Mostly credited to an increase in screening for and removal of polyps, the incidence has been declining during the past decade.

Most colon cancers occur in people over fifty. It strikes men and women nearly equally. Colorectal cancer develops over a ten- to fifteen-year period and produces no symptoms until it is advanced. If the disease is detected early enough and the tumour has not metastasise, the survival rate is quite high.

Causes and Risk Factors

A genetic defect is connected with some forms of familial colon cancer. Other causes are not known. Risk factors associated with colorectal cancer include calcium deficiency; colorectal polyps; family history of colon cancer (Lynch syndrome); continued constipation and/or diarrhoea; personal history of colon-related diseases or uterine or ovarian cancer, such as polyps, non-polyposis colon cancer, or inflammatory bowel disease; buildup of toxins in the colon; possibly diabetes; a die high in saturated animal fat and low in fiber; high intake of charbroiled, burned wood-smoked, or fried foods; obesity; smoking; alcohol consumption; and cancer in another part of the body. Many studies have show that active people are not as likely to develop colon tumours as those who do not regularly engage in physical activity.

Signs and Symptoms

Symptoms of colorectal cancer can include rectal bleeding; blood in the stool; changes in bowel habits (persistent diarrhoea, gas pains, and/or constipation); persistent abdominal pain or bloating; anaemia or significant weight loss; unusual paleness or fatigue; and ulcerative colitis.

Detection and Diagnosis

Screening for colon cancer is the best way to detect polyps before they turn cancerous. During regular checkups (and annually after age forty), men and women should have a rectal exam. Beginning at age fifty, one of the following tests should be performed along with a rectal exam:

1.      Faecal occult blood test (FOBT) and flexible sigmoidoscopy (if normal, repeat the FOBT yearly and the flexible signoidoscopy at 5-year intervals).

2.      Colonoscopy (if normal, repeat at 10- year intervals).

3.      Double contrast barium enema or colon x-ray (if normal, repeat at 5-10 year intervals).

If you have a personal history of inflammatory bowel disease, you should have a colonoscopy every one to two years. If you have a family history of colorectal cancer, you may have an inherited genetic mutation at an early age, even In the teenage years. Investigate any family history of colon cancer and discuss proper screening guidelines with your physician.

In addition, a test kit for detecting blood in the stool can be purchased at most drugstores (See Colon Cancer Self Test in this section)

Dietary and Nutritional Factors

It was once believed that a high-fiber diet protects the colon by reducing the time any harmful carcinogens that are present in the stool are in contact with the intestinal wall. There have since been conflicting reports on this, but most health professionals still recommend a high-fiber, low-fat diet. A high-fat diet has a strong link with colon cancer. Either a vegetarian diet or a diet low in red meat, alcohol, and refined foods and high in vegetables, fruits, soy, fish, whole-grain breads, and cereals, as well as low- or non-fat dairy products and lots of fruit and vegetable juices offers optimum dietary protection. Garlic, broccoli, cabbage, cauliflower, Brussels sprouts, citrus fruits, melons, and dark green, red, and yellow vegetables are recommended for their antioxidant and sulphur compounds. Tomatoes may lower risk. Consumption of chlorinated water has been linked to a greater incidence of colon cancer. Coffee has been reported to have positive effects on reducing colon cancer risk.

Beta-carotene, calcium (1200 milligrams daily), selenium, and vitamins C and E, and the long term use of a multivitamin containing folic acid (above 400 micrograms daily) have been linked to a reduced risk of colon cancer. Probiotics (which can be found in yoghurt and supplements) may inhibit colon cancer. Low levels of vitamin D and, possibly, excessive iron intake, have been associated with an increased risk of colon cancer. Quercetin has been shown to have anticancer properties with respect to colon cancer.

ENDOMETRIAL CANCER

See under ENDOMETRIOSIS in Part Two.

OESOPHAGEAL CANCER

Oesophageal cancers are more common in men than in women, and in African-Americans than in whites. Tumours in the oesophagus usually occur in the middle or lower half of the oesophagus. Oesophageal cancer is one of the fastest growing and deadliest forms of cancer in the United States because symptoms usually do not occur before it is in advanced stages when there is little chance of recovery.

Causes and Risk Factors

The cause or causes of oesophageal cancer are not well understood. Risk factors include the use of tobacco and/or alcohol; age; personal history of Barett's oesophagus (a precancerous condition resulting from the reflux of stomach fluid into the bottom portion of the oesophagus over an extended period of time), achalasia (constriction of the lower portion of the oesophagus), tylosis ( a very rare inherited disease that causes the overgrowth of skin on the palms of the hands and soles of the feet), or oesophageal webs (small portions of tissue that stick out into the oesophagus, often making it difficult to swallow); a high-fat diet; consumption of wood-smoked foods; previous ingestion of lye; and frequent heartburn. The risk generally rises with age. Those who smoke or drink heavily (or both) are at greatest risk. People with tylosis have nearly a 100-percent chance of developing oesophageal cancer. Screening must begin at an early age for people with tylosis.

Signs and Symptoms

Usually there are no symptoms until the cancer is in the advanced stages. When they develop, symptoms may include progressive dysphagia (difficulty swallowing), often with a feeling of something being stuck in the throat or chest; vomiting and vomiting of blood; bringing up excess mucus; and unintended weight loss.

Detection and Diagnosis

See your doctor without delay if swallowing becomes even the slightest problem. Your doctor may use a barium x-ray and an endoscopic exam, or request a biopsy. A computerized tomography (CT) scan or a new procedure called an endoscopic ultrasound (an endoscope with an ultrasound probe) may also be ordered.

Dietary and Nutritional Factors

A diet high in fruits (including tomatoes) and vegetables may decrease the risk of this form of cancer. Fish, berries, mushrooms, and Brussels sprouts are all good sources of omega-3 fatty acids, which offer protection. The consumption of salted, pickled, or mouldy foods has been associated with an increased risk. Another risk factor may be the consumption of extremely hot or cold foods that cause physical damage to the esophagus.

Vitamins A and C, selenium, and riboflavin may help protect against esophageal cancer. Spirulina has been found in several studies to inhibit the growth of oral tumours.

LARYNGEAL CANCER

The larynx (also known as the voice box) is the part of the respiratory tract between the pharynx and the trachea, containing the vocal chords. Cancer of the larynx affects more men than women. It usually strikes after the age of 50. Most laryngeal cancers develop from squamous cells, the thin layer of cells that make up the lining of the larynx. This type of laryngeal cancer usually begins as dysplasia and forms over a period of time – in fact, most of the precancerous cells go away on their own without treatment. However, some of them for carcinoma in situ (CIS), the earliest form of cancer. Tumours located on the true vocal chords rarely spread because the connective tissues underneath do not contain lymph nodes, but tumours on other parts of the larynx are apt to spread early. Laryngeal cancer can be treated by radiation therapy, especially If diagnosed early, and by surgery to remove part or all of the larynx. If the larynx is completely removed, you must learn a new method of speech that involves the swallowing of air and bringing it up again. Some surgical techniques have been developed to reconstruct larynx tissue so that speaking can be returned to normal. One method that has worked for many people is the insertion of a prosthetic device.

Causes and Risk Factors

Most cases of laryngeal cancer are associated with the prolonged use of tobacco and/or alcohol. Associated risk factors include chronic inhalation of fumes; frequent laryngitis or vocal straining; and an inherited predisposition.

Signs and Symptoms

Possible symptoms of laryngeal cancer include a persistent cough; hoarse throat; swallowing difficulties, sometimes with a pain that radiates to the ear; persistent ear pain; chronic sore throat, sometimes so mild that it is hardly noticed; blood in saliva or sputum; unintended weight loss and difficulty breathing.

Detection and Diagnosis

Persistent symptoms such as those listed above should be evaluated by a doctor who specializes in the head and neck area, or an otolaryngologist. Most voice changes are not a sign of cancer, but it is better to be safe and see a doctor if you are hoarse for more than two weeks. Diagnosis is made by laryngoscopy (visual examination of the larynx by means of a scope) plus biopsy.

Dietary and Nutritional Factors

The diet should be rich in fruits, vegetables, and foods containing vitamins, and retinoids. It is best to avoid alcohol.

If you are unable to acquire proper amounts of the above nutrients through diet alone, you should take supplements. Be sure that your total daily intake of vitamin A does not exceed 25,000 international units.

LEUKAEMIA

Leukaemia is any of a variety of diseases of the blood forming tissues (bone marrow, lymph system, or spleen). Leukaemia involves the production of abnormal white blood cells that do not function like normal cells, do not mature properly, and do not die off in a normal fashion. Leukaemia affects both children and adults, although certain forms are most common in particular age groups. It is somewhat more common in Caucasians than in African-Americans. There are many different types of leukaemia. Leukaemia's are categorized by type (named after the type of cell infected) and by whether they are chronic (in which the growth rate is slow) or acute (in which the onset is sudden). While there is no known cure, transfusions, chemotherapy, and bone marrow transplants are often effective treatments. Newer treatments include stem cell transplant, infusion of cell-specific antibodies, and biological therapy.

Causes and Risk Factors

No one knows exactly what causes leukaemia, but suspected causal factors include genetics, viruses, and exposure to certain toxic chemicals. Known risk factors include heredity, radiation exposure, chronic viral infections, age, Down Syndrome, having a sibling with leukaemia, exposure to human T-cell lymphotropic virus 1 (HTVL-1), use of commercial hair dyes, alkylating agents, certain cancer therapies, and environmental exposure to benzene (found in unleaded gasoline) or radon).

Signs and Symptoms

Signs and symptoms of leukaemia can include paleness; fatigue; shortness of breathing when active; weight loss; repeated infections; excessive sweating; fever; easy bruising; slow-healing cuts; bone and joint pain; nosebleeds, swollen lymph nodes; and an enlarged liver or spleen.

Detection and Diagnosis

Leukaemia is usually diagnosed by means of blood tests and, possibly, bone marrow biopsy.

Dietary and Nutritional Factors

Soy products, which contain genistein and other isoflavones, may offer protection against leukaemia. Good soy foods include tempeh, roasted soy nuts, soy powder protein, and miso.

The bioflavonoid quercetin has been found in numerous studies to have anti-leukaemia properties. Genistein has shown positive effects in destroying leukaemia cells in laboratory tests. Low selenium levels have been associated with a greater risk.

LUNG CANCER

Lung cancer is the most common cause of cancer-related death in both men and women. The average age at diagnosis is sixty. There are two general types of lung cancer: small cell (or oat cell) lung cancer, which accounts for approximately 25 percent of all lung cancers, and non-small cell lung cancer, which accounts for approximately 75 percent of lung cancers. Small cell lung cancer grows very rapidly and has a tendency to spread early to other parts of the body. This type of lung cancer is commonly found in smokers. There are three main types of non-small cell lung cancer: squamous cell carcinoma (the most common form of lung cancer), adenocarcinoma, and large cell carcinoma.

About 170 000 new cases of lung cancer are diagnosed each year, and nearly 160 000 people die of the disease. If caught before it has spread to the lymph nodes or other organs, lung cancer has about a 50-percent survival rate. However, most cancers (about 85 percent) are not caught at an early stage because they do not generally produce early symptoms, making the all-around survival rate relatively low – only about 12 percent – although it has been improving thanks to new diagnostics and rugs.

Causes and Risk Factors

Smoking is the leading cause of lung cancer, and is thought to be responsible for over 80 percent of cases. Associated risk factors include marijuana use; exposure to secondary smoke; exposure to asbestos, nickel, chromates, radon, or radioactive materials; alcohol consumption; chronic bronchitis; history of tuberculosis; exposure to certain carcinogenic chemicals in the workplace, such as pesticides and herbicides; pollution; radon exposure; having had previous lung cancer; personal history of lung diseases caused by breathing certain minerals; tuberculosis; arsenic compounds; lung scarring from certain types of pneumonia; exposure to raw forms of talcum powders (not those found in household powders such as baby and facial powders); and deficiency (or excess) of vitamin A.

Signs and Symptoms

Lung cancer can cause a persistent cough; sputum with blood; chest pain; shortness of breath; fatigue; hoarseness; unintended weight loss; loss of appetite; recurring bronchitis or pneumonia; fever for an unknown reason; new onset of wheezing; swelling of neck and face.

Detection and Diagnosis

If you have any persistent symptoms, see your doctor. Although many of these symptoms are often caused by other conditions, an examination is a crucial step in early detection. If your doctor does suspect lung cancer, he or she may order a series of imaging screenings, a study of a phlegm culture, a biopsy, a mediastinoscopy, a bronchoscopy, a bonemarrow biopsy, and/or blood tests. There are also two diagnostic imaging tools that that may be used in place of a biopsy, and/or blood tests. There are also two diagnostic imaging tools that may be used in place of a biopsy: The Xillix LIFE-Lung Fluorescence Endoscopy System and Nofetumomab. Another imaging test, called NeoTect, may also aid in diagnosing cancer – possibly eliminating the need to have a biopsy done on a suspicious growth. A new chest scanning technique called low-dose computed tomography (CT) may be a screening option if you are at high risk for lung cancer. Researchers are looking into the possibility of using routing CAT scans as a screening method for lung cancer, in the hop that this might substantially improve the survival rate for the disease. This type of screening is able to detect tumours smaller than the size of a kernel of corn, rather than the size of an orange.

Dietary and Nutritional Factors

A diet high in fruits (including tomatoes) and vegetables is associated with a greatly reduced risk of lung cancer. Shiitake mushrooms contain lentinan, which may also offer protection.

Genistein, an antioxidant found in soybeans, may have an inhibiting effect on the growth ok lung cancer cells. Apha-carotene, beta-carotene, and other carotenoids are believed by many researchers to aid in reducing the risk of lung cancer, although there is some evidence that betacarotene may be linked to a higher rate of lung cancer and mortality in smokers, former smokers, and those subjected to exposure to asbestos in their working environments.

Vitamins C and E and beta-carotene all work together, and when taken together, the potential adverse side effects are counteracted. Selenium, lycopene, lutein, and glutathione have been associated with a decreased risk of lung cancer.

LYMPHOMA (NON-HODGKIN'S)

A key player in the body's immune system, the lymphatic system is made up of a circuitry of vessels that branch out and spread to all the body's tissues – much like blood vessels do. Lymph nodes, found in the abdomen, chest, groin, neck, and underarms, are located along these vessels. Other parts of the lymph system include adenoids, bone marrow, the spleen, tonsils, and thymus gland. The intestines, skin, and stomach also contain lymphatic tissue. Lymph is a colourless fluid that contains lymphocytes, which fight infection.

Cancer that develops within the lymphatic system is categorized as either Hodgkin's disease or non-Hodgkin's lymphoma (all other forms of cancers in the lymph system). In non-Hodgkin's lymphoma (NHL), the body's ability to fight off infection is significantly decreased because fewer than normal white blood cells are produced. In addition, the cancer can spread through the lymphatic vessels to other parts of the body. NHL can be low-grade (slow-growing), intermediate-grade, or high-grade. Both intermediate-grade and high-grade NHL are fast-growing and can be deadly within 1 to 2 years if left untreated.

Non-Hodgkin's lymphoma is the fifth most common cancer in the United States, and the number of cases diagnosed has increased by nearly 50 percent in the past fifteen years. The actual number of new cases has increased, but the increase is also due in part to better methods of detection. Although this type of cancer can develop at any age, older adults are at highest risk.

Causes and Risk Factors

At least some cases of lymphoma are linked to a viral cause. In other cases, the cause is unknown. Risk factors include heredity; immune-system dysfunction; exposure to herbicides, pesticides, or black hair dye; a diet high in the red meat; AIDS; Immune-depressing therapies; previous organ transplantation; benzene; and HTVL-1.

Signs and Symptoms

Symptoms of non-Hodgkin's lymphoma vary, depending on the area of cancer growth. If cancer is in the abdomen, it can cause nausea, vomiting, and abdominal pain or enlargement; in the chest –shortness of breath and cough ; in the brain – headaches, vision changes, and seizures; in the bone marrow- anaemia; in the thymus – shortness of breath or feeling of suffocation, and coughing.

Detection and Diagnosis

A biopsy can be done on lymphatic tissue to detect if there is any cancer present, and if so, what type. If any symptoms of non-Hodgkin's lymphoma are persistent, you should see you doctor for proper evaluation.

Dietary and Nutritional Factors

A biopsy can be done on lymphatic tissue to detect if there is any cancer present, and if so, what type. If any symptoms of non-Hodgkin's lymphoma are persistent, you should see our doctor for proper evaluation.

Dietary and Nutritional Factors

The diet should be low in fat and high in fiber. Alcohol should be avoided.

MOUTH (ORAL) CANCER

Ten thousand Americans each year die from oral cancer. It is twice as common in men as in women and falling in men.

Tumours in the oral cavity are not always malignant however, some tumours can be precancerous. Oral leukoplakia is a precancerous condition of the mouth to which smokers and drinkers are particularly prone. People who have had cancer in the oral cavity are at greater risk of developing cancer in nearby areas and should have follow up exams regularly throughout their lives.

Causes and Risk Factors

Smoking and the use of chewing tobacco are the primary causes of oral cancer. According to the American Cancer Society, 90 percent of people with mouth and throat cancers use tobacco, and the risk of developing these cancers increases with the amount smoked or chewed and the duration of the habit. Other risk factors include irritants inside the mouth, such as a broken tooth, or ill-fitting or broken dentures; excessive alcohol

intake; chronic use of a mouthwash with a high alcohol content; poor oral and dental hygiene; ultraviolet light exposure to the lips; vitamin deficiency; Plummer-Vinson syndrome; HPV; immune system depression.

Signs and Symptoms

While some oral cancers produce early symptoms, others do not until it is advanced. Symptoms may include a chronic sore of the mouth, tongue, or throat that does not heal; loss of feeling in the mouth or tongue; discoloured patches in the mouth or throat area; swallowing difficulty or a feeling that something is stuck in the throat; mass in the cheek or neck; swelling or motion difficulty of the jaw; changes in the voice; and unintended weight loss. Cancer in the mouth has been known to disguise itself as another condition- even as a toothache.

Detection and Diagnosis

Cancer in the mouth can be found early through recommended regular exams by the dentist or doctor. If cancer is suspected, your doctor will refer you to an otalaryngologist (head and neck specialist). The doctor may perform a complete head and neck exam, which may or may not include a biopsy. If it is likely that cancer is present, a panendoscopy will be done, which includes a complete, thorough exam performed under anaesthesia. A mouth wash containing a blue dye that helps dentists to see very small suspicious sores and ulcers is undergoing testing.

Dietary and Nutritional Factors

A diet low in fat and high in fruits (including tomatoes) and vegetables, with little or no alcohol consumption, is recommended. Omega-3 fatty acids, found in fish, berries, mushrooms, and Brussel sprouts, offer protection against oral cancer. Fiber-containing foods, soy, and other legumes may also reduce the risk. A study published in the Archives of Otalaryngology – Head and Neck Surgery suggests that taking beta-carotene supplements may reverse oral leukoplakia.

Vitamin deficiencies have been associated with oral cancer. Spirulina has been found in several studies to inhibit the growth of oral tumours.

OVARIAN CANCER

Ovarian cancer is a deadly form of cancer – it kills more women than any other type of cancer of the reproductive system if diagnosed and treated early, however, the survival rate is quite high. Unfortunately, ovarian cancer is known as a silent disease- it produces no symptoms until it is in its later stages, so the death rate is also quite high.

Ovarian cancer is the second most common cancer of the female reproductive system. It affects approximately 1 in 70 American woman at some point in their lives. The risk of developing ovarian cancer heightens past the age of 40 and menopause further increases the risk .

Causes and Risk Factors

The cause or causes of ovarian cancer are not know. Risk factors include not having gone through pregnancy and childbirth; exposure to asbestos or radiation; high dietary fat intake; the use of talcum powder in the genital area; personal history of breast, uterine, colon, or nonpolyposis colon cancers; family history of breast or ovarian cancer; HPV infection; early onset and/or late cessation of menstruation; obesity; and a diet high in saturated animal fat and low in fiber. Taking birth control pills has been known to reduce the risk of ovarian cancer by 50 to 60 percent.

Signs and Symptoms

Often there are no obvious symptoms until the cancer is in its later stages of development. These symptoms may include enlargement of the abdomen, diarrhoea or constipation, frequent urination, or in rare cases, vaginal bleeding.

Detection and Diagnosis

Any enlargement of the abdomen or persistent digestive disturbances that cannot be explained by any other condition should prompt you to see a gynaecologist for an exam. Women who have a family history of ovarian cancer may want to be tested for genes with which it has been associated. Routine pelvic exams can detect a hardened or enlarged ovary or an ovarian growth, while Pap smears are not very useful in detecting this. A tumour may also show up on a transvaginal ultrasound. A biopsy is needed to confirm any suspicions. Researchers are studying the possibility of developing a blood test to detect ovarian and other gynaecological cancers. Levels of lysophosphatidic acid (LPA), a substance found in the blood, seem to rise consistently in women who have ovarian cancer. This may provide a basis for a blood test in the future.

Dietary and Nutritional Factors

A diet that is high in fiber and low in saturated animal fats is a good defence against ovarian cancer.

Quercetin has been found to have properties that protect against ovarian cancer. Low levels of selenium have been associated with a greater risk of ovarian cancer.

PROSTATE CANCER

See PROSTATE CANCER in Part Two.

SKIN CANCER

See SKIN CANCER in Part Two.

STOMACH CANCER

Stomach cancer affects approximately 8 in 1000,000 Americans. It is nearly twice as common in men as in women, and is more common among lower income people. The risk of stomach cancer increases past the age of forty. Stomach cancer is more common in foreign countries such as Japan, Chile, and Austria, while stomach cancer in the United States is on the decline, probably due to healthier diets and lifestyles, and to an increased use of refrigeration.

The stomach is divided into five portions, and cancer can develop in any of them. Depending on the location where the cancer develops, stomach cancer can produce different symptoms and different outcomes. Most researchers agree that stomach cancer develops gradually and is often preceded by the development of precancerous cells. Stomach cancer has the ability to spread in several ways; through the stomach lining to surrounding organs, through the blood or lymphatic system, or by extending into the oesophagus or small intestine.

Causes and Risk Factors

Some cases are probably a result of Helicobater pylori (H.pylori) infection. In other cases, the cause is unknown. Risk factors for stomach cancer include pernicious anaemia; lack of hydrochloric acid and dietary fiber; high-fat diet; diet high in smoked, salted, or pickled foods; foods high in starch and low in fiber; tobacco and/or alcohol use; previous stomach surgery; chronic gastritis; stomach polyps; hereditity; having type A blood; and a personal history of pernicious anaemia or atrophic gastritis (a condition resulting in a reduction of gastric acid secretions).

Signs and Symptoms

There are often no symptoms in the early stages. When they develop, symptoms can include indigestion, pain, and bloating after eating; pain in the stomach that cannot be relieved by antacids; vomiting after eating or vomiting blood; black or tarry stools; anaemia; fatigue; and unintended weight loss.

Detection and Diagnosis

If you are experiencing any of the symptoms listed above, it is important to see our doctor (especially if you are in the higher risk category), even though many of the symptoms can be caused by other less threatening conditions. If your doctor suspects stomach cancer, he or she may run several tests, including laboratory blood and faecal occult blood tests, an endoscopy, or a barium upper GI radiograph. A biopsy is needed for formal diagnosis. An endoscopic ultrasound is a newer method that can be used to see how far along the cancer is.

Dietary and Nutritional Factors

A diet high in fruits (including tomatoes), vegetables, rice, pasta, and beans, with limited amounts of meat products, is a good defence. Broccoli, onions, garlic, and pineapple are high in sulfur compounds, which offer protection against stomach cancer. Also, you should keep your consumption of smoked, barbecued, pickled, or salt-cured foods to a minimum, and avoid alcohol and tobacco products.

Antioxidants are a strong defence against free radicals that can damage cells and, possibly, make them turn cancerous. Vitamins C and E, alpha-carotene, betacarotene, selenium, and lycopene are good sources of protection.

TESTICULAR CANCER

Testicular cancer generally strikes men of younger ages – usually between the ages of twenty and thirty five – an the chance of developing testicular cancer declines with age. It is more likely to occur in Caucasians than in African-Americans. The incidence of testicular cancer has been rising in recent years.

Tumours in the testicle tend to grown very rapidly – they can double in size in only 20 to 30 days. They can also spread quickly through the lymph nodes. For this reason, testicular cancer often spreads before diagnosis. The cure rate for testicular cancer is very high – over 95 percent – if it is detected early. Thankfully, new treatment methods can destroy even testicular cancers that have spread.

Causes and Risk Factors

The cause of testicular cancer is not know. It is known that cryptorchidism (undescended testicles) substantially increases the risk, even if the condition is corrected by surgery. Other risk factors include inguinal hernia during childhood and a personal history of mumps orchitis.

Signs and Symptoms

Symptoms of testicular cancer include a lump or lumps in the testicle; enlargement of a testicle; thickening of the scrotum; sudden collection of fluid in the scrotum; pain or discomfort in a testicle or in the scrotum; mild ache in the lower abdomen, back, or groin; enlargement or tenderness of the breasts; blood in the semen; and breast enlargement.

Detection and Diagnosis

A monthly self exam is the best way to detect testicular cancer early (See Testicular cancer Self-Test on page 249), especially for boys, and men between the ages of fifteen and forty. Yearly examinations by a physician are suggested as well. If cancer is suspected after examination of a mass, your physician will request a testicular ultrasound. Ultimately, a biopsy is needed for complete diagnosis.

Dietary and Nutritional Factors

A low-diet that includes generous helpings of fruits, vegetables, and grains is recommended. Tomatoes and watermelon are good sources of lycopene, which may protect against testicular cancer. Avoid high-fat foods and alcohol.

Vitamin E and other antioxidants may help reduce the risk. Some studies have suggested that vitamin A supplements may raise the risk.

q     Some types of cancer are treated with chemotherapy, which can apparently cause cancer to go into remission. Cancer chemotherapy is the administration of highly toxic medications meant to kill cancer cells. L Most chemotherapy medications destroy normal cells in the process, causing adverse side effects including hair loss, extreme nausea, vomiting, fatigue, weakness, sterility, and damage to the kidneys and heart. Certain nutrients may help the body avoid some of the damage done by this treatment, among them vitamin B6 (pyridoxine), coenzyme Q10, glutathione, and vitamin C.

q     In some cases, radiation therapy may be recommended. This involves aiming concentrated x-rays directly at a tumour to kill the cancerous cells. Radiation therapy too has unpleasant side effects, including fever, headache, nausea and vomiting, and loss of appetite.

q     There is a wide variety of drugs employed to fight cancer, and new drugs and therapies are being and developed on an ongoing basis, with many new treatments being approved by the FDA. Taxotere is a drug recently approved for battling cancer.

q     Non-small cell lung cancers, which account for most cases of lung cancer in the United States, may be treated with porfimer (Photofrin), paclitaxel (Taxol) in combination with the commonly used cancer drug cisplatin (Platinol), and gemcitabine (Gemzar) in combination with cisplatin. Docetaxel (Taxotere) is another drug approved for treating non-small cell lung cancer that does not respond to cisplatin-based chemotherapy.

q     Doxorubicin (Adriamycin) is a potent chemotherapeutic drug used for treating many forms of cancer. However, irreversible heart damage can occur with use of this drug. Supplementation with vitamins A and E and selenium are suggested to alleviate some of the side effects of this drug.

q     ONYX-015 is a genetically engineered virus that is designed to infect and kill cancer cells without harming healthy ones. It is under study at the University of Texas and the University of Glasgow in Scotland. Other drugs undergoing testing as cancer therapies include:

q     Antiosttin and endostatin, promising anticancer agents that stop the growth of new blood vessels to feed tumours.

·         BR96-DOX, a drug that zeroes in on cancer cells, leaving the healthy cells alone. Its active ingredient is doxorubicin, a proven chemotherapy cancer killing substance.

·         Hydrazine sulfate is a monoamine oxidase (MAO) inhibitor available as a dietary supplement that may help offset the inability to eat, fatigue, weight loss, and muscle deterioration often associated with cancer. It also had bee studied for over three decades as a treatment for cancer itself. Possible side effects include nausea and vomiting, tingling, loss of feeling, and inflammation of the nerves in the hands and feet, and irregularities in glucose level, alkaline phosphatase, and liver function tests have been reported. Dizziness, weakness, drowsiness, and itching may also occur.

·         Interleukin-2 (IL-2), an immune system chemical that is currently used for kidney and skin cancer, is under study for potential use against other forms of cancer, including leukaemia. Since its discovery, IL2 has decreased the rate of death from kidney cancer by more than 30 percent.

q     Hyperthermia, a procedure in which body tissue is exposed to extremely high temperatures (up to 106°F), may be effective against tumour cells and can be used alone or in combination alone or in combination with radiation therapy and other therapies. Researchers believe that the heat may damage tumour cells or deprive them of the nutrients they need to live. It is important that hyperthermia is applied in a safe way under a physician's care.

q     Conventional therapies (chemotherapy, radiation, and surgery) may not be as effective at fighting cancers of the lung, pancreas, liver, and bone, and advanced colon and breast cancers, as they are at fighting other types of cancer.

q     Evidence is growing that bee products may contain anti-cancer properties. Propolis, a substance bees produce to seal their hives, is rich in polyphenolic antioxidants and has been shown to combat the disease in laboratory tests.

q     The hormone dehydroepiandrosterone (DHEA) is believed to help prevent cancer by blocking an enzyme that promotes cancer cell growth. 7-keto DHEA is a form of DHEA that, unlike DHEA itself, is not converted into testosterone or estrogens, and it may be a better option for those at high risk for breast, endiometrial, uterine, and prostate cancers. (See DHEA THERAPY in Part Three.)

q     Some physicians use dimethylsufoxide (DMSO), either alone or in combination with other therapies, to treat certain forms of cancer.

q     Studies have shown grape seed extract to not only enhance the development of normal cells, but also inhibit abnormal cell growth.

q     Hyperbaric oxygen therapy has been effective in reducing the death of healthy tissue due to radiation treatment for cancer (See HYPERBARIC OXYGEN THERAPY in Part Three).

q     Studies are underway on an Investigational New Drug (IND) application that contains an extract of maitake for use on patients with advanced breast and prostate cancer.

q     Research is ongoing regarding the anticancerous effects of melatonin, a hormone involved in regulating the production of oestrogen and testosterone, among other things. It may also regulate other hormones that promote certain types of tumour growth. It is particularly effective in fighting cancers of the male and female reproductive system, breast, and prostate. Studies are needed to determine the effects of long-term use of melatonin in supplement form.

q     Shark cartilage has been shown to be helpful for certain types of cancer, including cancer of the breast, cervix, pancreas, and prostate, as well as Kaposi's sarcoma, a type of skin cancer. It suppresses angiogenesis (the development of new blood vessels), depriving cancerous tumours of nourishment and, often, causing them to shrink and die. Squalamine, a substance present in shark tissue (especially in the liver), is currently being studied by Georgetown University and the Cancer and Therapy Research Center for its effectiveness in slowing the growth of tumours.

q     The single most avoidable cancer risk is smoking. Cigarette smoke is made up of 4000 chemicals, including 43 that are known to cause cancer. It also contains the poisonous gases nitrogen oxide and carbon monoxide. Lung cancer was a rare disease until the twentieth century, when cigarette smoking became widespread. The American Cancer Society estimated that in 1999, tobacco use caused about 173 000 cancer deaths and alcohol caused an additional 20 000 cancer deaths. The cancerous effects of smoking are multiplied by alcohol consumption, and the two are frequently used in combination. Research suggests that if you quit smoking when precancerous signs are found, damaged lung tissue may return to normal, often times within five years. There has bee some debate on this subject, however.

q     Recent evidence has shown that women who smoke are at greater risk of developing lung cancer than male smokers.

q     Regular exposure to second hand smoke can increase a non-smoker's chance of getting cancer by 30 percent.

q     There have been some claims that diary products increase the risk of cancer. However, it is likely that it is fat that is the problem, not mil, Almond, rice soy milk are good low-fat alternatives.

q     A study published by the American Journal of Epidemiology has disproved suggestions that there is link between lactose and / or galactose (sugars found in milk) and ovarian cancer.

q     Obesity in men may cause or contribute to colon and rectal cancer; in women, it has been linked to gallbladder, cervical, uterine, and breast cancer. Overweight women are more likely to develop cancer of the uterine lining than other women and tend to do poorly if they develop breast cancer. Fat effects the level of sex hormones in the body. Hormones produced by the adrenal glands are converted into oestrogen in fat tissue, so the greater the amount to fat present, the higher a woman's oestrogen levels are likely to be. Oestrogen stimulates cells in the breast and reproductive system to divide.

q     Fluoride (which is in the toothpaste, tap water, and every product made with tap water) may be a risk factor for cancer.

q     The incidence of leukaemia among children who were breastfed has been found to be significantly lower than that among bottlefed children.

q     A group of seventy-five Environmental Protection Agency (EPA) experts ranked pesticide residues among the top three environmental cancer risks.

q     The risk of prostate cancer for men who have undergone vasectomies may be as much as three times greater than that of men who have not had vasectomies.

q     Urinating frequently may reduce your risk of bladder cancer by releasing dangerous substances from the body.

q     According to the American Cancer Society, oestrogen replacement therapy lowers the risk of osteoporosis and Alzheimer's disease in postmenopausal women, but it may increase breast and uterine cancer risk. Estriol can be used in place of synthetic estrogens in post-menopausal women. It is a natural form of oestrogen that is better to reduce cancer risk.

q     High-voltage power lines have been under study as a possible contributor to cancer. Researchers at the National Institute of Environmental Health Sciences (NIEHS) have reported that, while it is possibility, it is not likely. Many researchers believe that further evaluation is needed, however.

q     Since women have been having Pap smears, the mortality rate for cervical cancer has dropped by about 70 percent; however, Pap smears are not always accurate – 5 to 10 percent of the results can show a false-negative reading. The most common cause of false-negative results is sampling error. This can occur as a result of either improper preparation (women should not have intercourse, douche, or use any type of vaginal creams, medicines, foams, or jellies for two days prior to the test, and the test should be done between ten and twenty days after the first day of the menstrual period) or inadequate cell collection (there must be enough cells from the entire cervical surface collected, placed on the slide, and preserved immediately).

q     Some tests show promise for improving the accuracy of Pap tests. Papnet and AutoPap are two different computerized screening tests designed to improve the Pap test's accuracy. ThinPrep is another variation on the Pap test. It utilizes a different method of collecting the cells that can make it easier to detect cell abnormalities. Another test, the Hybrid Capture HPV DNA test, can detect the presence of human papillomavirus (HPV), which is associated with cervical cancer. Women at higher risk for cervical cancer may want to discuss these tests with their doctors. Research on other types of test to detect cervical cancer is ongoing. For example, testing is underway on an at-home test that uses a tampon-like probe designed to measure cervical cells.

q     Irritable bowel syndrome does not increase the risk of colon cancer.

q     A gene linked to the development of colon cancer (when it becomes defective and shuts off individuals who do not seem to have a family history of the disease) has been identified by researchers at the Ireland Cancer Center at University Hospitals of Cleveland and Case Western Reserve University School of Medicine. The gene, called hMLH1, normally acts to correct errors in cell replication. If it becomes defective and “shuts off,” colon cancer may be the result. It is known that this gene can be “turned on” again by an experimental drug called 5-azacytidiine. This drug, however, is toxic to humans, so researchers are working to develop a safe form. They say that if the gene can be turned back on again in people with tumours of the colon, their cancers might be more responsive to chemotherapy, and new tumors might possibly be prevented.

q     Cancer has been reported to be badly underdiagnosed. In one autopsy review, of those found with malignancies, over half of the deaths were caused by undiagnosed cancer.

q     Just as each of us looks different, each of our bodies has its own unique composition. What some of us react well to may cause an adverse reaction in others- which is why some treatments prove to be successful for some, but not for others. This is why dietary wellness and prevention are so important. If we can keep our bodies healthy and avoid known cancer-causing agents, we have a good defence against ever getting cancer in the first place. And if you have cancer, it is imperative to maintain optimum health: If you go into battle unarmed, you don't stand much chance of winning; but if you go in with a full coat of armour, through the healthiest diet and nutrition, you have the best fighting chance to successfully conquer cancer.