Chapters 4 and 5 will tell you about the treatment choices that are available, and Chapter 6 offers a checklist to go through to make sure you are ready to make your final decision. Chapters 7 and 8 will help you to prepare for your treatment and find the relevant, effective complementary supportive care during treatment.
Once you are clear as to the choices you wish to make, it is wise to draw up your plan of action so that you remain crystal-clear about what you are going to do, how you are going to do it and with what support. If you need help in doing this, or a short cut, then seek specific guidance from an integrated medicine doctor (see the Resources Directory) to devise a medically supervised programme that is tailor-made for you and your needs.
If you choose to receive neither orthodox nor alternative medicine, you should proceed straight to Chapter 9 on the long-term health creation approach to recovery.
Meanwhile, if you are looking for creative solutions to help with troublesome symptoms, they can be found in Chapter 8.
CHAPTER 4 The medical frontier: getting the best orthodox treatment
The oncologist’s perspective by Professor Karol Sikora with cancer nurse Patricia Peat
This chapter covers the current best practices available at the most advanced treatment centres, giving you a benchmark against which to measure the treatment you are being offered locally. This information will enable you to check worldwide for the very best resources and treatments available for your individual situation. Advice will be given on how to obtain second and third opinions as and when necessary.
In the last 20 years, there have been dramatic strides in our understanding of what cancer is and how best to treat it. Some cancers that were almost uniformly fatal in the past, such as Hodgkin’s disease and testicular cancer, are now mostly curable, thanks to chemotherapy. We are more open about the diagnosis of cancer in society and there is much media interest in cancer stories – good and bad. We are also living longer, which means that, as cancer is more common in older people (due to the declining effectiveness of the immune system, and longer exposure to poor dietary habits and environmental pollutants), the incidence of the disease is increasing.
Above all, we have managed to break some of the taboos that surround cancer so that the diagnosis is now usually acknowledged between doctor and patient, family and friends. This new frankness means that the need for information has never been greater.
Consumerism is hitting healthcare in a big way and, if used correctly, can change for better the way in which we obtain care. But, to avoid tilting at windmills, it is essential that you arm yourself with facts. To this end, we offer you here an unbiased guide to the world of cancer and its treatment to help you find the combination of orthodox and complementary medicine that will provide you with the best springboard to deal with your situation.
Nevertheless, on a cautionary note, please remember that with all forms of research the end results cannot be guaranteed. So, some of the areas being currently researched or developed and included in this chapter may not ultimately become available treatments. To confirm what really is available now, the major cancer information services listed in the Resources Directory (pages 257–63) can give you up-to-date information on all orthodox treatments, surgical procedures and clinical-trial availability to help you assess the potential effectiveness of any treatments you have been offered.
But first, let us go back to the beginning of the story and think more about the nature of cancer so that the modes of treatment can be better understood.
The cancer cell
To understand cancer, we need to think about the construction of the body. About one thousand billion cells are needed to make a person. Each cell carries information on how to function from the time it is developed till the time it is supposed to die. Depending on where it is situated in the body, the cells of different tissues are specialized to have different functions. A muscle cell has tiny molecular ropes that allow it to contract, so pulling other structures to cause a movement. A skin cell has a tough waterproof coat to protect us from the environment, while a liver cell is a chemical refinery that is continuously clearing the blood of potential poisons.
All organisms, including man, grow from a single cell that splits into two in a process called ‘mitosis’. In health, the two new cells are identical to the one they came from. These two daughter cells then divide to form four cells, then eight, and so on. In most people, the cells work in perfect harmony, but sometimes they go wrong. If a cell dies, then one of its many identical kin takes over its job.
But if a cell starts to grow and divide in an abnormal way, problems may arise. The information carried in the cell’s DNA, the thread of life, becomes altered, forming an abnormal cell with abnormal growth patterns. This is called ‘malignant transformation’ and is the first change towards cancer. The abnormal cell continues to grow, but does not mature properly, and has characteristics that differ from its healthy parent cell. As this cell reproduces, over time, each new generation of cells becomes a little less like the cell it originated from and, thus, less effective at performing its designated tasks. Cancer cells can develop because the DNA in the cell nucleus has been damaged by either radiation, chemical toxins or viral infection. This is more likely to happen in tissues that are inflamed and poorly nourished due to a low blood and oxygen supply.
Characteristics that distinguish a normal cell from a cancer cell
Cell Recognition
A normal cell recognizes its borders. It sees other cells next to it, but knows it is not supposed to invade and spread into their territory. A cancer cell lacks this information and will invade the surrounding tissues.
Immune Attack
In health, when a cell becomes abnormal due to infection or cancer, the immune system recognizes its abnormality and destroys it. When cancer develops, the ability of immune cells to recognize the abnormality is lost, thereby allowing the abnormal cells to carry on growing unchecked.
Staying in Place
A normal cell knows where it should be, and stays there until it dies, when another cell takes its place. It does this by sticking to the cells surrounding it. A cancer cell loses this ‘stickiness’ and breaks away from its surroundings to be transported via various body systems to other organs, where it takes up residence and starts to divide and grow into a new tumour. This is known as ‘metastatic spread’, or the development of a secondary cancer.
Metastatic spread
With different types of cancer, there are differences in how quickly metastatic spread can take place. But it also depends on the individual who has it (more about this later).
There are two types of tumour – benign or malignant. Benign tumours are usually localized and do not spread. They are often enclosed in a clear capsule – a rim of normal tissue – which demarcates the limits of the abnormal cells. These tumours may be detected because, as they grow, they press on other structures in the body such as blood vessels or the intestines. In contrast, malignant tumours are virtually never encapsulated, but erode adjacent tissues by extending crab-like infiltrations in the body in all directions.
Most cancers do not spread completely haphazardly – certain tumours have favoured sites of metastases. Prostate cancer, for example, tends to spread to the bones, often the spine or pelvis. Breast cancer usually goes first to the lymph nodes, but then favours the liver, bones and lungs. Colon cancer spreads first to the liver, following the blood flow from the