A to Z Disease

What Is Cancer?

The word cancer refers to a large number of diseases characterized by abnormal cell growth that threatens to overwhelm healthy body tissue. Normal, healthy cells grow, die and are replaced on a very specific cycle. Cancer cells, on the other hand, don't know how to die, and multiply uncontrollably until a mass of cells, or a tumor, develops.

Developing a Cancer Treatment Plan
The first step in developing a cancer treatment plan is called 'staging.' Staging is the medical process whereby your doctor determines how much cancer there is, if it has spread, and if so, where it is in the body. Your doctor might perform imaging tests such as x-rays, CT scans, and MRI scans. Often the tumor is biopsied, meaning a small piece of it is removed and the cells are examined under a microscope.

Types of Biopsies
Fine Needle Aspiration Biopsy. This type of biopsy allows the surgeon to withdraw a small amount of tissue from a tumor with a very thin needle attached to a syringe.

Excisional Biopsy. In an excisional biopsy, a surgeon cuts through the skin to remove the entire tumor.

Incisional Biopsy. In an incisional biopsy, a surgeon cuts through the skin to remove a small part of a larger tumor.

Typically, biopsies are performed under local anesthesia. The recovery process will depend on the type of surgery you have, and whether or not you need additional treatment.

Today's Common Cancer Treatments
It's important to note that the side effects of different types of cancer treatment vary so much from person to person, and from treatment to treatment, that they're not a sign of whether or not the therapy is working.

Surgery. Surgery is the oldest treatment for cancer. It's often the best type of treatment for cancers that haven't spread, or metastasized.

• Preventative, or prophylactic, surgery is done to remove tissues like polyps and cysts that aren't cancerous but contain abnormal cells and have the potential to become cancerous.
• Palliative surgery is used to treat pain in advanced forms of cancer.
• Laser surgery involves using a highly focused, powerful beam of light. It's more precise than standard surgical tools like scalpels and does less damage to normal tissues.

Radiation. More than half of all cancer patients receive some type of radiation therapy, which uses much more powerful x-ray energy than is used to take simple diagnostic x-rays. The goal of radiation is to stop cancer cells from multiplying while sparing as much healthy tissue as possible. Radiation therapy is used in a number of situations:

• Before surgery to shrink a tumor
• During surgery to aim large doses directly at a tumor
• After surgery to stop the growth of any remaining cancer cells
• To decrease pressure and pain during cancers that can't be cured

Radiation side effects can include fatigue as well as sunburn-like burns to the skin where the radiation beam was focused.

Radiation is used to treat many types of cancers and can be delivered in two ways:

• External Radiation. This type comes from a machine outside your body and is the most widely used type of radiation therapy.
• Internal Radiation. This involves a higher dose of radiation delivered to a small area. Rather than coming from machines outside your body, the radiation source is placed inside your body. These sources include tubes or capsules that are filled with materials that deliver the radiation, or seeds that are placed in the tumor itself. Sometimes, these sources are left inside the body after the radiation "runs out." Your doctor may restrict contact with people while you're receiving internal radiation. This is because radioactive material can leave the body through saliva, sweat, and urine before the radioactivity decays.

Chemotherapy. Chemotherapy uses drugs, or chemicals, to kill rapidly dividing cells. These cells include both cancer cells and healthy cells. Unlike radiation, which targets a specific part of the body, chemotherapy affects the entire body. Most chemotherapy is given as a combination of drugs that work together to kill as many cancer cells as possible.

Typically patients receive chemotherapy intravenously. A thin needle is inserted into a vein, usually in the hand or lower arm, and removed at the end of the session. This type of chemotherapy can also be delivered into the body through catheters, or tubes; an entry port in the skin created by your doctor; and special pumps.

One of the most serious potential side effects is a low count of white blood cells—a condition called neutropenia. White blood cells help your body fight infection by protecting against foreign invaders such as bacteria and viruses.

Another side effect of chemotherapy is anemia, which is the medical term for a low red blood cell count. A low red blood cell count may cause you to feel fatigued or sluggish because there isn't enough oxygen circulating throughout the body. Thrombocytopenia is the medical term for a low platelet count. Platelets help your body stop bleeding by working with other blood factors to form a clot.

Your doctor will monitor your blood count throughout treatment to look for these conditions and treat them as necessary.

Promising Cancer Treatments

Biological Therapies. These are also known as immunotherapies and are designed to repair, stimulate, or enhance the immune system's response to fighting cancer. Biological therapies may one day help your body better identify cancer cells and destroy them.

Cancer Vaccines are one kind of immunotherapy. They work by triggering your own immune system to fight or block cancer cells. Some vaccines are made of cells from your own cancer. Still others are made of cells from your immune system. Vaccines can also be used to prevent certain viral infections that can lead to cancer, such as Human Papillomavirus, or HPV.

Hormone Therapy. Hormones are naturally-occurring substances in the body that stimulate the growth of certain organs and glands, like the breasts and prostate. Hormone therapy combats cancer with drugs that block hormone production or change the way hormones work.

The goal of new, emerging cancer treatments is to destroy only the cancerous cells, leaving healthy cells alone. New research is revealing ways to do this in order to reduce side effects, get more patients into remission and to perhaps find a cure.

Summary for HealthiNation's Cancer Treatment & Nutrition

Hosted by Sharon Richter, Registered Dietician

The following is an interview conducted with Carrie Levin, a breast cancer survivor and chef and owner of Good Enough to Eat in New York City. As a chef, Carrie has some delicious cooking tips for cancer survivors to help them keep their energy and spirits up as they go through cancer treatment.

SHARON: Carrie, about a year ago you were diagnosed with breast cancer. Tell me about the treatment you had to go through.

CARRIE: Well, first they thought I would just have to have a mastectomy and then reconstruction. Then they had to take my lymph nodes out, which meant that I had to have very strong chemo, and then radiation. So, I received the full treatment.

SHARON: During treatment, did your doctors recommend foods that you should add or take away from your diet?

CARRIE: Well, when I had the reconstruction, my beautification doctor told me to have pineapple, because pineapple is good for bruising. And then my oncologist when I met her, said to have raw vegetables and mostly cabbage. So I made different kinds of slaws. And cabbage is supposed to be wonderful to prevent breast cancer. Protein, because the chemo drains you just about everything you have in you, so you need the protein. Red meat is really good, and you do have to have it well-done.

SHARON: And you want to avoid those nitrates.

CARRIE: Exactly.

SHARON: So, take me through a day. How did you start your day and incorporate all these different foods in your diet?

CARRIE: Okay, for breakfast…a lot of the times my husband made for me a Swiss breakfast—it has fruit, nuts, dried fruits, and wheat germ. Wheat germ is a wonderful food, with all the Vitamin B in it. So, I had that a lot at breakfast. At lunch time, I prepared all different kinds of coleslaws.

SHARON: That's excellent because cabbage helps block estrogen. So, you have cabbage in your diet, you're including that in lunch, so let's talk about lunch, what you really made.

CARRIE: Okay, so one of the things I would have quiet often is coleslaw with a protein. And you can put anything in your coleslaw. I use peppers, carrots, and the pineapple. That's how I get the pineapple in there.

SHARON: And then the protein, what did you make?

CARRIE: I did a lemon parmesan shrimp, because that's one of our dishes at the restaurant that people love.

SHARON: Can you show me how to make it?

CARRIE: Absolutely. So I'll just give you a quick little tip for this. Flour and parmesan reggiano, if you want it. But if you don't like the smell, don't use it. You don't have to do it. White pepper, kosher salt, and then the mustard—dry mustard—and paprika brings out the flavor of cheese. Just put that in everything. You don't have to have cancer (laughs). That's just a really good thing to have in your house.

SHARON: And they don't have strong smells.

CARRIE: No smell. No smell at all. It's wonderful. Okay, now the egg. You can do the whole egg, which is great for protein. And egg white is wonderful. So we'll just add the egg white here.

SHARON: That's great. You've taken out the fat then.

CARRIE: Yeah, there's no fat.

SHARON: The meal is so low in fat to begin with, and now you don't even have the fat of the yolk.

CARRIE: Exactly. Okay, we take the shrimp, dip it in the egg white, and then roll it in our flour and cheese mix. Take it out and shake it a off a little. And then keep on going with the rest of the shrimp. For lunch I would try to make myself eat five to seven medium-sized shrimp.

SHARON: That's like a serving of protein.

CARRIE: Five ounces of protein. It's perfect.

SHARON: So now you've drenched the shrimp. What do you do next?

CARRIE: So now you get your fat hot, and then you take your shrimp and put it in the frying pan and sauté it on both sides for about two minutes.

SHARON: What are you looking for when you cook it?

CARRIE: Get a little crinkly and brown. That brings out the flavors. And it looks good on the finished dish. You want to get a little bit of contrast in color and texture.

SHARON: It looks delicious. So, you made this wonderful lunch that includes a lot of the nutrients that your physician told you to add into your diet. What do you do with dinner?

CARRIE: Okay, dinner. I made a lot of stews. So, in the stew we have tomato sauce and tomato paste, and that has…

SHARON: That's terrific lycopines. Lycopines is an amazing antioxidant. Everyone should really include it in their diet. It's very health.

CARRIE: Yes, it's good for all different kinds of cancer—to not get all different types of cancer.

SHARON: Absolutely.

CARRIE: The stew also has all the vegetables. Then we have the prunes. Prunes are loaded with iron, which you need because you're depleted with the chemo. And also, you've had so much stuff put into you, you get constipated, so you need your prunes.

SHARON: Such a high-fiber source. It helps with digestion.

CARRIE: It's wonderful.

SHARON: I have a question about the meat. You said you want it well-done. Do you cook it first, or do you let all the ingredients cook together?

CARRIE: No, you always sear.

SHARON: Searing is only cooking the outside of it?

CARRIE: Yes. And it keeps the juices inside. And then you cook for two to three hours depending on the size of your meat. So now we're going to get the fat hot. I'm going to take my flour, and salt and pepper. I always use kosher salt because, again, your taste buds are pretty dead, and kosher salt has a stronger flavor. So, mix it all together. When you hear the sound of the fat sizzling, you add your spices—your salt, pepper, and a little paprika for the color. Get that hot. When it gets to be light brown, you then add your onions, your garlic and your celery. And put your garlic in at the end so it won't burn. Because I had my lymph nodes removed I really can't get burned, so I always keep a keep a big pot holder with me to not get hurt. Now, while this is cooking, you shake it. And you want to make sure the salt and the pepper are nice and roasted, and the vegetables stick a little bit. Then we put the meat in the seasoned flour. When the vegetables get nice and brown—10 or 15 minutes depending on how big you cut them. And then you do the same thing with the meat. Then you put everything back in the pot and you deglaze with your beer or your juice. At that point, you put your tomato paste, and that's when you put your herbs in. When you put in your liquid, you bring it to a boil, and then you turn it down. After about an hour and a half, you put your carrots and your potatoes in.

SHARON: Then how long do you need to cook it? Potatoes take awhile to cook.

CARRIE: Another hour or hour and a half. And then it's ready.

SHARON: And you're ready to eat.

CARRIE: And then it makes your whole house smell really good, and you want to eat.

SHARON: Carrie, thank you so much for coming today and sharing your story with us. You taught us about adding calcium, which you can get in milk you added to the wheat germ in the morning. The wheat germ has the B Vitamins, which gave you a lot of energy, you said. Then you incorporated so many different nutrients. The coleslaw, pineapple, protein sources with your lunch. And then even the stew you had for dinner had a ton of vegetables. And it all sounds so delicious.

If you or someone you know is affected by cancer, some of these comfort foods might help them during this difficult time..