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Dealing with chronic cancer patients

cancer is generally seen as a sudden illness that changes the entire previous life of those affected and their environment, short-term and radical side-effects-laden treatments requires, may result in short-term unsuccessful treatment to death. This image is right and our determined efforts to caring for cancer patients in order to facilitate the handling of the disease. But this picture is not complete. It allows the increasingly large number of patients from outside, we must describe as chronic cancer patients. They can be divided into three groups: first

Patients with cancer who are not or only very slow progress

second Patients with advanced disease that must be treated again and again

third Patients after cancer

The first part presents the three groups in second part shows characteristics of emotional confrontation with a chronic disease, cancer, the third part, implications drawn.
The number of patients diagnosed with cancer increases'

Exact figures on the number of cancer there is in the Federal Republic, could not before. In the specialized clinics and medical practices, we see increasing numbers of patients.

first Patients with very slowly progressing cancer:

A group of very different types of cancer by a very slow, sometimes referred to for years and not progressive disease. Prime examples of this group are patients with chronic lymphocytic leukemia and low-grade non-Hodgkin's lymphoma. These diseases can be discovered by accident, for example, was carried out because of another reason, a blood test or because the operation of another disease, a lymph node was removed.

In some patients the disease is stationary over time, that it does not progress. For example, the average life expectancy of patients with germinal center lymphoma, the most common form of low-grade lymphoma, with over ten years. The disease in many patients must be treated only if it advances or the person concerned makes you sick - makes you sick in the sense of physical discomfort. Ill feel this Patients from the time of diagnosis.

prostate cancer can also, especially in old men, have a very slow pace. Both the low-grade lymphoma and prostate cancer among the cancer, the increase in frequency.

second Patients regularly in need of treatment of cancer:

The last years were marked in the treatment of cancer through the development and approval of many new drugs. This can now be treated diseases in advanced stages, for which no or few effective drugs were available. This is in part to substances in the field of chemotherapy, hormone therapy, but also to substances of the immunotherapy and novel agents such as drugs to prevent the formation of new blood vessels or to influence the bone metabolism. Particular progress has

it in patients with advanced disease of the colon. By chemotherapy, by treatment with a new anti-angiogenesis inhibitor, the average life expectancy of these patients by about five months in 1990 rose to over 20 months. Significant progress it is

including breast cancer, with prostate cancer, lung cancer, in gastric cancer with ovarian cancer, metastatic tumors of the bladder, in chronic leukemia and in the low-grade non-Hodgkin's lymphoma. The patients treated by these new treatments are not cured of their cancer, but they can live longer with less discomfort and with better quality of life.

third Patients after cancer:

increases the number of cured cancer patients, albeit slowly. The key is for most tumors in the early discovery. This is true for all organ tumors such as breast cancer, colon cancer, lung cancer, prostate cancer, etc.. In a group of patients with larger tumors and / or lymph node involvement can be a so-called adjuvant therapy, ie chemotherapy or hormone therapy after surgery and radiotherapy, the number of healed Patients increased.

Adjuvant therapy is standard for women with breast cancer in patients with colorectal cancer and more recently in patients with lung cancer. For each of these patients was shown that the forecast can be improved in high-risk situations by adjuvant treatment. There is also a small group of tumors, which is possible even with extensive metastatic disease a cure by chemotherapy.

These include germ cell tumors (testicular tumors), sarcomas, malignant lymphomas (Hodgkin's lymphoma and Non-Hodgkin's lymphoma) and acute leukemias. especially among children and adolescents, the cure rates are high, but also in adults can eg 90% of patients with testicular tumors and 50-80% of patients with high grade non-Hodgkin's lymphoma are cured. Have contributed to this improved cytotoxic agents, new drugs and high-dose therapy with stem cell transplantation.
patients with cancer forget 'the diagnosis never

first Burden of disease:

patients with chronic cancer must be based in their whole way of life from the disease. The following very schematic diagram of the emotional drain of dealing with acute and chronic disease is shown. After an initial phase of shock about the diagnosis (red) over weeks and months, a phase of the sovereign handling be achieved with the disease (orange and yellow). While the patient then the acute disease can reach the green area ', the chronically ill cancer expect relapses, worsening of the findings and new treatments. Cancer patients know that these phases do not expire so schematic as shown in the diagram. There are good and bad phases, emotional relapses and periods in which the disease is better to endure.

second Exposure to the disease:

An important finding of recent years is that even patients healed a long time, often for life, are burdened by the consequences of the disease and treatments. This relates to consequences of surgery, radiation and chemotherapy. On the loss of organs, such as gastrointestinal surgery or lung surgery, this is understandable to all. But less visible side effects, such as the force fatigue syndrome with generalized weakness and loss of efficiency, long-term burden on cancer patients and a change of lifestyle. The fear of a recurrence decreases with each month and year obtained, but remains present in most patients. Before the follow-up, they develop insomnia, become restless and are confronted with the fears as the initial diagnosis of cancer.
The doctor-patient relationship is changing

first Information:

patients with chronic Cancer must be based in their whole way of life from the disease. This first rise above all the need for information. Information about disease and treatment are almost fully available through the Internet. However, the abundance of unordered and unweighted information for many patients more confusing than enlightening. The following diagram - parallel to the emotional situation - the learning curve of patients is shown schematically. At the beginning of a disease's physical symptoms are often so dominant that a comprehensive recording of information is not or hardly possible. Over time, increases the need for information. Not a few chronically ill patients are about aspects of their disease better informed than the non-specialist physician. The role of support groups for teaching and assessment of information can not be overestimated in this situation.

second Shared decision making:

The doctor-patient relationship has changed dramatically in the last 20 years. This relationship is today, especially in the treatment of cancer patients, preferably by the model of 'Shared Decision Making', described in German participatory, that is joint decision-making. The model envisages that over with doctors and patients of their expertise in the treatment decisions Others bring.
Many treatments will not worsen the prognosis by a shift to days, weeks, sometimes months. In this case, the patient can decide when a treatment fit into his lifestyle.

medical decisions (such as the correct dosage) will largely lie with the doctor. Fundamental issues such as decisions to a specific treatment or for not carrying out a treatment require that doctors and patients to respect each and bring together the relevant expertise in the responsible decision. The doctor brings his expertise, the patient brings to a person with his history, his life plan and its already suffered competence 'through experience with the disease, a cancer.
Conclusion

Because of the success of early detection and treatment increases the number of people who are confronted in their lives diagnosed with cancer '. Many will be healed, others must and can live for years with cancer. These experiences shape with all stakeholders for the further life. In the training of physicians in the design of programs of self-help groups and health care we have to face the special requirements of chronic cancer patients.

Prof. Dr. B. Woermann, Medical Department, Division of Hematology / Oncology, Municipal Hospital Braunschweig

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hyperthermia in cancer treatment

oncologists and radiation therapists met in June in Prague at the annual conference of the European Society for Hyperthermic Oncology (ESHO), and discussed the latest studies and experiences of hyperthermia. Hyperthermia is a supportive treatment in cancer therapy to improve the treatment success of classical therapies. As reported on the current conference, U.S. researchers were able to show that it was possible through the use of hyperthermia in addition to radiotherapy treated patients with recurrent breast cancer successfully. In addition, the results of a new international study of Unversitätsklinikums Munich presents for hyperthermia for soft tissue sarcoma. In the world's first randomized controlled phase III study, the researchers demonstrated the effectiveness of regional hyperthermia in combination with chemotherapy in sarcomas. The fact that different types of tumors, hyperthermia in combination with standard therapy in certain cases may be appropriate, is already known for some time. This is the case for certain types of prostate and colon cancer. Also for lung cancer, there is a positive combination therapy study results.
working principle and applications

The principle of hyperthermia, a warming of the body or the tumor to about 40 ° C by the action of the conventional Therapy should be strengthened. A possible application of hyperthermia is dependent on the type, location and spread of the tumor.

In Germany, the combination treatment with standard therapy and hyperthermia is not yet used in routine, as there are too few scientific investigations. In malignant diseases, can be addressed by means of a standard treatment (surgery, radiotherapy, chemotherapy) with good to very good results, therefore, hyperthermia is not used. In general, typical areas of difficult cases of disease, such as recurrent
tumors that occur after conventional treatment again or bad or unresectable locally advanced tumors.
use forms of hyperthermia

Local H. In limited, superficial tumors are
applicators (antennas) mounted on the tumor, emit electromagnetic waves and thus heat up the tissue.

Regional H.: In low-lying tumors, the patient is surrounded by a ring-shaped applicator, the coupling of energy occurs in the water bolus (water irrigation).
partial body-H. A larger region in the abdomen or lower abdomen is heated with magnetic resonance monitoring.

Full-H. Heating of the entire body to 41-42 ° C is, for example in a steam-saturated chamber with water flowing through tubes, the energy can also be generated by infrared lamps.

thermal ablation: applicators are placed in small tumors and destroy by achievement of Tmperaturniveaus of 80 ° C or more cancer cells.

Interstitial H. antennas are placed in the tumor or introduced via hollow organs to him, usually combined with interstitial radiotherapy.

limb: On the feeding artery and the efferent vein of a limb is heated the blood through an external heat exchanger.

Further information on hyperthermia visit the website of www.hyperthermie.org Interdispziplinären hyperthermia group of the German Cancer Society eV

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preparation for the treatment of cancer

As shown by recent research results to be nourished at the start of cancer treatment to be as good as possible to maximize the impact of treatment and achieve to shorten the time spent in hospital. However, this is not always easy.

A healthy diet before and during cancer treatment is very important. You must make sure that you take vitamins, minerals and other essential nutrients in adequate amounts.

A balanced diet is essential for a good nutritional status. According to research people who eat lots of fruits and vegetables have a lower risk of cancer. It may therefore be helpful to eat each day fresh fruit and vegetables, especially dark green, dark yellow or orange vegetables such as spinach, greens, sweet potatoes, broccoli, parsnips, turnips and carrots. These are especially rich in antioxidants that can prevent the emergence of cancer. Fruits with lots of antioxidants are cranberries, blueberries, blackberries, raspberries and strawberries. Also, black or green tea contains antioxidants.

Only after your treatment has started, you know exactly how you feel feel and what side effects can occur if necessary. One way to prepare is to see your treatment as a time when you refer to yourself and focus on being healthy again.

In preparation for a cancer treatment, you should also: Positive thinking



* Many people themselves show little or no side effects in terms of eating behavior.
Even if such occur, they may be low, and most disappear after cancer treatment. In addition, there are new medicines that can be used effectively against side effects.
* If you have a positive attitude, talk about your feelings, learn well about the cancer and its treatment and think about how you're more comfortable so can result in less worry and anxiety, give you the feeling of self-determination and ensure that you do not lose your appetite .
* See Meals positive.
Even if you have problems with eating, sometimes it will be a pleasure.

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treatment concept of oncologic surgery

Integrative Oncology

combination of various new treatments

goal is to make the different available treatment modalities and methods to an optimal treatment plan for the Patients to add together to achieve optimum efficiency with minimum impact on the patient. Emphasis is placed on one to create individual and not just standardized treatment plan for each individual patient, all available treatment options such as immunotherapy, surgery or chemotherapy are used appropriate.
It offers the oncological surgery a truly unique variety of different and novel treatment options at high levels. Thus, the various treatment options were combined to cost the patients. Specifically, these

* Regional Chemotherapy Systemic chemotherapy

* * * Oncological Surgery
to induction treatment of inoperable primary tumors
* Specific and nonspecific immunotherapy
* gero-oncology

here briefly discuss the various treatment options.
Regional chemotherapy

understood In this form of therapy is the targeting of cytotoxic drugs in certain regions of the body. Purpose of such a regional administration of chemotherapeutic agents is to increase local drug concentration with possibly a simultaneous reduction of side effects. By increasing the concentration of chemotherapeutic agents to the tumor, the existing resistance of tumor cells be broken in order to improve efficiency. That while the incident rate for the 'Rest'-body can be lowered is a positive side effect.
As treatment options of regional chemotherapy are here mainly for three different application forms:

* Intra-arterial infusion with angiographically placed catheter. Here, the agents are using a special catheter that is inserted into the tumor supplying artery, administered directly into the tumor.
* Intraperitoneal application. Here, the drugs are administered directly into the abdomen, with a concentration of up to 1 advantage: can be reached 1000th

Systemic chemotherapy

course, has this highly specialized department about all the possibilities of a systemic, that whole-body chemotherapy. Used to come here mainly cytostatic combinations with a low or acceptable side effect profile.
oncological surgery

The heart, however, the oncological surgery. Due to an experience of more than 20 years here, there is the possibility of curative and palliative resection of tumors in different areas of the body at a high level. This operations in mostly all areas of the body and are similar to the lungs, mediastinum, liver, the pancreas, colon, the urogenital tract or the small pool. It also tumor resections are performed in several other centers that have been already classified as inoperable. The important thing is that while a very low morbidity observed by low rate of complications remains. To achieve this goal, we need not only a long-time experience, but especially the perioperative stimulation of the immune system.
induction treatment of inoperable primary tumors

Certain tumor formations with the currently available methods do not initially completely removed. To resectability for this extensive, or very unfavorable achieve localized tumors to have made a previous therapy, which reaches a suitable size reduction. To achieve this goal, a regional induction therapy and / or pre-irradiation is carried out - depending on the type and location of the tumor. Later, followed by the resection and appropriate treatment. Such treatment is also great for breast cancer such as liver tumors, pancreatic or Rektumcarcinome possible. Specific and nonspecific immunotherapy


Many cancer patients suffer with low tumor volume of the so-called tumor disease. This leads to loss of appetite, weight loss and fatigue. Mediates these Krankheitssysmptome tissue through the release of hormones and an immune system disorder, the appropriate specialist and / or non-specific therapy with immunostimulants in order to eliminate these symptoms as possible and achieve a substantial improvement in the patient's quality of life can be.
gero-oncology

The combination of these different treatment methods, a high efficiency, even in patients with advanced tumors, poor general condition and especially advanced age can be achieved. The view that an effective oncology - including the use of Chemotherpeutika - in old age no longer seems possible, we believe obsolete oh. Rather, it is just the old patient, who are protected by targeted and less invasive treatment measures before the severe consequences of the tumor must.
treatment range of oncological surgery

All solid tumors of the body - with the exception of the head and neck area, the bone and the tumor types in the field of blood diseases - is to treat the medical profession from Hammelburg.
comprises the treatment spectrum therapy following tumor types: tumors of the mediastinum

* *
Laryngeal / Pharynxrezidiv
* liver / bile duct tumors
pancreatic tumors
* * *
gastric cancer colon tumors
* Urologic tumors including prostate cancer
gynecological tumors
* * *
breast cancer sarcomas

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early

For most cancers early detection is important. Only rarely, such as lung cancer, early detection is ineffective so far. Early detection is the primary task of every human being and not merely of the doctor. If left untreated, the malignant tumor grows until the organ or body destroyed is. Since the risk varies with cancer for a population and among other things dependent on emerging environmental toxins or by the elimination of such toxins by environmental protection laws, as well as the dietary habits and the willingness to protect it from direct sunlight, but also by the sexual behavior (prevalence of a population potentially cancer-causing viruses), shall, for each generation and each country are determined always to get the individual cancer risk.

The sooner a cancer is diagnosed, the better the prognosis. It could be more cancer cure diseases, if detected early. But not every early offers nothing but benefits (See also screening). You trade one risk against a bunch of other risks such as false-positive findings.

For men, regular examinations of the doctor for blood in the stool and the scanning of the prostate are important for women, a cervical smear (Systematic Screening for cervical cancer) and mammography screening (over 50 years), said in absolute terms, low benefit of mammography should be discussed with your doctor.

also using genetic engineering studies it is possible to detect certain cancers at an early stage. This procedure is rarely applied in practice. Many

Cancers are detected by patients themselves due to changes. A doctor visit is recommended for:

* unusual swelling, wounds do not heal that, changing the shape, size or color of skin time, or abnormal bleeding
* chronic cough, persistent hoarseness, a change in bowel or urination, or an unexplained weight loss
* changes in the regular scanning of the breasts to determine.

Each of these self-examinations is associated with a very large risk of error. Nodules in the breast may well be harmless, and also can lay malignant Grope breast tumors only after they have been 1 ml volume - and have likely already metastasized.

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CANCER TREATMENT BY biofield

CANCER TREATMENT BY biofield

knnen We offer an alternative Behandlungsmglichkeit Fri advanced Krebsflle.
The cancer treatment by bio-field is by placing the durchgefhrt Hnde and by influencing the bioenergetics of geschdigten institution.

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This method was called as a method of bio-energetic influence. The high Effektivitt this method was successful with several hundreds treated and cured patients proved.

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Nothing speaks against alternative cancer therapies, as long as they ergnzen the medical school.
However, if the medicine is gesto your limits and you must refuse to help, we knnen you open new avenues for improvement.

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treatment

* Surgery: Surgical removal of the tumor and adjacent lymph nodes.
* radiotherapy
o (takes active thyroid iodine on) of radioactive material
+ by radioactive iodine
o with X-rays
o with electrons or neutrons
o with proton therapy, or ion radiation (protons and ions, which protects the tumor surrounding tissue) o
with microwaves (heating of the affected tissue)
* o cytostatic drug treatment
(Chemotherapy), cancer cells are prevented from reproducing or stopped
o hormone therapy, such as testosterone withdrawal in prostate cancer
o inhibition of blood vessel growth (cancerous tissue attracts blood vessels to grow toward the cancer tissue to supply it. )
o immunotherapy (increasing the immune response to tumor cells) immunological cancer therapy
* radioimmunotherapy
o This form of therapy is the development of immunotherapy. Radioimmunotherapy combines the targeted mode of action of immunotherapy / antibody therapy with the high efficacy of radiotherapy. When an antibody radioimmunotherapy out (Ibritumomab) a cancer cell-destroying radiation source precisely to the cancer cells. In contrast to pure immunotherapy in radioimmunotherapy are not only destroys the cells at the tumor surface, but also the cells inside the tumor mass.
* Palliative treatment and the promotion of quality of life
o administration of analgesics
o improvement of the general state of pain treatment
o Adequate nutrition
o inhibition of bone resorption
o increase blood production in bone marrow
o Symptomatic treatments such as dilatation of strictures by dilatation or insertion of stents
o Physiotherapy (especially Respiratory therapy in lung cancer)
* Alternative treatment methods, including the mistletoe therapy or the use of amygdalin. Both are controversial. But the fact is that many successful cytotoxic drugs (such as vincristine) were originally found in plants. These cytotoxic drugs are, however, highly pure and highly concentrated and therefore not "herbal" or to compare similar.
* There are experiments to treat cancer with viruses.

The unsatisfactory cure rates for certain tumors and the side effects of established treatments often cause fear and despair among those affected and their families from. This may lead to turning unconventional treatments, which in many cases lacking evidence of effectiveness, and their bases mostly a scientific review does not stand up. Some of them are rejected as "miracle cure" while others are accepted as complementary therapies but also by orthodox medicine.

Even if - unfortunately often - a complete cure can not be achieved is to be considered, that is to be considered for a 75-year-old cancer patient a life time extension of 1 or 2 years ago as a very good result (older cancer patients often die on anything other than the cancer), while a 45-year-old breast cancer patient only a 10-year relapse freedom is assessed as "very good" - because they really now have a much higher life expectancy.

In developed countries, 75 of 100 surviving children with cancer, while cancer-related mortality rate among children in developing countries with two thirds (The Lancet).

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cancer prevention

They are not all known factors that promote or inhibit cancer development. In order to reduce

the risk of cancer, should avoid exposure of the body against cancer-causing substances.

Major cancer-promoting factors are:

* Smoking and passive smoking
* inhalation of other fine dusts (including asbestos, soot, car exhaust fumes)
* radiation (radioactivity, UV radiation from the sun, X-rays)

While it is not proved that you can, for example, by a "general healthy lifestyle," the risk of cancer to reduce cancer, but this can also act in other diseases (such as heart attack), beforehand.

It is advisable to be examined at regular intervals on cancer as early detection greatly in many cancers, the prognosis improved - this is especially true for older people because they occur in many cancers more frequently than boys.

How diet and cancer rates might be linked: the EPIC study [20] seen since 1992, over 500,000 initially healthy participants from ten European countries on the dining table. In addition, their weight, height and body fat distribution and registered blood drawn. For 15 years, all new-onset cancers and other chronic diseases recorded and associated with dietary habits and lifestyle. Over the years, so more and more knowledge about the composition of a "healthy" diet can be obtained, which could provide a potential protection against cancer and other diseases. In April 2007, attracted researchers of the study centers at the German Cancer Research Center in Heidelberg and the German Institute of Food Research (DIFE) in Potsdam-Rehbrücke Balance

* A high fruit and vegetable consumption protects against lung cancer and cancer of the upper digestive tract. Especially men with lower consumption benefit from an increase to 300 g of fruit and vegetables a day. A connection with other cancer entities has not been established. Women who eat lots of onions and garlic have probably rarely, an ovarian cancer.
* A high fiber intake is associated with a decreased risk of colon cancer. Who's daily consumption of 15 g to 35 increases may reduce their risk by 40%. * Who
much red meat (beef) and sausages to eat, has an increased risk of stomach and colon cancer [21]. With 100 g of red meat a day increases the risk by 49%, can be a plus in 100 g sausage It probably rise by 70%.
* The higher the vitamin C levels in the blood, the lower the risk of gastric cancer. A high vitamin C levels has a preventive effect especially with high meat and sausage consumption against stomach cancer.
* eat plenty of fish lowers the risk for colon cancer.
* Alcohol use is associated with higher sex hormone levels in women. Women who drink much alcohol, have a slightly increased Mammacarcinomrisiko. *
physically very active people have a lower risk of colon cancer. In breast cancer, the role of the movement remain rather unclear [22].

To explain the preventive effects of fruit and vegetables, some substances are, which act synergistically in nature: phytochemicals, vitamins, minerals and fiber have [23] Numerous studies on the action of phytochemicals in cancer development through [24].

* Antioxidants bind causing cancer free radicals. *
carotenoids, polyphenols, flavonoids are deposited to the DNA in the nucleus, bind where else carcinogens. *
phenolic acids, glucosinolates, sulfides inhibit the activation of procarcinogens.
* Glucosinolates, monoterpenes, sulfides, polyphenols stimulate karzinogenentgiftende enzymes. *
phenolic acids, ellagic acid, ferulic acid, caffeic acid bind carcinogens, according to this are eliminated.
* Phytosterols slow, saponins proliferation of tumor cells in the colon.

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classification of cancers

Malignant (malignant) tumors differ from benign (benign) tumors by three characteristics: they grow

* infiltrate: the tumor cells cross tissue boundaries and grow into adjacent tissue destructive
*: they destroying surrounding tissue *
metastases: they form via blood and lymph vessels, or by draining secondary tumors (metastases).

The staging is in cancers according to the international TNM classification. It is T0 to T4 for the extension of the primary tumor, N0 to N3 lymph node involvement (lymphatic Latin nodulus) and M0 and M1 for the absence or presence of distant metastases.

special forms

also be distinguished even semi-malignant tumors and precancerous lesions. Semi malignant tumors, only two meet the above criteria, precancerous lesions are degenerative tissue, which is very likely to dedifferentiated malignant tumors, but still is not up to infiltrating and metastasizing.

The most common semi-malignant tumor is basal cell carcinoma, a tumor of the basal cell layer, especially the sun-exposed skin that grows infiltrative and destructive, but not metastasized. Untreated, the tumor can destroy the entire face, including the facial bones.

far the most common precancerous cervical intraepithelial neoplasia is a proliferation of the cervix, the cells of cell biology show signs of malignancy, but have not yet infiltrated the tissues ago, destroys or metastasized. For women, annual screening Cervical smear Papanicolaou, including PAP smear called, recommended as precancerous lesions can be treated much better.

tissue origin

cancer tumors are classified by the type of degenerated tissue. The vast majority of all cancers account for cancer, so tumors that arise from the epithelium. These are further differentiated into squamous cell or squamous carcinomas, which derive from cornified and cornified (mucus) skin, and adenocarcinomas, which are derived from glandular epithelium and, depending on the origin and structure can be further differentiated. From the outgoing transitional tissue cancers are called urothelial carcinomas and are also typical for the bladder cancer. Another large group are the hematological Cancers of the blood and blood-forming organs, which are called in leukemias and lymphomas, also called "lymphatic" divide, leave. There are rare malignant tumors, such as that of supporting and connective tissue emanating sarcomas, neuroendocrine tumors such as carcinoid tumor or teratoma originating from embryonic tissue (especially the sex glands).

localization

The International Classification of Diseases and Related Health Problems (ICD-10) classifies malignant tumors according to their location.

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Statistics

developed Statistically, one in three Europeans in the course of his life cancer. [11] In Germany, approximately 395,000 people suffer from cancer each year, of which about 195,000 women and 200,000 men. Most cases occur at the age of over 60 years. Make under 60 with about 107 000 cases, only about Quarters of new cases of cancer. A U.S. study found that worldwide around 20,000 people die every day from the effects of cancer. Overall, it is then given in 2007 about 7.6 million deaths from cancer - of which 4.7 million in developing countries. The total number of all new cancers diagnosed worldwide each year is given to this source, with 12.3 million. This is the first estimate of its kind by the death of smoking researchers expect further with increasing numbers. In the 20th Century, tobacco use caused about 100 million deaths has been in the 21 Century could be expected in about a billion dead. [12] [13]

Every year, some 1,750 in Germany Children under 15 years of cancer. Most often in this age group, leukemia, tumors of the brain and spinal cord and lymph node cancer diagnosed. The latest available statistics for Germany figures (Cancer Registry of Saarland) result for the period from 1998 to 2002 for all cancers, a relative 5-year survival rate of 55 percent. After this 5-year survival results for the survivors then usually an average life expectancy, the corresponding peer of the general population. Only in very few cancers that is not the case here, a 10-year period must elapse. Of all cancer cures about 90 % Only by the local to the tumor region oriented, so-called locoregional treatment, that is by surgery and radiotherapy ("steel beam") is reached.

Rarely, there are spontaneous remissions. They occur in only about 1:50.000-100.000 cases. As spontaneous remission is defined as a complete or partial disappearance of a malignant tumor in the absence of all treatments or treatments for which evidence of efficacy are not yet an out. However, the likelihood of such spontaneous remission is less than the likelihood of misdiagnosis. Despite intensive research, it is possible to view does not specifically spontaneous remission inducing therapy.

"We are watching for 15 years that the cancer mortality in the United States and Germany decreased," said Nicholas Becker of the German Cancer Research Center in Heidelberg. The largest part of the success attributes the U.S. Census of colorectal cancer screening. In men, decreasing the rate of lung cancer because they smoked less. [14]

Many cancer patients do not seem to appear in cancer statistics. Often malignant tumors are discovered only through a different section. In Hamburg it has between 1994 and 2002 at the Institute of Legal Medicine, examined more closely in matters conducted autopsies cancer diagnosis. 8844 sections were included in the analysis. At 519 deaths (5.9%), there was a malignant tumor. Only 58 of these cases had been reported to the Cancer Registry. Two thirds of the cancers were well known during his lifetime, 27.2% were discovered only at autopsy. At least half the cancer was the cause of death. Even with the lethal tumors 17% were detected only at autopsy. Thus seem to cancer registries, so based on his lifetime known tumor diseases, not to be exact.

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theories Cancer triggers

According to the above theory are mainly influences that alter the genetic material, cause cancer. Particularly sensitive for the cell during cell division, so are cells that divide quickly, particularly vulnerable. Even influences that prevent the immune system from recognizing and eliminating malignant cells are considered carcinogenic. Especially dangerous are therefore: * Physical

pollutants
o ionizing radiation such as ultraviolet light, X-ray or gamma radiation. Example: When Koronaruntersuchung by computer purchase is the increased sensitivity of patients with an increased risk of cancer. American scientists thus calculated that sick at twenty year olds of 143 examined by coronary CT women in their lives due to this radiation angiography with cancer, but only one of 686 men the same age. The CT angiography of the coronary arteries seems especially among women and young people to increase the cancer risk is not negligible [3].
* Chemical pollutants
o mutagenic chemicals. The most important are large polycyclic aromatic hydrocarbons, Benzene, chromium (VI) compounds and nitrosamines.
* oncoviruses (as estimated by the American Cancer Society, about 17% of cancer cases [4])
o Several DNA viruses (eg hepatitis B virus (HBV), which hepatocellular carcinoma, and HPV, which can lead to cervical cancer)
o Several RNA viruses
* Some tumors can be transmitted from animal to animal, including the Sticker sarcoma of dogs and DFTD (Devil Facial Tumour Disease) of the Tasmanian devil. [5]
* stem cells can trigger in certain circumstances cancer. [ 6]
* The Million Women Study confirmed the assumption that obesity increases the risk of cancer. An elevated body mass index had both the incidence and mortality increase as the following cancers: endometrial cancer, esophageal cancer, kidney cancer, multiple myeloma, pancreatic cancer, non-Hodgkin's lymphoma, ovarian cancer, breast cancer and colon cancer after menopause. This can be according to the study authors 5% of all cancer cases in overweight and obesity lead back.

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consequences of tumor growth

malignant tumor growth, the consequences for the organism are very diverse and very different in each patient individually pronounced. Tumor growth can lead to a directly to local effects in the neighboring tissue. On the other tumors can also cause systemic (whole organism-related) effects. Key to the disease process often is the formation of secondary tumors, which may in turn lead to the institutions concerned on a number of disorders [9].

Local effects

If growing tumors, they may crowd out the healthy neighboring tissue without destroying it or destructive grow into the surrounding tissues (invasive-destructive growth). Both forms of growth can lead to local complications. For example, by expansive growth of a blood vessel leading compressed. Which occurs as a result of circulatory disturbance-dependent tissue can cause this tissue dies (necrosis). Infiltrative, destructive growth, for example, in hollow organs like the intestine through the destruction of the tissue to openings (perforations) and fistulae lead. Tumorfisteln often lead to further complications due to infections [9].

Systemic effects

tumors can affect in different ways the whole organism. From the primary tumor outgoing secondary tumors in other organs can settle here and destroy tissue by local growth and cause malfunctions. For many patients experience during their cancer to a general loss of strength and weight loss (cachexia, wasting). The systemic effects of tumors, so-called paraneoplastic syndromes are calculated. This results in characteristic symptoms in various organ systems that are ultimately caused by the tumor. For example, a lung cancer lead to a disruption of the hormonal regulation of water balance (Schwartz-Bartter syndrome) [9].

Most patients do not die on the primary tumor but from its metastases. The uncontrolled proliferation steals most of the metastases vital organs until they its function can not comply. Frequent direct causes of death are occlusions (thromboembolism), or no longer controllable by the organism infections (septicemia, blood poisoning).

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multistep model / three-stage model

Most cancer researchers are based on a "multi-step model of carcinogenesis. The multi-step cancer development model attempts to understand the cause. The proliferation of the relevant genetically modified cell into a clump of cells, without external influences over time, or faster by doctoral students influences increased, thereby significantly the probability of another relevant genetic changes under the multi-step process. Such changes can again be induced by external factors (carcinogenic substances), or come by genetic instability of the altered cell population reached. Irritating stimuli can increase the proliferation speed up this process. Up to ten different mutations have to be done. Some of these necessary mutations can be inherited, which explains why even very young children can get cancer and that cancer can occur in so-called "cancer family" frequently. A typical example is the hereditary xeroderma pigmentosum. In close relatives of patients with breast cancer is likely to get breast cancer twice as high as in the general population. In the intermediate steps of tumor development (promotion and progression) is not genotoxic processes play a major role, which could tempt observers to these influences than actual "carcinogen" classification. The actual malignancy (malignant tumors) of the degenerated cell in the phase of progression achieved. The terms promotion and progression are increasingly being replaced by the concept of co-carcinogenesis.

The older so-called "three-step model" breaks down the cancer, however in phases: initiation, promotion and progression. Asked that the years or decades of latency period between the initial DNA damage So the transformation of a single cell, and the detectable tumor are explained. The problem with the three-stage model is that the terms describe initiation, promotion and progression and not only explain the cause.

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Historical assumptions

John Beard wrote in 1902 that cancer cells resembled trophoblastic embryonic cells. At the beginning of pregnancy, these cells made sure that the embryo can implant in the uterus. The growth is aggressive and chaotic. The cells divided quickly and gain ascendancy their energy from sugar fermentation. They suppressed the immune system of the mother and produced human chorionic gonadotropin (hCG), which is now recognized as a tumor marker. The growth stops when the embryo from the seventh week, pancreatic enzymes produced. Without these enzymes would give the most malignant tumor, the choriocarcinoma. The assumption that cancer tumors would gain energy from the sugar fermentation (ie, the tumor would live anaerobic) was the basis for many outdated treatments.

In 1908, Ellerman and Bang discovered a virus that caused leukemia in chickens. Peyton Rous

it was then, in 1911 from a muscle tumor with the high filter fineness 120 nanometers an extract filtered, with whom he was able to cause cancer. He suspected a virus in this extract. 1966 Rous was awarded for the discovery of the Rous sarcoma virus (RSV), the Nobel Prize.

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name history

The name cancer was inspired by Galen, according to the similarity of the swollen veins of a cancer tumor with external legs (→ Illness as Metaphor). Before Hippocrates used the term "cancer" probably the first, when he discovered in the treatment of breast ulcer, the resemblance to the legs of a crustacean - in addition to the breast area to the zodiac sign of Cancer was a part (cf. Homo signorum). Aristotle called superficial cancer detectable in infiltrating adjacent organs and ingrowing tumors (such as advanced Skin cancer or breast cancer).

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cancer

In cancer cells, the coordination of growth, division and destruction in the cell group is suspended. Regulatory signals are not recognized or not performed because most of the genetic code is required for this defect.

About 5,000 of the 25,000 human genes are responsible for the safe conservation of the genetic code from one cell generation to the next. These so-called oncogenes and tumor suppressor monitor the correct sequence of base pairs in the DNA after each reduplication decide on the need for repair processes to be observed by the cell cycle until the repairs are carried out and where appropriate, initiate a programmed cell death (apoptosis), if the repair does not work.

After today's most plausible theory of cancer development (carcinogenesis), the primary disease event, a change in one of these "guardian genes" is either a copy of rare inborn error or by a mutation. This gene can be monitored by the sub-step is no longer accompany him correctly, that it come in the next generation of cells to more defects can. If a second Wächtergen affected, the effect is potentiated continuously. Although apoptosis genes (eg p53) affected, in such a situation would trigger the programmed cell death, these cells are immortal.

By further changes in the DNA form the cell additional features that make the treatment of the cancer to survive including the ability to lack of oxygen to build up its own blood supply (angiogenesis) or to emigrate from the association and in foreign tissue such as bone, lung or brain to settle (metastasis). Only with this ability to win its deadly potency of cancer: 90% of all cancer patients where the deadly disease starts to die, not by the primary tumor but from its metastases or to sequelae of metastatic disease. The immune system tries

principle, to combat the uncontrolled growing cells. Since these same but in many ways normal body cells that defensive measures are usually not sufficient to control the tumor.

cancer cells are often aneuploid, which means they then have a change in chromosome number. [1] It is the subject of research whether the aneuploidy of cancer cells cause or consequence of disease. This also raises the theory that the development of cancer is not, or not only on the mutation individual genes but is due to the change of the complete set of chromosomes.

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occurrence and course

principle, any organ of the human body are affected by cancer, there are significant frequency differences by age, gender, collective membership, geographic region, food habits, etc. In Germany, cancer diseases frequently in organs such as breast (women), prostate ( men), lung and bowel wall.

cancer after heart and circulatory diseases are the second leading cause of death in Germany. However, not every cancer progression is deadly, if timely therapy is initiated or the cancer appears only in advanced age and then slowly grows. The current cure rate average for all cancers is 30 to 40 percent. As is known in oncology cured a patient who is at least five years without relapse (recurrence) survives. This definition of healing is problematic because many of the relapses occur at a later date. It, therefore, many patients will flow into the cancer-success statistics, which die later of cancer (see Cancer Atlas).

The cancer manifests itself in various forms and diseases, for this reason can not give general statements about life expectancy and chances of recovery are made. There are currently about 100 different cancer diseases are known, which differ in survival, treatment options and the formation of metastases in part, strong.

, the frequency of most cancers significantly with age, so that you can also view cancer as a disease of old age of cell growth. Besides smoking, other carcinogenic pollutants, family history (assessment) and viral infections are the leading causes of cancer.

through cancer prevention and early detection, the cancer risk under certain circumstances (depending on the time of diagnosis, the cancer and a conducive age of the patients) are significantly reduced.

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Cancer (medicine)

cancer known in medicine a malignant (malignant) tumor - a malignant neoplasm. In a narrower sense, the malignant epithelial tumors (carcinomas), and malignant mesenchymal tumors (sarcomas) are meant. Colloquially, the hemoblastoses malignant than cancer, such as leukemia, known as "blood cancer".

All other tumors, which include benign (benign) neoplasms are not a "benign cancer" or some form of cancer. These are tissue augmentation or lesions in the body that do not form metastases. This affects the swelling of inflammation and benign neoplasms (new growths of body tissue by abnormal regulation of cell growth).

Benign tumors including moles and fatty tumors (lipomas) will not be technically called cancer, but they can still be dangerous, degenerate as they can or affect vital organs in their functioning (such as the cerebellar pontine angle tumor). Cancer is in common usage a collective term for a variety of related diseases, in which cells grow uncontrollably, divide and destroy healthy tissue and can displace. Cancer has different triggers that ultimately all in a disruption of the genetically controlled balance between cell cycle (growth and division) and cell death (apoptosis) . Lead