Oncology

Oncology: Cancer

Cancer is a disease in which abnormal cells in some organs or tissues go out of control – growing and increasing in number. Normal cells reproduce themselves throughout a person’s life, but in an orderly and controlled manner. In normal cells, growth occurs, worn out tissues are replaced and wounds heal.

When cells grow out of control and form a mass, the mass is called a tumour. Some tumours grow and enlarge only at the site where they began and these are called benign tumours.

Other tumours not only enlarge locally, but they also have the potential to invade and destroy the normal tissue around them and to spread to distant parts of the body. Such tumours are called malignant or cancer.

Specific Cancers

Breast Cancer:
Normal breast cells grow and divide in a controlled manner to replace cells that have died because of damage or age. Breast cancer is a disease in which abnormal breast cells increase in size, divide, and destroy normal tissue. The cancer cells grow out of control for several months or years before they are large enough to be found on a mammogram or felt as a lump. By the time breast cancer is found it already has many millions of cells. Screening mammograms done in women over 50 years old sometimes find the lump before it can be felt.

The most common way for breast cancer to spread is through the lymphatic channels to the lymph nodes in the axilla (armpit). The normal role of these lymph nodes is to drain fluids from the breast and arm.

There are 2 types of surgery for breast cancer — mastectomy and lumpectomy (partial mastectomy).

  • A mastectomy removes the complete breast.
  • A lumpectomy removes the lump and some normal breast tissue around it.

Colorectal Cancer

Colorectal cancer is a malignant tumour that first appears in the colon or rectum. It grows and progresses fairly slowly and in a predictable way. These cancers start in the inner lining of the bowel wall or mucosa. They spread through the wall to surrounding tissue or to the adjacent lymph glands or nodes in the abdomen. The colorectal cancer cells can also travel to distant parts of the body (metastasize). It is primarily when cancer metastasizes and destroys normal tissues, thereby disrupting their functions, that it becomes life-threatening.

Despite the high numbers of people developing colorectal cancer every year, awareness and understanding of this disease is low. This is one of the most preventable and curable of all cancers if it is diagnosed early. Improved awareness can save lives.

Staging
How colorectal cancer is treated primarily depends on the stage of the cancer. Staging describes how deeply the cancer has invaded the wall of the bowel, and whether it has spread to the lymph glands or more distant organs such as the liver or lungs. Cancer that has spread to distant organs is said to have metastasized, and is referred to as metastasis.

The stage of the cancer also determines the prognosis. Prognosis is the prospect of controlling or recovering from the disease. Two different staging systems are commonly used in colorectal cancer. The stages are designated as I, II, III, IV or Dukes A, B ,C, or D, and reflect variations of the criteria described above. A higher number or letter indicates a higher stage of cancer and a worse prognosis. For example, both Stage IV and D refer to cancer that has metastasized.

Primary Therapy
The primary therapy for early stage colorectal cancer is surgery. For colon cancer, the segment of the bowel which contains the cancer, plus the draining lymph glands are removed. For rectal cancer, whether surgery will be done and how it will be done is determined by a number of factors. These include: the size of the tumour, whether it is attached to surrounding tissue and whether the muscles of the anus can be spared. If the entire rectum is removed, the open end of the bowel is brought out through the abdominal wall and is called acolostomy.

What is chemotherapy?
The word is derived from the combination of “chemical” and “treatment. It means the use of drugs to destroy or control the growth of cancer cells. Drugs have been used in the treatment of cancer for the past 30 years. A number of different drugs are currently used to treat many different kinds of cancer.When is chemotherapy used?
Chemotherapy is one of the major methods used to treat cancer. It may be used alone or in com-bination with other forms of treatment, primarily surgery or radiotherapy. The method or combi-nation of methods used to treat cancer are selected individually, according to each patient’s needs. In some cases chemotherapy is the treatment of choice and is considered curative in certain cancers. In others, chemotherapy may keep the cancer under control for months or years. This form of treatment can lengthen and improve the quality of your life.

The benefits of chemotherapy vary from patient to patient and only a doctor can decide how best to treat each individual.

What does chemotherapy do?
Cancer cells are immature cells that are growing out of control within your body. One of the characteristics of these cells is that they multiply at a greater rate because the cells do not die off normally. Also, rapidly dividing cells are more vulnerable to the effects of drugs than most normal cells, and cancer cells are more severely affected by chemotherapy. Chemotherapy drugs work to:

  • destroy cancer cells
  • interfere with the ability of cancer cells to divide or reproduce
  • mimic nutrients in order to starve cancer cells to death

Unfortunately, there are normal cells that also multiply rapidly and are affected by chemotherapy. The normal cells that may be affected include those of the bone marrow (where red and white blood cells and platelets are made), mouth, stomach, intestines, reproductive system, hair follicles and skin. Most of the toxic side effects related to chemotherapy occur in these organ systems. The toxic effects usually last a relatively short time, since the cells in these systems have a remarkable ability to regenerate and return to nor-mal.

Coping with Cancer
Having cancer affects many aspects of a person’s life. Although every person is different, many people experience shock, denial, distress and similar feelings when they are told that they have cancer. Talking about these feelings is difficult, but it can provide support for the person and nurture a close and loving bond among friends and family members.Family Relationships
The best person to talk to about a diagnosis of cancer is whoever will listen well, make you comfortable and respond appropriately. Many people are uncomfortable talking about emotions, but not talking about them can make normal family conversation almost impossible. It often helps to have family members present when the doctor is telling the patient about the diagnosis, to make sure everybody has the same information and avoid somebody having to “break the news.”

Pharmacia and Oncology

Pharmacia Oncology, is the oncology business unit of Pharmacia Canada Inc. Our mission statement at Pharmacia Oncology is “Bringing Discovery to Life for Every Person Touched By Cancer.” For decades now we have been focused on developing innovative molecules, conducting extensive research and clinical trials, and providing the best of products, service and support to our customers, stakeholders and patients in the cancer community. Times are changing, and perhaps the Beatles said it best: “It’s getting better all the time…”

Whether through involvement in a major research group like the NCIC CTG, or with individual centres or investigators, Pharmacia Oncology is a partner in many, many research initiatives. We have been working in partnership across Canada for over 15 years, for example, helping improve the treatment of women with early stage breast cancer with combination regimens such as CEF. And major improvements have been seen recently in the treatment of colon cancer, improvements based on excellent research, a significant portion of it done in Canada, using a combination regimen including the product Camptosar”.

Historically speaking, Pharmacia has deep roots in oncology. You may have known us by some of our previous heritage companies in Canada such as Adria Labs, or Upjohn, or Kabi – Pharmacia, or Pharmacia & Upjohn, or Searle. We are proud of the products we have brought to market and the positive impact they have had on patients and their families, whether through increasing survival or improving quality of life.