Health Discussion At St Rose—

The First Line Of Defense

Against Cancer Is Knowledge

By Dottie Evans

The more we know about cancer, the greater hope there is for a cure.

This was the dominant theme of a lecture given by Lilla Dean, RN, MSN, before an audience of parishioners and guests on Monday evening, March 29, sponsored by the St Rose of Lima Parish Nurse Ministry.

“I’m going to talk about cancer in a way you might never have thought about it before,” promised Professor Dean.

She then confessed to a 50-year fascination with the disease that not only preoccupied her early academic life and subsequent long professional career, but has also motivated her to dedicate many years as a cancer volunteer.

After graduating from Grace New Haven School of Nursing, the University of Bridgeport, and New York University, Professor Dean worked for 34 years as a staff nurse at Danbury Hospital.

She recently retired as professor emeritus of nursing from her position at Western Connecticut State University where she taught for 23 years.

She currently volunteers for the American Cancer Society and in 2001, she received the society’s Volunteer of the Year award.

A Hawleyville resident since 1950, Lilla Dean is now in her seventh year serving on Newtown’s Planning and Zoning Commission.

As Professor Dean opened her talk at St Rose School Monday night, she spoke directly and to the point.

 “What is cancer? We’re not sure because it’s not a single entity,” she said, mentioning the different disciplines that come into play when studying the disease –– biology, genetics, epidemiology, and patho-physiology.

“We do know this much: cancer is an uncontrolled growth of abnormal cells. If early detection were the norm,” she continued, “we could reduce the death rate by 30 percent. Fully 50 percent of all cancers can be treated successfully, and 95 percent of patients treated who present with Stage One cancer [the most benign form] are alive after five years. ”

The incidence of cancer seems to increase as a person ages, especially after 55.

“The United States population is getting older. There were 1.3 million new cases of cancer this year, and by the year 2050 that number will double. The good news is that nine million cancer survivors whose cancers were cured or controlled are alive today,” she said.

“When I started out in nursing, we saw children dying from leukemia or Hodgkins Disease within three months of their diagnosis. Now 80 percent with these diseases are living normal lives.”

Her clear message was this: There is hope in knowledge. While a positive attitude might not prevent a person from getting cancer in the first place, it has everything to do with what happens next.

“Your best shot at a cure is to get the right treatment the first time around,” Prof Dean said.

Cancer Cells Don’t Play By The Rules

There are more than 60 trillion cells in the body and they are normally replaced in an orderly fashion when they become damaged or wear out.

“In the gastro-intestinal tract, cells are actually changing and turning over all the time. They may be totally replaced within a three- to five day-cycle.”

She explained that cell replacement is usually a regulated, predictable process in which the new cell is identical to the old cell and takes up its specialized functions without incident.

Occasionally, cells are produced that do not look normal and do not behave normally. These abnormal cells continue to multiply and grow without regard for function or boundaries.

“They may look immature, bizarre, and strange, and their DNA is different. They may break off into the blood stream or the lymphatic system and can spread. There is no built-in age limit so they do not die at the rate normal cells do. Cancerous cells stay vigorous and may even secrete hormones that cause a separate circulatory system to grow and support a tumor.

“We all make a few abnormal cells every day and our bodies recognize those cells. The white cells, called macrophages, eat them up. But cancer cells can disguise themselves so the macrophages don’t recognize them.”

When cancer is suspected, Prof Dean said, it is very important for a pathologist to examine the cells under a microscope in order to identify them. Cell samples may be obtained through a biopsy, or through extraction of body fluids. After examination, the pathologist categorizes the cancerous cells by grade, and the data is used to make the diagnosis and to recommend appropriate treatment.

For example, if a cancerous cell still resembles its cell of origin, it is considered grade one. If it looks nothing like its cell of origin and is totally undifferentiated as to function, it is grade four.

The test for relative stage of the disease involves examining the physical extent of the cancer spread using scans to estimate the size and location of tumor growth, and also its degree of aggressiveness. A stage one tumor is in its earliest form of development, and stage four is more advanced.

A new diagnostic technique called a sentinal node biopsy allows the pathologist to examine a particular node in the lymphatic system where cancer cells usually appear first, thus bypassing the process of looking at all the nodes for evidence of cancer.

If a cancer has metastasized, or spread into the circulatory or lymphatic system, it may find fertile ground in organs that act as filters, such as the lungs or the liver.

Angio-genesis, or the ability of a cancerous tumor to feed itself by stimulating nearby cells to grow into blood vessels, has been the subject of much study and a recent discovery has opened the way for a new and effective treatment, Prof Dean said.

“We’ve developed drugs that cut off the blood supply to the tumor, and stop it from growing in a metastatic way,” she said.

“We’ve made great progress in educating the public against exposure to the sun, which shows up decades later as skin cancer, and against smoking, which is one of the primary risk factors.”

Another risk factor is obesity, she said, “because estrogen is stored in fat, and some tumors are estrogen specific.”

Prof Dean added that it is important for communities to fight for clean air and clean water, since there is evidence that chemicals in the environment are harmful and can be carcinogenic.

 

Treatment Options Always Increasing

When considering treatment options, patients have long turned to surgery, she said, but there are other good options.

“Radiation is effective because while it destroys all the cells in its path, normal cells can repair themselves in a short time, where cancer cells cannot. The implantation of radon seeds to cure prostate cancer has been successful, and often produces fewer side effects than surgery,” she said.

“Chemotherapy, which can lead to permanent cures, has seen great progress in the last 15 years, and we have whole new classes of drugs. With chemo treatment, cancer cells are more prone to die than normal cells.

“We might give two or three different drugs intermittently, each one being specific to a certain cycle of cell growth. Then we wait for the normal cells to recover and repeat the dose. It’s a process that might take from six to nine months, or from 18 months to two years.

“In this way, we can spread out the side effects and tackle the tumor from every possible standpoint. Of course, we are always looking for new drugs to control side effects such as nausea,” she added.

In conclusion, Prof Dean listed the familiar cautionary steps including medical surveillance through regular check-ups, mammograms, colonoscopy, moderate exercise, nonsmoking, the use of sunscreens, and practicing good nutrition.

“Don’t eat too many cured meat products like bacon or sausage or luncheon meats,” she added.

For those fighting cancer and undergoing treatment, there are other complementary medicines that can be beneficial, she added, such as practicing yoga, attending support groups, undergoing massage therapy, the use of aromatherapy.

“Any of these may impact you and help you manage your cancer. If you take herbal supplements, get your oncologist’s permission first.”