CANCER is a group of diseases characterized by the development of abnormal cells that divide uncontrollably and have the ability to infiltrate and destroy normal body tissue. Cancer may be able to spread throughout your body by a process called metastasis. Cancer is the second-leading cause of death in the world. But survival rates are improving for many types of cancer, thanks to improvements in cancer screening and cancer treatment.

SYMPTOMS caused by cancer will vary depending on what part of the body is affected. Some general signs and symptoms associated with, BUT NOT SPECIFIC TO, cancer, include:

• Fatigue

• Lump or area of thickening that can be felt under the skin

• Weight changes, including unintended loss or gain

• Skin changes, such as yellowing, darkening or redness of the skin

• Sores that won’t heal, or changes to existing moles

• Changes in bowel or bladder habits

• Persistent cough or trouble breathing

• Difficulty swallowing

• Hoarseness

• Persistent indigestion or discomfort after eating

• Persistent, unexplained muscle or joint pain

• Persistent, unexplained fevers or night sweats

• Unexplained bleeding or bruising

Make an appointment with your doctor if you have any persistent signs or symptoms that concern you. If you don’t have any signs or symptoms, but are worried about your risk of cancer, discuss your concerns with your doctor. Ask about which cancer screening tests and procedures are appropriate for you

Cancer is caused by changes (mutations) to the DNA within cells. The DNA inside a cell is packaged into a large number of individual genes, each of which contains a set of instructions telling the cell what functions to perform, as well as how to grow and divide. Errors in the instructions can cause the cell to stop its normal function and may allow a cell to become cancerous.

A gene mutation can instruct a healthy cell to allow rapid growth, fail to stop uncontrolled cell growth or make mistakes when repairing DNA errors.

Normal cells know when to stop dividing so that you have just the right number of each type of cell. Cancer cells lose this control, resulting in uncontrolled cell divisions and a very large number of cancerous cells.

Gene mutations can occur for several reasons. In rare cases, you could be born with them when they are inherited from your parents. In most cases, they occur after birth, when factors such as smoking, radiation, viruses, cancer-causing chemicals (carcinogens), obesity, hormones, chronic inflammation and a lack of exercise can cause gene mutations.

An inherited cancer-linked gene mutation does not always mean that a cancer development is inevitable. While your inherited gene mutation could make you more likely than other people to develop cancer when exposed to a certain cancer-causing substances, you will likely need one or more other gene mutations to cause cancer.

The following factors increase your risk of cancer:

Your age: Because cancer can take decades to develop, most people diagnosed with cancer are 65 or older. Still, cancer is not exclusively an adult disease, and can be diagnosed at any age.

Your gender: Simply by virtue of difference in organs, ovarian and uterine cervical cancers are seen only in females, while testicular cancer is seen only in males. The female and male sex hormones such as estrogen and androgen regulate cell division at the molecular level, resulting in differences in cancer incidence between women and men. Thus, prostate, bladder cancer and leukemia occur the most in males, while breast, and colorectal cancer are predominant in females. Thyroid cancer incidence is much higher in females than in males.

Your habits: Certain lifestyle choices are known to increase your risk of cancer. Smoking, drinking more than one alcoholic drink a day (for women of all ages and men older than age 65) or two drinks a day (for men age 65 and younger), excessive exposure to the sun or frequent blistering sunburns, being obese, and having unsafe sex can contribute to cancer. It is important to recognise that you can change these habits to lower your risk of cancer.

Your family history: Only a small portion of cancers are inherited. In such families, it is possible that mutations are being passed from one generation to the next. You can opt for genetic testing to see whether you have inherited mutations that increase your risk of certain cancers.

Your environment: The environment around you may contain harmful chemicals that can increase your risk of cancer. Even if you don’t smoke yourself, you might inhale secondhand smoke if you are around habitual smokers. Chemicals like asbestos, benzene, certain synthetic pesticides in your home or workplace (or a farm if you are a farmer) can increase your risk of cancer.

Your health conditions: Some chronic health conditions, such as ulcerative colitis, can markedly increase your risk of developing certain cancers.

There’s no certain way to prevent cancer. But researchers have identified several lifestyle changes which reduce cancer risk.

Stop smoking. Smoking is linked to several types of cancer, including lung cancer, cancer of the larynx (voice box), mouth, esophagus, throat, urinary bladder, kidney, liver, stomach, pancreas, colon and rectum, and uterine cervix, as well as acute myeloid leukemia. So if you don’t smoke, don’t start. If you smoke, quit. Stopping now will reduce your risk of cancer in the future.

Avoid excessive sun exposure. Harmful ultraviolet (UV) rays from the sun increase your risk of skin cancer. You should limit your sun exposure by staying in the shade, wearing protective clothing or applying sunscreen.

Eat a healthy diet. Choose a diet rich in fruits and vegetables. Select whole grains and lean proteins. Unsaturated oils like olive, peanut, and canola are good for you. Avocados, nuts such as almonds, hazelnuts, and pecans and seeds such as pumpkin and sesame seeds should be a part of your diet. You should avoid saturated fats from animal-derived products like beef, cheese, and ice cream to reduce cancer risk. Similarly, reduce the excess use of plant-derived products like coconut, coconut oil, palm oil, and palm kernel oil.

Exercise most days of the week. Regular exercise is linked to a lower risk of cancer. Aim for at least 30 minutes of exercise most days of the week. If you haven’t been exercising regularly, start out slowly and work your way up to 30 minutes or longer.

Maintain a healthy weight. Being overweight or obese may increase your risk of cancer. Work to achieve and maintain a healthy weight through a combination of a healthy diet and regular exercise.

Drink alcohol in moderation, if you choose to drink. If you choose to drink alcohol, limit yourself to one drink a day if you’re a woman of any age or a man older than age 65, or two drinks a day if you’re a man 65 years old or younger.

Schedule cancer screening exams. Talk to your doctor about what types of cancer screening exams are best for you based on your risk factors.
Ask your doctor about immunizations. Certain viruses increase your risk of cancer. Immunizations may help prevent those viruses, including hepatitis B, which increases the risk of liver cancer, and human papillomavirus (HPV), which increases the risk of cervical cancer and other cancers. Ask your doctor whether immunization against these viruses is appropriate for you.

Myth: Antiperspirants or deodorants can cause breast cancer.

Fact: There’s no conclusive evidence linking the use of underarm antiperspirants or deodorants with breast cancer. While these products contain harmful chemicals such as aluminum compounds and parabens that can be absorbed through the skin or enter the body through nicks caused by shaving, there is no definitive evidence suggesting that these products cause cancer. If you are still concerned, choose products that don’t contain chemicals mentioned above.

Myth: People who have cancer shouldn’t eat sugar, since it can cause cancer to grow faster.

Fact: Rigorous research is ongoing to understand the relationship between sugar in the diet and cancer. All body cells, including cancer cells, depend on blood sugar (glucose) for energy. But giving more sugar to cancer cells doesn’t make them grow faster. Likewise, depriving cancer cells of sugar doesn’t make them grow more slowly. There is some evidence that consuming large amounts of sugar is associated with an increased risk of certain cancers, including esophageal cancer. Indirectly, eating too much sugar can also lead to obesity and diabetes, which in turn may increase the risk of some cancers. Moderate use of sugar is prudent.

Myth: Cancer is contagious.

Fact: There is no need to avoid someone who has cancer because cancer is not contagious. It is not just alright to spend time with someone who has cancer, in fact, your valuable support and positive attitude may be crucially beneficial for cancer victims. Though cancer itself is not contagious, sometimes viruses, which are contagious, can lead to the development of cancer. Examples of viruses that can cause cancer include: Human papillomavirus (HPV, a sexually transmitted pathogen that can cause cervical cancer and other cancers), Hepatitis B or C viruses (HBV or HCV, transmitted through sexual intercourse or use of infected IV needles that can cause liver cancer), etc. Aside from lifestyle changes, there are vaccines available to protect you from these viruses.

Myth: Microwaving food in plastic containers and wraps releases harmful, cancer-causing substances.

Fact: Plastic containers and wraps that are labeled as safe for use in the microwave don’t pose a threat. There is some evidence that plastic containers that are not intended for use in the microwave could melt and potentially leak chemicals into your food. Avoid microwaving plastic containers that are not approved for use in a microwave oven. Research evidence shows that chemical bisphenol A (BPA) commonly used in the plastic industry, as well as Bisphenol S (BPS), a substitute for BPA, both can potentially increase the aggressiveness of an existing breast cancer Given all this evidence, it is safe to avoid BPA/ BPS-containing plastics. The microwave-safe containers must therefore be marked as BPA-free and BPS-free.

Various human cancer types include carcinoma (cancers of epithelial cells), sarcoma (cancers of connective tissues like muscles, bones and cartilages), lymphoma, leukemia, central nervous system (CNS) tissue tumors, and melanoma (skin cancer).

Diagnosing cancer at its earliest stages often provides the best chance for a cure. So talk with your doctor about what types of cancer screening may be appropriate for you. Studies show screening tests can save lives by an early diagnosis of some cancers (like breast, colorectal, prostate, oral cancers, etc.) For other cancers such as familial breast and ovarian cancers, and lung cancer, screening tests are recommended only for people with increased risk.

Your doctor may use one or more of the following approaches to diagnose cancer: Physical exam, Laboratory tests, Imaging, Biopsy, Molecular diagnostics

Physical exam: Your doctor may feel areas of your body for lumps that may indicate a tumor. During a physical exam, he or she may look for abnormalities, such as changes in skin color or enlargement of an organ, that may indicate the presence of cancer.

Laboratory tests: Laboratory tests, such as urine and blood tests, may help your doctor identify abnormalities that can be caused by cancer.

Imaging tests: Using a variety of physics-based mechanical imaging systems, but from a distance, without actually touching the body, doctors can understand changes in the composition of the body’s interior. Such diagnostic imaging technologies include X rays, magnetic resonance imaging (MRI), ultrasound imaging or ultrasonography (USG), computerized axial tomography scan (CAT or CT scan), positron emission tomography (PET scan), etc. These medical imaging methods have made great progress in the field of medicine, making it easier to diagnose changes in organs and bones within the body.

Bone Marrow Biopsy: Bone marrow is the spongy material inside some of your larger bones like thigh bone and hipbone, where blood cells are produced. Analyzing a sample of bone marrow may reveal if the cellular composition of your blood has changed. Bone marrow biopsy can diagnose a variety of noncancerous and cancerous blood disorders, including thalassemia, hemophilia as well as blood cancers, such as leukemia, lymphoma and multiple myeloma. A bone marrow biopsy may also detect cancers that started elsewhere in the body but traveled to the bone marrow.

Endoscopic biopsy: During endoscopy, your doctor uses a thin, flexible tube (endoscope) with a light on the end to see structures from the suspicious area inside your body. Special tools are passed through the tube to pinch and take a small sample of tissue to be analyzed. Tubes used in an endoscopic biopsy can be inserted through your mouth, rectum, urinary tract or a small incision in your skin. Examples of endoscopic biopsy procedures include cystoscopy to collect tissue from inside your bladder, bronchoscopy to get tissue from inside your lung and colonoscopy to collect tissue from inside your colon. Depending on the type of endoscopic biopsy you undergo, you may receive a sedative or anesthetic before the procedure.

Needle biopsy: During a needle biopsy, your doctor uses a special needle to extract cells from a suspicious area. A needle biopsy is often used on tumors that your doctor can feel through your skin, such as suspicious breast lumps and enlarged lymph nodes. The needle biopsy can be combined with an imaging procedure, such as X-ray, and used to collect cells from a deep-seated suspicious area that cannot be felt through the skin.
Image-guided biopsy: Image-guided biopsy combines a diagnostic imaging procedure with a needle biopsy. Image-guided biopsy allows access to deep-seated suspicious areas that cannot be felt through the skin, such as abnormalities on the liver, lung or prostate. You will receive a local anesthetic to numb the area being biopsied in order to minimize the pain.

Skin biopsy: A skin (cutaneous) biopsy removes cells from the surface of your body, typically used to diagnose skin conditions, including melanoma and other cancers.

Surgical biopsy: If the suspicious tissue cannot be accessed with other biopsy procedures or if other biopsy results have been inconclusive, your doctor may recommend a surgical biopsy when the surgeon makes an incision to access the suspicious cells.

Following biopsy, a tissue sample is sent to a laboratory for analysis. The sample may be subjected to microscopic tissue analysis by histochemistry where the very thin sections of the tissue, sliced at room temperature or frozen, are chemically treated with stains or antibodies. The sections placed on glass slides are then studied by a pathologist under a microscope. The results help determine whether the cells are cancerous or not. If cancerous, the biopsy results are further analysed to understand the type of cancer.

A biopsy helps your doctor determine how aggressive your cancer is, by understanding the cancer’s grade or extent of its growth. The grade is often expressed as a number on a scale of 1 to 4 and is determined by how altered the cancer cells look under the microscope. Low-grade (grade 1) cancers are generally the least aggressive and high-grade (grade 4) cancers are generally the most aggressive ones. This information is essential to help guide an oncologist for deciding the treatment options and chances for a cure (prognosis).

Besides pathological assessment, imaging tests such as bone scans or X-rays can also assist in defining the aggressiveness of cancer, and help find out if cancer has spread to other parts of the body. Cancer stages are generally indicated by Roman numerals I through IV. Higher the numeral, more advanced is the cancer. In some cases, cancer stage is indicated additionally using letters or words.

With the exception of blood cancers, blood tests generally cannot tell with certainty whether you have cancer or some other noncancerous condition. Hence, you must not misunderstand that a cancer diagnosis has been made and you have cancer simply because your doctor has ordered cancer-related blood test. Speak to your doctor to understand what he or she was looking for. The blood samples may show cancer cells, proteins or other substances made by the cancer cells. Blood tests can also give your doctor an idea of how well your organs are functioning and if they are affected by cancer.

Examples of blood tests used to diagnose cancer include a complete blood count (CBC, which measures the amount of various types of blood cells, or if too many or too few of a type of blood cell or abnormal cells are present), a bone marrow (BM) biopsy, serum protein testing (which looks for tumor marker proteins produced by cancer cells in your body). Examples of serum tumor markers include prostate-specific antigen (PSA) for prostate cancer, cancer antigen 125 (CA 125) for ovarian cancer, calcitonin for medullary thyroid cancer, alpha-fetoprotein (AFP) for liver cancer and human chorionic gonadotropin (HCG) for germ cell tumors, such as testicular cancer and ovarian cancer.

Tumor cells that have broken away from an original cancer site may float and circulate in blood. The circulating tumor cells (CTCs) are extremely rare and hard to find when searched on the background of billions of blood cells. Therefore an oncologist must strive to use a CTC test with very high sensitivity and precision. Most CTC tests use either of two common features: the surface proteins made predominantly by cancer cells, or the slightly larger size of cancer cells. But it must be understood that neither of these features is unique to cancer cells alone, which lowers the specificity of the test. A CTC test is typically never used alone but in combination with other diagnostic method.

Although blood and urine tests can indicate a cancer diagnosis, other tests such as a biopsy are usually necessary to make the definitive diagnosis. In some cases, tumor marker levels are monitored over several months. These tests are also useful to determine whether your cancer is responding to treatment or it is continuing to grow.

Metastasis means that cancer spreads from where it started to a different body part. When this happens, doctors say the cancer has “metastasized”, or “advanced” or “progressed to stage 4 cancer.” (But note that a locally advanced cancer may not have invaded the surrounding normal tissues and may not be metastatic.) Metastases most commonly develop when cancer cells break away from the main tumor and enter the bloodstream or lymphatic fluid. These fluid connective tissues in our body carry materials around the body, thus can carry the cancer cells far from the original tumor to a different part of the body, and form new tumors upon settling (secondary tumors). Metastases can also sometimes develop when cancer cells from the main tumor, typically in the belly area, break off and float in the ascitic fluid around the cancerous organ, and travel to grow in nearby areas like the liver, lungs, or bones.

Some cancer patients present (are diagnosed) with a metastatic cancer, which means their cancer has already advanced beyond early stages of progression. The treatment in these patients must be correspondingly more aggressive and different than one offered to early-stage cancer patients.

Cancer cells of certain organs have a propensity to find home in specific body parts. Thus, breast cancer tends to spread to the bones, liver, lungs, chest wall, and brain; the lung cancer tends to spread to the brain, bones, liver, and adrenal glands, while the Prostate cancer tends to spread to the bones. Similarly, colon and rectal cancers tend to spread to the liver and lungs. This “homing” of cancer cells to specific secondary sites is thought to be due to biochemical affinity to specific receptor proteins that the destination organ cells display on their outer membranes.

Yes, a cancer that has spread to another area is given the same name as the original cancer. For example, a breast cancer that spreads to the liver is called metastatic breast cancer, and not liver cancer. This is because the cancer started in the breast and the treatment used is one that is effective for breast cancer.

Treatment of a metastatic varies based on the origin of the cancer, the extent of cancer spread, where it is located, patient’s age and health, and the patient’s personal preference for treatment option. Recent research has told us that metastases may differ from the original tumor at the molecular and genetic level, hence treatment for metastasis is often different from the treatment used for the original tumor. Treatment options are usually systemic (meaning it affects patient’s entire body) and is either targeted therapy, chemotherapy, hormone therapy or immunotherapy, alone or in combination. Obviously, since the tumor has spread beyond the primary organ, surgery and radiation therapy are the options with limited utility.

In some situations, metastatic cancer can be cured, but most commonly, treatment may not provide complete cure. But doctors can slow its growth and reduce symptoms. It is possible to live for many months or years with certain types of cancer, even after the development of metastatic disease.

The right questions to ask your oncologist can be the following:
1. What is the type of my cancer?
2. How far has the cancer spread and where is it located?
3. How much cancer there is?
4. Is the cancer growing quickly or slowly?
5. What is the type of my treatment?
6. How will the cancer respond to treatment?
7. What is the goal of treatment? (Complete cure, slowing down the tumor growth, or symptomatic relief from pain?) [Remember: These goals may change during treatment, depending on how the cancer responds.]
8. What are expected side effects of the treatment? [pain, nausea, hair loss, etc.]
9. How do I manage the side effects ?

Clinical trials offer experimental treatments that are not yet approved for widespread use and not yet available to the general public. Typically, the clinical trial option is used by only 3% to 5% of adults with cancer. A clinical trial might be the main treatment for metastases, or one of the options. The clinical trial treatment may or may not help individual patients participating, but it gives clinical researchers valuable information that could help future patients. Often, leading oncologists in association with pharmaceutical companies developing novel anti-cancer drugs design and conduct a clinical trial.

When you live with cancer for many months or years, doctors often treat it like a chronic, or long-term, illness; and adhering to continuous treatment is crucial. You also need support for the physical, emotional, and social effects of living with cancer. An association with a suitable supporting organization will be highly beneficial.

Bone metastasis occurs when cancer cells spread from their original site to a bone. Nearly all types of cancer can spread (metastasize) to the bones. But some types of cancer are particularly likely to spread to bone, including breast cancer and prostate cancer. Bone metastasis can occur in any bone but more commonly occurs in the spine, pelvis and thigh. Bone pain indicating bone metastasis may be the first presenting sign that you have cancer. Alternatively, bone metastasis may occur years after cancer treatment. Bone metastasis can cause pain and broken bones. Commonly, cancer that has spread to the bones can’t be cured. Treatments can help reduce pain and other symptoms of bone metastases.

Signs and symptoms of bone metastasis include bone pain, broken bones, urinary incontinence, bowel incontinence, weakness in the legs or arms, high levels of calcium in the blood (hypercalcemia), which can cause nausea, vomiting, constipation and confusion.

The cancers most at risk of bone metastasis include breast cancer, kidney cancer, lung cancer, lymphoma, multiple myeloma, prostate cancer and thyroid cancer.

Brain metastases occur when cancer cells spread from their original site to the brain. Growing metastatic brain tumors create pressure on and change the function of the surrounding brain tissue. Surgery, radiation therapy or both are the primary treatment options. In some cases, chemotherapy and immunotherapy may be helpful. Treatment is often palliative, meaning focused on reducing pain and symptoms resulting from the cancer.

Signs and symptoms of brain metastases include headache, sometimes with vomiting or nausea, mental changes, such as increasing memory problems, seizures and dizziness.

The cancers most at risk of brain metastasis include lung cancer, breast cancer, colon cancer, kidney cancer and melanoma.

Any cancer treatment can be used as a primary treatment, but the most common primary cancer treatment for the most common cancers is surgery. If your cancer is particularly sensitive to radiation therapy or chemotherapy, you may receive one of those therapies as your primary treatment.

Doctors have many tools when it comes to treating cancer. Cancer treatment options include surgery, chemotherapy, radiation therapy, bone marrow transplant, immunotherapy, hormone therapy and targeted therapy.

Neo adjuvant therapy is treatment provided before curative cancer surgery or curative radiation therapy, and is performed with the intent of reducing tumor burden. Adjuvant therapy is treatment provided after the curative surgery, where the goal is to kill any cancer cells that may remain after primary treatment in order to reduce the chance that the cancer will recur. Any cancer treatment can be used as an adjuvant therapy. Common adjuvant therapies include chemotherapy, radiation therapy and hormone therapy.

Palliative treatment is medical management of symptoms and side effects of therapy to offer better quality of life. It can help patients feel more satisfied with the treatment received. Surgery, radiation, chemotherapy and hormone therapy can all be used to relieve signs and symptoms. Medications may relieve symptoms such as pain and shortness of breath. Palliative treatment can be used at the same time as other treatments intended to cure your cancer.

The goal of surgery is to remove the cancer entirely or as much of the cancer as possible, with cure as the primary intent.

Chemotherapy is use of intravenous drugs to kill cancer cells.

Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation treatment can come from a machine outside your body (external beam radiation), or it can be placed inside your body (brachytherapy).

Bone marrow transplant is also known as a stem cell transplant. Your bone marrow is the material inside your bones that makes blood cells. A bone marrow transplant can use your own cells or cells from a donor. A bone marrow transplant allows your doctor to use higher doses of chemotherapy to treat your cancer. It may also be used to replace diseased bone marrow.

Immunotherapy, also known as biological therapy, uses your body’s immune system to fight cancer. Cancer can survive unchecked in your body because your immune system doesn’t recognize it as an intruder. Immunotherapy can help your immune system “see” the cancer and attack it.

Some types of cancer are fueled by your body’s hormones. Examples include breast cancer and prostate cancer. Removing those hormones from the body or blocking their effects may cause the cancer cells to stop growing.

Targeted drug treatment focuses on specific abnormalities within cancer cells that allow them to survive.

Clinical trials are studies to investigate new ways of treating cancer. Thousands of cancer clinical trials are underway. Other treatments may be available to you, depending on your type of cancer.

Cancer and its treatment can cause several complications, including:

Pain: Pain can be caused by cancer or by cancer treatment, though not all cancer is painful. Medications and other approaches can effectively treat cancer-related pain.

Fatigue: Fatigue in people with cancer has many causes, but it can often be managed. Fatigue associated with chemotherapy or radiation therapy treatments is common, but it’s usually temporary.

Difficulty breathing: Cancer or cancer treatment may cause a feeling of being short of breath. Treatments may bring relief.

Nausea: Certain cancers and cancer treatments can cause nausea. Sometimes your doctor can predict if your treatment is likely to cause nausea. Medications and other treatments may help you prevent or decrease nausea.

Diarrhea or constipation: Cancer and cancer treatment can affect your bowel habits and cause diarrhea or constipation.

Weight loss: Cancer and cancer treatment may cause weight loss. Cancer steals food from normal cells and deprives them of nutrients. This is often not affected by how many calories or what kind of food is eaten; it’s difficult to treat. In most cases, using artificial nutrition through tubes into the stomach or vein does not help change the weight loss.

Chemical changes in your body: Cancer can upset the normal chemical balance in your body and increase your risk of serious complications. Signs and symptoms of chemical imbalances might include excessive thirst, frequent urination, constipation and confusion.

Brain and nervous system problems: Cancer can press on nearby nerves and cause pain and loss of function of one part of your body. Cancer that involves the brain can cause headaches and stroke-like signs and symptoms, such as weakness on one side of your body.

Unusual immune system reactions to cancer: In some cases the body’s immune system may react to the presence of cancer by attacking healthy cells. Called paraneoplastic syndrome, these very rare reactions can lead to a variety of signs and symptoms, such as difficulty walking and seizures.

Cancer survivors have a risk of cancer recurrence. Some cancers are more likely to recur than others. Ask your doctor about what you can do to reduce your risk of cancer recurrence. Your doctor may devise a follow-up care plan for you after treatment. This plan may include periodic scans and exams in the months and years after your treatment, to look for cancer recurrence.

Clinical outcome is determined by a complex interplay of various factors which are 1) Patient-Related (age, Comorbidities, Genetic predisposition, Lifestyle), 2) disease-related (Disease type and stage, Tumor biology, Disease progression), 3) treatment-Related (Treatment type and intensity, Treatment adherence, Treatment timing), 4) healthcare System-Related (Access to care, Quality of care, Healthcare provider experience) and 5) environmental and Social Factors (Socioeconomic status, Environmental factors, Social support).

Cancer epidemiology is the population-level study of distribution of cancer, cancer types and cancer-related characteristics.

Prognosis is a medical term that refers to the predicted outcome or future course of cancer. It is a forecast of the likely progression, outcome, and potential complications of a patient’s condition, based on their individual characteristics, medical history, and the severity of their condition. Prognosis can be Good (a favourable outcome with a high likelihood of recovery), Poor (an unfavourable outcome with a low likelihood of recovery or successful management of cancer) or Terminal (cancer is incurable, and the life expectancy is limited). Prognosis can help Informed decision-making, Treatment planning, Emotional preparation and Resource allocation for the Healthcare entity.