According to cancer statistics, about 153,100 people will be diagnosed with cancer in 2006 and over 70,400 of them will die from it.

What is cancer?
Cancer is a disease resulting from the spreading and the accelerated growth of “abnormal” cells. While healthy cells grow, divide and die, abnormal ones divide endlessly, then aggregate and form a tumour. Tumours can be benign (non-cancerous) or malignant (cancerous). Metastases are groups of tumour cells that spread in other parts of the body, either close to or remote from the site of the primary tumour. Early detection of malignant tumours is important to avoid progression and to facilitate treatment. 
 
BREAST CANCER
An estimated 22,300 women and 160 men in Canada will be diagnosed with breast cancer in 2006. It is also believed that one out of nine women will develop breast cancer during her lifetime. Finally, breast cancer is the most common form of cancer diagnosed in women (except for skin cancer, excluding melanoma) in Canada.

What is breast cancer?
Breast cancer is a malignant tumour that develops in glandular tissue of the breasts. There are several types of breast cancers, and some develop faster than others. 

Several risk factors have been identified, including family history of breast, uterine, colon, rectum and ovarian cancer. Age is also a risk factor, since the risk of breast cancer increases as women get older.

Other factors are:

• Previous breast disorders and abnormal cells detected by biopsies
• No pregnancy or pregnancy after the age of 30
• Early menstruation or late menopause
• Dense breast tissue
• Using hormone replacement therapy

Breast cancer cannot be diagnosed based only on those risk factors, as most women with that type of cancer do not have any known risk factors.

Signs and symptoms
The earlier the detection of cancer, the better are the survival rates. Nine breast tumours out of ten are detected by patients. Several signs and symptoms may lead you to think you have breast cancer. However, they can apply to other problems too, so it is important to see a doctor to be sure.

• Lump in breast or armpit
• Blood-stained discharge without squeezing
• Nipple turned inwards
• Crusting, ulceration or eczema-like symptoms on the nipple
• Various changes in the epidermis of the breast
• Changes in breast size and shape

Treatment of breast cancer
Treatment varies according to the grade and stage of the cancer at diagnosis, the patient’s general health and the type of cancer detected.

A few definitions

Surgery: An operation to remove part or all of the tumour and some surrounding tissue.

Hormone therapy: The use of hormones to slow down the development and spreading of cancer cells.

Radiation therapy: The use of X rays to destroy cancer cells.

Chemotherapy: The use of drugs or medications that interfere with the cancer cell’s ability to grow and spread.

OVARIAN CANCER
Carcinoma of the ovary is one of the most common gynecologic malignancies. According to Canadian Cancer Statistics, 2,300 new cases of ovarian cancer will be diagnosed in Canada in 2006. Of these women, more than 1,600 will die – an alarming mortality rate of 69%.

What is ovarian cancer?
Ovarian cancer is frequently referred to as the “disease that whispers” because it lacks specific signs or symptoms. As a result, ovarian cancer is diagnosed in the majority of patients only after the disease has progressed to an advanced stage. Ovarian cancer is categorized by four stages according to the extent of the disease. In stage I, growth is limited to the ovaries; in Stage II, the disease has spread to the uterus or other pelvic tissues; in Stage III, the cancer has spread to lymph nodes and/or the abdomen, whereas in Stage IV, other organs in the body are affected as well.

Though the causes of ovarian cancer are not well understood, several factors have been identified, which can potentially reduce the risk of the disease, including the use of oral contraceptives, hysterectomy, tubal ligation, full-term pregnancies, breastfeeding, and low-fat diet. Statistically, the risk of developing ovarian cancer increases with age.

BRAIN TUMORS
What are primary brain tumours?
A primary brain tumour is a mass formed by the growth of abnormal cells or by uncontrolled growth of such cells in the brain. Primary brain tumours, whether benign (noncancerous) or malignant (cancerous), may be localized or extended.

Tumours can destroy brain cells, but they can also damage them indirectly by causing inflammation, compressing other parts of the brain, inducing cerebral edema or by exerting internal pressure as they grow.

Brain tumours are classified based on the specific site of the tumour, the type of tissue affected, and whether the tumour is benign or malignant in nature.

What causes primary brain tumour to develop is still unknown. Certain kinds of tumours tend to be hereditary, while others are congenital. They may also develop at any age, although several are seen in certain age groups.

The symptoms, the treatments and the prognosis vary with the site and the type of tumour, as well as the age and the general health of an individual.

What are the symptoms?
Individuals are all unique. Symptoms vary from person to person and are often vague and confusing, which makes diagnosing the tumour even more difficult. Plus, symptoms can mimic other problems in the body and be so subtle that it may be a long time between onset and diagnosis.

Symptoms are typically caused by the tumour growing in size, which increases pressure in the skull and on the brain, and more specific symptoms can usually allude to a tumour's location, size, or type.

• Headaches
  Most patients experience headaches at some point during the course of their illness. They are usually not a throbbing type of headache, but they can be so intense that they can awaken a person from sleep. These pains come and go, with severe aches in the morning that gradually dissipate throughout the day. These headaches can worsen with exercise, a change in position, or coughing.
  
• Seizures
  Seizures are caused by a disruption in the normal flow of electricity in the brain. A seizure may be the first indication of a brain tumour, or the first sign of a recurring tumour.

Other general symptoms of brain tumours include:

• Change in vision (blurred vision, double vision, and loss of peripheral vision)
• Changes in personality, memory, and speech
• Nausea or vomiting
• Weakness or loss of feeling in arms and legs
• Drowsiness

Note: Specific symptoms vary. Other symptoms can occur. Please refer to your health specialist for further information.

What are the treatments?
Surgery, radiation therapy and chemotherapy, or a combination of these treatments, are used to treat brain tumours. When determining which treatment to use, physicians usually look at the severity of the tumour and the general health of the patient.

Surgery is usually the first treatment used for brain tumours if the tumour can be removed without causing damage to healthy brain tissue.

During radiation therapy, high-powered rays are used to eliminate cancer cells as well as stop their growth. Radiation mainly affects the DNA, which is the basic building material of all cells. Damage to the DNA interferes with the ability of a cell to divide. Eventually, cells that have been radiated die while attempting to reproduce. Radiation therapy affects both normal cells and tumour cells, but normal cells can repair themselves.

With chemotherapy, either one or a combination of drugs is used to eradicate cancer cells. Chemotherapy can be used as the first therapy or as additional therapy. Chemotherapy is commonly added to the treatment of gliomas because a significant survival benefit has been seen when it is used in combination with surgery and radiation therapy.

SKIN CANCER
Skin cancer is by far the most common form of cancer in Canada. The three major types of skin cancer are the highly curable basal cell and squamous cell carcinomas and the more serious malignant melanoma.

The Canadian Cancer Society estimates that approximately 4,500 Canadians will be diagnosed with melanoma in 2006. About 880 people in the country are expected to die of melanoma in 2006. The chance of developing melanoma increases with age, but it affects all age groups and is one of the most common cancers in young adults.

What is melanoma?
Melanoma is a very serious form of skin cancer. It begins in melanocytes— cells that make the skin pigment called melanin. In its early stages, melanoma often goes unnoticed. Although melanoma accounts for only about 4 percent of all skin cancer cases, it causes 75% of skin cancer-related deaths. The good news is that melanoma is often curable if it is detected and treated in its early stages.

Malignant melanoma occurs in varying shades of tan, brown or black or in multicolored patches of red, white, and blue. It may have an asymmetrical outline with notched or ragged edges, and is usually larger than 6 mm (1/4 inch).

Reducing the risks
Since melanoma is most often caused by being in the sun too much, it makes sense that people should try to avoid or protect themselves from the sun's harmful rays. This is especially important between 10 AM and 4 PM, when the sun's rays are the strongest. Self-protection like wearing wide-brimmed hats, long-sleeved shirts, and long pants is recommended. It is also crucial to always use a sunscreen with a sun protection factor (SPF) of 15 or higher on all exposed skin — even in the winter — and to carefully follow the manufacturer's instructions.

Regular Skin Check-Ups
One key to fighting skin cancer is early diagnosis and treatment. A cancerous growth can develop rapidly, perhaps in a location that may not be noticed or cannot be seen (for example, on the back). The sooner it can be detected, the greater the chances are of treating it successfully. That's why dermatologists recommend that you visit a doctor for routine skin cancer screenings.

Risk Factors
Risk factors for melanoma include:

• Family history of melanoma
• Dysplastic nevi (noncancerous, but unusual-looking moles)
• Previous melanoma
• Immunosuppressive therapy
• Many nevi (ordinary moles): more than 50
• Severe, blistering sunburns
• Many freckles
• Fair skin, light eyes

Melanoma occurs more often in people with fair skin that burns or freckles easily. These people also usually have red or blond hair and blue eyes. Melanoma is also more common in people who live in areas with large amounts of ultraviolet (UV) radiation from the sun.

People who have had one or more severe, blistering sunburns as a child or teenager are at increased risk for melanoma also. Because of this, doctors advise parents to protect their children's skin from the sun. Sunburns in adulthood are another risk factor for melanoma.

Melanoma sometimes runs in families, so people with two or more close relatives who have had melanoma are at increased risk too.

In addition, certain types of mole patterns are associated with an increased risk of developing melanoma, such as having dysplastic nevi (unusual moles). The risk of melanoma is greater for people with a large number of dysplastic nevi - for example, more than 50.

Also, people with a weakened immune system due to certain cancers, drugs given following organ transplants, or HIV/AIDS are at increased risk of developing melanoma.

What are the Signs and Symptoms?
Melanoma can appear suddenly as a new mole, or it can develop slowly in or near an existing mole. In men, melanomas are often found between the shoulders and hips, or the head and neck area. In women, melanoma often develops on the lower legs as well as between the shoulders and hips.

If you see any of the following signs of skin cancer or precancer, consult your doctor promptly.

• A skin growth that increases in size and looks pearly, translucent, tan, brown, black, red, pink, or multicolored.
• A mole that changes in color or in texture, becomes irregular in shape, gets larger, or is bigger than a pencil eraser.
• A spot or growth that continues to itch, hurt, crust, scab, erode, or bleed.
• An open sore that lasts for more than 4 weeks, or heals and then reopens.
• A scaly or crusty bump that is horny, dry, and rough and may produce a pricking or tender sensation.

Since moles may develop into melanoma or indicate an increased risk for melanoma, it is important to know the difference between melanoma and an ordinary mole. An ordinary mole is usually an evenly-colored brown, tan, or black spot in the skin. It can be either flat or raised, round or oval. Moles are generally smaller than the diameter of a pencil eraser (1/4 inch). They may be present at birth or appear during childhood or adulthood. Several moles may appear at the same time, especially in areas that have been exposed to the sun.

Once a mole develops, it usually stays the same size, shape, and color for several years. Most people have moles that are almost always harmless. However, it is important to recognize changes in a mole that may suggest melanoma is developing.

The following ABCDE system can help tell a normal mole from one that could be melanoma.

A = Asymmetry: melanoma lesions are typically asymmetrical, whereas benign moles are typically round and symmetrical.

B = Border: melanoma lesions frequently have uneven or irregular borders (ie, ragged or notched edges), whereas benign moles have smooth, even borders.

C = Color: melanoma lesions often contain multiple shades of brown, black, red, grey or white whereas benign moles are usually a single shade of brown.

D = Diameter: a mole growing in diameter or in width is often characterized as a melanoma. A melanoma can have a size of 1-2 mm or more.

E = Evolution: the appearance of melanoma lesions changes rapidly (within a few months)

Treating Melanoma
Treatment for melanoma is based on the stage of the disease (how far along the cancer has progressed), on the age as well as general health of the patient. The specific treatment will most likely be prescribed by a dermatologist or an oncologist, a doctor who specializes in cancer.

For any stage melanoma, surgery — removal of the tumour — is the first treatment. Surgery is often sufficient to cure people with early-stage melanoma — patients with small, thin tumours that haven't spread to other parts of the body.
In later stages of the disease, surgery is generally followed with additional therapy. Chemotherapy, radiation therapy or immunotherapy are the most frequent kinds of additional therapies for melanoma.

References

Canadien Cancer Society/National Cancer Institute of Canada: Canadian Cancer Statistics 2006 , Toronto, Canada, 2006.

Canadian Cancer Society, [Online] http://www.cancer.ca/ccs/internet/standard/
0,2939,3172_10175_273057_langId-en,00.html

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