Cancer - 1st Edition
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Cancer
Susan E. Pories, Marsha A. Moses,
and Margaret M. Lotz
Biographies of Disease
Julie K. Silver, M.D., Series Editor
GREENWOOD PRESS
An Imprint of ABC-CLIO, LLC
Copyright 2009 by Susan E. Pories, Marsha A. Moses, and Margaret M. Lotz
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, electronic, mechanical,
photocopying, recording, or otherwise, except for the inclusion of brief quotations in a
review, without prior permission in writing from the publisher.
Library of Congress Cataloging-in-Publication Data
Pories, Susan, 1953–
Cancer / by Susan E. Pories, Marsha A. Moses, and Margaret M. Lotz.
p. cm. — (Biographies of disease)
Includes bibliographical references and index.
ISBN 978–0–313–35979–8 (hard copy : alk. paper) — ISBN 978–0–313–35980–4
(ebook)
1. Cancer—Popular works. I. Moses, Marsha A. II. Lotz, Margaret M. III. Title.
RC263.P67 2009
616.99´4—dc22 2009022708
13 12 11 10 9 1 2 3 4 5
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This book is printed on acid-free paper
Manufactured in the United States of America
This book is dedicated to the next generation of scientists and doctors whose
work will provide hope for the future of all those touched by cancer.
It’s the little pebbles that make a path.
—Mary Claire King
Contents
Series Foreword ix
Preface xi
Acknowledgments xiii
Introduction xv
Chapter 1. Know the Enemy: Understanding Cancer 1
Chapter 2. Detective Work: Making the Diagnosis of Cancer 65
Chapter 3. Plan of Attack: Cancer Treatments 77
Chapter 4. Maintaining Quality of Life after a Cancer Diagnosis 101
Chapter 5. When Cancer Treatments Don’t Work 111
Chapter 6. Hope for the Future 117
Appendix A. How You Can Pursue a Career in Science or Medicine 127
Appendix B. Cancer Timeline 135
Appendix C. Internet Resources 143
viii Contents
Glossary 145
References 155
Index 171
Series Foreword
E
very disease has a story to tell: about how it started long ago and began to
disable or even take the lives of its innocent victims, about the way it
hurts us, and about how we are trying to stop it. In this Biographies of Dis-
ease series, the authors tell the stories of the diseases that we have come to know
and dread.
The stories of these diseases have all of the components that make for great
literature. There is incredible drama played out in real-life scenes from the past,
present, and future. You’ll read about how men and women of science stumbled
trying to save the lives of those they aimed to protect. Turn the pages and you’ll
also learn about the amazing success of those who fought for health and won,
often saving thousands of lives in the process.
If you don’t want to be a health professional or research scientist now, when
you finish this book you may think differently. The men and women in this book
are heroes who often risked their own lives to save or improve ours. This is the
biography of a disease, but it is also the story of real people who made incredible
sacrifices to stop it in its tracks.
Julie K. Silver, M.D.
Assistant Professor, Harvard Medical School
Department of Physical Medicine and Rehabilitation
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Preface
A
s a young girl, I was introduced to cancer in a very personal way. My mother
and her best friend both developed breast cancer in their forties. My mother
survived her battle with cancer and is still thriving in her eighties, but her
friend, Violet, died shortly after being diagnosed. At the same time, I started accompa-
nying my father on his rounds as a surgeon at the hospital and have a searing memory of
seeing a man whose face was covered with skin cancers, a consequence of radiation
treatment for acne when he was a teenager. These experiences have formed the basis
for my lifelong interest in cancer research.
Susan E. Pories, M.D.
Cancer is a diagnosis that causes fear and confusion. However, as evidenced
by the examples above, cancer is really a family of diseases and the disease pro-
cess, causes, and prognosis can vary widely. This book introduces you to this vast
topic by starting with the history of cancer as well as seminal figures and discov-
eries on the path to today’s understanding of cancer. Chapter 1 will teach you
about the various causes of cancer and the principles of genetics. The impor-
tance of angiogenesis—the development of new capillaries—in the growth and
progression of cancer is discussed, and the various factors contributing to the
occurrence of cancer are explored. Chapter 2 explains the process of diagnosis,
xii Preface
and Chapter 3 introduces cancer treatments, including surgery, radiation,
chemotherapy, and targeted treatments such as hormonal therapy, immuno-
therapy, and antiangiogenesis agents. The dangers of unproven or alternative
treatments are also discussed. In Chapter 4, the growing field of psycho-
oncology and the importance of support from family and community are intro-
duced. Role models from the sports world show the inspiration of courage and
hope in the face of disease. In Chapter 5, the limits of cancer treatments are
explained with a discussion of drug resistance and an introduction to end of life
care. Finally, Chapter 6 discusses new frontiers in cancer research and preven-
tion and gives students an idea of how they can enter careers in medicine and
science. A comprehensive glossary of terms and a timeline of advances in cancer
research and treatment are provided.
As it is not possible to cover all of cancer in a volume of this size, we have
chosen to focus on illustrative examples and interesting stories that we hope will
intrigue and interest you. We hope to encourage and inspire you to learn more
and perhaps join us in medicine and science.
Acknowledgments
W
e thank Dr. Julie Silver for the opportunity to work on this exciting
educational project. We are grateful to Kristin Johnson for her excel-
lent illustrations, Caitlin Welsh and Megan Lafferty for editing and
administrative support, and are most appreciative of the beautiful images pro-
vided by Dr. Pierre Sasson, Dr. Athos Bousvaros, Benny Lassen, and Dr. Brian
Organ.
Most of all, we thank our families Christopher, Louis, Gerard, Alexander, Athos,
and George with love and appreciation.
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Introduction
I ignore all the doomsaying nonsense. I’m in a business where the odds of ever
earning a living are a zillion to one, so I know it can be done. I know the impos-
sible can become possible.
—Marcia Wallace
Wallace, an Emmy Award-winning actress, commenting on her husband’s
diagnosis of pancreatic cancer. People Magazine (March 2, 1992).
T
he word ‘‘malignant’’ comes from the Latin combination of ‘‘mal’’ mean-
ing ‘‘bad’’ and ‘‘nascor’’ meaning ‘‘to be born.’’ Malignant then literally
means ‘‘born to be bad.’’ This implies that cancer is inevitably pro-
grammed into cells and prevention is doomed to fail. Today we know that many
cancers are preventable and treatable with early diagnosis and proper care.
There are many common cancer myths that persist into modern times, such
as these: cancer is contagious, cancer is a death sentence, biopsy can make a
cancer spread, curses can cause cancer, cancer is God’s will, dying is preferable
to surgery, and air can cause cancer to grow (Pories, et al., 2006). Although we
have not yet won the ‘‘war against cancer’’ we have made immense progress
xvi Introduction
against this disease and move ever closer to the day when cancer is better under-
stood and can be managed as a chronic disease, much like infection or diabetes.
This book provides an introduction to the topic of cancer. We have not
attempted an encyclopedic approach but rather have chosen to focus on the
most common cancers in adults and some of the most interesting and seminal
advances in cancer research and treatment. Human interest stories are included
to help bring the study of scientific research to life. We have also tried to make
complicated scientific knowledge understandable. Even if you are not yet fully
interested and engaged in science, we hope that you might be inspired to enter
this important field. We also hope to empower you to educate your friends and
families about cancer prevention and treatment.
Understanding cancer is more important than ever because, according to the
World Health Report, cancer is predicted to become the leading cause of death
worldwide in the year 2010 (Boyle and Levin, 2008). The global burden of
cancer doubled between 1975 and 2000 and is expected to continue at an
unprecedented rate, redoubling by 2020 and tripling by 2030. Scientific research
along with educational and preventive strategies such as tobacco and alcohol
control, widespread screening, and improved access to care, has the exciting
potential to change this trajectory.
