Some Common Facts About Cancer and Common Misconceptions in Cancer Treatment
What is cancer?
Cancer, also called malignant tumor, is the result of qualitative change in genetic regulation of human cells under the long-term action of various internal and external factors, leading to excessive proliferation.
The internal and external factors that induce cancer are complex and include physical, chemical, and biological factors. Heredity, nutritional and endocrine disorders, cellular immune deficiency, and long-term excessive stress responses—such as excessive mental tension and other adverse stimuli—can also induce tumors.
Some difficult-to-cure inflammatory reactions, tissue hyperplasia, and excessive proliferation may all induce cancer. Even a scar or a mole on the body can become malignant, turning into scar carcinoma or malignant melanoma.
Although cancer is an ancient disease, at the beginning of the twentieth century it was a rare disease in countries around the world. As late as the early 1950s, cancer ranked only ninth among causes of death among Beijing residents. But with industrialization over recent decades, cancer has leaped into the top three causes of death in countries worldwide.
In China, cancer has become the leading cause of death among urban residents and the second leading cause among rural residents. Statistics show that 25% of urban and 21% of rural Chinese will unfortunately develop cancer; that is, one in every four to five people will become a cancer patient at some stage in life, and in first-tier cities this proportion is close to one in three.
China's cancer incidence is currently at the world average and not the highest, but it continues to climb. It can be expected that China will rapidly enter the ranks of countries with the highest cancer incidence, and eventually perhaps one in three people will die of cancer.
The rising cancer incidence is related both to environmental pollution and to modern people's dietary and lifestyle habits, and also to the continuous increase in average life expectancy. Cancer generally becomes frequent only after age forty (though in recent years it has begun to trend younger). From a societal perspective, rising life expectancy also drives the high incidence of cancer.
The threat cancer poses to Chinese residents is already extremely severe. Paying attention to cancer, taking it seriously, and declaring war on it brook no delay. As Professor Jia Jiafu, director of Peking University Cancer Hospital, has said: If we do not act now, we will in future pay a heavy social price for the cancer problem.
How many stages does cancer go through? Is cancer a death sentence?
According to modern medicine, cancer can be divided into five stages:- Precancerous stage: At this stage, human cells have undergone a certain degree of change but are not yet cancer. They can develop in either direction—progressing to cancer or reversing to normal cells.
- Carcinoma in situ: Generally also called stage 0 cancer. This is the stage at which cells have just become malignant; the malignant change is confined to the epithelial layer. Cancers discovered at this stage are cured by surgical resection with a nearly 100% cure rate.
- Invasive cancer: In modern medicine generally denoted T. By this stage, the site of malignant change has progressed from the epithelial layer deeper, for example into the submucosa.
- Local or lymphatic metastatic cancer: Generally denoted N. Here, malignant cells have spread from the tissue of origin along lymphatic vessels to lymph nodes.
- Distant metastatic cancer: Generally denoted M. By this stage, tumor cells have spread through the bloodstream to distant organs.
Patients already in a precancerous state should take their health seriously and, on the doctor's advice, undergo early cancer screening at intervals, so that if carcinoma in situ appears it can be treated in time with radical surgery and further deterioration prevented.
Cancer that has passed the carcinoma-in-situ stage is generally harder to treat, but a proportion of patients can still be cured. As medicine develops, cancer treatment modalities multiply; a considerable number of patients with advanced cancer can also achieve long survival through comprehensive treatment.
What treatment measures exist for cancer?
At present, the main cancer treatment modalities in medicine are surgery, chemotherapy (including cytotoxic drugs and targeted therapy), radiotherapy (a treatment using nuclear medicine; conventional radiotherapy and the various "knife" and "ray" named schemes that use nuclear medicine all belong to radiotherapy), immunotherapy, traditional Chinese medicine treatment, and various natural therapies.
On the whole, the Chinese medical community has reached a consensus that cancer requires integrated Chinese and Western medicine treatment. Cancer patients treated with integrated Chinese and Western medicine enjoy longer survival.
The treatment and rehabilitation of cancer is globally an issue of enormous controversy. Some TCM practitioners in China oppose Western treatment, and some Western doctors oppose TCM treatment; both can be said to harbor certain prejudices.
From my years of observation, both TCM and Western medicine have cured some cancer patients, but among middle-to-late-stage cancer, especially the advanced and end-stage cancers commonly seen clinically, treatment is tricky whether by TCM or Western medicine.
My own advice is that patients and their families should, in a truth-seeking manner, choose a treatment plan they can afford and that is effective, according to their financial situation.
In addition, patients and families should be psychologically prepared for the expected outcomes of cancer treatment. I often see families who spend their entire fortune treating cancer and end up with neither person nor money remaining; though heroic, it lacks reason.
Should doctors be changed frequently when treating cancer?
Seeking help blindly in desperation is a widespread phenomenon, and most patients consult doctors everywhere. In fact, among the long-term cancer survivors I have seen, almost none was treated this way. Those who consult doctors everywhere ultimately mostly end up disappointed.
After patients and families learn of a cancer diagnosis, the first thing they should do is gain a comprehensive understanding of the disease and rationally assess what treatment can achieve. Some advanced patients pursue complete elimination of the tumor; this expectation is unrealistic and also gives medical scammers an opening.
If patients can survive with good quality, they need not focus excessively on tumor progression. The tumors in most patients will definitely progress; patients whose tumors stop progressing are the lucky ones, and these lucky patients mostly achieve this result after receiving standardized integrated Chinese and Western treatment and recuperation.
Many of the cancer patients I have seen who survived ten-plus years did not change doctors frequently; when they did change, it was mostly because the original doctor had died or changed jobs.
Each time a treating physician changes, patient and doctor must go through a process of mutual understanding and trust-building. Often, during this process, the patient's condition is handled cautiously and superficially, which is very unfavorable for recovery.
A doctor needs time to understand a patient's body, and understanding requires testing with medication. Generally, in the early stage of treatment, doctors conservatively try tentative treatments, observe the body's response, and then proceed further; this safeguards both the patient's life and the doctor's own professional safety.
Those who frequently change doctors tend to remain at the shallowest initial stage of collaboration, and in the end most harm themselves.
Some patients I have seen treat with one doctor for a week or at most a month, feel the effect is not obvious, and immediately switch to another doctor. Generally, when such patients come to me for help, I treat them cautiously.
Among my own patients, those with marked results are also the long-term ones, not those I have met only once. I think most doctors share this experience.
What is overtreatment?
Cancer treatment is extremely prone to overtreatment. Some patients undergo surgery, chemotherapy, radiotherapy, and TCM all at once, exceeding what their bodies can bear, and their constitution rapidly deteriorates; such treatment does more harm than good.
But in China, another form of overtreatment has not received enough attention: excessive hospitalization and excessive intravenous infusion.
I often encounter patients receiving excessive IV infusions who improve slightly at first but then collapse after a period of infusion. Some patients or families naively assume that as long as it is not chemotherapy, IV infusion can do no harm; in fact this is not so.
I have met Western oncology doctors who, when we talk, express helplessness: they do not want to order IV drips for patients, but the patient or family demands that the doctor add various nutrient solutions or antibiotics, or prescribe patent medicines that have no effect on the tumor. Usually in such cases the doctor adds a note to the order: "At the request of the patient's family."
Excessive infusion causes many problems. Some patients develop infusion-induced hiccups or infusion-induced fluid retention; others collapse under the overload and die too quickly after excessive infusion.
Sometimes I am asked to offer TCM advice to patients receiving IV drips in hospital. Most often I prescribe some water-draining, swelling-reducing Chinese herbs, and many patients improve greatly after taking them. In reality, these herbs are not used to fight the cancer but to counter the fluid retention and other adverse effects caused by excessive infusion in cancer patients.
Do cancer patients' children have a higher cancer risk than the children of non-cancer patients?
The children of cancer patients do indeed have a higher cancer risk than the children of non-cancer patients; many cancers show familial clustering.
In one neighbor's family, three generations of males all died of bone cancer within the same year. There are also families in which siblings develop the same cancer, such as breast, stomach, liver, or esophageal cancer. This is partly related to hereditary genes and partly to shared family lifestyle.
Therefore, the children of cancer patients should take their health seriously. After reaching a certain age, physical checkups should include cancer screening. It is also worthwhile to find a family doctor specializing in oncology; such doctors can be found among professional tumor specialists, who can help manage one's health.
One should also reflect on family lifestyle. For example, some families love pickled vegetables, which is a very bad habit; the nitrite in pickled vegetables is a highly carcinogenic substance, and such habits should be corrected. Other bad habits such as smoking also deserve full attention.
Some diseases, such as Helicobacter pylori infection, also show familial clustering. H. pylori is one of the carcinogenic causes of stomach cancer; in such a situation the whole family should actively treat the infection, to avoid the tragedy of multiple cancer patients in one household.
What should cancer patients pay attention to in diet and exercise?
Cancer development is related to human dietary habits to some extent. Generally, a broad diet with a mix of meat and vegetables is fine, but those who frequently eat pickled vegetables, overly salty foods, overly hot foods, or excessive high-fat and high-protein foods are prone to cancer.
For cancer patients, fresh, organic ingredients are best; these are also the best ingredients for healthy people to prevent and fight cancer.
The nutrition the body needs is closely tied to physical activity. We often see cancer patients, after diagnosis, trying every means of food supplementation, yet not loving exercise.
This may be a long-standing bad habit among Chinese: people always feel the sick should be tonified and nourished. In fact, aside from the need to boost nutrition during surgery, radiotherapy, and chemotherapy, there is no need for food supplementation at other times; a normal diet is enough, and a certain amount of exercise must also be maintained.
Some patients, after cancer, not only supplement their food but also avoid exercise, which makes recovery very difficult.
In my clinical work, besides giving medication advice, the most common and important advice I give is for patients to exercise more. At present, patients who follow this advice have achieved satisfactory treatment results.
Cancer patients should do more aerobic exercise such as jogging and hiking; those with poor stamina may practice Tai Chi, qigong, yoga, or walking, but a certain amount of exercise must be guaranteed. Patients who refuse any exercise mostly have very poor outcomes.
Exercise not only helps patients digest food but also helps them move qi and blood and relax the mind; exercise is no less important to cancer patients than medicine.
Should patients be kept in the dark about their true condition?
This question is likewise highly controversial, but statistics show that informed patients fare much better than uninformed ones. Informed patients are far more cooperative during treatment; some clinicians are even reluctant to take on patients who do not understand their condition, because patients who do not know their diagnosis mostly do not cooperate during treatment.
Patients themselves have the right to know their condition, to participate in planning their treatment, and to arrange the rest of their lives. Concealing the condition from patients actually deprives them of these rights.
Life and death are the greatest matters in life. Families should let patients know their true condition; even if death is approaching, patients should have the chance to fulfill their final wishes.
But when telling patients the truth, some method is needed. One may draw on the help of professional doctors and psychological counselors to inform the patient and, through communication, help build confidence in overcoming the disease.
Having spent many years in the cancer circle and seen many patients, I know from experience that being informed benefits patients.
Some cancer patients do indeed lose emotional control when they first learn the truth, but in the end they accept the facts, and the great majority build confidence to fight the disease.
The mental collapse that most families fear rarely occurs; on the contrary, constantly hiding the truth makes patients anxious and emotionally labile.
Some uninformed patients have been doing well in treatment, but then one day accidentally learn the diagnosis through some channel, suffer a huge psychological blow, reject the current treatment plan, and panic-look for a new one. The risk of this is far greater than the harm of telling the patient the truth.
Should one cut oneself off from the world after cancer?
Many cancer patients suffer a severe psychological shock after diagnosis, doubt life, and even gradually choose an isolated lifestyle. Some young cancer patients, after diagnosis, easily vent their anger on others and even choose extreme measures such as divorce to end their past social and family relationships.
From my years of observation, isolating oneself after cancer does not help recovery. After diagnosis, one should maintain beneficial social contact as much as possible, and it may even be necessary to return to work. Some long-surviving cancer patients I have treated are now all in normal employment. This helps reduce mental and economic pressure and is extremely favorable for recovery.
Under the influence of traditional Chinese culture, some cancer patients become Buddhists or Daoists after diagnosis; some, out of these beliefs, even go deep into the mountains. Only a very few benefit from such an isolated life; most cancer patients who do so suffer severe psychological problems from self-isolation—pessimism, despair, and tension with nowhere to vent—and their recovery is poor.
But patients who previously socialized too frequently benefit from reducing socializing after cancer and keeping only a certain amount of beneficial contact. Cancer patients who had too many drinking-and-dining friends especially need a major change from their past dissipated lifestyle. In Chinese social culture, such associations usually mean excessive intake of alcohol, tobacco, and meat, plus the various negative emotions generated by face culture—all very harmful to cancer recovery.