It helps more than 70 per cent of all cancer patients to get cured or obtain relief from pain or bleeding in advanced stages. It consists of either external therapy with X-rays or Gamma-rays or internal therapy called ‘brachytherapy’, where radioactive needles are directly implanted into the tumor. External beam therapy takes a few minutes daily and about five to six weeks to complete an entire course during which, besides the tumor, a large number of normal cells also receive radiation. While the latter suffer only temporary harm due to their capacity to recover, cancer cells are damaged permanently. In due course of time, the normal cells not only regain their function completely, but also re-grow to cover up the gap left by the destroyed cancer cells. Today, radiotherapy is planned and executed with the help of dedicated computers to get an optimum ratio between therapeutic and undesirable effects.
The side-effects of radiotherapy result from its action on the normal cells in the treated region. Hence, patients with mouth, throat or food-pipe (esophagus) cancers develop soreness or ulcers in their inner lining, leading to difficulty in swallowing while abdominal reactions manifest as diarrhea, cramps or vomiting. Majority of these effects are temporary and would subside within three to six weeks of completion of therapy. The skin of the treated area may show hair loss without any other damage.
Although different cancers respond variously, nearly 80 per cent of all cancers can be completely cured with standard therapy, if detected in stages I or II. Unfortunately, most of our patients come with advanced disease due to personal neglect or poor awareness on the part of primary care physicians. While most of these cases cannot be cured, the quality of their remaining life can be improved with modern palliative and rehabilitative care. Multipronged efforts including media support are desirable to create greater awareness among the people and care givers to promote early detection and prompt therapeutic intervention. Well-equipped facilities for cancer treatment are few in India and exist mainly in only about a dozen Regional Cancer Centers, besides a few medical colleges.

Question: My mother is on methotrexate for treatment of cancer. It is having terrible side effects. Is it worth continuing?
This is an extremely difficult and delicate question of ethics, medical technology and common sense. The treatment of a cancer can include surgery, irradiation and drugs. The type of treatment will vary depending on the type and site of the cancer. Methotrexate is a drug that kills cancer cells. Unfortunately it, and other cancer drugs, can have severe side effects, as they damage some normal cells while destroying the cancer. The usual problems are loss ot hair and vomiting associated with constant nausea and a sense of being unwell.
Ethically, all doctors ate required to do everything possible to prolong human life, and cure disease. If statistics indicate that methotrexate, or any other drug, is likely to be the best treatment, a doctor is ethically obliged to prescribe it. Medical technology may also indicate that certain treatments are sometimes successful, and that a combination of several treatments may give a slightly higher chance of success, but with a dramatic increase in side effects.
This is where common sense is required. If a patient is likely to be cured in 50% or even 25% of cases with the use of a course of Treatment that may be most unpleasant, most doctors and patients would proceed. If the success rate was only 1%, most doctors would consult with the patient and relatives and not proceed, leaving the remainder of the patient’s life as calm, peaceful and free of side effects as possible.
The problem arises between these extremes. Should the patient be given a slight chance of survival after a few months ot drug-induced agony, or should nature be allowed to take its course? There is no simple answer. Frank discussions between the patient, doctor and relatives is the only way for a consensus to be reached in solving the dilemma.

Question: Where does cancer spread to when you have a secondary cancer? I have had cancer in the breast, and I have been told that surgery has been successful and I have no secondaries, but I would like to watch out for any problems.
The liver, lymph nodes, and bones are the most common areas involved in the spread of cancer, but cancel can spread almost anywhere in the body from its original site. The type of cancer will also determine where it may spread, as some types of cancer cells appear to spread more easily to one part of the body than another.
The lymph nodes are responsible for dealing with waste products and infection, and there are direct channels from them to every part of the body. Cancer cells can spread very easily along these channels, and so with most cancers, the nearest group of lymph nodes is often surgically removed, irradiated or treated with cancer-killing drugs.
The liver is responsible for processing the blood to remove abnormal and dying cells, waste products and toxins. This too can therefore be easily affected by cancer cells. Bone marrow is responsible for producing many of the infection- and cancer-fighting cells in the body, and may itself be infilttated by cancer cells that destroy its correct function.
Secondary cancer is certainly harder to treat than primary, but it is not an inevitable death sentence because modern anti-cancer drugs, the new radiation techniques available and delicate surgery can still remove and control many of these growths.

Question: Does a person who is terminally ill have to suffer excruciating pain, or can it be controlled?
This can be a very difficult problem for doctors, patients and their families particularly when the patient is dying from a very aggressive form of cancer. There are undoubtedly medications available that will control the most sever pains, but the patient may be so stuporous from the side effects that they are unable to function effectively, and may end up completely unconscious. To keep a patient alert and pain free is the challenge.
Medications, including self-administered doses of narcotics by tablet or injection, can play a part in this process, but in many cases there are other options. The use of a TENS (trans cutaneous electrical nerve stimulator) machine, which through pads on the skin stimulates nerves in a way that blocks pain, may give some patients relief.
The most radical options include injecting into the nerves that are responsible for the pain to temporarily shut them down, or permanently destroy them. Surgery ro cut these nerves may also be undertaken. The wishes of the patient must always be taken into consideration by doctors, and a discussion of the available options allows the patient to remain in control of his/her pain in the way that s/he desires.

Question: Several members of my family have had cancer of different sorts, and this scares me. What causes cancer? How can I avoid it?
Cancer, the crab of astrology, is so named because the ancients could see the cancer clawing its way into the normal tissue, destroying everything in its path. Doctors now understand a great deal about cancer, but we do not fully understand what starts the process.
Although the specific cause of cancer is unknown, sun exposure, a low-fiber diet and smoking are well-known precipitating factors.
Cancer occurs when otherwise normal cells start multiplying at an excessive rate, and the cells made by the rapid process of reproduction are abnormal in shape, size and function. Although they may have some slight resemblance to the cells around them, cancer cells cannot perform the correct work of that type of cell, and they prevent the normal cells around them from working properly, thus enabling the cancerous cells to spread.
Cancer is not just one disease process; dozens of different types of cancer occur in different parts of the body, and each type causes different problems and responds differently to treatment. Several different types of cancer can be found in the lungs for example.