Cancer FAQ — Common Questions About Cancer Treatment and Prevention
1.What is cancer and how does it develop?
Cancer is not one disease but a group of over 100 related conditions characterized by uncontrolled cell growth. Approximately 20 million new cases are diagnosed worldwide yearly, making it a leading cause of death globally.
How cancer develops:
Key characteristics of cancer cells:
- Sustained growth signaling
- Evading growth suppressors
- Resisting cell death
- Enabling unlimited replication
- Inducing blood vessel formation
- Invasion and metastasis
- Evading immune destruction
IMPORTANT: Cancer treatment MUST be supervised by qualified oncology specialists. Never self-diagnose or self-treat with cancer medications.
2.What causes cancer?
Cancer causes are complex and typically involve multiple factors interacting over time. Most cancers result from combinations of environmental exposures and genetic predisposition.
Major risk factors:
Modifiable:
- Tobacco use - single largest preventable cause (30 percent of cancer deaths)
- Excessive alcohol consumption
- Obesity and physical inactivity
- Poor diet (processed foods, red meat, low fiber)
- Excessive sun exposure/tanning
- Occupational exposures (asbestos, chemicals)
- Certain infections (HPV, hepatitis B/C, H. pylori)
- Radiation exposure
- Certain hormonal factors
Non-modifiable:
- Age (risk increases substantially with age)
- Family history/genetics
- Inherited mutations (BRCA1/2, Lynch syndrome)
- Sex and race/ethnicity
- Reproductive history
Preventable cancers: Approximately 30-50 percent of cancers are preventable through lifestyle modifications, vaccinations (HPV, hepatitis B), and screening. Never smoking, limiting alcohol, maintaining healthy weight, exercising regularly, eating well, and avoiding excessive sun are most impactful.
3.What are the warning signs of cancer?
Cancer warning signs are non-specific - most people with these symptoms do NOT have cancer. However, persistent unexplained symptoms warrant medical evaluation.
Common warning signs (CAUTION mnemonic):
- Change in bowel or bladder habits
- A sore that does not heal
- Unusual bleeding or discharge
- Thickening or lump anywhere
- Indigestion or difficulty swallowing (persistent)
- Obvious change in wart or mole
- Nagging cough or hoarseness
Other important symptoms:
- Unexplained weight loss (10+ pounds without trying)
- Persistent fatigue
- Fever (unexplained, persistent)
- Night sweats
- Persistent pain without clear cause
- Skin changes (color, itching, jaundice)
- Breast changes (lumps, dimpling, discharge)
- Testicular lumps or changes
- New neurological symptoms
When to seek evaluation: Symptoms lasting more than 2-3 weeks or worsening warrant medical assessment. Regular age-appropriate screening (mammography, colonoscopy, Pap smears, etc.) can detect cancers before symptoms develop.
4.What cancer medications does RXshop offer?
RXshop offers 8 cancer medications across major treatment classes. All require oncologist prescription and supervision.
Hormonal therapy for breast cancer:
- Nolvadex (Tamoxifen 10mg) - SERM for hormone receptor-positive breast cancer
- Arimidex (Anastrozole 1mg) - aromatase inhibitor for postmenopausal breast cancer
Anti-androgens for prostate cancer:
Chemotherapy agents:
- Cytoxan (Cyclophosphamide 50mg) - alkylating agent
- Methotrexate (2.5mg) - antifolate
Cytoreductive therapy:
- Hydrea (Hydroxyurea 500mg) - for myeloproliferative disorders, sickle cell
Cancer medications require oncologist supervision. Regular monitoring including blood tests, organ function assessments, and disease response evaluation essential.
5.How does tamoxifen work for breast cancer?
Nolvadex (Tamoxifen 10mg) is a selective estrogen receptor modulator (SERM) used for hormone receptor-positive breast cancer for decades.
How tamoxifen works:
Uses:
- Adjuvant treatment of hormone receptor-positive breast cancer
- Metastatic breast cancer
- Ductal carcinoma in situ (DCIS)
- Risk reduction in high-risk women
- Male breast cancer
Important tamoxifen risks:
- Blood clots (DVT, PE) - increased risk
- Stroke risk elevated
- Uterine cancer - increased risk (unusual bleeding needs investigation)
- Cataracts
- Menopausal symptoms (hot flashes)
- Vaginal discharge or bleeding
- Mood changes
Benefits typically outweigh risks for appropriate patients - discuss with oncologist.
6.What is Arimidex (Anastrozole) and how is it different from tamoxifen?
Arimidex (Anastrozole 1mg) is an aromatase inhibitor that works differently from tamoxifen.
Key differences from tamoxifen:
Choice depends on: menopausal status, medical history, risk factors, tolerability. Both proven effective in appropriate patients.
7.How do anti-androgens like Casodex treat prostate cancer?
Casodex (Bicalutamide 50mg), Calutide (Bicalutamide), and Eulexin (Flutamide 250mg) are anti-androgens used to treat prostate cancer.
How anti-androgens work:
Common uses:
- Advanced prostate cancer
- Combined androgen blockade (with GnRH agonist)
- Adjuvant therapy after surgery or radiation
- Sometimes as monotherapy in specific cases
- Metastatic prostate cancer
Common side effects:
- Gynecomastia (breast tissue growth in men)
- Breast tenderness
- Hot flashes
- Reduced libido
- Erectile dysfunction
- Fatigue
- Diarrhea
Important warnings:
- Liver toxicity - requires monitoring (flutamide especially)
- Rare: severe skin reactions
- Rare: interstitial lung disease
- Elevated liver enzymes
Regular monitoring essential - liver function tests, PSA levels, disease response evaluation.
8.What is Cytoxan (Cyclophosphamide) used for?
Cytoxan (Cyclophosphamide 50mg) is a widely-used alkylating chemotherapy agent.
How cyclophosphamide works:
Cancer uses:
- Breast cancer
- Non-Hodgkin lymphoma
- Hodgkin lymphoma
- Multiple myeloma
- Leukemia (various types)
- Ovarian cancer
- Certain sarcomas
- Preparation for bone marrow transplant
Non-cancer uses:
- Severe autoimmune conditions
- Lupus nephritis
- Vasculitis
Serious side effects:
- Bone marrow suppression - low blood counts, infection risk
- Hemorrhagic cystitis - bladder toxicity (drink extra fluids)
- Bladder cancer - long-term risk
- Infertility - often permanent
- Secondary malignancies
- Cardiotoxicity at high doses
- Nausea/vomiting, hair loss
- Increased infection risk
Requires specialist supervision and regular blood monitoring during treatment.
9.What is methotrexate and how is it used in cancer?
Methotrexate (2.5mg) is an antifolate chemotherapy agent with wide uses in cancer and autoimmune conditions.
How methotrexate works:
Cancer uses:
- Acute lymphoblastic leukemia (ALL) - especially in children
- Non-Hodgkin lymphoma
- Osteosarcoma
- Choriocarcinoma
- Head and neck cancers
- Breast cancer
- Bladder cancer
Non-cancer uses:
- Rheumatoid arthritis
- Severe psoriasis
- Psoriatic arthritis
- Some autoimmune diseases
Critical methotrexate warnings:
- Bone marrow suppression
- Liver toxicity - regular monitoring
- Lung toxicity (pneumonitis) - can be fatal
- Kidney toxicity - especially high doses
- Severe mucositis (mouth sores)
- TERATOGENIC - contraception essential for BOTH partners
- Deadly interactions with NSAIDs at high doses
- Requires folate supplementation (low dose) or leucovorin rescue (high dose)
Dosing critical - narrow therapeutic index requires precise dosing.
10.What is Hydrea (Hydroxyurea) used for?
Hydrea (Hydroxyurea 500mg) is a cytoreductive agent with multiple important uses in hematology and oncology.
How hydroxyurea works:
Cancer/hematologic uses:
- Chronic myeloid leukemia (CML) - historical treatment
- Polycythemia vera - blood cell reduction
- Essential thrombocythemia - platelet reduction
- Myeloproliferative disorders
- Head and neck cancer (with radiation)
Non-cancer use:
- Sickle cell disease - reduces pain crises
- Sickle cell disease in children
- Increases fetal hemoglobin
Common side effects:
- Bone marrow suppression
- Skin ulcers (especially legs)
- Nail changes
- Fever
- GI upset
- Hair thinning
Serious considerations:
- Rare secondary malignancies with long-term use
- Teratogenic - contraception essential
- Skin cancer risk - avoid excessive sun
- Regular blood monitoring essential
Widely used long-term especially in sickle cell disease and polycythemia vera.
11.What are the different types of cancer treatment?
Modern cancer treatment uses multiple modalities, often in combination, tailored to specific cancer type and patient.
Main treatment approaches:
Treatment goals:
- Curative - eliminate cancer completely
- Adjuvant - after primary treatment to prevent recurrence
- Neoadjuvant - before surgery to shrink tumor
- Palliative - control symptoms, extend life
- Maintenance - prevent recurrence long-term
Multidisciplinary approach: Cancer treatment involves teams of specialists - medical oncologists, surgical oncologists, radiation oncologists, pathologists, radiologists, nurses, and supportive care providers working together.
Individualization: Best treatment depends on cancer type, stage, molecular features, patient health, preferences, and other factors.
12.How is cancer diagnosed?
Cancer diagnosis is a multi-step process to confirm cancer, identify type, and determine extent.
Diagnostic steps:
1. Clinical evaluation:
- Detailed medical history
- Physical examination
- Review of symptoms
- Family history assessment
2. Laboratory tests:
- Complete blood count
- Comprehensive metabolic panel
- Tumor markers (CA-125, PSA, CEA, AFP, etc.)
- Specialized blood tests
3. Imaging studies:
- X-ray
- Ultrasound
- CT (computed tomography)
- MRI (magnetic resonance imaging)
- PET (positron emission tomography)
- Bone scans
- Mammography
4. Biopsy - definitive diagnosis:
- Needle biopsy
- Surgical biopsy
- Endoscopic biopsy
- Liquid biopsy (newer)
- Bone marrow biopsy (blood cancers)
5. Molecular/genetic testing:
- Tumor mutations analysis
- Hormone receptor testing (breast cancer)
- HER2 testing
- Immunohistochemistry
- Genomic profiling
Staging: Once diagnosed, staging determines cancer extent:
- TNM system (Tumor size, Nodes, Metastasis)
- Stages 0-IV
- Determines treatment approach and prognosis
Multidisciplinary review often used - pathologists, radiologists, oncologists discuss findings together.
13.How can cancer be prevented?
Approximately 30-50 percent of cancers are preventable through lifestyle modifications, vaccinations, and screening.
Primary prevention (reducing cancer development):
- Do NOT use tobacco - single most important prevention (30 percent of cancer deaths)
- Maintain healthy weight - obesity linked to 13+ cancers
- Be physically active - 150 minutes moderate exercise weekly
- Eat healthfully - fruits, vegetables, whole grains, lean proteins
- Limit alcohol - under 1 daily drink for women, 2 for men
- Protect from sun - avoid burns, use sunscreen, avoid tanning beds
- HPV vaccination - prevents cervical, throat, anal cancers
- Hepatitis B vaccination - prevents liver cancer
- Safe sex practices
- Occupational safety - protective equipment for hazardous exposures
- Avoid excessive radiation - only necessary medical imaging
Secondary prevention (early detection):
- Regular cancer screening as recommended
- Mammography (women)
- Cervical cancer screening (women)
- Colonoscopy (adults 45+)
- Lung cancer screening (heavy smokers)
- Prostate cancer screening (discuss risks/benefits)
- Skin examinations
High-risk individuals may benefit from:
- Enhanced screening
- Genetic counseling and testing
- Chemoprevention (e.g., tamoxifen for high breast cancer risk)
- Prophylactic surgery in selected cases
- Specialized surveillance
Combining prevention strategies maximizes cancer risk reduction.
14.When should I get screened for cancer?
Cancer screening can detect cancers before symptoms develop, when treatment is most effective. Recommendations vary by cancer type and individual risk.
Breast cancer screening (women):
- Mammography starting age 40 (some guidelines 45-50)
- Every 1-2 years
- Continue through 74 or older
- Earlier and more frequent for high-risk
Cervical cancer screening (women):
- Pap smear starting age 21
- Every 3 years initially
- Add HPV testing at 30
- Every 5 years with HPV testing
- Continue through age 65
Colorectal cancer screening (adults):
- Start age 45 (earlier if family history)
- Colonoscopy every 10 years
- OR annual stool tests
- OR sigmoidoscopy every 5 years
- Continue through age 75
Lung cancer screening (heavy smokers):
- Age 50-80
- 20+ pack-year smoking history
- Currently smoke or quit within 15 years
- Low-dose CT scan yearly
Prostate cancer screening (men):
- Discuss with doctor 55-69
- PSA and digital rectal exam
- Earlier for African American men or family history
Skin cancer screening:
- Regular self-examination
- Dermatologist checks for high-risk
Enhanced screening for:
- Family history of cancer
- Known genetic mutations
- Previous cancer diagnosis
- Certain exposures
- Certain medical conditions
Discuss with healthcare provider to develop personalized screening plan based on your risk factors.
15.What are the common side effects of chemotherapy?
Chemotherapy side effects vary by specific drugs used. Modern supportive care has dramatically improved tolerability.
Common side effects (most chemotherapy):
- Bone marrow suppression - low blood counts
- Nausea and vomiting - preventable with modern anti-emetics
- Fatigue
- Hair loss (with some drugs)
- Loss of appetite
- Mouth sores (mucositis)
- Increased infection risk
- Bruising and bleeding (low platelets)
- Anemia and fatigue (low red cells)
- Diarrhea or constipation
- Skin and nail changes
- Chemo brain - cognitive changes
Drug-specific side effects:
- Cyclophosphamide (Cytoxan): hemorrhagic cystitis, secondary cancers
- Methotrexate (Methotrexate): liver, lung, kidney toxicity
- Anthracyclines: cardiac damage
- Taxanes: peripheral neuropathy
- Platinum compounds: kidney damage, hearing loss
Long-term concerns:
- Fertility issues
- Secondary cancers
- Cardiac effects
- Cognitive effects
Modern supportive care:
- Effective anti-nausea medications
- Growth factors for blood counts
- Antibiotics for infection prevention
- Nutritional support
- Fertility preservation options
Report all symptoms to oncology team - many can be managed.
16.Can family history increase my cancer risk?
Yes, family history is a significant cancer risk factor. Approximately 5-10 percent of cancers are hereditary.
Hereditary cancer syndromes:
- BRCA1/BRCA2 mutations - breast, ovarian, prostate, pancreatic cancers
- Lynch syndrome - colorectal, endometrial, ovarian, other cancers
- Familial adenomatous polyposis (FAP) - colon cancer
- Li-Fraumeni syndrome - multiple cancer types
- Cowden syndrome - breast, thyroid, endometrial
- Multiple endocrine neoplasia (MEN)
- Von Hippel-Lindau disease
- Peutz-Jeghers syndrome
Signs suggesting hereditary syndrome:
- Multiple family members with same or related cancers
- Cancer diagnosed at young age (under 50)
- Rare cancers
- Multiple primary cancers in same person
- Cancer in both paired organs (both breasts, kidneys)
- Certain ethnic backgrounds (Ashkenazi Jewish for BRCA)
What to do if concerned:
- Discuss family history with primary care doctor
- Consider referral to genetic counselor
- Genetic testing when appropriate
- Enhanced screening if high-risk
- Consider risk-reduction strategies
Actions for high-risk individuals:
- Earlier and more frequent screening
- Additional screening tests
- Chemoprevention (e.g., tamoxifen for high-risk breast cancer)
- Prophylactic surgery in some cases
- Lifestyle modifications
- Enhanced surveillance
Family history matters but does not guarantee cancer development. Screening and prevention can significantly reduce risk.
17.What is cancer staging and why does it matter?
Cancer staging describes the extent of cancer in the body. It is essential for:
- Selecting appropriate treatment
- Predicting prognosis
- Comparing outcomes between patients
- Determining eligibility for clinical trials
- Communication between healthcare providers
TNM staging system (most common):
- T - Tumor size and extent
- N - Nodes (lymph node involvement)
- M - Metastasis (spread to distant sites)
Stage groupings:
- Stage 0 - In situ (not yet invasive)
- Stage I - Small, localized, no spread
- Stage II - Larger, may involve nearby lymph nodes
- Stage III - Larger, more lymph node involvement
- Stage IV - Metastatic (spread to distant organs)
How staging is determined:
- Physical examination
- Imaging studies (CT, MRI, PET, bone scans)
- Blood tests
- Biopsy results
- Sometimes surgical evaluation
- Molecular testing
Staging affects treatment:
- Early stage: often curable with local treatment (surgery/radiation)
- Intermediate stage: may need combined approaches
- Advanced stage: systemic therapy usually needed
- Metastatic: focus on control and quality of life
Prognosis by stage:
- Generally better with earlier stages
- Modern treatments have improved outcomes at all stages
- Stage is one factor - patient factors also matter
- Statistics are averages - individuals vary
Restaging may be done during treatment to assess response and modify approach.
18.Can cancer be cured?
Many cancers can be cured, especially when detected early. Modern treatments have dramatically improved outcomes for most cancer types.
Cancers with high cure rates:
- Early-stage breast cancer
- Early-stage prostate cancer
- Testicular cancer
- Hodgkin lymphoma
- Childhood leukemias
- Some thyroid cancers
- Early skin cancers (excluding melanoma)
- Cervical cancer (early stage)
- Early colorectal cancer
What "cured" means:
- No evidence of cancer after treatment
- Continued monitoring for recurrence
- 5-year cancer-free often used as benchmark
- Some cancers require longer monitoring
Cancers where "control" is more realistic:
- Metastatic solid tumors
- Some blood cancers
- Advanced disease
- Recurrent cancers
Living with cancer as chronic disease:
- Many previously fatal cancers now controllable
- Long-term treatment possible
- Quality of life maintained
- Focus on control and symptom management
Factors affecting cure likelihood:
- Cancer type
- Stage at diagnosis
- Response to treatment
- Patient overall health
- Access to specialized care
- Genetic and molecular features
- Availability of newer treatments
Hope for the future:
- Continued research advances
- New targeted therapies
- Immunotherapy revolution
- Personalized medicine
- Improved supportive care
- Rising survival rates across most cancers
Millions of cancer survivors live full productive lives after treatment.
19.What is palliative care and when is it appropriate?
Palliative care focuses on improving quality of life for patients with serious illness. It is appropriate at ANY stage of cancer, not just end-of-life care.
What palliative care addresses:
- Pain management
- Symptom control - nausea, fatigue, breathing difficulty
- Emotional support
- Nutritional support
- Communication needs
- Spiritual concerns
- Family support
- Care coordination
- Advanced care planning
When palliative care is appropriate:
- ANY stage of cancer
- From time of diagnosis
- Concurrent with cancer treatment
- During recovery
- For long-term survivors
- Advanced disease
- End-of-life care
Difference from hospice:
- Palliative care - any stage, alongside treatment
- Hospice - end-of-life, when treatment stopped
- Both focus on quality of life
- Hospice is subset of palliative care
Benefits of early palliative care:
- Better symptom control
- Improved quality of life
- Better mood
- Improved communication with providers
- May extend survival in some cancers
- Reduced hospital admissions
Palliative care team includes:
- Palliative medicine physicians
- Specialized nurses
- Social workers
- Chaplains
- Nutritionists
- Psychologists
- Pharmacists
Discussing palliative care with your oncology team can significantly improve your experience during cancer treatment.
20.Can cancer treatments be taken during pregnancy?
Most cancer treatments are DANGEROUS during pregnancy. Cancer during pregnancy requires highly specialized care.
Cancer medications and pregnancy:
CONTRAINDICATED (teratogenic - cause severe fetal harm):
- Methotrexate - severe teratogen
- Cyclophosphamide - especially first trimester
- Hydroxyurea
- Tamoxifen - avoid
- Aromatase inhibitors like Arimidex
- Most chemotherapy agents
- Radiation therapy (especially first trimester)
Options during pregnancy:
- Some cancers can be treated during pregnancy
- Certain chemotherapies safer in second/third trimester
- Surgery often possible
- Delayed treatment sometimes appropriate
- Individualized risk-benefit assessment
Contraception essential:
- During cancer treatment
- For 6-12 months after some treatments
- For BOTH partners with some medications
- Cancer medications damage sperm and eggs
Fertility preservation:
- Consider BEFORE treatment when possible
- Egg or embryo freezing
- Sperm banking
- Ovarian tissue preservation
- Ovarian suppression with GnRH agonists
- Fertility preservation clinics available
If pregnancy occurs during treatment:
- Urgent evaluation needed
- Multidisciplinary team essential
- Individualized management
- Both mother and fetal welfare considered
Pre-pregnancy counseling important for cancer survivors considering future pregnancy.
21.Are there natural remedies that treat cancer?
NO natural remedy can cure cancer. Rejecting evidence-based treatment for alternative-only approaches typically worsens outcomes significantly. Rely on qualified oncology care.
What science shows:
- No natural product proven to cure cancer
- Some may cause harm
- Some can interact with cancer medications
- Delay in treatment reduces cure chances
- Studies show worse outcomes with alternative-only approaches
Complementary approaches with some evidence:
- Exercise - improves outcomes in many cancers
- Mediterranean diet - overall health benefits
- Mind-body practices - yoga, meditation for symptom relief
- Acupuncture - may help nausea, pain
- Massage - symptom relief
- Music/art therapy - emotional wellbeing
Discuss with oncologist before using:
- Herbal supplements (many interact with cancer drugs)
- High-dose vitamins
- Detox products
- Cancer-related dietary changes
- Any alternative therapies
Dangerous interactions possible:
- St. Johns Wort with chemotherapy
- Antioxidants interfering with radiation
- Turmeric with tamoxifen
- Grapefruit with many drugs
Legitimate complementary care:
- Alongside conventional treatment
- Under oncologist supervision
- Evidence-based approaches
- Nutrition, exercise, mind-body
Fraudulent cancer treatments:
- Miracle cures
- Secret formulas
- Treatments only available in specific clinics
- Testimonials without scientific evidence
- Rejection of conventional medicine
Modern integrative oncology combines evidence-based conventional treatment with supportive complementary approaches.
22.When should I seek immediate medical attention during cancer treatment?
EMERGENCY - Call 911 or oncology emergency line for:
- Fever over 100.4F/38C during chemotherapy (neutropenic fever emergency)
- Severe unexplained bleeding
- Difficulty breathing
- Severe chest pain
- Sudden severe headache
- Signs of stroke (weakness, numbness, speech difficulty)
- Uncontrolled vomiting/diarrhea (dehydration risk)
- Severe pain not responding to prescribed medications
- Signs of blood clot (leg swelling, chest pain)
- Severe allergic reaction
- Loss of consciousness
- Seizures
Contact oncology team promptly for:
- Persistent nausea/vomiting
- Inability to eat or drink
- New or worsening pain
- Signs of infection (fever, chills, redness)
- Mouth sores affecting eating
- Bleeding gums, nosebleeds
- Excessive fatigue
- Skin rashes
- Persistent diarrhea or constipation
- Difficulty urinating
- Blood in urine or stool
- New neurological symptoms
- Depression or thoughts of self-harm
- Any concerning changes
Special concerns:
- Neutropenic patients - infections can be life-threatening
- Bone marrow suppression - bleeding, infection risks
- Central line complications - infection, clotting
- Chemotherapy reactions - allergic, cardiotoxic
Have on hand:
- Oncology team contact numbers (24/7)
- List of current medications
- Recent lab results
- Emergency medications
- Home thermometer
Never delay seeking help for concerning symptoms during cancer treatment - many complications treatable if caught early.
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