Introduction

More than one in three of us will develop cancer. There are now probably more than two million people in Britain who have had treatment for cancer, not far short of one in 25 of the population. The majority of these are long-term survivors. Attitudes are changing and for most people cancer is no longer the taboo subject that it used to be. People who have cancer now find it easier than in the past to talk about their diagnosis in the same way they would about most other illnesses. Being able to share their feelings also makes it easier for their family and friends to offer support.

 

You may already be aware that advances in medical science have had a major impact on the outlook for people with cancer. Of course the news is not all good, but the future for many cancer patients is now rather more hopeful than for many of those with other illnesses that traditionally have been much less feared. We are rapidly learning more about what exactly goes wrong when cells become cancerous and these discoveries are leading to exciting new treatments. In recent years some treatments for some patients have become progressively more customized, not infrequently based on the precise genetic make-up of their particular cancer. It seems highly likely that cancer management will become increasingly personalized over coming years.

 

Cancer has become increasingly common and this trend also seems likely to continue. The main reason for this is that people are living longer and cancer is to a large extent a disease of older people – two thirds of cancers occur in those aged over 65. It has been estimated that by 2020 almost one in two Britons dying from any cause will have been diagnosed with cancer at some time in their lives. It has also been estimated that more than four in ten cancers could be prevented by lifestyle changes such as not smoking, cutting back on alcohol, maintaining a healthy body weight and avoiding excessive sun exposure.

 

Although cancer has become more common, at the same time the chances of a cure have been steadily increasing. Over the past few decades the percentage of people surviving cancer has increased dramatically, and those people who can’t yet be cured are living longer and have a better quality of life. It is increasingly proving possible to provide long term cancer control for many patients, rather like managing raised blood pressure or diabetes.

 

Improvements have come about as a result of earlier diagnosis, better treatments, better supportive care and better organisation. Anyone who has cancer should now be able to expect ‘state of the art’ treatment as well as having access to wide-ranging support from both the NHS and many charitable and voluntary organisations.  There are also opportunities for patients and other lay people to become actively involved (‘user involvement’) in the planning and provision of cancer services, at both local and national levels. The pace of change is rapid and it has been necessary to revise Understanding Cancer very substantially since the first printed edition was published in 2000. Human papilloma virus (HPV) vaccine, offered to 12 and 13 year old girls since 2008, will substantially reduce the number of people developing cancer of the cervix and some other cancers. Drug treatments to prevent breast cancer in those at high risk of the disease have recently become routinely available.

 

Another improvement is the better knowledge that patients now have about their disease and treatment options. Studies have shown that a substantial majority of patients now want as much information as possible, whether the news is good or bad. Patients are becoming progressively better informed in several ways and in general they are less content than in the past to be passive partners in decision-making about their care. A very large amount of excellent written information is available from a variety of sources and much is now provided routinely in most hospitals providing care for people with cancer. But it is important to be aware that not all sources of information are reliable, particularly some of those to be found on the internet, and that even reliable information is not necessarily helpful or applicable and can on occasions cause unnecessary distress.

 

Understanding Cancer does not deal with the causes of cancer nor does it discuss particular cancers in detail but, where they and their treatments are mentioned, it concentrates on the more common types. Mention of anti-cancer or symptom controlling drugs is largely confined to those that patients might be expected to take in their own homes. When specific drugs are mentioned their non-proprietary ‘approved’ names are generally used rather than their manufacturers’ proprietary names. Much more detailed information is available from the authoritative sources listed under ‘Further help’ and, most importantly, from patients’ own doctors, nurses and other health care professionals.

 

This e-book aims merely to give a brief introduction to what is known about the nature of cancer, what can now be done for people who get it, and what treatment and care in general are likely to involve. Later sections assume that you have become familiar with some concepts and terms introduced earlier on. Thus, although much of the book may well be irrelevant to your own situation, you may nevertheless find it most useful if you read at least the first three chapters as an introduction. It is worth mentioning that the study of everything to do with cancer is known as oncology – ‘onkos’ is the Greek word for lump.

 

Although there is an enormous amount to celebrate in our battle against cancer very many patients still have unmet needs – physical, psychological, social and financial. Quite often these stem from a lack of understanding and a lack of awareness of what help is available. It is of particular concern that survival rates for patients with some types of cancer tend to be lower in poorer than in richer patients. There is evidence that less well-off people are in general less likely to take up screening, less likely to see their GP when they have early symptoms, and are less assertive about their treatment and overall care. Understanding Cancer has been written for anyone who has cancer, their families and friends and other interested lay people, in the hope that they will find it informative, helpful and easy to understand.

KEY POINTS

• Well over one in three of us will develop cancer and about two million people in Britain have had treatment for the disease

• Treatment and support for people with cancer is improving all the time