World Cancer Day: medical experts answer the most important questions

This article first appeared on RTL.de.

Surely everyone knows at least one person who has had cancer before or who may even have cancer. Around 18 million people are currently diagnosed with cancer every year – the WHO is now warning that this number is set to double in the coming years. By 2040, around 37 million people will be diagnosed with cancer.

You asked us your questions about the insidious disease on Facebook. RTL medical expert Dr. Christoph Specht gives you the answers here.

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Wouldn’t it be better to ask these questions to your oncologist?

Necessarily! Cancer is such an individual event. In addition, every patient is completely different, so that these special questions can only be clarified in a trusting conversation with the doctor treating you. I hope, however, that by answering general questions, I will on the one hand take away the fear associated with the topic and on the other hand contribute to clarification.

Thank God we have a very good health care system in Germany (despite all justified criticism) with the possibility of having cancer check-ups. This is a great advantage over most countries in the world. From my point of view, you should therefore take advantage of these offers – always in consultation with your doctor.

What role does alternative medicine play in cancer therapy?

Many cancer patients swear by alternative therapy approaches. A distinction must be made here between alternative medicine and complementary therapies. Alternative medicine would mean not using classic methods that have been scientifically proven to be effective and choosing other forms of therapy instead. I would advise against that. But there are many complementary medical therapies, especially in the treatment of cancer. These are not used instead of but in addition to the recognized classic forms of treatment (e.g. mistletoe therapy). Many doctors who look after cancer patients are at least not completely opposed to these forms of therapy, as long as therapies that have been scientifically proven to be effective are not rejected. The reason for the demand for complementary therapies is often the patient’s wish to contribute something to the therapy themselves, and this is also supported by many doctors.

If someone uses complementary medical methods (e.g. takes any substances), they should definitely inform the doctor treating them so that they can assess any side effects/interactions that may occur. Example: Not every hormone therapy for breast cancer is compatible with mistletoe therapy.

Decades of struggle or quick death?

In fact, the successes in cancer treatment in recent years have been enormous. For example, breast cancer was often a death sentence for many women. Today, however, many patients live for decades. With many other tumors, the cancer has become a chronic disease. This means that the cancer has not completely disappeared as a result of the therapy, but it can be kept in check to such an extent that those affected can lead a largely normal life for many years. Even in cases that are completely hopeless from a medical point of view (e.g. metastatic prostate cancer), there are always inexplicable courses. They’re very rare, but they exist. I have experienced it myself! A patient with multiple bone metastases wanted to spend his final months without therapy and as peacefully as possible. When he presented himself for a check-up nine months later, no bone metastases were detectable. The former patient survived many more years without symptoms. He eventually died of prostate cancer, but not until many years later.

fear of diagnosis

In fact, there is a hereditary or familial cluster of colorectal cancer. In particular, children of patients who have developed colon cancer before the age of 50 should in fact register earlier for colon cancer screening. It usually takes place from around the age of 50. However, if colorectal cancer runs in families, you should take advantage of the opportunity to detect it as early as possible.

With all due respect for your fear, however, you should realize that an examination can either take away this fear from you or – if a precancerous stage is actually discovered – it can be removed/treated at an early stage. The examination itself is much more benign than most people imagine. Almost all those examined are then completely amazed that the examination is already over because they didn’t even notice it.

Why is a cervical cancer screening only required every three years?

A test for cervical cancer only every three years instead of annually as before initially seems like a disadvantage. In fact, however, according to all scientific data, this new regulation is an advantage. Because: Not only the PAP test is now done every three years, but there is also a new test, namely the HPV test. Here, the cancer-causing viruses (human papilloma viruses) are detected. It has been found that the combination of both tests (i.e. PAP test and HPV test) makes screening even more effective and only needs to be carried out every three years. In fact, the new regulation has become better and not worse with the addition of the HPV test.

Is there a precaution for salivary nozzle cancer?

Unfortunately, no! Such a tumor cannot be seen in an early stage on ultrasound, nor is there a blood test. This is also why so few people with pancreatic cancer survive just a year alone. The cancer is usually discovered very late and has already set metastases. It is one of the most dangerous types of cancer. With colon cancer, the situation is completely different. With the colonoscopy, you can not only identify the preliminary stages of colon cancer, but also remove them in the same “wash-up”. In my opinion, this is the ideal form of prevention/early detection. Unfortunately, for many cancers, such as B. pancreatic cancer, ovarian cancer and prostate cancer, no good screening / screening.

Why do you have to go to radiation therapy even if the course is mild?

After all, tumors develop from individual cells, which only become the actual tumor after they have often divided, which can then also be detected or seen through examinations. Similar to chemotherapy, attempts are made to hit the tumor cells with radiation therapy, e.g. B. are left over after a tumor operation, but which cannot be made visible by any examination method. The purpose of radiation therapy used in this way is to destroy even individual tumor cells that have not yet formed a detectable “clump”.

Does Chronic Fatigue Go Away After Cancer?

Fatigue syndrome, i.e. chronic tiredness, is often associated with cancer or its therapy. It is most pronounced during therapy, but some patients complain about it later on. All in all, one has to say that the cancer itself, but also the therapy, puts a lot of strain on the body, which is often accompanied by a feeling of exhaustion. Thankfully, that feeling wears off over time. Even if the tiredness persists after the therapy, there is a justified hope that the feeling of one’s own strength will return.

What is the difference between chemotherapy and radiation therapy?

In chemotherapy, substances are administered that impede the process of cell division. The main aim is of course to hit the rapidly dividing tumor cells. Unfortunately, many chemotherapies also affect other body cells that are not tumor cells but also divide. This is the reason why some chemotherapy e.g. B. the hair falls out or problems with the mucous membranes arise, because these cells also divide, even if they are not tumor cells.

Radiation therapy uses ionizing radiation to destroy the tumor. No substances are administered here, but the tumor is treated with radiation.

There are forms of tumors in which both are used. In principle, one can say that chemotherapy is always used alone or in addition when the tumor is very widespread in the body, or when one wants to try to destroy metastases before they can be detected in an examination. Radiation therapy is often used when the tumor can be located in a specific location in the body.

Why is there no cure for cancer?

The same applies here: cancer is not just cancer. There will never be one cure for cancer, but different forms of therapy for different types of cancer. Example breast cancer: In the past, breast cancer was always treated in the same way. In the meantime, analyzes can be used to distinguish between a large number of types of breast cancer and depending on which form is present, the therapy also differs. It is also known today that some women with breast cancer do not benefit from chemotherapy at all. Others, on the other hand, very much. That depends entirely on the analysis of the tumor in question. But there will never be THE one remedy for all forms of cancer.

Why do people die from chemotherapy?

Chemotherapy can sometimes be very stressful. The first cycles often work very well, but in the course of therapy you have to resort to other substances in order to achieve an effect against the tumor. However, these drugs often have very strong side effects. In principle, chemotherapy can actually make the difference between dying and defeating the tumor, but the truth is that sometimes cancer cannot really be destroyed even with the toughest chemotherapy. Then the question actually arises as to whether one should really expect further chemotherapy from oneself or the patient. However, this is a very individual matter that has to be decided together with the patient, taking into account many factors – above all the patient’s will.

While one person may be willing to accept the severe limitations caused by chemotherapy for a short-term prolongation of life, this is out of the question for another. Ultimately, it is the patient’s will that counts.

Can cancer come back or am I safe now?

It all depends on what type of cancer you have. It is also important at what stage you were, e.g. B. daughter tumors (metastases) were present. In any case, you should attend the follow-up examinations planned for your type of cancer.

In Germany almost every second person gets cancer

In Germany, 65 percent of all people suffering from cancer survive for at least five years. This puts Germany well ahead internationally. But that also means “that 35 percent of all fellow citizens who develop cancer do not survive five years,” says the head of the German Cancer Research Center (DKFZ), Michael Baumann. According to the Robert Koch Institute (RKI), almost every second person in Germany suffers from cancer: the lifetime risk is 42.6 percent for women and 47.5 percent for men.