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‘Cancer’ is one of the leading causes of death worldwide, including in Thailand. When talking about cancer, many people often think of it as a fatal disease with no cure. However, in reality, cancer is a group of diverse diseases with different stages, and many cases can be completely cured.
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For metastatic cancer, although it cannot be completely cured, there are currently effective medications that improve the quality of life for patients receiving treatment and allow them to live longer than before.
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<h2>What is cancer? 
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Cancer is a disease caused by abnormal and uncontrolled cell division in the body. Cancer cells have the ability to spread to other organs. Cancer can occur in any organ of the body, such as the lungs, liver, breast, and colon. We name the type of cancer according to the organ of origin, even if the cancer has spread to other organs. For example, lung cancer that has spread to the liver or bones is still called lung cancer, not liver cancer or bone cancer.
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<h2>Why does cancer occur? 
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Cancer is caused by genetic abnormalities, specifically mutations in genes that control cell division and growth, turning those cells into cancer cells. Gene mutations occur normally in our bodies, but mostly in genes that are not critical, or sometimes our bodies can repair them, so no problems arise. When mutations occur in critical genes and are sufficient in number, they lead to cancer. These mutations may happen by chance, be triggered by other factors, or be inherited genetically from parents.
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<h2>What are the real factors causing cancer? 
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Many studies have tried to identify risk factors for cancer. However, we still cannot definitively state why one person develops cancer and another does not. Research data shows that some factors are associated with cancer development, such as smoking, alcohol consumption, aging, obesity, UV radiation, and certain infections like hepatitis B and C viruses and HPV. Regarding diet, there is no clear conclusion yet, although most data from animal studies suggest that meat cooked at high temperatures produces substances like HCAs and PAHs, which can cause cancer in experimental animals.
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<h2>Recommendations to stay away from cancer 
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Most recommendations focus on health care and hygienic living, such as:
<ul>
<li>Do not smoke and avoid environments with cigarette smoke</li>
<li>Avoid alcohol consumption</li>
<li>Eat a balanced diet with complete nutrients</li>
<li>Exercise regularly</li>
<li>Maintain a normal weight</li>
<li>Get vaccinated against cancers with available vaccines, such as the HPV vaccine, which prevents cervical cancer</li>
<li>Regularly check your health, especially for risks of various cancers</li>
</ul>
Nevertheless, many people who try to take good care of their health can still develop cancer. This raises the question&#8230; Is it possible to screen for cancer at an early stage to receive curative treatment and increase survival rates? The answer is ‘yes.’ This method is called cancer screening, which detects cancer at an early stage because early-stage cancer may have no symptoms. The earlier cancer is detected, the higher the chance of a complete cure.
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However, cancer screening recommendations are currently limited to certain common cancers, such as:
<ul>
<li>Breast cancer: Mammogram screening is recommended for women aged 40 and above</li>
<li>Cervical cancer: Screening is recommended for women aged 21 and above, using Pap test or HPV test</li>
<li>Colorectal cancer: Screening is recommended for people aged 45 and above, using colonoscopy and stool tests</li>
<li>Prostate cancer: Screening is recommended for men aged 55 and above, using PSA blood test</li>
<li>Other cancers with screening, such as liver and lung cancer, are currently recommended only for high-risk groups</li>
</ul>
Cancer screening is important and beneficial. If you fall within the recommended age group for any cancer screening, you should consult a doctor for more details without waiting for symptoms to appear.
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<h2>What symptoms might suggest cancer? 
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You may observe symptoms in various parts of your body, such as:
<ul>
<li>Changes in bowel or urinary habits, such as black stools or blood in urine</li>
<li>Difficulty swallowing or persistent indigestion and bloating</li>
<li>Hoarseness and chronic cough</li>
<li>Abnormal bleeding or chronic wounds</li>
<li>Changes in warts or moles on the body</li>
<li>Lumps in different parts of the body</li>
</ul>
In fact, these symptoms are not specific to cancer and may be caused by other conditions. Therefore, the best approach when experiencing abnormal symptoms is to see a doctor to find the true cause. If cancer is suspected, further tests such as biopsy will be performed to confirm the diagnosis and provide details about the cancer cell type. Imaging tests like CT scan and MRI are also used to determine the extent and stage of cancer.
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<h2>Cancer treatment methods 
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Cancer treatment depends on the type and stage of the disease and varies for each individual. The main treatments include surgery, radiation therapy, and chemotherapy. Nowadays, you may have heard more about targeted therapy and immunotherapy, which are scientific advancements that have revolutionized cancer treatment.
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Targeted therapy is medication that specifically acts on genes or proteins that help cancer cells divide and grow. These drugs inhibit cancer cells specifically and effectively. Currently, targeted therapy is used to treat several cancers, such as metastatic lung cancer with EGFR gene mutations, colorectal cancer, and breast cancer.
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Meanwhile, immunotherapy is another cancer treatment approach that stimulates the body&#8217;s immune system to destroy cancer cells. There are various methods, but in practice, immunotherapy usually refers to the use of antibodies called immune checkpoint inhibitors. These injectable drugs enhance the immune system&#8217;s function to attack cancer cells. Immunotherapy is currently used to treat many types of cancer.
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<h2>What to do when diagnosed with cancer? 
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First, stay calm and prepare to receive information. Patients should understand their disease, including the type of cancer, stage, treatment options, and treatment goals—whether aiming for a cure or for palliative care to control the disease. Once the treatment plan is known, patients should learn about the treatment and possible side effects to prepare themselves and their families.
Ultimately, is cancer as frightening as it seems? You are the judge. But remember, cancer is no longer a hopeless disease. Early detection can lead to a cure. If cancer has spread, it may not be curable, but effective treatments can improve quality of life and prolong survival. In the end, if the disease cannot be cured or controlled, palliative care can help relieve symptoms, reduce suffering, and allow patients to live as comfortably and happily as possible.
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<div style="text-align: right;">Dr. Tarawimon Techasathien</div>
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<div style="text-align: right;">Oncologist</div>
<div style="text-align: right;">Cancer Center (Cheevisuk) Phyathai 1 Hospital</div>
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Cancer treatment depends on the type and stage of the disease. The main treatment methods include surgery, radiation therapy, chemotherapy, and currently, there are also effective treatments using targeted therapy and immunotherapy.

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Is "cancer" really as scary as you think?

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