With approximately 230,000 deaths per year, cancer is the second most common cause of death in Germany (first place: cardiovascular disease). Due to the aging process, the number of new cancers occurring each year is increasing. Currently, the most common cancer for men is prostate cancer, followed by lung and colon cancer. For women, on the other hand, breast cancer is the most common cancer, followed by colorectal and lung cancer. This leaves most (affected) people wondering what cancer is and how it occurs. How cancer develops has not yet been clarified in detail. However, it is known that all types of cancer have in common a degenerate development of originally healthy body cells. They grow uncontrolled, into the surrounding tissue, and thus have a fatal functional restriction of the affected organs. These cancer cells can originate in almost any organ and migrate to other organs and lymph nodes via blood vessels or lymphatics. From there, they can develop into metastases, which also grow into healthy tissue just like the main tumor. In the case of cancer, therefore, survival depends on the timing of the cancer diagnosis, since cancer in its early stages has a good chance of cure and is usually not metastasized. Diagnostics play a key role in this: nowadays, cancer is diagnosed with the help of laboratory tests. To develop fast and targeted control examinations and therapy concepts, good laboratory equipment is, therefore, a mandatory requirement of every clinic. The faster and more accurately cancer is detected, the greater the chance of a successful cure. 

What actually is cancer?

 The body of every creature is made up of countless different cells, all of which have different tasks. An association of cells is called a tissue, which is a component of an organ. Each cell has a certain lifetime, therefore it can form new (and identical) cells by its division to maintain the organ function. If the body cells are healthy, their growth, development, and division as well as their death proceed without any problems. Cancer is a pathological change in the cells of the body. In this case, uncontrolled multiplication occurs due to rapid and defective division. So that they eventually form a lump (tumor). A tumor is defined as a hardening or swelling. They can be benign or malignant. The malignant tumor cells are often dangerous, as these cells can invade deeper and deeper into adjacent tissues and form metastases. The difference between benign and malignant tumors is no benign cells reach healthy tissue. Benign tumors include lipomas (fatty growths), moles, hemangiomas (vascular growths), and myomas (muscle cell growths).

How does cancer develop?

Taking a closer look at the development of cancer, there are various misregulations in the cell’s division. This disturbing process is called carcinogenesis, which originates in a cell whose genetic material is altered (by inheritance or independently acquired). This change (defect) is not reversed by misregulated repair mechanisms and is passed on accordingly during cell division. The older the human being gets, the more unreliable the repair system of the genetic material works. With further proliferation, these defective malignant cells can displace and damage the healthy cells. Among the best-known and most frequent causes, besides old age, are cigarette smoke, alcohol, sunlight, or radioactive radiation. Besides, there is a whole range of other causes of genetic changes, which would be too much to list here. However, it should be known that lifestyle such as diet, exercise, alcohol consumption, and smoking, in addition to external factors such as sunlight and pollutants, play a major role in the development of cancer. Accordingly, some of these risk factors can be influenced, while others cannot. It is estimated that about one-third of cancers could be prevented by avoiding risk factors such as smoking or alcohol. The remaining diseases are due to factors that cannot be influenced or are unknown.

What are the cancer classifications?

Cancer can be classified according to organ, cell of origin, characteristics of the tumor tissue (dignity), appearance type of the tumor (phenotype), diversity of cells within the tumor (grading), state of spread (staging), and metastasis of the main tumor. The classifications and tumor type are important for subsequent therapy and control examinations, as they allow more targeted planning and treatment. The internationally standardized classification is the TNM-classification (tumor, “nodus” or lymph nodes and metastases). These classifications are highly relevant for every type of cancer in every possible organ (from the brain to the urinary bladder) and vascular system. The classification has the advantage of standardizing cancer studies worldwide for research and prognostic purposes, thus enabling better treatment planning.

How can cancer be diagnosed?

Early diagnosis of cancer is extremely important because it significantly improves the prospects for treatment. Thus, the chances of recovery increase the earlier the cancer is detected. The first step in diagnosis is a detailed interview and physical examination of the patient. There are various examination methods for localizing the exact location of cancer. For example, blood tests, imaging procedures (ultrasound examination, X-ray, computer tomography, or MRI), and taking tissue samples (biopsy) provide important information about the organ, metastases, and corresponding functional impairment of the body. There are also so-called tumor markers in the blood, which are the body’s substances that proliferate in some cancers. These substances are either formed by the cancer cells themselves or are stimulated to form. These tumor markers are usually determined during control examinations after successful treatment to rule out a recurrence of cancer.

How can cancer be treated?

Since every cancer is different from person to person, it is essential to tailor treatment to the individual. Each patient has different requirements for certain therapies. Therefore, the general condition and concomitant diseases of the patient must be strictly considered beforehand. Thus, the optimal cancer treatment depends on the type of cancer as well as its spread. Treatment usually consists of three basic pillars: surgery, chemotherapy, and/or radiotherapy. In surgery, depending on the condition, cancer can be completely removed, chemotherapy stops the uncontrolled altered cell division by special cell toxins (cytostatics), and if necessary, radiation therapy can also be used to target cancer cells with electron radiation or X-rays. This procedure causes targeted damage to the cancer cells, which in turn causes cancer to decrease in size or stop growing. In addition to the three therapy options mentioned, other treatment options are used depending on the particular type of cancer, such as hormone therapy for hormone-dependent prostate or breast cancer, or antibody therapy (immune treatment), in the course of which special antibodies attack the cancer cells. When considering the therapy concept, a clear objective should also be defined, i.e. is the treatment completely curative, or does it only alleviate the symptoms and improve the quality of life for a certain period. Therefore, as a person affected or a close caregiver, one should not immediately think of a death sentence when cancer is diagnosed. If the serious disease is detected at an early stage, a cure is often possible. For this reason, it is advisable to attend cancer screening examinations regularly.