Cancer: Your essential guide

This guide provides a comprehensive overview of cancer, from its fundamental nature and development to personalized care planning, holistic support, and the management of treatment-related side effects and complications.

1. What is cancer?

Cancer is a condition characterised by the uncontrolled growth and multiplication of abnormal cells in the body. These cancerous cells can invade and destroy surrounding healthy tissue and organs. The NHS website indicates that approximately 1 in 2 people will develop some form of cancer in their lifetime.

Normally, cells in the body grow, divide, and die in a systematic manner to replace old or damaged cells. When this process malfunctions, abnormal or damaged cells can accumulate, forming masses of tissue called tumours.

• Benign (non-cancerous) tumours: These do not spread or invade nearby tissues. They generally do not grow back after removal, though they can become quite large and cause severe, even life-threatening, symptoms if they press on vital organs (e.g., benign brain tumours).
• Malignant (cancerous) tumours: These invade or penetrate nearby tissues and can spread to distant parts of the body, a process known as metastasis, forming new tumours. While most cancers form solid tumours, blood cancers like leukaemia typically do not.

Development of cancer

Cancer is primarily caused by changes (mutations) in genes that control cell function, growth, and division. Damage to DNA from harmful environmental substances (e.g., ultraviolet rays from the sun, tobacco smoke) or inherited genetic changes can also induce cancer. While the body usually disposes of cells with damaged DNA, this ability decreases with age, increasing cancer risk later in life. Each individual has a unique combination of genetic changes contributing to their cancer.

Spread of cancer (metastasis)

When cancer spreads from its original site to another part of the body, it is called metastatic cancer. The metastatic cancer will always retain the name and type of the primary cancer (e.g., lung cancer that spreads to the liver is metastatic lung cancer, not liver cancer). Under a microscope, metastatic cells typically resemble their original source. Treatment for metastatic cancer often aims to control its growth or alleviate symptoms, and in some cases, can prolong life.

2. Types of cancer

There are over 200 types of cancer, generally classified by their origin in the body and the type of tissue affected.

Carcinoma

The most common type, forming in the skin or tissues lining internal organs. Subtypes include:

• Adenocarcinoma: Forms in cells that produce fluids or mucus (e.g., most colon, breast, prostate cancers).
• Basal cell carcinoma: Begins in the lower base layer of the epidermis (outer layer of skin).
• Squamous cell carcinoma (sometimes called epidermoid carcinomas): Forms in squamous cells found below the outer surface of the skin and lining organs (e.g., stomach, lungs, intestines, bladder, kidneys).
• Transitional cell carcinoma: Forms in a type of tissue made of several layers of cells that can be smaller or larger; this tissue is located in the linings of the ureters, bladder, and part of the kidney. It may also be found in a few other organs.

Sarcoma

Forms in bones and soft tissue, including fat, muscle, blood vessels, lymph vessels, and fibrous tissue, such as tendons and ligaments. Osteosarcoma is the most common bone cancer, while common types of soft tissue sarcoma include leiomyosarcoma, Kaposi sarcoma, malignant fibrous histiocytoma, lymphosarcoma, and dermatofibrosarcoma protuberans.

Leukaemia

Cancers formed in the blood-forming tissue of the bone marrow. Instead of forming solid tumours, these cancers create a build-up of a large amount of abnormal white blood cells in the blood and bone marrow, forcing out normal blood cells. The lack of normal blood cells makes it more difficult for the body to oxygenate its tissues, control bleeding, or fight infections. The four common types of leukaemia are grouped on the speed of progression of the disease (acute and chronic) and on the type of blood cells the cancer originates in (lymphoblastic or myeloid).

Lymphoma

Begins in lymphocytes (T cells or B cells)—white blood cells that are part of the immune system and fight disease. Lymphoma occurs when abnormal lymphocytes accumulate in lymph nodes and lymph vessels and in other organs of the body. Two main types of lymphoma are:

Hodgkin lymphoma

Abnormal lymphocytes called Reed-Sternberg cells form from B cells.

Non-Hodgkin lymphoma

A large group of cancers starting in lymphocytes. Grows either quickly or slowly and begins to form from B cells or T cells.

Multiple Myeloma

Forms in plasma cells, a type of immune cell. Myeloma cells (abnormal plasma cells) pile up in the bone marrow and create tumours in bones and throughout the whole body. This cancer is also called plasma cell myeloma and Kahler disease.

Melanoma

Originates in cells that become melanocytes. These cells are specialised in making melanin (the pigment giving skin its colour). Apart from the skin, they can also form in other pigmented tissues, such as the eye.

Brain and spinal cord tumours

These tumours get their name according to the type of cells where they originated and where the tumour primarily occurred in the central nervous system. An example is Astrocytoma, which begins in brain cells called astrocytes, aiding to keep nerve cells healthy. Can be cancerous (malignant) or non-cancerous (benign).

Germ cell tumours

A type of tumour that commences in the cells producing sperm or eggs. They can form anywhere in the body and can be either cancerous or non-cancerous.

Neuroendocrine tumours

Originate from cells releasing hormones into the blood in response to a signal from the nervous system. Neuroendocrine tumours producing an exceeding amount of hormones can be the cause of different symptoms and can be cancerous or non-cancerous.

Carcinoid tumours

A slow-growing type of neuroendocrine tumour, typically found in the gastrointestinal system, mostly rectum and small intestine. Can spread to the liver or other places of the body and other locations in the body. May excrete substances such as prostaglandins or serotonin, causing carcinoid syndrome.

3. Factors increasing cancer risk

• Age – Cancer may take decades to advance; hence many people are diagnosed with cancer at 65 and above. Nevertheless, cancer can be diagnosed at any age.
• Habits – Smoking and drinking alcohol (for women more than one alcoholic drink per day, for men two drinks and above), prolonged exposure to the sun, obesity, and unsafe sex can all contribute to cancer.
• Family history – A small amount of cancers are due to inherited conditions. Remember that having an inherited genetic mutation does not mean you will get cancer.
• Health conditions – Consult your doctor about risks regarding any chronic health conditions as they may contribute to an increased risk of developing some cancers.
• Environment – Even if you are not a smoker, you may inhale second-hand smoke while living with someone who smokes. Chemicals such as asbestos and benzene that may occur in your home or workplace are also connected with a raised risk of cancer.

4. Cancer care plans

A cancer care plan is a collaborative programme that is devised by you along with your doctor and nurses. It serves as a detailed roadmap for treatment, recovery, and beyond, incorporating your wishes and personal needs, including how you want to be cared for if you become too ill to make later decisions yourself.

Importance of a cancer care plan

• Ensures you get the best possible healthcare as you move forward with your treatment.
• Provides tools and resources you have been given to move forward positively and encourages a successful transition back into normal life after cancer treatment.
• Guarantees that your providers and care team will continue to be available to provide advice, resources, and follow-up care after your treatment finishes.
• Facilitates a comprehensive and multidisciplinary care team (e.g., surgical, medical, and radiation oncologists, pathologists, radiologists, and others) who combine their expertise for your treatment plan.

What your cancer care plan may include

• Diagnosis and stage of cancer
• Details about treatment, including the type of treatment (e.g., surgery, chemotherapy, radiation, transplantation, hormone therapy, or other), and beginning and ending dates
• Possible late and long-term effects of treatment and their symptoms
• Wellness recommendations, including a healthy diet, exercise, and smoking cessation information
• Emotional effects and support services available
• Contact information for your care team
• Recommended cancer screenings and other testing and follow-up appointments

5. Holistic care for cancer

Holistic care for cancer integrates traditional medicine with complementary therapies, aiming to alleviate treatment side effects, manage symptoms, and improve overall well-being. It is crucial to understand that holistic care is not a cancer treatment and should never substitute mainstream medical approaches.

Holistic Needs Assessment (HNA)

An HNA is a conversation with your healthcare team where you would answer questions and discuss your needs and concerns impacted by cancer. This assessment is “holistic” because it covers all aspects of your life—physical, practical, emotional, spiritual, and financial. Following the assessment, you agree on a suitable plan for your care. You can discuss having an HNA with your GP or healthcare team if not presented with the option.

Benefits of having an HNA

• Identification of your concerns
• Support to manage your matters of concern, such as emotional worries
• Offer of referral to services providing further support (e.g., counselling, help with finances, physiotherapy)
• Highlighting to your healthcare team what’s important to you
• A helpful tool to plan ahead

Types of holistic care (complementary therapies)

These therapies are used to improve physical and emotional health, to reduce cancer symptoms, or the side effects of cancer treatments. Main types include:

• Acupuncture
• Aromatherapy
• Reflexology or other touch therapies, massage
• Meditation and hypnotherapy (also called mind-body therapies)
• Therapies using diet or supplements
• Therapies utilising herbs and plants
• Talking and counselling groups

Advantages of complementary therapies

• Help manage stress and improve mood due to their relaxing elements.
• May foster a strong relationship with a therapist, providing uplifting support and help coping with difficult feelings.
• Group sessions can be a good way to meet people with similar experiences in a supportive environment.
• Typically focus on relaxation and reducing stress after treatment, calming emotions, improving general health and well-being, and alleviating anxiety.
• Specific therapies, like acupuncture, have shown to control certain cancer symptoms and treatment side effects.
• Provide a sense of control to cancer patients, fostering a significant partnership with a therapist for treatment and recovery.

Safety of Complementary Therapies

Even though many complementary therapies are safe to use in combination with conventional treatments, always talk to your doctor before beginning any complementary therapies you’re planning to use. This is especially important if you are currently undergoing a course of cancer treatment.

6. Managing treatment complications and side effects

Cancer and its treatments can lead to various complications and side effects, requiring proactive management to maintain quality of life.

• Pain – Can be caused either by treatment or by cancer, yet not all cancer causes pain. Cancer-related pain can be managed by your healthcare team.
• Fatigue – Often temporary and common during chemotherapy or radiation therapy treatments, and generally manageable.
• Breathing difficulties – Treatments are available for shortness of breath caused by cancer or its therapies.
• Nausea – Your doctor may be able to predict if your treatment would be likely to cause nausea and prescribe medications or alternative treatments to prevent or decrease nausea.
• Diarrhoea and constipation – Both cancer and its treatment may disturb your bowels causing diarrhoea and constipation.
• Weight loss – Cancer deprives healthy cells of nutrients, causing weight loss independently of how many calories are consumed. In many cases, artificial nutrition via tubes into the stomach or vein does not reverse weight loss.
• Chemical imbalance – Cancer can cause chemical changes in your body, leading to severe complications with symptoms like confusion, frequent urination, extreme thirst, and constipation.
• Nervous system issues – Pressing on adjoining nerves, cancer can cause pain and loss of function of a part of your body. Headaches and stroke-like signs and symptoms such as one-sided weakness may appear in cancers involving the brain.
• Immune reactions (Paraneoplastic Syndrome) – In particular situations, the body’s immune system may start attacking healthy cells. These unique reactions can lead to symptoms, such as walking difficulties and seizures.
• Cancer spread (metastasis)  – Spread of cancer to other places in the body depends on the type of cancer.
• Relapse of cancer – Some cancers are more prone to returning than others. Consult your doctor about the best approach to reducing your risk of cancer recurrence. Your doctor may design a follow-up care plan for you after treatment, such as periodic scans and exams in the months or years after your treatment.

Specific Side Effects: Oral and Cardiac Health

A. Effects of Cancer Treatment on the Mouth

Chemotherapy, immunotherapy, and some biological therapy drugs used for treating cancer may create mouth problems.

• Infection: Symptoms of infection can be a temperature of 37.5 degrees Celsius and above, extremely sore mouth, white coating on your tongue, and large deep ulcers in your mouth. Contact your doctor immediately if you notice any of these symptoms.
• Soreness and mouth ulcers (Oral Mucositis): Oral mucositis causes the mouth’s lining to become very sore and can even be the cause of mouth ulcers. This can happen after your treatment (5-10 days) and gradually improves after the end of your treatment (3-4 weeks). There is a greater risk of oral mucositis for older people. Once oral mucositis develops, a treatment for relieving symptoms and decreasing acuteness is available.
• Changes in taste: Some cancer treatments may give you a metallic taste in your mouth and make food taste different. Your taste should return to normal once treatment is complete, though it can be up to a few weeks. To better cope with taste changes, choose foods with distinctive flavour, pungent spices, and herbs. Sauces are another option to intensify the flavour of meat and fish (e.g., curry, chilli, sweet and sour). Try eating your food cold, as some people find it tastes better that way. Swapping classic metal cutlery for wooden or plastic may also help decrease metallic taste. For beverages, fizzy drinks with a sharper flavour, such as ginger or lemon, may be more refreshing.
• Dry mouth: Cancer drugs and treatments can make your mouth dry. For example, some people suffer with perpetually dry mouth after undergoing radiotherapy on their head. Insufficient food and drink intake due to not feeling well can also cause dry mouth. Ways to moisten your mouth can be eating meals with gravies and sauces to enable easier swallowing. Take regular sips of water with your meal to aid with chewing and swallowing, and drink as much as possible throughout the day. Chew sugar-free chewing gum or keep your mouth fresh by sucking on ice. Fruit and vegetable juices are a good choice; just make sure to avoid anything acidic if your mouth is sore. Discuss options of saliva-stimulating medications or concerns about dry mouth with your doctor.
• Dry lips: Yellow paraffin or a regular lip balm is advised to use to moisten dry lips. However, if you are on oxygen or going through radiotherapy to your head or neck, consult your doctor or nurse first before applying any products.
• Bad breath: Coupled with dry mouth, your breath may be badly affected. This can be solved with good mouth care. Useful tips include: regular teeth brushing, daily flossing, use of mouthwash after brushing teeth or eating, sugar-free gum or mints, regular dental check-ups, and drinking plenty of water.
• Preventing mouth sores and infection: Check your mouth daily for changes and let your doctor or nurse know of any issues. Follow your mouth routine strictly (day, night, and after eating). To stop bacteria from flourishing, use a salt water rinse (1 teaspoon of salt in 1 pint of cold or warm water) after each meal, preparing a fresh rinse daily. Avoid consuming sharp foods (e.g., crisps, crackers). Alcohol, especially pure spirits, can irritate the lining of your mouth. According to Cancer Research UK, sucking on crushed ice during chemotherapy sessions is helpful in reducing blood flow to the mouth, but discuss this option with your doctor prior to trying.
• Providing oral care to someone else: If you need to provide mouth care for someone too weak or in and out of sleep, regular oral care and moistening the mouth are very important for their comfort. Encourage them to drink or tap their mouth with a sponge stick. Mouth care should be done with products recommended by the healthcare team, ideally when the person’s head and shoulders are elevated. If elevation isn’t possible, ensure no fluids accumulate. Seek advice from healthcare professionals for help and recommendations to ensure a comfortable experience for both of you.

B. Effects of Cancer Treatment on the Heart

Although uncommon, some cancer treatments can cause heart problems that are either short-term or long-term. These are serious side effects that can affect treatment, lower a person’s quality of life, and, rarely, cause death.

• Symptoms: Shortness of breath, light-headedness or dizziness, discomfort or pain in the chest, fatigue, swollen hands and/or feet, nausea.
• Risk factors: Chemotherapy, chest radiation, immunotherapy, other targeted therapies, pre-existing heart disease, diabetes, high blood pressure.
• Causes:
  • Chemotherapy: Can be highly effective in destroying tumours and reducing cancer risk, but high doses can potentially cause heart failure. This means the heart muscle is no longer as efficient as it should be at pumping blood around the body. It can weaken the heart muscle from a build-up of calcium and other chemical reactions that release harmful free radicals.
  • Radiation therapy: Radiation used in cancer treatment can cause problems in the heart and vascular (circulation) system. This can prompt a thickening of the blood vessels and heart valves, inflammation, and artery blockages.
• How heart problems are diagnosed:
  • Physical exam: The doctor listens to your heartbeat looking for unusual sounds or changes, indicating if further tests are needed.
  • Echocardiogram (Echo): Uses sound waves and an electronic sensor to look at the heart’s structure and function.
  • Blood tests: Check for indicators of heart failure or another illness.
  • Chest X-ray: Can show changes or problems in the lungs that stem from heart problems (e.g., fluid in the lungs from congestive heart failure).
  • Cardiac magnetic resonance imaging (MRI): Takes images of the heart and is used to diagnose a wide range of heart problems.
  • Other tests may include an angiogram, electrocardiogram (ECG), and multigated acquisition (MUGA) scan.
• Getting support: The Macmillan Support Line offers confidential support to people living with cancer and their loved ones. Visit their resources for more information about heart problems related to cancer treatment and how Macmillan can support you.

7. Reducing Cancer Risk

Several lifestyle choices and preventative measures can help reduce the risk of developing cancer:

• Quit smoking/avoid starting: Significantly reduces the risk of various cancers, not just lung cancer.
• Sun protection: Stay in the shade, apply sunscreen, wear protective clothing, and limit sun exposure.
• Healthy diet: Choose non-processed, nutrient-rich foods, such as fresh fruit and vegetables, whole grains, and lean protein.
• Regular exercise: Healthcare professionals advise at least 30 minutes of exercise most days of the week; tailor exercise guidance to your capabilities.
• Maintain healthy weight: Keep your weight within advised limits, as obesity is known to increase the risk of cancer.
• Limit/avoid alcohol: Reduce or completely abstain from drinking alcohol.
• Immunisation: Ask your doctor about immunisation against viruses, such as hepatitis B and HPV, which can heighten the risk of cancer.

8.  Hearth health

Some cancer treatments, despite their effectiveness, can uncommonly lead to serious heart problems, potentially affecting quality of life and, in rare cases, proving fatal. Watch out for symptoms like shortness of breath, light-headedness or dizziness, chest discomfort or pain, fatigue, swollen hands and/or feet, and nausea. Key risk factors include certain chemotherapy drugs (which can weaken the heart muscle and lead to heart failure) and radiotherapy to the chest (which can thicken blood vessels and heart valves). Other contributing factors can be immunotherapy, other targeted therapies, existing heart disease, diabetes, and high blood pressure. Doctors diagnose these issues through physical examinations, echocardiograms (Echo), blood tests, chest X-rays, cardiac Magnetic Resonance Imaging (MRI), and other specialist investigations. For support and further information, the Macmillan Support Line is available.

Research and initiatives

Cervical Cancer Elimination Initiative

The Global Breast Cancer Initiative

The Global Initiative for Childhood Cancer

Clinical Trial Research – Cancer Research UK

How can Cavendish Homecare help?

At Cavendish Homecare, we are experts in providing cancer homecare for clients who want to remain in their own homes. When it comes to your health and well-being, choosing the right homecare package is of utmost importance and navigating this process can be overwhelming. With Cavendish Homecare by your side, you’ll have the support you need to remain safely at home while enjoying elevated health and wellbeing.

If you would like to enquire about our homecare services, contact us on, 020 3008 5210 or email us at info@cavendishhomecare.com.

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