4The Daily Tar Heel Wednesday, October 20. 1932
Cancer:
o
lejearea meases u
mps researcners
Seexaminations and reg
three types of cancer prevalent among
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By SUSAN HUDSON
Feature Editor
ancer kills more people between the im
ages of 15 and 34 than any other disease.
Only accidents kill more young women
and homicides and accidents more young -
men. : . - ' ; )::- :
Although a cure for this dread disease -has
not yet been discovered, some cancers ?
that affect young people can be detected
early enough to be treated successfully.
Unfortunately, most young people -neglect
important self-examinations and
regular medical check-ups, disregard early
warning signals and remain ignorant of
how ' their' environment, lifestyle and
background can affect their chances of
having cancer and thus needlessly fall vic
tim to the disease.
Three types of cancer that pften affect
young people cervical cancer (women), ;
testicular cancer (men) and breast cancer
(women) can usually be treated suc
cessfully if detected early enough.
Cervical cancer
Cancer of the cervix, the lower' narrow
end of the uterus that projects into the up
per vagina, is particularly widespread
among college-age women.
"We are alerting young women of col
lege age that they may be at high risk,",
said Ehana McGrath,' director of the
Cancer Education and Communication
program at Duke University,
An estimated 7,100 women will die from
cervical cancer this year, most of them
needlessly.
"Cervical cancer is a highly curable
disease," McGrath said. "If it is spotted
early, the chances are very good that it can
be cured." ,
The reasons that college age , women
have a higher risk for cervical cancer are
twofold: they are at the age when both sex
ual activity and the number of sex partners :
increase. Virgins almost never develop
cancer of the cervix.
The key to early detection of cervical
.cancer is a simple, painless, uvoffice pro
cedure called the Pap test. For this test the
doctor scrapes a tissue sample from the
rim of the cervix that is then examined for
- the presence of abnormal cells.
"Doctors often see abnormalities during
the Pap test, but it's usually the result of
women using the Pill," McGrath said: If
the doctor does find something unusual,
he will usually ask the woman to come
back in three months and. repeat the Pap
test. , ' ' . '. .
Another examination a doctor may per
form is called a colposcopy. Looking
through a colposcope, the doctor examines
the cervix for abnormalities by painting the
areas with iodine, which reveals the
suspicious cells. The doctor can then
scrape some of the tissue put for a biopsy.
Abnormalities found during these tests
could indicate one of three conditions,:
dysplasia, carcinoma in situ or invasive
cancer. . v .:;'",';'v.'C
Dysplasia, or the presence of abnormal
cells, may. be classified as mild, moderate
or severe. It is the condition that affects
more women in their late teens or early
20s. If untreated, dysplasia may go
through a series of changes and develop in
to cancer, ; w-v
Carcinoma in situ (literally, "where it
begins"), also known as very early cancer,
sometimes occurs in women in their 20s.
This cancer affects only the top layers of
cells in the cervix but if left untreated, it
may progress to .invasive. -cancer; :':' '
The most dangerous condition of the
three is invasive cancer of the cervix. One.
sympton of invasive cancer is abnormal
" bleeding from the vagina, but this condi
tion may have no symptoms at all, in
cluding pain. If : unchecked, . . invasive
cancer of the cervix may spread to other
parts of the, body. C :
Treatment for dysplasia and very early
cancer is usually minor, such as
cryosurgery -(freezing) ; or, cauterization
(burning) of the abriorrnal cells; Since the
cervix contains no pain-sensitive : nerve
fibers, 1 these proceduf es; are only slightly
uncomfortable. 0rCr-''--, V '
The treatment of more advanced cancer
can be very serious,' possibly involving the
surgical removal of the cervix and uterus
a hysterectomy. This decision should be
carefully considered beforehand since after
having this operation the woman can no
longer bear children.
. ; Testicular cancer
Testicular cancer, the one that strikes
young men more often than older men,
: has the highest incidence rate and fifth
highest mortality rate for cancers in young
: men. v. ,
In this cancer, malignant tumors grow
in the testes and usually spread to other
organs unless medically treated. In 88 per
cent of testicular cancer cases, the disease
: has spread throughout the body by the
s time it is actually diagnosed by a physician.
Since the testicular cancer tumors are
often painless, it is important that young
men regularly : examine their testes for
slight enlargement or a change in con
sistency. This examination takes only three
, minutes and should be done once a
month. ' - v;v;--;'.
"Most men don't know about doing
; testicular examinations," McGrath said.
; 'Now we're putting the same emphasis on
testicular examinations for men- as on
breast examinations, for women."
There are two basic steps for testicular
self-examination. The first step is visual
examination of the testes for abnormal
changes, such as swelling of the scrotal sac.
Then the testes are physically examined
as the man feels for lumps or swelling in
each testicle. Men should not confuse the
epididymus, the rope-like sperm collecting
structure on the top and back of each testi
cle, with an abnormal lump. . ;
Although not all tumors are cancerous,
young men should report any abnormal
lumps to their physicians. Other symptoms
of testicular cancer include breast enlarge
ment, a dull ache in the scrotum, lower ab-.
domen and groin, or a feeling of heaviness
in these areas. . ;
If a tumor is diagnosed as malignant,
the cancerous testicle is usually removed.
Removal of one testicle does not render
the young man impotent or infertile and
an artificial, gel-filled testicle made of
medical plastic may be inserted during the
operation. Radiation and chemotherapy
(taking a combination of anti-cancer
drugs) are also effective treatments for
testicular cancer.
Breast cancer
; Breast cancer is the leading cause of
cancer death for females between the ages
of 15 and 34. Last year breast cancer killed
37,000 women.
; Cancer of the breast can be identified by
unusual lumps, puckering, redness, irrita
tion, pain or tenderness of the breast. A
discharge from or an inversion of the nip
ple is sometimes a warning signal.
Although eight out of 10 breast lumps
are benign, it is important for a woman to
examine her breasts at least once a month.
Women locate 90 percent of all breast
lumps themselves, and if the lump is
WM DIAGNOSIS
cancerous, early detection can lead to ar
rest of the cancer. .
The best time to perform a breast self
examination is two to three days after the
end of the menstrual period. The first step
is checking in a mirror for external changes
in the breasts.
By first clasping her hands behind her
head and then placing her hands firmly on
her hips, a woman can check for a change
in the shape or contour of her breasts. .
In the shower, a woman can examine
her breasts for lumps by pressing her
fingers over them in small circular mo
tions. Women should also gently squeeze
each nipple to check for a discharge.
If any abnormalities are detected, the
woman should contact a physician im
mediately, through mammography (breast
x-rays) and other sophisticated examina
tions, the physician will be able to deter
mine if the abnormality is really cancer.
In the event that cancer is diagnosed,
surgical procedures ranging from a simple
mastectomy (removal of the breast only)
to radical mastectomy (removal of the
breast, underlying muscles and auxiliary
lymph nodes) may be prescribed. Radia
tion therapy, hormonal therapy and
chemotherapy are additional treatments
for breast cancer.
Prevention is an often overlooked way
.of treating cancer. Sometimes just curbing .
excesses in lifestyle can decrease one's
chances of getting some kinds of cancer.
For example, eating less and shedding ex
tra pounds could help a woman avoid
breast cancer since that disease is more
predominant in obese women.
"You can choose the lifestyle that you
want," McGrath said. "But you can't
choose the consequences of that lifestyle."
dancer Genter 11
bHoicis UNC's research
Reputation
By MELISSA MOORE
Staff Writer..
dividual cancer research is by nature a slow
process. But at the Cancer Research Center at
UNC's School of Medicine, faculty members from
various backgrounds all work as a group to dis
cover the causes of cancer. :
"The unit itself is stronger than any individual,"
said Dr. J.W. Pledger, a molecular biologist in the
program. -
"Basic and clinical research on various aspects
of cancer has been performed by individual faculty
(members) at the schools of Medicine and Public
Health for over 30 years," said Dr; Shelley Earp;
associate to the director of the center., :
But because of changes in the complexity of :
cancer research, a faculty advisory committee
planned and applied , for a grant to establish a
Cancer Center in 1974, Earp said. The .Cancer
Center was subsequently founded in 1975 with a
National Cancer Institute grant. ;
"Since that time the Cancer Research Center
has encouraged; interactions between, different
departments, provided specialized research facili-
"v... "
- '
DTHJeH Neuville
Dr. J.W. Pledger conducting rcssarch at tha Cancer Research Center
... The Center searches for a prevention to the disease
ties, promoted symposia and seminars, provided
efficient, economical ways to make supplies and
equipment available to faculty, and co-recruited
and supported promising new faculty to promote
interdisciplinary research," Earp said.
The National Cancer Institute recently renewed
the center's grant for the third time. Individual
researchers obtain their own funding for projects
from various agencies of the National Institute of
Health and private foundations such as the
American Cancer Society and the Leukemia Socie
ty of America, Earp said.
- The initial aim of the center was to develop six
basic science research programs: tumor immu
nology, tumor virology, cancer epidemiology,
chemical carcinogenesis, cancer cell biology and
drug development, Earp said. '
In the last three years, the center has begun to
develop other areas of study cancer control and
clinical research. "The cancer control program at
tempts to develop new strategies for cancer preven
tion and to promote the utilization of preventive
methods known to be effective," Earp said. Inves
tigators in the clinical and basic research programs
"collaborate in an attempt to determine which
aspects of basic research are clinically applicable,"
he said. ... ; '
Each of the six areas of basic research studies a
different aspect of cancer. !
. . The cancer cell biology program seeks to under
stand normal cell growth and how control of this
growth is lost when cancer develops, Pledger said.
When cancer is present, cells which are going
through the normal growth cycle do not stop
growing. 'Although the body would normally tell
the cells to stop proliferating if the body does not
need any more, when cancer is present, cells do not
stop growing. Next, a tumor forms and cells can
infiltrate other parts of the body. In addition,
tumors can arise from other tumors. The re
.searchers in cancer cell biology want to understand
why this process happens. ,
Dr. Stephen Haskill of the tumor immunology
program said, "We're doing experimental studies,
taking normal blood macrophages (large cells
which consume foreign material and debris), trying
to see what makes them become killer cells, what
agents activate them so they can destroy tumor
cells and how you could use them to treat cancer."
It is possible to educate cells to kill cancer cells or
to stimulate cancer cells to grow better, he said.
Dr. Yung-Chi Cheng of the drug development
program said that program focuses not only on the
discovery of new drugs but also on improvement
of old drugs. Few compounds look promising for
development of new drugs, and it is too early to
say if they can be used in the clinic, he said.
However, a new protocol (regimen) developed
in clinical research is "one of the hottest protocols
used in the country for leukemia," Cheng said.
"We've been helping them improve that protocol,
making it even better." Collaboration between re
searchers in different disciplines is very important,
he said.
Cheng also said, "We hope to develop a proto
col for treatment which will be more effective than
current treatment for brain tumors."
Dr. Ron Swanstrom of the tumor virplogy pro
gram saidt "Viruses give us a system to study
rapidly developing cancers. Some types of tumors
are probably caused by viruses, though the number
is small." He said many characteristics of a cell
change when a cell is transformed. "Now that we
have an idea of the primary change, we want to
. look at other changes."
The key question: How does a virus cause cell
transformation? "We know that cells are growing
inappropriately but don't know what controls ap
propriate growth," Swanstrom said. "We don't
know enough about the normal cell. I think we're
getting close to some of those answers."
Researchers in tumor virology study cells grown
in cultures. One reason is the expense of working
with animals. But at some point they must go back
to animal study to see if they are right, Swanstrom
said. '
Dr. David Kaufman of the chemical carcino
genesis program said, "Cancer happens because
things change slowly over a long period of time.
It's that that we're trying to reproduce (in the
laboratory)."
"We're trying to develop methods to look at
evolution of malignancies," he said. Researchers
in chemical carcinogenesis use radioactive material
, i . i ll .1
in laooraiory wont oecause u aiiows mem iu sec
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wnai is nappening lmmeuiqieiy.
Dr. Barbara Hulka of the cancer epidemiology
program said, "We're interested in disease causa
tion." Unlike the other basic research programs,
which do laboratory work, epidemiology work is
with groups of people. "We work with statisticians
with quantitative numerical data," Hulka said.
Epidemiologists' research goes even more slowly
than in other basic research programs. They must
gather information about hundreds jbf subjects
and manipulate all the information to get it on a
computer before they can look at it, Hulka said.
Studies can last for years.
"Of course we all live in the era of having to ap
ply for funding," she said. This takes even more
time.
Hulka said prevention of cancer is a better route
to take than searching for a cure. Similarly, Kauf
man said, "In the long run, it is better to prevent
the disease from happening than to try to treat it.
For ,the most part, that's the objective of our ap
proach. We look for a means to recognize it earlier
when it is more treatable." In describing the
Cancer Research Center, he said, "It's really a
process of mutual dependency."
Swanstrom said, "I think prevention is some
thing that in the short run we have potential for
making the greatest strides in." He said smoking is
an example of something people could avoid and
that, in time, other environmental factors which
cause cancer will be recognized.
When asked about one cure for the many dif
ferent kinds of cancer, Pledger said, "Right now
in the immediate future I don't think there
will be one curet that will cure everything." He
said, "We're learning a lot; magnificent 6is
coveries are made every day. But it is a very com
plex thing, and we know so very little."
In December 1981, construction began on a new
$8.4 million building for the Center. The Line
berger Cancer Research Center Building will bring
together people in the basic aspects of research,
Earp said. It will have specifically designed labora
tories for core facilities and 'will give the center a
greater sense of identity, he said.
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