Frequently Asked Questions

In 2019, it is estimated that there will be 1,762,450 new cases of cancer of any site and an estimated 606,880 people will die of this disease. In 2016, there were approximately 15.5 million cancer survivors in the United States. That number is expected to increase to 20.3 million by 2026. Over 38% of Americans will be diagnosed with cancer at some point during their lifetimes. Some cancers are more common than others. The table below lists the risk of developing and dying from different types of cancer.

	Females		Males
	Risk of developing (%)	Risk of dying from (%)	Risk of developing (%)	Risk of dying from (%)
All types	37.65	18.76	39.66	22.03
Melanoma	1.72	0.21	2.77	0.43
Lung	5.95	4.73	6.85	5.96
Bladder	1.12	0.34	3.76	0.94
Renal	1.20	0.33	2.09	0.62
Colorectal	4.15	1.74	4.49	1.91
Breast	12.41	2.62	0.12	0.03
Prostate	0	0	11.55	2.45

 

National Cancer Institute. Cancer Stat Facts: Cancer of Any Site. Available at: https://seer.cancer.gov/statfacts/html/all.html

Lifetime Risk (Percent) of Being Diagnosed with Cancer by Site and Race/Ethnicity: Males, 18 SEER Areas, 2012-2014 (Table 1.16) https://seer.cancer.gov/csr/1975_2014/results_merged/topic_lifetime_risk.pdf
and Females, 18 SEER Areas, 2012-2014 (Table 1.17) https://seer.cancer.gov/csr/1975_2014/results_merged/topic_lifetime_risk.pdf

Lifetime Risk (Percent) of Dying from Cancer by Site and Race/Ethnicity: Males, Total US, 2012-2014 (Table 1.19)https://seer.cancer.gov/csr/1975_2014/results_merged/topic_lifetime_risk.pdf and Females, Total US, 2012-2014 (Table 1.20) https://seer.cancer.gov/csr/1975_2014/results_merged/topic_lifetime_risk.pdf. Accessed on January 3, 2018.

The lymph system is a network of vessels in the body that collects fluid and waste material found in body tissues and returns it to the blood stream. Fluid in the lymph system is filtered through lymph nodes, small bean-shaped structures that contain white blood cells, the cells of the immune system that fight infections and cancer. The lymph system contains hundreds of lymph nodes throughout the body. When an infection or cancer is present, lymph nodes may swell or enlarge. Cancer that starts in a lymph node is called lymphoma. Most often, cancer starts in other tissues and then spreads to the lymph nodes. Although most cancer cells that travel away from the tumor are killed, some may begin to grow in a new area. This spreading of cancer cells is called metastasis.

Lymph nodes may be biopsied or may be removed during surgery to treat cancer. A pathologist will look at the cells within the lymph node under a microscope to determine the number of cancerous cells in the node and how fast the cells are growing. The staging of your cancer and your treatment options will be partially determined by the amount of cancer found in your lymph nodes.

If lymph nodes are removed during cancer surgery, lymph fluid will not be able to drain out of the area. This can lead to lymphedema, or the accumulation of lymph fluid in a part of the body.

 

American Cancer Society. Lymph Nodes and Cancer. https://www.cancer.org/cancer/cancer-basics/lymph-nodes-and-cancer.html

Stage refers to the extent of your cancer, such as the size of the tumor and whether the cancer has spread. The stage can help a doctor determine your chances of recovery and decide on an appropriate treatment plan. There are several ways in which your healthcare team may refer to the stage of your cancer.

• Stage 0: abnormal cells are present but it is not cancer. This is also called carcinoma in situ.
• Stage I through III: Cancer is present. The higher the number, the larger the tumor and the greater the spread to nearby tissues such as lymph nodes.
• Stage IV: the cancer has spread to distant parts of the body

Another system of cancer staging is the TNM system. This is the most widely used cancer staging system by healthcare providers. Your TNM staging will consist of 3 letters and 3 numbers, such as T1N1M0 or T4N3M1. Use the key below to learn what these letters and numbers mean.

In the TNM system:

• The T refers to the size of the tumor.
  • TX: the main tumor cannot be measured
  • T0: the main tumor cannot be found
  • T1, T2, T3, T4: refers to the size of the tumor. The larger the number, the larger the tumor

 

• The N refers to the number of nearby lymph nodes that have cancer
  • NX: cancer in nearby lymph nodes cannot be measured
  • N0: there is no cancer in nearby lymph nodes
  • N1, N2, N3: refers to the number of lymph nodes with cancer. The higher the number, the more lymph nodes with cancer

 

• The M refers to whether the cancer has spread or metastasized.
  • MX: metastasis cannot be measured
  • M0: the cancer has not spread to other parts of the body
  • M1: the cancer has spread to distant parts of the body

A lower number usually indicates a better prognosis, or chance of recovery. Speak to your doctor about what your particular cancer stage means for your treatment options and prognosis.

 

National Cancer Institute. Cancer Staging. https://www.cancer.gov/about-cancer/diagnosis-staging/staging

Talking often with your health care team and asking questions are important for making informed decisions about your health. There is no one-size-fits-all approach to treating cancer and it is vital that you receive personalized information about your cancer and health. Many people feel anxious about questioning their doctor or worried that they may not understand medical terms. The following strategies may help you talk to your doctor and get the information you need:

• Take someone with you when you go to the doctor. This person can help by listening, asking questions, and taking notes.
• Ask as many questions as you need to. Write down your questions and bring them with you to appointments. Ask your most important questions first and express yourself and your concerns clearly.
• Remember that all of your questions are important. There is no such thing as a silly question when it comes to understanding your health care.
• Ask the doctor to explain any medical terms you don’t understand.
• Ask your doctor to write down any terms you aren’t sure about.
• Repeat back what you heard the doctor say in your own words to make sure you understood the information.

The following is a list of potential questions you may want to ask your health care team. Remember that there are no silly questions and you should ask for clarification on anything you find confusing or unclear.

• What type of cancer do I have? What stage and grade is my cancer? What do these terms mean?
• What does my diagnosis mean? What is my prognosis?
• Where is the tumor located?
• What treatment plan do you recommend, and why? Is the goal of treatment to eliminate the cancer, or make me feel better?
• What are the possible short-term and long-term side effects of this treatment?
• What is the chance that the cancer will return? Should I monitor for specific signs or symptoms?

 

American Cancer Society. Questions to Ask Your Doctor When You Have Cancer. https://www.cancer.org/treatment/finding-and-paying-for-treatment/choosing-your-treatment-team/questions-to-ask-your-doctor.html

It is normal to experience grief, sadness, anger, crying spells, and fear after a diagnosis of cancer. Grief and sadness are normal, healthy reactions to the uncertainty of life with cancer. These feelings usually do not last long, and although they may seem like depression, they are not.

 

About 1 in 4 people with cancer do develop depression. Depression may make it more difficult for you to seek help or keep up with treatment plans. Some people may be embarrassed or afraid to admit they are depressed. However, it is important to realize that depression is not a sign of weakness and it can be treated with medications or counseling. Talk to your doctor if you experience any of the following signs of depression:

• Your grief lasts for weeks and doesn’t seem to be improving
• You are having difficulty with day-to-day activities (such as being too sad to get out of bed or leave the house)
• You feel useless, worthless or hopeless
• You have very low energy and decreased drive
• You have trouble making decisions

 

American Cancer Society. How do I cope? Available at www.cancer.org/treatment/understanding-your-diagnosis/after-diagnosis/how-do-i-cope.html

Support groups can be an important resource for people diagnosed with cancer. They allow you to discuss your concerns, find people who understand what you are going through, and point you towards valuable resources you might not have found on your own. You can find local support groups by asking your doctor or the staff of a hospital, or through an online search. Support groups vary in format, from in-person groups, to support groups for family and caregivers, to online or telephone support groups. No one support group is right for everyone and it is important that you find one that makes you comfortable. Use the resources below to begin your search:

 

Cancer.net. Finding Support and Information. https://www.cancer.net/coping-with-cancer/finding-support-and-information

 

American Cancer Society. Support Programs and Services. https://www.cancer.org/treatment/support-programs-and-services.html

You may experience bothersome side effects from your cancer therapy or from the cancer itself. It is important to remember that managing side effects is an essential component of each cancer patient’s care plan. Ask your doctor about what side effects you may experience with your treatment and let him or her know if you notice any new symptoms. Although the side effects you may experience largely depend on your treatment, the following are side effects common to many cancer therapies.

• Pain is commonly caused by cancer and its treatment. Work with your doctor early to develop a pain management plan that meets your needs.
• Lymphedema is an abnormal buildup of excess fluid in specific areas of the body, most commonly in the arms and legs. This swelling is caused by interruptions or blockages in the flow of lymphatic fluid caused by the removal of lymph nodes, or from cancer and its treatment.
• Hair loss, or alopecia, is caused by some cancer treatments and usually begins within 2 weeks of starting treatment. Hair will grow back after treatment is complete.
• Immune-related adverse events are side effects you may experience with immunotherapy. They range from skin rashes to diarrhea to changes in lab values. Your doctor will monitor you closely to make sure your liver, thyroid and pituitary gland are functioning normally during treatment. Some side effects may be treated with steroids. It is important that you tell your doctor about any new side effects you experience to make sure you remain healthy during treatment.