Devil with less Evil

If you compare “Cancer with Devil”- not all the cancers are “fatal or equally bad”. In other words- few cancers are so slow growing that some other chronic conditions like “ Diabetes cause more long term health damage compared to the slow cancers”

I am not trying speak about the “Not all tumors are cancers”- I.e. benign vs malignant tumors. I foucus my next parts on the few “borderline/ true cancers, which grow extremely slow”

The word cancer and the psychological trauma / stigma is much more than the tumor per-se

Few examples we shall discuss - As the detailed management of the individual disease shall stretch the article, let me focus on few key pointers- leaving the details

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Carcinoid- Carcinoid tumors (also known as NEURO Endocrine Tumors) are a rare type of neoplasms happening in 3-4 of 1 lak population. They usually originate in the endocrine (hormone-producing cells)like organs eg- pancreas, gastrointestinal tract, testes, ovaries or lungs. These are small in size and relatively slow growing compared to other cancers. The lag period between tumor origin and symptoms is long and can be few decades before they are symptomatic. These symptoms (often due to excess production of hormone substances, such as serotonin, bradykinin, histamine, and prostaglandins) are non specific and referred to as "carcinoid syndrome." The diagnosis is often based on the Imaging (latest of all is DOTA Nac scan) blood tests (including- serum chromognanin and 24 hr urine test) along with biopsy.?As far as food is concerned- It has been shown that giving niacin supplementation ( a food based vitamin) to carcinoid patients not only resolves several common symptoms of carcinoid and pellagra, such as skin lesions and diarrhea/ steatorrhea, but also generally improves the health of the carcinoid patients.

Chronic Lymphocytic Leukemia ( CLL)-?is a type of blood cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).?This is one such rare caner, where medical filed officially put a “ Stage- Zero, acknowledging its mild nature”.?Early on there are typically no symptoms.?Later non-painful lymph node swelling, feeling tired, fever, night sweats, or weight loss for no clear reason may occur. It typically worsens gradually over years

Phyllodes tumors?(from Greek: phullon leaf)- This is predominantly a type of breast tumor of adult women, with very few examples reported in adolescents. Patients typically present with a firm, palpable mass. These tumors are very fast-growing, and can increase in size in just a few weeks. A complete removal is often enough to cure, and most of them don’t need chemo/radiation

Borderline ovarian caners- Also known as atypical proliferating tumors and used to be called low malignant potential tumors. These tumors look the same as invasive epithelial ovarian cancers when seen on an ultrasound or CT scan- but often surgery lone is curative, in contrast to true tumors, which always need a chemo

Pseudomyxoma peritonei is a rare malignant growth characterized by the progressive accumulation of mucus-secreting (mucinous) tumor cells within the abdomen. Tough we rarely cure this, it is so slw growing that you may have to wait long enough before you even notice this

Low grade Lymphomas- With few exceptions, most of them are often just observed without any treatment. People with good genetics shall live beyond decades with this disease without any medical intervention.

Predicting the “devil with less evil”- a cue from the genes

Some cancers grow and spread more quickly than others. By looking at your DNA, genomic testing can give your doctor an idea of whether your cancer is likely to grow slowly or if it will be more aggressive and spread quickly. This information can help your doctor plan out the best treatment strategy for you. A faster-growing cancer will need more aggressive and fast treatment, but a slow-growing cancer may not need treatment right away. Your doctor might monitor you instead. Waiting could also help you avoid the side effects that treatment could cause. If your doctor recommends genomic testing, ask why they think it's a good idea for you. Find out how your test results will be used to diagnose and treat your cancer, and what that could mean for your outlook.

A multi disciplinary team approach as always is the best way to go forward- in any case

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