Cancer and cancer patients are often associated with hair loss. And, the stereotypical image we have of, patients suffering from cancer is that they have shaved their heads and they have lost all their hair. This is not always the case. Some of the cancer treatments, especially the older, more classical treatments, and chemotherapy agents, can cause hair loss. So when patients start chemotherapy, they start losing hair, and sometimes they wake up in the morning and the pillow is covered with a bunch of hair. Sometimes they’re combing their hair, and, they get a whole bunch come off or they’re running their fingers through their hair and they get a clump of hair caught in the hand.

Now this, of course, is quite distressing to the patient, and also the baldness with chemotherapy drugs is often started as a thinning of the hair, so you can see the scalp through the hair to avoid that and give a more symmetrical look. Often, the patients prefer to shave off all the hair from the head so they don’t have to go through this repeated trauma of clumps and bunches of hair falling off and also to have an asymmetrical baldness in which some parts of the scalp still have hair and others do not have hair. So that is the reason why, you see people with cancer on cancer treatment of certain types, getting their heads shaved off.

But I must say that the newer treatments are coming in. They have less chance of hair loss. Also, interestingly, some of the treatments of cancer, like the hormonal treatment given to prostate cancer patients, can increase hair growth on the head. So prostate cancer patients who are on different forms of hormone treatment often come back with more hair growth on the head. And some who have gone bald in the past could start having regrowth of hair. Conversely to, they often start losing body hair so the hair on the head starts growing. However the hair on the body starts shedding, So there are different patterns of hair loss seen among different patients. I would always recommend to my patients that they should not shave off their hair till

they have started treatment, seeing how much hair loss they are having. If they’re having significant hair loss, they can go ahead and shave off the hair. But if they are not having significant hair loss, or if the treatment is even helping to grow more hair, then there is no point for them to shave their hair off.

There’s been a lot of discussion about nicotine and its effects on health, especially cancer.

Firstly, most of the chemicals that cause cancer in cigarette smoke from tobacco are other than nicotine. So nicotine by itself has not been shown to cause cancer. The other chemicals found in tobacco do cause cancer. However, studies have shown that nicotine in low doses has the effect of increasing cell growth, including cancer growth. So nicotine can act as a promoter of cancer, even if it cannot cause cancer. We have no evidence so far that it causes cancer. But if a cancer is there or is being born, it does help it grow. So potentially, nicotine gum would have the same effect. However, because nicotine gum is taken by mouth, it will have very little effect on the lungs and any chances of lung cancer happening. However, if there are damaged cells or abnormal cells in the mouth that are turning cancerous, then nicotine in nicotine gum can help promote the growth of these cancer cells in the mouth. By itself, it will not cause cancer. So far, we do not have very strong evidence in this regard. However, the potentially harmful effects of nicotine in long-term use can lead to increased growth of already existing cancers or cancers that are being born at the time when a person is using nicotine gum. I would also like to add that long-term and heavy use of nicotine gum can cause ulcers in the mouth and inflammation and ulcers in the mouth are one of the factors which increase the chances of cancer of the mouth. And again, this would be an indirect effect of using nicotine gum that the chances of cancer can potentially go high.

Chickenpox is caused by a viral infection and the name of the virus is Varicella-Zoster Virus (VZV). It is usually caught in childhood and when we grow up, we have immunity to it. Most of the people do. Having cancer itself does not make chickenpox more dangerous to the patients. But if people are on anticancer treatment, especially chemotherapy, which lowers their immune level, and their body’s defense against infection, including viral infection, then they are at more risk of chickenpox, whether new or old infection. Now, if somebody has had chickenpox in the past as a child, and most of us have had that, the virus still stays in the body. But the body’s immune system has the ability to suppress the virus and not let it make an infection again and again. If anything destroys or weakens the immune system, like chemotherapy, then the virus gets reactivated and you see it in the form of skin eruptions known as shingles. If the immune system is very suppressed, the virus could become more active and it will cause more complications and problems like damage to the nerves in the body. If somebody’s never had chickenpox and it’s the first time they’re contracting the disease and their immune system is suppressed due to the use of anticancer drugs like chemotherapy, then, yes, it is more dangerous because they will have more complications of this virus. The chickenpox virus especially is good at invading and infecting nerves and causing damage to the nerves. It can also cause damage to the eyes and the vision and the retina the back of the eye where all the vision-sensitive cells are present. So all of these things can be affected. The conjunctiva, the front covering of the eye could also be infected and damaged. And this is not due to cancer, but due to a suppressed immune system. A weakened immune system due to cancer treatment.

Firstly, we have to know that there are many types of lung cancers, some are more aggressive and some are less aggressive.

Secondly, every cancer behaves differently from one person to another, and a cancer can behave differently in the same person from one day to another.

So it depends on the aggression of the cancer, and how long a person can live with cancer, with or without treatment.

Now, if the treatment response is good, and you get good control of the disease, the patient can go on and live for years. There are some types of lung cancers that are very responsive to treatment, and they tend to shrink and very rarely might even go into remission, which means they might disappear or stop growing altogether. And you can have many, many years of living with good treatment. Immunotherapy is another thing, which is a new modality of treatment. This has shown very promising results in some patients who have gone for many years having good control of lung cancer.

Please do remember that if we can catch lung cancer in the early stages, we can give it intensive treatment and get rid of it for good, in which case a patient can be cured of lung cancer, especially if you find it in the early stages of Stage 1 and Stage 2 and to some extent Stage 3A and very rarely stage 3B. These may respond to radical treatment and be cured or get a very good result. Usually, Stage 3A is the level up to which you can give radical treatment and hope for very good results, and even a complete cure of the cancer.

A free dental treatment is possible in the UK on the NHS. Every dental surgery has a certain quota to see free patients, it’s obligatory for them, and cancer patients are often given priority by dental surgeries. Some cancer patients require very close follow-up and assessment for their teeth and oral cavity. In that case, free dental treatment can be arranged on the NHS on the recommendation of the oncologist, and this is usually carried out by specialist teams such as the maxillofacial or oral surgeons who follow these patients up and keep a close eye on them. But it’s not a hard and fast rule for all cancer patients that if they’re diagnosed with cancer, all of them are going to be entitled to free dental treatment.

But yes, in certain cases and in certain types of cancers and certain cancer treatments which can affect the teeth jaw bone, and gums, there is a case for them getting free treatment. And there are procedures in place that help them have regular free dental treatment and checkups.

Breast cancer, like all other cancers, tends to be a spectrum of diseases.

Some types of breast cancers are very slow-growing, while others are more aggressive.

The best thing is to treat it in an early stage and get cured of it by having effective treatment as soon as possible.

Even patients who have treatment in late stages (advanced disease) of breast cancer, can go on living for many years. Ten-year survival rates after being diagnosed with breast cancer in the United Kingdom are 80% or above, and cure rates are quite high. If caught in the very early stage, up to 90% of breast cancers can be cured if you find them in Stage 1.

Now this question is quite interesting.

It says how long can you live with breast cancer without treatment? And I have seen patients who have got slow-growing breast cancer, they have lived for a long time without having treatment. It’s either by choice or they’re not fit enough for treatment, or they have other health problems which take precedence over the breast cancer treatment because they are an imminent risk to their life like a heart attack. So it varies depending on the type of cancer. If it’s a slow-growing cancer and the person is generally fit and well, you can go on for months or even more than a year living with breast cancer and not having a progressive disease, or even if the disease progresses, it is progressing slowly.

However, I would not advise anyone to deny themselves treatment, especially because breast cancer treatment is very effective. In good cases, early stage, you can cure it. And in cases where the disease has progressed, even if you don’t cure it, you can control it for many years. And I have had patients who had breast cancer control for 5, 10, 15, 20, even more than 20 years with effective treatment. Without treatment, of course, longevity, survival, and disease control are much poorer.

Prostate cancer is one of the cancers that are very hormone-sensitive. Most types of prostate cancers can be controlled and treated with hormone therapy, which has fewer side effects and fewer toxicities.

Often when you use the hormone therapy for a long time, the prostate cancer becomes resistant to it.

Let’s see what happens when hormone therapy stops working.

Number one, when hormone therapy stops working, we do not stop the hormone therapy. You have to remember that hormone therapy blocks hormones from acting on prostate cancer and the prostate cancer needs them as a growth stimulant. So blocking the growth stimulant is always good, even if effectiveness is low and it’s not shrinking the prostate cancer anymore and not controlling it as before. Having some level of growth factor control is always a good idea. Usually what we tend to do is add further agents to the hormone therapy. We can add further hormone control drugs. There are many kinds of drugs and we often start with a maximum androgen blockage, which means blocking the hormones at different levels by using more than one type of hormone-blocking drug.

Nowadays there is a very good trend, that if people are failing hormone therapy, or even when they are hormone sensitive, we offer them upfront chemotherapy, which has a good control rate. And then once the cancer has shrunk, with the chemotherapy, we restart hormone therapy and it is more effective because there are fewer cancer cells.

Hence hormone therapy tends to be continued even if it stops working. Some sort of hormone therapy, especially the LHRH antagonist, Goserelin injections, are given indefinitely as long as the patient can tolerate them. Added to this therapy is additional hormone therapy chemotherapy or other kinds of treatment that can kill prostate cancer

Esophageal cancer is one of the most aggressive types of cancer and often requires treatment for good control and survival. If caught in the early stages, it can be cured with radical, aggressive treatment. Living with esophageal cancer without treatment is usually, limited to a few months, usually six months or less. very few patients would survive beyond that period without any treatment. The reason is that oesophageal cancer, even if it has not spread to other parts of the body, its local growth, can make it difficult to swallow. Now you can feed the patient through a tube in the stomach, but the main problem is the saliva. Every day our mouth produces up to two liters of saliva, which needs to go down the esophagus into the stomach. And if there’s a blockage in the esophagus, there’s a backflow of saliva from the food canal into the air tubes, the trachea, and the bronchi. From here the saliva goes down into the lungs and can cause pneumonia known as aspiration pneumonia. And that tends to be the biggest cause of, mortality among esophageal cancer patients rather than the cancer itself or the lack of nutrition. If you’re not eating and drinking. As I said, you can always give nutrition through a tube in the stomach. You can give it parenterally through the intravenous lines. But the problem is not the nutrition. It is the aspiration aspect, the blockage to the flow of saliva from the mouth to the stomach, which becomes life-threatening.

Most lung cancers tend to be quite aggressive, and if not given treatment, they progress very quickly to cause life-threatening complications. Patients often don’t survive for a very long time without treatment. Generally, survival is limited to less than six months, especially in advanced stages. Sometimes a person can go from six months to one year.

In some cases patients have treatment, the cancer shrinks and stops growing and then the treatment is stopped. They can go on for many months without treatment. The newer modality of treatment, especially immunotherapy, has shown a very strange but positive pattern in some patients sometimes you stop the treatment, and the effects of treatment continue. And that is because the immunotherapy makes your immune system strong. And once the immune system learns how to kill the lung cancer cells, it continues to do so even without further treatment.

In such cases, people can go on for many months or even years living without treatment. But that’s not technically a treatment for naive patients. It’s not a patient who’s never had treatment, but the patient has had treatment. The treatment has been very effective. The cancer has taken a big beating. It’s been knocked out and it’s still there, but not able to cause a threat to their life. In that case, you can see patients who are not on treatment, but they’re still living, and they go on living for months or even one year, two years, or more than that. But as a general rule, lung cancers tend to be aggressive and without treatment, the survival tends to be in months or maybe between six months to a year, depending on the stage of the tumor.

It will all depend on the type of cancer. Cancer is a spectrum of diseases. Every cancer is different from another cancer. Some cancers are more aggressive and fast-growing while other cancers are less aggressive and slower-growing.

Then among the same type of cancer in different people, there are different kinds of behavior. Some people have lung cancer which is very aggressive. Another person would have the same lung cancer, but it is less aggressive and less fast-growing.

Finally, in the same person, cancer can act and behave differently from one day to another. So sometimes cancer grows very fast and at other times they grow slow. There are multiple factors involved such as diet, nutrition, mutations, and immunity. All of them play an important role. And if you want to know more about it, my book You’ll Wish You Were An Elephant, Killing Cancer Kindly has got detailed information on the topic.

Now let’s talk about how fast cancer spreads without treatment.

Without treatment, an aggressive cancer can double within two weeks. For example, small cell lung cancer or small cell cancers of other parts of the body can have a doubling time of as little as two weeks.

So these cancers, within weeks, or months, can overwhelm the body and kill the patient.

Then there are slower-growing cancers like bowel cancer, and colon cancer, which has a doubling time of 90 days. And they would take months to spread and grow and become a threat to life. In fact, with bowel cancer, we give treatment, and once the cancer shrinks, we stop treatment and wait for it to grow again, if and when it grows, we hit it with treatment again.

It’s called intermittent chemotherapy. Trials have shown that it is an effective way to control this type of cancer.

The in-between-treatment-free period provides the body time to recover from the effects of intensive chemotherapy.

So the answer to the question of how fast a cancer spreads without treatment depends on the type of cancer and its treatment. It can spread very fast, doubling every two weeks, or it can spread a bit slowly, doubling every three months or so. And there may be a huge spectrum in between. Again, lifestyle factors, the general health of the patient, and mutations in cancer can make aggressive cancer become less aggressive or a low-aggression cancer to become very fast-growing and aggressive over a period of time especially if treatment is not provided.

Usually, cancer treatments are of two types.

One is curative and the other is non-curative.

Curative cancer treatment is given in the early stages of the disease with an aim to cure the cancer. If a patient refuses curative treatment, then the cancer can grow and progress and become incurable over a period of time and you miss that window of opportunity to get rid of it completely.

If it’s a non-curative treatment at a later stage and you refuse treatment, it becomes more difficult to control. The noncurative treatment aims to control cancer. Sometimes this control can be for months, at other times it could be for years, depending on the type of cancer and how effective the response to treatment is. But refusing noncurative treatment is going to increase the risk of cancer becoming bigger and worse spreading to more parts of the body and becoming less responsive to treatment. Some people prefer not to have treatment at all, in which case they’re offered symptom controls. Whatever problems the cancer is causing such as malnutrition, pain, and weight loss, we try to treat those symptoms. Pain is a major factor and we have very good and effective pain control mechanisms.

Here I have to add something. Allow me to share something very interesting with you.

One in 1000 patients, their cancer tends to stop growing or starts shrinking or even disappearing on its own. Without any treatment!

We suspect there is a role of immunity in this bizarre but beautiful situation.

Again my book “You Will Wish You Were an Elephant, Killing Cancer Kindly” has got detailed discussions on this subject.

So every now and then I have come across patients who have refused treatment or who were not fit for treatment but their cancer has stopped growing or regressed and shrunk on its own or even disappeared completely. Some of these patients, outlive the cancer or they die of a disease other than their cancer and cancer never becomes a threat to their life. But this is extremely rare and usually, it’s one in a thousand cases in which this happens. It’s not a general rule. So refusing cancer treatment mostly results in cancer spread and complications.

It is mostly associated with a poor outcome and poor prognosis.

It can change a curable cancer to an incurable cancer and can make the control of an incurable cancer more difficult.

Throat cancers tend to be very aggressive. They can be complicated by eroding into the throat and the

mouth.They can block the air passage and they can block the food passage, which makes it quite a life-threatening situation.

Survival is short if they are not treated on time. Fortunately, most of the throat cancers can be treated very effectively. Cure rates are quite high with radical treatment compared to many other aggressive cancers. So it is highly recommended that the patient should go for treatment with throat cancer. There are some forms of throat cancer that are bordering on benign, very slow growing, and even if treatment is not provided, they do not cause life-threatening complications or become a threat to your life for a long period of time, months, or even years. But this is rare. Most of the throat cancers are quite aggressive and without treatment, survival is less, I would say less than six months, or at best possible, between six months to one year

Bladder cancer treatment has advanced a lot in the last few years. Depending on what stage the bladder cancer is, you can give potentially curative treatment or you can give treatment to control the disease for a long period of time.

The latest in bladder cancer treatment is immunotherapy, which strengthens your immune system and helps it to identify and kill bladder cancer cells. This has been associated with a very good response in selective patients who have a large number of cell surface receptors known as the PD-L1 receptor. Apart from that, there’s also targeted treatment becoming available which targets specific cancer growth and survival pathways. By blocking them these drugs can kill cancer cells.

The future is looking very bright and we are getting more and more treatment options available for bladder cancer.

The main focus that our team at Killing Cancer Kindly has, is on how to detect bladder cancer and cure it in the early stages, which is quite possible if you can catch it early.

We have very good valuable life-saving information on how to screen for bladder cancer, how to detect it early, how to prevent it, and how to cure it in our book, You’ll Wish You Were An Elephant; Killing Cancer Kindly. There are a lot of detailed sections dealing with it and I would refer you to have a read of it for more information.

Radiation treatment is a very effective way of treating prostate cancer. In the early stages of prostate cancer, it can even cure the cancer. However, there are many side effects associated with it. Some are short-term, and some long-term or permanent.

Short-term, immediate, during or after radiotherapy, include the patient feeling very tired. They can have irritation of the bladder, which is very close to the prostate, and the bowl, which is just behind the prostate.

Hence they can end up with cystitis-like symptoms. Increased frequency of passing water, dysuria

(stinging sensation on passing water), and urinary tract infections, which can lead to retention of urine.

Bowel dysfunction can occur so they can have diarrhea, or a painful sensation on moving their bowels.

Some people have constipation or bowel incontinence.

In the long term prostate cancer radiotherapy can cause long-standing bowel and bladder dysfunction. The bladder can shrink a bit because the radiation that is given to the prostate also affects parts of the bladder. Even though we try to avoid most of the bladder, the base of the bladder which is touching the prostate gets affected. This causes a reduced capacity of the bladder and there’s more frequency of passing urine. Holding urine becomes a bit difficult. Some people can develop incontinence of urine, which fortunately is very rare. The same happens with the bowel. Bowel dysfunction can occur. People can have constipation or diarrhea or lose tools. Very rarely they get incontinence. Not many people have that. If people already have existing bowel and bladder problems, then radiotherapy to the prostate can increase their risk of bowel and bladder dysfunction.

10% of the patients that is 1 out of 10 patients might get some bleeding from the back passage, like spotting after passing feces. And that’s because the overflow of radiation from the prostate treatment to the bowel, which is very close to it, can cause thinning of the bowel wall making its blood vessels very fragile. If the patient is constipated and has hard stools, passing those stools can rupture the small blood vessels and bleeding can occur. This only happens in 10% of one out of ten patients, and it’s not very common in the long run.

Radiotherapy to the prostate can cause erectile dysfunction due to damage to the nerves and vessels that supply blood to the penis. There is a 50% to 60% risk of erectile dysfunction. Of course, it can also make the person infertile and they may not be able to bear children.

One unusual side effect is that radiation to the prostate can cause loss of pubic hair. The pubic hair fall off and does not grow back., which means some people who shave them regularly don’t have to shave at all. However, I’ve never had any patient come back complaining about this loss. Last but not least we have to understand that if the patient does not get radiotherapy for prostate cancer, the disease can cause worse damage to the bladder bowel, and other organs.

So having radiotherapy has its side effects but these are much less than the damage that the cancer can cause.

Prostate cancer is one of the cancers which can be treated very effectively.

You can cure prostate cancer by offering radical radiotherapy or surgery in the early stages.

The treatment of prostate cancer depends on its stage.

Early stages you can give radical treatment, starting with hormone therapy to shrink the tumor, then radical radiotherapy, followed by more hormone therapy and this can cure the cancer. Sometimes we use brachytherapy, which is putting the radiotherapy seeds in the prostate or putting small tubes in the prostate. Those small tubes can carry radioactive elements inside and burn cancer and then the tubes can removed.

Similarly, surgery is also a very well-established old radical treatment for curing early-stage prostate cancer.

If the prostate cancer has spread beyond the prostate, then we give treatment to control it. This treatment can be very good and can go on for four to five years or ten years, sometimes even 20 years or more. My longest-living prostate cancer patient is in his 26th year of treatment and doing quite well.

Initially, we start with hormone therapy, but there is an increasing trend of offering upfront chemotherapy or advanced kinds of treatments, drugs like Abiraterone, which can give better control of the disease. And then you can give maintenance hormone therapy.

Nowadays we have a more aggressive approach of treating prostate cancer in advanced stages too, and the results are getting better.

We can use chemotherapy earlier on, just six lots of treatment and the results especially survival rates are better than using ten lots of treatment one or two years down the line.

As I said, survival can be really good going up to ten years plus or even 20 years plus.

Treatment for lung cancer depends on its type and stage.

There are many types of lung cancer and each type has a different form of treatment. The stage of lung cancer shows how much the lung cancer has spread.

If it is localized to the lung, you can give radical treatment with curative intent. So sometimes we use more than one modality of treatment chemotherapy, or radiotherapy or surgery in different combinations. By doing this we can aim to cure the cancer and get rid of it for good. Up to stage 3A, this is a possibility.

Once the cancer advances above stage 3A, it becomes very difficult to cure it.

However when the cancer is not curable, then the treatment is aimed at controlling the disease. Typical treatments we offer are radiotherapy, chemotherapy, and targeted treatment.

Targeted treatment is usually used in a certain type of lung cancer which is very sensitive to this therapy, and these cancers can be controlled for a long period of time, many months, sometimes even years, with targeted therapy. There is a newer modality of treatment called Immunotherapy, which strengthens the immune system and trains it on how to effectively attack lung cancer and kill the lung cancer cells. Immunotherapy can get very good results. It’s not feasible for every lung cancer patient, but the ones who do qualify for it and are sensitive to immunotherapy, when they respond, they often respond very well. Some of them even continue to have good control of the disease when the immunotherapy is stopped. Now, this is not the rule, but it does happen in some cases in which you can stop the treatment and the patient still has good control of lung cancer. The lung cancer may shrink or disappear, but it usually stops growing and becomes a stable disease.

The treatment of liver cancer depends on three things. Number one, how big the liver cancer is and whether it can be resected, taken out or destroyed at the site or not. Secondly, what is the extent of the disease? Is it only limited to the liver or has it gone beyond the liver spreading to other parts of the body?

Number three, how fit the patient is and how good the liver function is.

All of these three, determine what kind of treatment we’ll offer.

For limited cancer, you can resect part of the liver and the amazing thing about the liver is it can regrow up to 20%. So even if you cut part of the liver, it can grow back again.

Similarly, you can have a liver transplant, remove the whole liver, and replace it with a new liver from a donor, and that way you get rid of the cancer.

We can also block the blood supply to the cancer and this shrinks it down and kills it. Or we can inject chemotherapy agents. Or we can freeze the tumor or burn the tumor and give radiotherapy or radioactive nucleotides which can again destroy the tumor on site in the liver.

For patients who have more extensive disease, these options cannot be used but there’s a combination of treatments that has been found to be very effective.

We use two types of drugs Bevacizumab, which affects the blood supply of the tumor, and Atezolizumab, which is an immunotherapy treatment. Both given in combination provide good results by shrinking down the liver cancer.

There are also targeted agents available like Sorafenib or Lenvatinib which target specific growth pathways and survival pathways of the liver cancer cells. They kill cancer cells by blocking these pathways.

If these treatments can shrink the liver tumor and make it resectable, then the option of surgery or liver transplant is also available to the patient.

Bowel cancer treatment depends on three things. Number one is the type of bowel cancer.

Number two, is the location of the bowel cancer, whether it’s a rectal (lower part of the bowel) or colon cancer.

And the third thing is the stage of the bowel cancer, how far the bowel cancer has spread.

In the early stages, when the cancer is limited to the bowel or just in the nearby lymph nodes, you can use surgery to cure the disease and get rid of it completely.If it is in the lower part of the bowel and early-stage localized to the rectum and some nearby lymph nodes, you can give chemotherapy and radiotherapy in combination or radiotherapy alone to shrink it down and then do surgery to get clear margins. This increases the chances of a cure.

Sometimes if you have a localized tumor with some small metastases, you can give chemotherapy initially to shrink down the metastatic disease and the primary tumor. And if the metastatic disease remains stable or disappears, you can do a resection. You could also remove the metastasis if they are small and respectable.

Bowel cancer tends to be mostly a slow-growing tumor giving us a good window of opportunity to treat it more aggressively with an intent to cure.

After the operation, we look at the risk factors and if we think we might have still some residual disease, microscopic disease, or some lymph nodes involved that have not been taken out then further treatment with chemotherapy, known as adjuvant treatment is given to increase the chances of cure.

In later stages of bowel cancer where it has spread to other parts of the body, maybe the liver, which is a very common site or lung or bones, or is locally advanced and cannot be resected, Chemotherapy is the mainstay of treatment and it tends to control the disease quite well.

There is an option of giving intermittent treatment in which chemotherapy is initially given and when cancer shrinks down, we have treatment holidays for the patient. If and when the tumor starts growing again we restart the treatment.

Sometimes maintenance treatment with one drug is used in between these gaps to continue to provide some level of control.

The most interesting thing about bowel cancer which has recently happened is the use of a drug called “Dostarlimab” This is an immunotherapy agent that increases the efficacy of the immune system in killing cancer cells with a certain type of mutation in rectal cancer.

This treatment was initially given for six months before surgery in the hope to shrink the disease. But what we found was that the disease completely disappeared. All the patients were apparently cured or went into remission.

We are still doing surveillance for them to see if the disease comes back.

Now, this is a remarkable new development in which the use of a single drug has completely killed the cancer, made it disappear, and gone into remission.

This opens a lot of avenues for immunotherapy in the future.

So watch this space. We’ll be updating you with new information on our YouTube channel and other social media platforms about all new cancer treatments, especially bowel cancer as this seems to be a very promising area of development and we are looking forward to more effective treatments and cures.

Treatment of breast cancer depends on three factors. Number one, what type of breast cancer we have? There are different types of breast cancer. Some are sensitive to hormone treatments, some are not. There are others that are sensitive to some other growth blockers, like HER-2 blockers, which are a growth factor for these cancers. If blocked, it can stop the cancer from growing.

The second factor is how advanced is the breast cancer. If the breast cancer is in an early stage that is limited to the breast or maybe involves the local lymph nodes but not going to any distant parts of the body, it can be cured. And chances of cure in very early stages where the cancer is only limited to the breast can be more than 90%.

The third important factor in treating breast cancer is the fitness of the patient and the age of the patient, how fit the patient is for intensive and aggressive treatment.

Patients who can be cured of the disease are given curative treatment. This often involves chemotherapy at the start to shrink the disease, followed by surgery, and then followed by more chemotherapy and radiotherapy to reduce the risk of cancer coming back. Then maintenance treatment can be given with, for example, hormone therapy, in patients who are sensitive to hormones.

If their cancers are feeding on the hormones, we can block the hormones and reduce the risk of cancer coming back and increase the chances of cure.

For patients whose cancer has spread beyond the breast and cannot be cured with surgery, we offer a combination of treatments, usually chemotherapy to shrink the tumor down, then hormone therapy to maintain control, or simple hormone therapy and other targeted treatments with an aim to control cancer. But overall the treatment responses are very good. 80% of breast cancer patients after diagnosis live beyond ten years with effective treatment.

For many breast cancer patients, it becomes a chronic disease that is controlled by maintenance treatment and occasional intensive treatment like chemotherapy.

Skin cancers are of different types. Some are very easy to treat.

For example, basal cell carcinomas are one of the most treatable cancers with almost 100% cure rates. They hardly ever spread beyond the area of their growth, they do not tend to metastasize, and they are very sensitive to treatment. Then there are squamous cell carcinomas, which are a bit more difficult to treat.

Another type, malignant melanoma can be quite resistant to treatment and very aggressive. There are also some other rare types like Merkel cell carcinoma. Again, they tend to grow fast and are more aggressive.

Treatment depends on the type of tumor and how aggressive it is.

The more aggressive the tumor, the more intensive the treatment required.

It also depends on the extent of the disease. If cancer has traveled to other parts of the body and has spread to other organs, then the aim of the treatment is to control cancer and to stop it from growing any further or slow down the growth of cancer rather than cure it. But in the early stages, skin cancers can be treated with surgery or combination treatments with the aim to cure them.

Radiotherapy is often used when surgery is not a possibility depending on the location of the cancer the extent of the disease or the fitness level of the patient.

Radiotherapy can be used as a single modality treatment and can give good cure rates, especially in basal cell carcinomas.

Some types of squamous cell carcinomas can also be treated with curative intent if they are localized. New treatments for skin cancer involve targeted treatments and immunotherapy which are giving very good results and good control of disease even when the cancer has spread to other parts of the body. The future is full of hope and success for skin cancer treatment.

One of the best things about working in the NHS is that treatment is free for all, especially cancer patients. This is my biggest joy in life as a doctor, that when any patient comes to me with any kind of problem, especially cancer, I never, ever refuse them treatment. NHS is one of the best health systems in the world for providing free health care.

However, there is a catch. Not all kinds of cancer treatments are available for free. Some of the treatments, which are mostly the new ones, take time to be approved. There is a National Institute of Clinical Excellence (NICE), which approves new cancer treatments and other drugs. Until the approval arrives, we are not able to provide these treatments. Having said that, there’s another excellent parallel system known as the Cancer Drug Fund, which provides a pot of money to use for treatments that are not freely available or are still awaiting approval to be available, free of cost. The doctors have to make a good case for the patient and justify that the treatment would benefit the patient and save their life. And once the Cancer Drug Fund is convinced with this argument presented to them, they release the money, for these treatments. In my career as an oncologist, I have never come across any drug being refused to my patients by the Cancer Drug Fund once I have put in a request. And I have rarely ever seen it being refused by my colleagues’ patients.

We can also make a case for exceptional circumstances in rare tumors or exceptional circumstances of a patient to provide treatment not generally available in the NHS. Sometimes patients want to go for certain types of treatments that are not yet approved either by the Cancer Drug Fund or the National Institute of Clinical Excellence, and in such a case, they get fundraising from private sources and seek treatment privately.

Here. I would also like to add that not only the treatment is free in the National Health Services UK, but diagnosing and starting treatment is also quite quick. We have targets of diagnosing a patient within four weeks if suspected of cancer and starting treatment within eight weeks of having the suspicion. Most of the time these patients get diagnosed and treated even earlier than the target dates. If the target dates are missed, then the whole oncology team and the hospital are held accountable and answerable for the delay.

The 7 warning signs of cancer include:

• Unexplained, unintentional weight loss,
• Fever of unknown cause which is continuous and recurrent,
• Tiredness and fatigue which can not be explained,
• Having a very low stamina especially if it’s of a recent origin and has not developed over a period of time could be a warning sign. 5- Pain is usually rare and late but is considered a warning sign and is often indicative of a cancer that has spread outside its area of origin and is now affecting other parts of the body. 6- Skin changes are a common sign in skin cancers may they be basal cell carcinomas or squamous cell carcinomas then melanomas there’s a whole list of skin changes that you have to look for and be aware of. The details are present in our book “You Will Wish You Were An Elephant, Killing Cancer ” We have a detailed chapter and section on the signs and symptoms of cancer especially skin cancer, and how to identify, detect, prevent, and treat it. 7- For some cancers there will be changes in the bowel habits and bladder function, so diarrhea, constipation, and frequency of passing water or urinary retention could be an indication. Unusual bleeding and discharge are also important signs, if someone is having bleeding like coughing up blood or passing blood in feces or urine. This could be a warning sign of an underlying cancer.

However ( and this is very important to note) all these warning signs are also associated with noncancerous diseases that could be due to infections, inflammations, and chronic ailments.

So one has to have them investigated and must consult a doctor before coming to any conclusions. Most of the time these warning signs are not due to cancer but because they can occur in cancer it is sensible not to overlook them and not to take them lightly. Even if they are happening due to another disease for example if there’s blood in the urine which is due to a kidney stone it needs to be treated and it needs to be treated as soon as possible.

Cancer is associated with a lot of physical and mental suffering as it’s a chronic disease that is often difficult to treat and can also be a threat to life. It’s understandable that anyone who’s diagnosed with cancer undergoes a lot of stress and depression which is normal and expected. Usually, the biggest problem with cancer is weight loss, pain, and inability to eat (anorexia). However with new treatments we have very effective control of pain and if you can control the cancer and shrink the size of the tumor the symptoms can disappear altogether. Nowadays, you would come across patients who look very healthy and are in fact in good health with a well-controlled cancer with effective treatment.

The stereotypical appearance of cancer patients who are not able to eat and drink, vomit, and have hair loss is becoming rarer and rarer as time passes by. Most of the cancer patients feel that they have a chronic disease that is being controlled by medication for example those who are suffering from prostate and breast cancer can take hormone therapy and have their cancer controlled for many many years and enjoy a good quality of life. In fact, one of the biggest focuses of the new cancer treatments is the quality of life and we try to find a treatment that causes fewer side effects and improves the quality of life of the patient rather than making them suffer and live longer. So nowadays it’s not unusual to find cancer patients not having any symptoms such as pain or other complications from the cancer because they have got good symptom control medication and the treatment that they are having is controlling their cancer and taking away all the complications associated with it.

Cancer is associated with a lot of physical and mental suffering as it’s a chronic disease that is often difficult to treat and can also be a threat to life. It’s understandable that anyone who’s diagnosed with cancer undergoes a lot of stress and depression which is normal and expected. Usually, the biggest problem with cancer is weight loss, pain, and inability to eat (anorexia). However with new treatments we have very effective control of pain and if you can control the cancer and shrink the size of the tumor the symptoms can disappear altogether. Nowadays, you would come across patients who look very healthy and are in fact in good health with a well-controlled cancer with effective treatment.

The stereotypical appearance of cancer patients who are not able to eat and drink, vomit, and have hair loss is becoming rarer and rarer as time passes by. Most of the cancer patients feel that they have a chronic disease that is being controlled by medication for example those who are suffering from prostate and breast cancer can take hormone therapy and have their cancer controlled for many many years and enjoy a good quality of life. In fact, one of the biggest focuses of the new cancer treatments is the quality of life and we try to find a treatment that causes fewer side effects and improves the quality of life of the patient rather than making them suffer and live longer. So nowadays it’s not unusual to find cancer patients not having any symptoms such as pain or other complications from the cancer because they have got good symptom control medication and the treatment that they are having is controlling their cancer and taking away all the complications associated with it.

The 7 warning signs of cancer include:

• Unexplained, unintentional weight loss,
• Fever of unknown cause which is continuous and recurrent,
• Tiredness and fatigue which can not be explained,
• Having a very low stamina especially if it’s of a recent origin and has not developed over a period of time could be a warning sign. 5- Pain is usually rare and late but is considered a warning sign and is often indicative of a cancer that has spread outside its area of origin and is now affecting other parts of the body. 6- Skin changes are a common sign in skin cancers may they be basal cell carcinomas or squamous cell carcinomas then melanomas there’s a whole list of skin changes that you have to look for and be aware of. The details are present in our book “You Will Wish You Were An Elephant, Killing Cancer ” We have a detailed chapter and section on the signs and symptoms of cancer especially skin cancer, and how to identify, detect, prevent, and treat it. 7- For some cancers there will be changes in the bowel habits and bladder function, so diarrhea, constipation, and frequency of passing water or urinary retention could be an indication. Unusual bleeding and discharge are also important signs, if someone is having bleeding like coughing up blood or passing blood in feces or urine. This could be a warning sign of an underlying cancer.

However ( and this is very important to note) all these warning signs are also associated with noncancerous diseases that could be due to infections, inflammations, and chronic ailments.

So one has to have them investigated and must consult a doctor before coming to any conclusions. Most of the time these warning signs are not due to cancer but because they can occur in cancer it is sensible not to overlook them and not to take them lightly. Even if they are happening due to another disease for example if there’s blood in the urine which is due to a kidney stone it needs to be treated and it needs to be treated as soon as possible.

One of the best things about working in the NHS is that treatment is free for all, especially cancer patients. This is my biggest joy in life as a doctor, that when any patient comes to me with any kind of problem, especially cancer, I never, ever refuse them treatment. NHS is one of the best health systems in the world for providing free health care.

However, there is a catch. Not all kinds of cancer treatments are available for free. Some of the treatments, which are mostly the new ones, take time to be approved. There is a National Institute of Clinical Excellence (NICE), which approves new cancer treatments and other drugs. Until the approval arrives, we are not able to provide these treatments. Having said that, there’s another excellent parallel system known as the Cancer Drug Fund, which provides a pot of money to use for treatments that are not freely available or are still awaiting approval to be available, free of cost. The doctors have to make a good case for the patient and justify that the treatment would benefit the patient and save their life. And once the Cancer Drug Fund is convinced with this argument presented to them, they release the money, for these treatments. In my career as an oncologist, I have never come across any drug being refused to my patients by the Cancer Drug Fund once I have put in a request. And I have rarely ever seen it being refused by my colleagues’ patients.

We can also make a case for exceptional circumstances in rare tumors or exceptional circumstances of a patient to provide treatment not generally available in the NHS. Sometimes patients want to go for certain types of treatments that are not yet approved either by the Cancer Drug Fund or the National Institute of Clinical Excellence, and in such a case, they get fundraising from private sources and seek treatment privately.

Here. I would also like to add that not only the treatment is free in the National Health Services UK, but diagnosing and starting treatment is also quite quick. We have targets of diagnosing a patient within four weeks if suspected of cancer and starting treatment within eight weeks of having the suspicion. Most of the time these patients get diagnosed and treated even earlier than the target dates. If the target dates are missed, then the whole oncology team and the hospital are held accountable and answerable for the delay.