Introduction- An Overview of Cancer
Our body contains about a trillion cells which constantly keep dividing to form new cells and replaces the old ones. It is only when a type of cells start dividing incessantly and directionless, it turns into what we call cancer. Cancer is a much wider term for a group of related disorders.
Once the cancer is developed, the new cells formed are no longer defined in terms of size, shape or function. The cancerous cells are abnormal and do not perform any function. In the malignant form of cancer, they can spread and invade the surrounding cells, and also reach distant places through blood or the lymphatic system to form new tumors. However, benign tumors are usually confined to one place and do not spread to the surrounding areas.
Note - All benign tumors are usually harmless except the brain benign tumors, which can be life-threatening.
Why is Turkey a preferred destination for cancer treatment?
Turkey is a worldwide popular destination across the globe for medical treatment. The country tops the list when it comes to its cultural and historical appeal. Also, the panorama is such that, the medical tourists feel relaxed during their treatment leading to increased chances of improvement and positive results. Not only this, Turkey has been attracting a lot of international patients due to its hospital infrastructure, which is a result of years of large-scale investments by both the public and private sectors.
For instance, according to the Turkish Healthcare Travel Council, in the year 2017, the country rendered its medical services to approximately 765,000 patients from 144 countries.
In addition to this, Turkey has great connectivity internationally. The airlines are increasing the number of flights to Turkey each passing year. Turkish Airlines have started providing flight rates at much-discounted prices.
Some other advantages of getting a cancer treatment done in Turkey are:
- Adequate cost of cancer treatment.
- Quality medical care
- Precise diagnosis
- No language barrier
- Standardization of every treatment in terms of quality.
- No waiting list
Some of the most common treatments done in Turkey for cancer are:
- Robotic surgeries by Da Vinci robotic technologies
- Surgical intervention
- Hormonal therapy
Additional information - Some of the top hospitals in Turkey are now offering a specialized facility to provide a full range of radiation therapy. Such a facility is the first of its kind outside the United States in terms of quality treatment. To read more about this, click here.
Cancer causes and symptoms
Causes of cancer
The doctors think that there is no single cause for behind cancer. Instead, it is a combination of multiple factors which poses a risk or a threat for cancer. These factors may be social, environmental or genetic. Some of the most common risk factors for cancer are:
- Family history or genetics - Anyone who has a family member such as a parent, grandparent or sibling having a medical history of cancer, is more prone to develop cancer.
- Lifestyle - Certain lifestyle habits such as excessive smoking, drinking, or increased consumption of junk food act as a great threat for cancer in adults.
- Occupational factors such as working with toxic chemicals for years may also lead to cancer.
- Exposure to certain viruses - Viruses including Epstein-Barr Virus and HIV are the main causes behind AIDS (Auto-Immune Deficiency Syndrome), which in turn leads to an increased risk behind cancer, especially in children. Some of the examples for such cases are Hodgkin’s Lymphoma and non-hodgkin’s lymphoma. Moreover, a virus may also alter the cell structure in some way and these changes become cancerous and produce more cancer cells.
- Environmental factors - Continuous exposure to environmental chemicals such as pesticides and fertilizers. Such types of chemicals may also cause cancer in prenatal and infant stage.
- Other than this, children who are exposed to high-dose chemotherapy or radiation in the prenatal stage or otherwise have increased chances of malignancy later. Even a cancer treatment or a different type of cancer can lead to a second malignancy.
Role of gene mutations in causing cancer:
A gene mutation is a permanent alteration in the DNA sequence. A gene mutation can alter the functioning of a healthy cell in the following ways:
- A gene mutation can instruct a cell to grow and divide more rapidly.
- A mutation may also suppress the gene that tells the cells when to stop dividing.
- A mutation in a DNA repair gene may cause hindrance in the correction of errors.
A gene mutation can be caused as a result of the following reasons:
- An infant may be born with a genetic mutation inherited from the parents.
- Other mutations can occur as a result of smoking, radiation, hormonal imbalance, viruses, chronic inflammation or cancer-causing chemicals known as carcinogens.
Signs and symptoms
The exact signs and symptoms of cancer depend upon the type of cancer and where it has occurred or areas affected.
What are the ways in which cancer can affect our body? There are multiple ways:
- As a tumor grows, it pushes the surrounding structures such as nearby organs, blood vessels, or nerves.
- Any tumor in critical areas such as the brain, even a small tumor can cause severe symptoms.
- On the other hand, in organs such as the pancreas, cancer may not manifest any symptoms until it grows large enough.
- Tumors growing around bile duct blocks the flow of bile juices and show symptoms of jaundice.
- Other than the area-specific symptoms, cancer can also involve some general signs and symptoms such as fatigue, fever, or unexplained weight loss. This is because the cancerous cells also consume most of the body’s energy and also affect the immune system.
Some of the most common signs and symptoms associated with cancer are:
- Abnormal weight changes
- Lump under the skin
- Difficulty in swallowing
- Unexplained bleeding or bruising
- Hoarseness of voice
- Changes in bladder or bowel habits
- Difficulty breathing
- Changes in skin colour
- Joint or muscle pain
Cancer stages and its diagnosis
Staging of cancer is very important as it simplifies the location of cancer, the extent to which it is spread and also tell if it has spread to other parts of the body. The staging is helpful to the doctors and the patients in the following ways:
- Plan treatment for the case including chemotherapy, radiotherapy or surgical intervention.
- Predict the chances of cancer recurrence.
- Predict the chances of recovery
- To discuss the exact diagnosis of the case
TNM staging system
The TNM staging system is the most commonly used method used by doctors. This classification can convey the following information about a case:
T - how large is the primary tumor and where is it located?
N - has the tumor spread to the lymph nodes and if yes, how many?
M - has cancer spread to other body parts; if yes, how much?
It can also tell if there are any biomarkers linked to cancer.
The TNM staging is combined with I to IV classification:
Stage 0 - This means cancer has not spread to the surrounding structures. This type of cancer can be cured easily, mostly by surgical removing the tumor.
Stage I - The tumor is still small in size and has not spread deeper into the tissues, nor into the lymph nodes. The cancer is still curable and is known as early-stage cancer.
Stage II and stage III - these stages indicate a larger cancer that has gone deep into the tissues and may also have spread to the lymph nodes. However, it is still not metastatic.
Stage IV - This indicates advanced or metastatic cancer which has spread to other parts of the body.
Other than this, there is another classification for carcinoma. According to the National Cancer Institute, most of the cases are of following types:
Lymphoma - Tumor occurring in the lymphatic system including tonsils, thymus or spleen. It is mostly related to immune activity and hormones.
Myeloma - This mostly occurs in the bone marrow and originates from plasma cells
Leukaemia - This type of cancer also occurs from the bone marrow producing the red blood cells.
Sarcoma - This originates from connective tissue such as bones, muscle, fat, and cartilage. It is more common in young people.
How is it diagnosed?
The most common tests used the cancer doctors are as follows:
Clinical or physical examination - After asking you several questions and taking a medical history, the doctor will clinically evaluate you for any lumps or thickening of skin, color changes in skin, or enlargement of any organ. This evaluation gives a rough idea about the presence of cancer and also its location.
Laboratory tests - These tests include urine and blood tests used to identify the abnormalities in the cell number, function, structure etc. For example, a CBC test can reveal extremely high number of cells which indicate leukemia.
Imaging tests - Tests such as Computerized tomography or CT scan, bone scan, magnetic resonance imaging or MRI, positron emission tomography or PET scan, ultrasound and x-ray are used to evaluate the bones and other internal organs non-invasively.
Biopsy - A sample of affected cells is taken and sent to the laboratory. A biopsy helps in providing a definitive diagnosis of cancer. Depending upon the way of extracting the cells, the biopsy is of following types:
- Needle biopsy
- CT-guided biopsy
- Ultrasound-guided biopsy
- Bone biopsy
- Skin biopsy
- Surgical biopsy
- Punch biopsy
Common types of cancer
Here is a list of the most common types of cancer prevalent across the globe, along with the
- WHO data of the number of people affected by it
- Common symptoms for each cancer type.
- Originates from melanocytes - pigment forming cells.’
- Begins in the form of moles
- Found in skin, intestine or eyes
- The approximate number of current cases - 96,000
- One or more than one tumour in the breast
- Manifested as a change in shape, size, abnormalities in the skin of the breast.
- The approximate number of current cases - 2.09 million
- Affects the inner lining of lungs.
- Manifests as shortness of breath, hoarseness, cough with blood.
- The approximate number of current cases - 2.09 million
- Occurs in skin cells, mostly those which are exposed to the sun.
- Most common types are - squamous cell and basal cell carcinoma.
- The approximate number of current cases - 1.04 million cases
- The most common type of cancer in men.
- Involves trouble urinating, blood in semen, erectile dysfunction.
- Approximate number current cases - 1.28 million cases
- Cancer of large intestine
- Continuous changes in the bowel movement and unexplained weight loss
- The approximate number of current cases - 1.80 million cases
Cancer treatment: Understanding Your Treatment Options
While deciding the exact treatment for a particular case, the doctors have to consider three types of treatment objectives for treating cancer. These are:
Primary treatment - The objective of primary treatment is to remove the cancerous cells from the body. The most common form of primary treatment is surgery.
Adjuvant treatment - This type of treatment acts as a supplement therapy to kill the remanent cells left after the primary treatment to reduce any chances of recurrence. This mainly involves radiotherapy, chemotherapy, and hormone therapy.
Neoadjuvant therapy - This is similar to adjuvant therapy but it is used before the primary treatment to make it more effective and easier.
Palliative treatment - This treatment helps to get rid of the side effects of any given treatment or the symptoms due to cancer. Any treatment including surgery, radiation, chemotherapy or hormone therapy can be used. Palliative treatment can be used along with any other treatment at the same time.
The most common treatments used for cancer are:
- Surgical intervention - Most commonly used to treat cancer at early stages.
- Chemotherapy - Medications are injected systemically to kill the cancerous cells.
- Radiation therapy - High power beams are used such as x-rays or protons to kill cancerous cells. Radiotherapy can be in the form of external beam radiation or brachytherapy.
- Immunotherapy - This includes the use of the body's own immune system to fight cancer. Immunotherapy helps the body’s immune system to recognize the cancer cells as the abnormal cells and fight against them.
- Hormone therapy - Some cancer types occur due to hormone imbalance such as breast cancer or prostate cancer. Therapies targeting hormonal levels can help in stopping the progression of cancer.
- Targeted drug therapy - Targeted drugs are used to focus on the specific abnormalities within the cancer cells.
The survival rate of cancer in Turkey
An overall survival rate for cancer depends upon the following factors, such as:
- The type of cancer
- Location of cancerous cells
- Stage of cancer, in terms of the size of the tumour and extent to which it has spread
- Grade of cancer cells (the extent of abnormality in the cancerous cells)
- Age of the patient
- Medical history of the patient
- Response to the treatment
Cost of cancer treatment in Turkey
On average the cancer treatment can cost you around 2000 USD in Turkey. However, the exact cost may vary from case to case. The cost may be as low as 600 USD and as high as 3000 USD. Here is a cost comparison for cancer treatment in the top three medical destinations across the globe.
|2000 USD||4000 USD||70,000 USD|
Several factors contribute to deciding the exact cost of cancer treatment. These factors are:
The complexity of the case- Patients with a complicated and critical case may be charged higher than others as even a minute mistake can lead to fatal consequences.
The reputation of the hospital - some hospitals, which are popular for their treatment charge higher than the other hospitals to all patients.
Fees of the doctor- Doctors who are highly experienced and renowned in their fields usually charge more fees than others.
Cost of living - The cost of your accommodation place and commuting from one place to another also adds to the overall cost of your treatment.
City - some cities are more expensive than others in terms of general living expenses. For example, Gurgaon and New Delhi are more expensive than cities like Hyderabad.
Leading cancer hospitals in Turkey
- This is known as one of the best cancer hospitals in Turkey, which works with the most renowned doctor in Turkey.
- It is accredited by the Organization of European Cancer Institutes for innovative and effective cancer treatment options. There are only such places in the world.
- It uses the latest modifications as diagnostic tools and treatment, such as Da Vinci Robot, CyberKnife, and TrueBeam linear accelerator.
- The hospital is known for maintaining strict international protocols for quality treatment.
- It has been providing world-class medical services since February 2000.
- Patients come for treatment from more than 90 countries across the globe.
- Liv is the first recognized Center of Excellence outside the USA when it comes to colorectal and robotic surgery by Surgical Review Corporation.
- The hospital is also certified by TUV, European Technical Inspection Association, which confirms the high technological level of the applied equipment.
- The hospital was founded in 2010 and has become one of the most famous hospitals for oncology treatment in Turkey.
- It also has diagnostic equipment for visualization of tumors such as MRI, CT, PET-CT, and digital mammography.
- It is another popular multi-speciality hospital in Turkey, specialized in oncology treatment.
- The hospital is certified by JCI (Joint Commission International) for compliance with international standards of treatment quality and safety.
Leading cancer doctors in Turkey
- Dr. Yesim is a medical oncologist with more than 20 years of experience in the field.
- She is an esteemed member of the European Society of Medical Oncology, ESO, TTOD, and ATOD.
- She specialized in the diagnostic and medical management of malignant neoplasm of alimentary tract cancer.
- Dr. Metin is a well-known surgeon with extensive experience in his field.
- He is an active member of reputed organizations such as Intensive Care Journal and National surgery society.
- He has several publications to his credit.
- Dr. Nejat has more than 31 years of experience in surgical oncology.
- He has performed several surgeries related to the brain and spinal cord, especially in children.
- He has expertise in treating glioma, spine tumors, brain tumors etc.
- He is a renowned medical oncologist with more than 22 years of years.
- He holds expertise in treating blood cancers and bone marrow transplants.
- Dr. Turhul was also elected as the President of the Oncology Department of the European Medical Association from 2015-2017.
- Dr. Alper is a surgical oncologist as well as organ transplantation specialist in Turkey.
- He specializes in surgeries like organ transplantation such as liver transplant and kidney transplant.
Frequently Asked Questions
How many rounds of chemotherapy can a patient have?
Doses of chemotherapy may be administered on a daily basis, weekly or even monthly. The drugs are given at regular intervals, which are known as cycles. Generally, a patient may need four to eight cycles to treat cancer. However, it is entirely based on the type of case, the extent of its metastasis and structures involved. A series of cycles is called a course.
How long after the chemotherapy does the hair fall start?
In most cases, the hair fall begins 2 to 4 weeks after the treatment is started. It may instantly start falling out in clumps or slowly over time. The patient may start noticing accumulating loose hair strands on the pillow or in the hair comb.
The hair fall is continued throughout the treatment and up to a few weeks after that. In some cases, the hair only gets thinned, while others may get completely bald.
What is the difference between radiation therapy and chemotherapy?
Radiation therapy involves high doses of radiation focussed on the cancerous cells or the tumour, without causing much damage to the surrounding tissues. On the other hand, chemotherapy is structured to work throughout the body in the form of systemic administrations of drugs. The drugs can kill the cancerous cells in all parts of the body, but can also harm the natural cells.