Haemato- oncology and malignancy

Abstract

Cancer is a common cause of morbidity and mortality in the United Kingdom (UK), affecting approximately two out of every five people during their lifetime. In 2015 there was an estimated 2.5 million people in the UK who had had a cancer diagnosis, an increase of almost half a million in the previous 5 years. The proportion of people living longer after cancer is increasing, and the number of people alive more than 5 years from initial diagnosis is predicted to more than double between 2010 and 2030 to 2.7 million. By the end of 2020, more than a thousand people would have been diagnosed with cancer every day in the UK. Cancer can affect all organs of the body with over 200 types identified. However, only a small number of cancer types account for most cases. Over half of all new diagnoses are due to four cancers (in order of frequency)— breast, pros­tate, lung, and bowel. In 2011 there were approximately 50 000 new diagnoses of breast cancer in the UK. The in­cidence of cancer diagnosis is increasing year on year, in part due to improving diagnostic skills, but also because of an increasing elderly population. Cancer of unknown primary origin accounts for about 3% of total cancers. Although UK statistics show a general improvement in the 5-year survival rates for the majority of common cancers, some have not shown any notable improvement. Survival is not only determined by the type of cancer, but also the age at diagnosis, stage, and co- morbidities such as heart, pulmonary, and renal disease, which can affect the treatment regimen. As well as this, certain cancers carry a significantly worse prognosis than others. For example, 10- year survival for pancreatic and lung cancer are 1% and 5%, respectively. In comparison, the 10- year survival for testicular cancer is over 98% and almost 90% in skin con­fined melanoma. Newer diagnostic strategies are expected to detect all cancers early, allowing prompt intervention, and improving both morbidity and mortality rates further. Cancer is a product of mutations in genes involved in controlling cell growth, differentiation, and death (apop­tosis).