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The Difference Between Cancer and Lupus

The Difference Between Cancer and Lupus

What are Cancer and Lupus?

In the world of medicine, there are countless diseases with many different names. The reasons behind naming diseases have varied widely throughout the ages. Many diseases have gained their names through the clinical symptoms that patients present with. This method has been a prevalent way to describe illnesses before the emergence of modern medicine. After the advancement of modern scientific techniques, new ways of naming diseases appeared. Some diseases are directly named after their causative factor, while others are named after the scientist who first described the diseases.

Although modern medicine has answered many questions and established many facts related to various types of illnesses, some questions can still only be answered through studying the history of old nations and their documentations. One of these questions is the reason behind naming two of the very old and very famous diseases: Cancer and Lupus.

The words (Cancer) and (Lupus) were first  the names of two members of the animal kingdom before being names of any diseases. On the one hand, Cancer is a genus of marine crabs that still has eight existing species (the three other species in the family Cancridea have ceased to exist). On the other hand, Lupus is a Latin word for wolf; a canine animal native to the wilderness. Historically, wolves have been feared in many cultures due to their aggressive behavior. Wolves have been known for their potential to attack vulnerable human beings, especially kids and women.

The Diseases

Both diseases have been described in texts from hundreds of years ago. Cancer, as a disease, has been described in the records of the ancient Egyptians. Breast cancer has been reported in the Egyptian Edwin Smith Papyrus. The current naming of the disease as “Cancer” has been traced back to the time of Hippocrates, when he described the disease with the Greek word “karkinos” which means crab or crayfish in English. This name was actually inspired from the fact that the cut surface of a solid malignant tumor appeared to have multiple stretched projections and blood vessels similar to the extended feet of the crab. In contrast, the term Lupus started to be used as a description for multiple ulcerative diseases that looked similar to those inflicted by a real wolf (Canis lupus) attack. That is why different types of ulcerations, whether they were neoplastic, infectious, or traumatic, were labelled as lupus without specifying the exact reason behind these various manifestations.

More details about the different causative factors, manifestations, and managing plans of Cancer and Lupus will be discussed in the following parts of the article.

CANCER

Definition

Cancer is a very well-known and feared disease that is characterized primarily by the uncontrolled cellular growth within our bodies. This out of control and abnormal growth can result in the development of masses, disfiguring lumps,  or destructive ulcerations that often diffuse and infiltrate other parts of the body in a process called metastasis.

It is worth mentioning that not all tumours are cancerous. Benign tumours are those that neither invade tissues nor spread to other body parts.

Causes

The most common causes for cancer are environmental factors. Cancer can be caused by many harmful chemical and physical factors known as carcinogens. These chemical factors include many components associated with tobacco smoking. Other factors include infections such as Hepatitis C, B, and the Human Papilloma Virus (HPV). There are also genetic predisposing factors that significantly increase the chances of developing certain types of cancer.

Signs and Symptoms

Most cancers tend to have insidious onset, which means that the cancer does not represent itself, and the patient does not start to complain or seek medical advice until it is too late. This unique feature is undoubtedly one of the many reasons why cancer is considered one of the most serious health problems facing humankind.

Cancer can affect any tissue inside the body, altering its normal cellular behaviour into an abnormally out-of-control structure. This change disrupts the function of the affected tissue and neighbouring structures, before eventually targeting other remote tissues.

The period preceding the definite diagnosis of cancer usually mirrors the symptoms and signs of other illnesses. That is why cancer is considered to be the greatest imitator of diseases.

Symptoms and signs are usually categorized into 3 main types: local manifestations, systemic manifestations, and metastatic manifestations.

Local manifestations usually occur due to the direct effect of a mass or an ulcer either by compression and increased pressure inside a small cavity or by erosion of an important structure.

Systemic manifestations are not caused by the direct effect of the cancerous tumours but rather because of its depleting effect on the general state of health. This explains the similarity of general symptoms among the different types of cancers. Easy fatigability, anaemia, unexplained weight loss, and loss of appetite are among the most common general symptoms reported in cancer.

Metastatic manifestations emerge when the cancer spreads to remote parts of the body via lymphatic or haematogenous routes. The metastatic symptoms depend on the organs affected by these dispensed malignant cells.

Diagnosis

Initial diagnosis can be done through screening tests and other ordinary tests, such as X-ray, CT, endoscopy, and blood tests, depending on the existent signs and symptoms. However, the definitive diagnosis of cancer should be through a pathologist. A pathological examination of the cancerous tissue can detect the exact type of affected cells and give a good idea about the state of the disease so that a treatment plan can be created.

Prevention

Avoiding causative carcinogens, in addition to leading a healthy lifestyle, can help to dramatically reduce the risks of developing cancer.

Management

Most cancers can be treated or surgically removed if discovered early enough. The most available options are surgery, chemotherapy, radiotherapy, immunotherapy, and palliative therapy in advanced cases.

LUPUS

In the modern world of medicine, the word lupus is often used to refer to Systemic Lupus Erythematosus (SLE). However, it may be surprising for many people to know that the word lupus is also relevant to some other diseases. The two situations, where lupus is referred to as a remarkable medical term, have appeared in tuberculosis and an idiopathic form. We have learned only recently that these are two very different diseases with completely different etiologies.

Systemic Lupus Erythematosus (SLE)

SLE is similar to cancer because it is also a common  imitator disease. It is usually mistaken as other disease and requires further investigations to be diagnosed. But SLE has an entirely different etiology than cancer. SLE is simply known as lupus. It is an autoimmune disease where autoantibodies are formed that attack the body’s own healthy tissues. The disease often manifests itself in variable degrees among affected individuals. Connective tissues around the body are targeted by this autoimmune hostility.

Causes

SLE is believed to be an autoimmune disease, wherein the immune system attacks other healthy tissues, causing inflammations and destruction. The reasons for this misdirection are still not fully proven. Since  SLE is characterized by alternating periods of remissions and flares, there are some theories about its cause–disturbed female sex hormones, increased stress levels and genetic components are among the main players.

Signs and Symptoms

SLE symptoms can be vague and easily misdiagnosed. Several parts of the body can be affected as a result of targeting their connective tissues, producing mouth ulcers, facial rashes, swollen, painful joints, hair loss, easy fatigability, enlarged lymph nodes, and fever. SLE can be associated with more dangerous renal and eye sequelae, hence monitoring the health status of SLE patients is very crucial.

Diagnosis

Signs and symptoms can be suggestive but a definitive diagnosis requires some histopathology. Serologically, detecting Anti-Nuclear Antibodies (ANA) is widely used in screening tests for SLE patients, while testing Anti-dsDNA antibodies is highly specific for SLE. Anti-double stranded DNA antibody levels can also be used as a very good indicator for SLE activity.

Treatment

SLE has no definitive cure. Therapy plans usually focus on controlling acute attacks as well as avoiding flares. In order to do so, immunosuppressants, corticosteroids, NSAIDs, and methotrexate are being used to control and curb the autoimmune activity.

Lupus Vulgaris

Lupus vulgaris is a form of the tuberculosis disease in which painful skin lesions present on the face around the nose, cheeks, eyelids, lips, neck, and ears. In advanced cases, disfiguring ulcers develop.

Signs and Symptoms

Reddish-brown nodules that slowly enlarge to form irregularly shaped red plagues that later become ulcerates.

Cause

Mycobacterium tuberculosis sometimes invades the skin, causing local inflammations and nodules then plagues that eventually ulcerates with significant disfigurement.

Diagnosis

It is diagnosed as an “apple-jelly”-coloured skin lesion by diascopy. Tuberculoid granuloma with few bacilli can be detected by biopsy. Manteaux test is positive.

Treatment:

Combination therapy for TB should be administered: Rifampicin, Isoniazid, and Pyrazinamide.


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References :


[0]Hajdu, S.I., A note from history: landmarks in history of cancer, part 1. Cancer, 2011. 117(5): p. 1097-102.

[1]Fatovic-Ferencic, S. and K. Holubar, Early history and iconography of lupus erythematosus. Clin Dermatol, 2004. 22(2): p. 100-4.

[2]Hanahan, D. and R.A. Weinberg, Hallmarks of cancer: the next generation. Cell, 2011. 144(5): p. 646-74.

[3]Pagano, J.S., et al., Infectious agents and cancer: criteria for a causal relation. Semin Cancer Biol, 2004. 14(6): p. 453-71.

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[5]Barua, J.K., et al., Multifocal lupus vulgaris with involvement of palpebral conjunctiva. Indian J Dermatol Venereol Leprol, 2017. 83(2): p. 216-218.

[6]https://commons.wikimedia.org/wiki/File:Symptoms_of_SLE.svg

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