Nowadays, cancer has great repercussions in the society of the United States and throughout the world as it is one of the leading causes of death. However, sometimes the misconception that it is just one disease arises. There are many types of cancer, and each of them can develop in different ways. Also, it produces an impact in the patient and its environment as the healing process the patient goes through may be hard and painful. In the following paragraphs the disease of cancer will be explained, in addition to the causes, current treatments, and an exposition of my thoughts in relation to terminal cancer.

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 According to the National Cancer Institute, cancer is “the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.” In more detail, cancer begins within a single cell in the body when proto-oncogenes (normal, necessary genes that help to regulate cell growth) mutate into oncogenes (cancer-causing genes), creating a cancerous cell. The mass of body cells growing out of control is called a tumor; however, not all tumors are cancerous. Benign tumors are not cancerous, usually can be removed, and in most cases, do not reappear. The cells of the benign tumors do not spread to other parts of the body. The other type or tumors is malignant tumors, which are cancerous. The cells of these tumors can invade nearby tissues and spread to other parts of the body. When cancer spreads from one part of the body to another it is called metastasis.
 There are more than 100 types of cancer. Types of cancer are usually named for the organs or tissues where the cancers form. For example, lung cancer starts in cells of the lung. Other examples are liver cancer, colon cancer, or breast cancer among others. Cancers also may be described by the type of cell that formed them, such as an epithelial cell. Some categories of cancers that begin in specific types of cells are: carcinomas, which are the most common type of cancer and are formed by epithelial cells (cells that cover the inside and outside surfaces of the body); sarcomas, which are formed in bone and soft tissues; leukemia, which beings in the blood-forming tissue of the bone marrow; lymphoma, which begins in lymphocytes (T cells or B cells); multiple myeloma, which starts in plasma cells (another type of immune cell); and melanoma, which affects the specialized cells that make melanin (the pigment that gives skin its color) (National Cancer Institute). 
 Cancer is caused by abnormalities in the genetic material of cells. These abnormalities can be caused by carcinogens, such as radiation (ionizing, ultraviolet, etc.), chemical products (from industry, tobacco smoke and pollution in general, etc.) or infectious agents. Other cause is genetic abnormalities and mutations that are acquired during the normal division of DNA by not correcting the errors that occur during it. Also, they may be inherited, causing a greater probability of triggering the disease (Cancer Research UK). However, some of the causes mentioned before can be avoided through healthy habits and taking precautions. Some ways to reduce cancer risk are maintaining a healthy diet, exercising frequently, avoiding smoking or tobacco smoke, using sun protection, and taking regular screenings.
 With the latest technological advances, many people wonder why cancer is so difficult to treat. As it is mentioned in the previous paragraphs, the development of cancer is mainly due to a series of mutations that occur in the DNA of normal cells, which cause them to reproduce uncontrollably causing serious damages in the body. In most cases, cells detect such mutations and repair or destruct themselves. However, some mutations allow cancer cells to evade the self-defense mechanisms and invade nearby tissues or even penetrate other organs of the body. The reason why cancer is so difficult to treat is because it is extremely complex as there is a large number of genes involved. Also, it includes various types of cancers, which sometimes behave differently. Even a cancer started in one place can evolve and behave in other ways in the same place. Besides that, certain types of cancer can generate multiple subpopulations (groupings of cancer cells derived from another cell) that, at the same time, present their own mutations. This occurs because cancer cells are “masters” of adaptation that evolve constantly adjusting their molecular characteristics to survive any medication or immune response. By this way, one medicament could work in one subpopulation but not work in the others (Iberoamerican Agency for the Dissemination of Science and Technology). In addition, another reason why cancer is so difficult to treat is because each person responds differently to medications and treatments.
 As we have seen, it is not easy to treat cancer because of the numerous types and the different ways they evolve. However, there are different treatments depending on the stage and development of the disease that can cure or stop the development of cancer such as surgery, radiation, and chemotherapy. Surgery can remove a tumor, while radiation can disrupt cell division locally and chemotherapy can disrupt cell division throughout the body. Other treatments are immunotherapy, targeted therapy, hormone therapy, stem cells transplant, and precision medicine (National Cancer Institute).
 In the following lines I’m going to talk about the chemotherapy (also called chemo) treatment. Chemo uses drugs to kill cancer cells and works by stopping or slowing their growth, which is usually quick. It is used to cure cancer, lessen the chance of return, or stop or slow its growth. Also, it can be used to shrink tumors that are causing pain and other problems. Besides that, chemo used with other treatments can: make a tumor smaller before surgery or radiation therapy (neoadjuvant chemotherapy), destroy cancer cells that may remain after treatment with surgery or radiation therapy (adjuvant chemotherapy), help other treatments work better, and kill cancer cells that have returned or spread to other parts of your body (National Cancer Institute).
 The section above is more a “theoretical” part about cancer, but it encompasses much more. Currently, cancer is one of the diseases that causes greater fear in the developed world. The margin of healing is limited depending on its different manifestations and sometimes there is not certainty that the cure or treatment will work. I think that the diagnosis of cancer in every case is a shocking and painful new, especially in the case of terminal cancer as there is not an adjective more definitive and fatal than “terminal.” When receiving the diagnostic, it is crucial to listen to all the information provided by the doctor and start making decisions towards the future, assimilating that it is one of the most difficult situations in life for both, the affected person and the people around such as family and friends.
 From my point of view, one of the first decisions that should be made is consider if communicate to the patient that he or she has terminal cancer or hide it. The choice requires a previous reflection by the people closest to the patient and should not be a generalization according to the disease; instead it should be adapted to each patient, their age, situation, and family considerations. In my opinion, the best is to give and receive all the information. I believe that it is the way to offer the patient the possibility of deciding how he or she wants to spend the remaining time and where to invest their energies. On the other hand, share with the patient the situation could be risked as he or she may stop fighting from the beginning and be submerged in a depression that further aggravates the situation.
 In continuation, I will expose my thoughts in different cases of finding out that one person has terminal cancer: my grandparent, my children, and myself. In relation with this, I think that it is not the same to detect a terminal disease in an old person than in a child. An old person has already lived for a long time and has had many experiences and important moments. Also, in the last stages of life old people tend to think in the fact of dying as they have seen how people around them and some of their loved ones have been disappearing. Nevertheless, in the case of a young person or a child, they still have a lot to know, learn, and “live.” I think that in every case mentioned we should be happy with every achievement, confront each of the regressions, and look for a goal or reason that encourages everyone to dream and take advantage of the remaining time.
 I feel that finding out that my grandparent has terminal cancer would be very painful, at the beginning I would not believe it. I would think that there is still a solution and I would fight and try to do everything I could to find it. It would take me some time to accept it; however, after assimilating the situation and realizing that there is not a remedy, I would spend as much time as I could with him doing activities, talking about his life and experiences, remembering moments together, and, above all, enjoying each other’s company. I would like my grandmother to accompany us most of the time, so she can leave aside the sadness and worry during the time we are together. Also, I would like that his quality of life was not affected, and I would help him say goodbye to his people while feeling loved and cared. I believe the process would be hard as a grandparent is a person you have grown with.
 I think that we as humans are not prepared to see a child die. In the case of a grandparent you see him getting old and, in some way, you get prepared, but for a child there is not possible defense. Although we have not thought about it, I think that all parents believe that they will die before their child, so seeing a child knowing that he or she has terminal cancer must be devastating. I am trying to think as a mother, however, in my opinion, you don’t know the feelings that a mom has for her child until you have yours. I am not sure how I would react if I find out that my children has terminal cancer, but I know I would try to enjoy with him all the time he has left, and I would do everything to make him as happy as possible. Also, I think I would leave all to dedicate myself exclusively to him. I would not accept easily the diagnosis and at the beginning I would insist on treatments and cures. Even after accepting it, I do not think I could lose the hope of a miraculous cure. I would try to respect his decisions, and I would help him cope with the pain and face the path with patience and serenity. For me, the most important things would be facing the challenges together, sharing special moments, and making my child do not lose the smile.
 In my case, if I find out that I have terminal cancer I would be so scared, as it would be shocking to know that you have a certain time left. I think it would take me time to accept the reality, but then I would face the disease with all my strength. In my case, I would travel around the world, see its beautiful places, meet other cultures, and try different flavors. I would play basketball, run, and do every kind of sport until I had no energy. I think I could not stop. When the treatments and my body no longer allowed it, I would immerse myself in readings that would allow me to continue traveling and living adventures through their pages. Also, I would do activities that I like to keep my mind occupied such as play the guitar and draw.
 I would say to my family and friends that I love them so much, and I would encourage them to take advantage of life for the really important things. I think that I no longer would get mad at unimportant details and I would enjoy all minutes I could share with the people I love. However, I think that in some moments I would feel guilty for being a burden to my parents and I would feel impotence when people had to help me. At the end, I believe that I would appreciate the moments lived and during the path I would lose the fear of death.
In conclusion, cancer is more than just one disease as it includes diverse manifestations and the possibility of evolving in different ways. There are various treatments to fight the disease depending on the person and the type of cancer, and sometimes the mentality of the patient has an essential role. However, in few cases there is no remedy as in the case of terminal cancer. Through this essay, I have thought about situations of terminal cancer, realizing on the value of the support from the people you care the most and the importance of try to take advantage of our lives every day.
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