Carcinoma in Situ: Definition, Types, and Treatment Insights
Carcinoma in situ is an early-stage cancer, also known as stage 0 cancer. Early detection and treatment can reduce the spread.
What is the definition of carcinoma in situ?
Carcinoma in situ, also known as stage 0 cancer, is an early form of cancer that's less invasive than later-stage cancers. Cancer can start in different parts of the body, like breast, colorectum, lung, nasopharynx, and liver. According to the World Health Organization (WHO), 1 in 10 males and 1 in 9 females in Malaysia are at risk of developing cancer once in their life. Early detection of in situ cancer and proactive treatment can reduce the risk of it spreading to other organs.
This article will provide an overview of in situ cancer, common sites of occurrence, and treatment methods.
What is the definition of in situ cancer?
Before understanding the definition of carcinoma in situ, let's first learn what cancer is.
The human body is composed of numerous cells, and new cells automatically reproduce to replace aging or damaged cells. When this mechanism is disrupted, it can lead to uncontrolled and abnormal cell growth, forming tumours in different parts of the body. If a tumour is determined to be malignant (cancerous), it is referred to as cancer.
Malignant (cancerous) tumours, when they first appear, often remain confined to the base layer of the primary site. Because they do not invade nearby tissues, they are defined as "in situ cancer". However, if they are not treated appropriately, cancer cells have the opportunity to spread and invade other areas, becoming more aggressive "secondary cancer" or "metastatic cancer." For example, breast carcinoma in situ, cervical carcinoma in situ, skin carcinoma in situ, bladder carcinoma in situ, and colorectal carcinoma in situ, when left untreated, can progress to more high-risk forms of cancer.
What types of carcinoma in situ cancer are there?
| Common examples of carcinoma in situ cancers | Situation |
| Breast cancer in situ | Breast cancer in situ does not have obvious external symptoms, and it is not easily detectable by feeling for lumps in the breast. In a small number of patients, there may be abnormal nipple discharge and further examination is required through breast imaging. |
| Cervical cancer in situ | Cervical cancer in situ arises from severe changes in cervical epithelial cells, most of which are caused by the human papillomavirus (HPV). Due to the lack of obvious symptoms, it requires tests like cervical cytology (Pap smear) for confirmation. |
| Skin cancer in situ | Skin cancer in situ often appears as red, scaly patches on body areas such as the face, ears, neck, or limbs. If these patches persist, it is advisable to consult a doctor to discuss whether a biopsy (tissue sample) is needed. |
| Bladder cancer in situ | Early symptoms of bladder cancer in situ include painless haematuria (blood in the urine), painful urination, frequent urgency to urinate, and can often be mistaken for cystitis. Further diagnosis can be conducted through blood tests and cystoscopy. |
| Colorectal cancer in situ | Once adenomatous polyps in the colon evolve into malignant tumours and remain confined to the inner layer of the colon or rectum, it is defined as colorectal cancer in situ. Early-stage colorectal cancer may have no obvious symptoms. If there are long-term occurrences of black stools or changes in bowel habits, it is advisable to consult a doctor for endoscopy examination. |
Common carcinoma in situ treatment methods
1. Surgical removal
In general, if the tumour is larger or has spread to other parts of the body, surgical removal is a more comprehensive treatment method. Depending on the situation after the removal, it may eliminate the need for other therapies such as radiotherapy, chemotherapy, and radiation treatment. Take breast cancer in situ, for example; to prevent cancerous tissue from progressing into invasive breast cancer, total mastectomy surgery is an effective method for reducing the risk of recurrence. The probability of breast cancer recurring in the same breast following a mastectomy is generally quite low, typically ranging from 1% to 3%.
2. Chemotherapy
Because normal cells and tumour cells have differences in their biological and proliferative characteristics, chemotherapy aims to stop cancer cells from growing and spreading, which helps prevent the cancer from invading other parts of the body. It works by blocking the growth of cancer cells in different ways, both inside the cells and in their surroundings. However, it can also harm healthy cells, causing side effects, such as bone marrow suppression (resulting in lowered immunity, anaemia, or bleeding), oral ulcers, vomiting, nausea, loss of appetite, diarrhoea, skin pigmentation, hair loss and etc.
3. Targeted therapy
Targeted therapy is designed to address the molecules responsible for sending signals that trigger the growth or division of cancer cells. By specifically targeting these molecules, these medications interrupt their signalling pathways, thereby preventing the growth, and spread of cancer cells while minimizing any adverse effects on normal cells. Common categories of targeted therapy drugs include monoclonal antibodies, tyrosine kinase inhibitors, apoptosis-inducing drugs, angiogenesis inhibitors, mTOR inhibitors and hormonal therapies.
Can carcinoma in situ cancer be claimed under insurance/takaful?
In the insurance/takaful landscape, there are limitations of traditional critical illness coverage, which often exclude in-situ or early-stage cancer. Therefore, it is important for customers to carefully check their policies/certificates, as some may only cover advanced stages. In response to this limitation, FWD Takaful includes early-stage protection, such as carcinoma in situ, along with additional benefits in their cancer plans.
FWD i-Lindung Critical Illness Plan is an exclusive protection plan for EPF members available on the KWSP i-Akaun app. This comprehensive plan provides extensive coverage of up to RM200,000, addressing the top 3 critical illnesses – cancer, heart attack, and stroke, from early to advanced stages. The plan also provides coverage in the unfortunate event of death. EPF members can pay for their contribution with their EPF Account funds.
For those looking for a more targeted cancer protection plan, FWD Care Direct is a great option. This plan provides a lump sum payout of up to RM250,000 for all stages, including stage 0 (carcinoma in situ). Cancer treatment costs can be daunting, so having a cancer plan helps ensure that financial support is available in times of need. Whether it's to use on home modifications, nursing assistance, or travel expenses for treatment support, the payout has you covered so you can focus on your recovery.
Apply for our online plans today with no medical examinations required. You'll just need to answer a few simple health questions.
