CANCER………………….The Epidemic of Today

Cancer is a deadly disease and is struggling hard presently to become the number one killer of our times .The incidence of cancer is increasing. This is because of increasing longevity, changing lifestyle, increasing pollution and many other factors. Three out of every ten people in the world will have cancer in their lives by 2025 .Cancer is increasing in India too and in the next 15 years or so, one out of every six person, will have cancer, which means that at least one member of every family will have a patient suffering from cancer. It is hence imperative that we all know the basics about cancer and its causes, early symptoms and methods of treatment. The study of Cancer is called Oncology,

The most common cancers in the world are of Lung, prostrate, colon (large gut), and rectum. In India the three most common cancers in women are of cervix, breast and esophagus (food pipe) and in men, the head and neck region and esophagus are affected by cancer most commonly. Over one third of all the cancers of the head and neck region, of the world affect Indians

What is Cancer?

Cancer is a purposeless growth of cells, which is unresponsive to the normal growth control mechanism of the body. These soon become so large that they cause adverse impact on the body. This is done by various methods

• Cancer cells use up body nutrients and deprive the normal cells of food and energy
• If on surface they can cause disfigurement and ulceration
• By fast growth they cause pain
• They may obstruct blood vessels, intestine, airway, food pipe etc
• They secrete hormone like substances which cause fever, weakness and other metabolic imbalance
• It may spread to distant organs and cause organ failure

Benign or Malignant

Cancer is often confused with tumor. Neoplasia, which is a purposeless growth of cells, can be of two types, Benign or Malignant. The benign one is the harmless growth and is normally called a tumor, these are slow growing, normally well localized in a capsule and almost never spread to distant organs. Very few tumors may invade local tissue or organs. Malignant neoplasm is the harmful one, which is called Cancer. This is fast growing, does not have a localizing capsule, infiltrates into local tissue and spreads to distant organs, often leading to death. Spread of cancer to distant organs is called metastasis. The common organs affected by metastasis are lymph nodes, liver, lung, bones and brain.

Types or Cancers

Cancers are of various types depending upon the organ or part of the body involved. The common ones are

• Adenocarcinomas ,Squamous Cell Carcinomas ,Transitional Cell carcinoma- these affect the common organs of the body.
• Sarcoma-these are cancers of connective tissue like muscles, bone, fat etc
• Lymphomas and Leukemia- this affects the nodes and the blood cells

Causes of Cancer

The exact cause of cancer is not known. but it is believed that changes(mutations) in the genes lead to cancer. These changes may be caused by various factors like genetics, hereditary, geographical distribution, chemicals like aniline, benzene etc, chronic friction like old injury or burn scar, exposure to ionizing radiations and ultraviolet rays, smoking, drinking, use of pan, pan masala and tobacco, poor hygiene and certain preexisting diseases or conditions.

Myths and Facts About Cancer

• Age:- Cancer is not the disease of old age only, it can occur in any age and at times .Even a baby can be born with cancer.
• Survival and Cure Diagnosis of Cancer does not mean a death warrant. Cancer can be cured if detected early and a large number of patients survive several years and at times even normal life after having cancer
• Spread:- Cancer is not contagious, It does not spread by staying in the same house or by touch .
• Use of Knife:- People feel that use of knife for biopsy or surgery can spread cancer, but it is not so. Biopsy is essential to diagnose most cancers and plan treatment and surgery where ever possible is the most effective method of treatment in majority of cancers. It removes or decreases the diseased part and makes chemotherapy and radiotherapy more effective

Early signs of Cancer:-

Early detection of cancer is the most important way of curing it. So we must all be very careful of early signs of Cancer. They can be summarized as follows:

• C hange in bowel or bladder habits
• A sore that does not heal
• U nusual bleeding or discharge
• T hickening or lump in breast or elsewhere
• I ndigestion or difficulty in swallowing
• O bvious change in an existing wart or mole
• N agging cough or hoarseness of voice

Besides the above Cancer warning signals, one should consult a doctor in the eventuality of unexplained weight loss, continuous prolonged fever, or general weakness. Patients with family history of cancer or those who have had cancer in the past ,or who have had exposure to radiation or are working in an industry where they are in contact with chemicals are at high risk for cancer and should be careful, and undergo periodic checkups

The routine checkups advised in our country for common cancers is as follows

Woman 

• Cancer of Cervix – PAP Smear Test every 2-5 years from the age of 35
• Cancer Breast -Mammography every 5 years from the age of 35 years
• Self Breast Examination every month
• Breast examination by the doctor every 2-5 years

Men   

• Prostate – PSA (Prostatic Specific Antigen ) every 5 years from the age of 45years
• Colon and Rectum  -Stool for occult blood and per rectal examination every 2-5 years from the age of 45 years

Prevetion of Cancer

           Avoid tobacco,smoking and alcohol consumption

           Eat balanced Diet full of green vegetables and fresh fruit

           Avoid Obesity

Diagnosis of Cancer

The Diagnosis of Cancer involves three sets of investigations

Confirmation of Diagnosis, by biopsy

• Cytology
• Fine Needle Aspiration Cytology or Biopsy (FNA/FNAB)
• Cytology of Fluids
• Histopathology
• Endoscopic Biopsy
• Stereostatic Biopsy

Staging workup, to see the extent of disease locally, its spread and the operability

General Investigations, to assess the general fitness of the patient to undertake the treatment

Routine investigations done for diagnosis and staging of cancer are – X Rays, Ultrasound, Endoscopy, Doppler, CT Scan (Computerized Axial Tomography), MRI (Magnetic Resonance Imaging), Radioactive Scans, Tumor Markers(CA-125, PSA, CEA, AFP, BHCG, Calcitonin, Thyroglobulin)

   The various modality of treatment of cancer are as follows:

• Surgery
• Chemotherapy
• Radiotherapy
• Hormonal therapy
• Miscellaneous therapies like laser, radioactive ablation, gamma knife etc.