Dr Tejinder Kataria
Cancer is a disease that can affect any part of the body and manifests with symptoms pertaining to the organ / system it affects. Cancer is a non communicable disease and is responsible for a higher mortality than heart disease in the western world. As the developing nations adopt the western life styles the incidence will be on the rise in developing countries as well. According to International Agency on Research in Cancer (IARC) by 2025, developing countries will harbor 85% of the cancer burden, with only 15% resources to provide medical care to the affected population.
According to Indian council of Medical research (ICMR) tobacco related cancers form 33% of all cancers in India. We take tobacco not only as cigarette / biri but also consume tobacco in its smokeless form with betel leaf (paan) and zarda. There has been a change in the profile of age at presentation for oral cancers due to use of smokeless tobacco and a relatively younger population is presenting with advanced cancers.
The attack on cancer needs to be multipronged and we as a society need to awaken our psyche to take on this demon head on. A few of the suggested pathways are –
Prevention – be wise and keep away from cancer producing substances namely tobacco, katha, slaked lime, betel nut and alcohol. Avoid exposure to vehicular exhaust and follow the norms for prevention of environmental pollution.
Awareness of the symptoms/signs of cancer. Since cancer is not one disease, one needs to be aware that any symptom which does not resolve with simple medication over 2-3 weeks, needs to be investigated properly. A headache or fits with no localizing signs; painless bleeding from any part of the body, cough with production of blood mixed sputum; a swelling in any part of the body that starts growing rapidly; hoarseness of voice; difficulty in swallowing solid foods; alternating constipation with diarrhea; difficulty and increased frequency of urination especially in males over the age of fifty years; fever of unknown origin lasting for more than three weeks.
Early diagnosis- Cancer is curable if diagnosed in an early stage. An early diagnosis can be arrived at by having a regular health check, being aware of its symptoms and mounting screening tests appropriate for each age. Some of the cancers that have shown a down trend due to sustained screening effort in developed world are:
i. Cancer cervix- pap smear in women;
ii. Cancer breast- mammography;
iii. PSA-cancer prostate in men;
iv. Colon cancer-colonoscopy in males more than 50 years of age.
Vaccination- Two most common cancers that can be prevented by vaccination are cancer cervix amongst women and liver cancer, the latter is prevalent in large numbers in South East Asia. Vaccination for cancer cervix can reduce the incidence of cancer by 50% in vaccinated population. It needs to be given 6 months before marriage or first intercourse for best possible effects. Vaccination against Hepatitis-B has been the single most important denominator for reducing liver cancer in European countries. The efforts of vaccination yield results over 20-30 years.
Adequate and proper treatment. Cancer is a disease where multi-modality treatment in an appropriate sequence can help reduce the side-effects and maximize the benefits. In recent years, besides surgery and chemotherapy targeted radiation by way of robotic radiosurgery and proton therapy in available for curative cancer treatment. The endeavor of cancer treatment now is to cure, palliate or prolong life with minimum side effects.
Palliation-In advanced stages palliation of symptoms is most important and a concerted effort should be made to provide support in familiar surroundings at home with maximum comfort to the patient along with his/her loved once.
“Let us pledge to join our hands to overcome this disease where we can, identify it early, prevent its occurrence and provide relief when we have it in advanced stage”.
The author is (Chairman-Medanta Cancer Institute)
Follow our WhatsApp channel