Friday, October 22, 2010

CANCER - How much do we know ?.

Isn't it alarming that each year, over 12 million people receive a cancer diagnosis and 7.6 million die of the disease even when we know that approx.40 % of cancers are potentially preventable.
What is Cancer ?.
Cancer is an abnormal and uncontrolled division of cells which are able to invade and damage the organ in which they develop and also invade the other organs in their vicinity.Cancer cells can also spread to other parts of the body through blood or lymph.
How cancer develops ?
Cancer development is a highly complex process occurring at intracellular level.The following two videos are self explanatory of the mechanism of development of cancer at the cell level and its further progression.

What causes Cancer ?.
Apparently it is difficult to identify reasoning for most cancers.However, certain risk factors like smoking, chewing tobacco etc. are known to increase the chance that you are more likely to develop certain cancers of mouth,throat and lung.The substances, excessive exposure of which can lead to cancer are called Carcinogens.
Well known examples of Carcinogens are :
(1) Tobacco : 
Cancer Cures Smoking.
Smoking Grave.
Cancer Lips in a tobacco chewer.
Rick Bender,a former base ball player and tobacco chewer,after cancer surgery of lower jaw.

If you smoke or chew tobacco, you are more likely to develop cancer of the lungs,mouth,throat, esophagus bladder and pancreas.Smoking is thought to cause about a quarter of of all cancers.The heavier you smoke,the greater the risk.
(2) Workplace Chemicals : 

 Chemicals such as Asbestos,Benzene, Formalin etc.are known carcinogens.If you have worked with these chemicals without protection ,you have an increased risk of developing certain cancers like urinary bladder cancer,lung cancer,and skin cancers.For example a cancer called Mesothelioma is linked to past exposure to asbestos.Exhausts from factories and automobile sector is the biggest  problem now.
A common question often asked is "Doctor I have never taken any alcohol and tobacco in my entire life and also I have always lead  a healthy lifestyle,still I developed cancer,what actually happened ?"
(3) Radiation : 
Radiation is a well known carcinogen.Present day telecommunication advances viz. TV towers,wireless towers,cell phones etc pose a great threat to cancer development and its impact will be overt in 10-15 years time.Unnecessary medical irradiation in form of needless X-rays,ultrasounds,CT scans ,MRI's etc are also a great threat. Increasing sun rays radiation, 2nd world war aftermaths, and nuclear power plant disasters are a more than testimony to carcinogenesis.
There are certain other risks related to causation of cancer although they are highly variable in different settings : 
(a) Age : A good majority of certain cancers like breast cancer,prostate cancer,are attributable to age.
The reason for this lies in the fact that as you become older,there is an inappreciable accumulation of damage to cells in the body over time.For example,the ability to repair damaged cells and the immune system which may have destroyed the abnormal cells,may become less efficient with age.So,eventually one damaged cell may manage to survive and multiply 'out of control' into a cancer.
Women after 40 years of age and men after 50 years of age should undergo regular cancer screening programme to detect them at the earliest stage when they are most curable.
(b) Lifestyle factors : Diet and other lifestyle factors may increase or decrease the risk of developing cancer.
For example : 
 If you eat a a lot of fruits and vegetables you have a reduced  risk of developing certain cancers like stomach and intestinal cancers.The exact way in which they protect against cancer is not fully understood.They form the 'roughage' which lead to better bowel movements and efficient fecal clearance and therefore less exposure of intestines to harmful chemicals and by-products in the food and body, thus preventing cancer formation.These foods are also rich in vitamins and minerals,and also contain chemicals called 'anti-oxidants' which neutralize these harmful chemicals formed in the body.
'Dos' and 'Donts' to your dietary habits : 
*We should try to have at least some portions of fruits and vegetables per day (Experts recommend as much as possible).
* Eating too much of fatty foods possibly increases the risk of developing certain cancers like intestinal,prostate and uterus cancers.
*The risk of developing certain cancers is increased by obesity and lack of regular exercises,and drinking a lot of alcohol.
(c) Alcohol : Alcohol, a well known recreational and euphoric drink,always demands its dividends in form of soooo many human diseases.
In people of Indian origin,there is an increased risk of developing alcohol related diseases and ca
ncers as compared to western population.
Alcohol consumption increases the chances of liver,breast,colon,pancreas,stomach,throat and food pipe cancers as shown in the above diagram.
Polyamines-natural compounds essential for cell growth-react with acetaldehyde,which is produced when alcohol is metabolized in the body, to trigger a series of reactions that damage DNA - an event that can lead to formation of cancer.
It's not just heavy drinking - even small amounts of alcohol increases risk, but the more you drink, the greater the risk.
Despite some evidence that drinking regular, small amounts of alcohol (e.g. red wine) may reduce heart disease in older adults, there's no evidence that alcohol helps protect you from any type of cancer.
Your risk of cancer is the same for all types of alcohol including beer, wine and spirits.
How much should I drink?
To reduce the risk of cancer, you should limit your intake of alcohol or, better still, avoid it all together.
For those who do drink alcohol, we recommend no more than 2 standard drinks a day.
We also recommend those who drink avoid binge drinking (a single occasion of heavy drinking over a short period of time) and have at least 1 or 2 alcohol-free days each week.
Tips for drinking less
If you choose to drink:
# Alternate alcoholic drinks with non-alcoholic ones like sparkling or plain water (soda, lime and bitters is a great alternative to alcohol).
# Eat some food when you drink alcohol. Think of a glass of wine or beer as something to have with a meal rather than on its own.
# Dilute alcoholic drinks, for example, try a shandy (beer and lemonade) or white wine and mineral water.
# Choose a low-alcohol (or no-alcohol) beer and/or wine.
# Use water to quench your thirst and sip alcoholic drinks slowly.
# Offer to be the designated driver when you go out so you drink less, but make sure you stay under .05

Also along with smoking it further increases your chances of developing  cancers of mouth,throat,food pipe,breathing pipe and stomach.
(d) Infections : Infections in certaion parts of the body (mostly viral) are linked to certain cancers.
HPV-virus of cancer cervix.
For example,people with persistent infection with Hepatitis B virus or the Hepatitis C virus have an increased risk of developing cancer of the liver.Certain other infections,attributable to poor hygiene, like Human Papilloma Virus (HPV) can lead to cervical,penile and anal canal cancers.Most (possibly all) women who develop cervix cancer have been infected with a strain of the HPV virus at some point in their life.Similarly,infections with AIDS virus (Retrovirus), Herpes virus and Epstein Barr (EB) virus have lead to cancer development.
An important point here is that although these infections can be transmitted from one person to another, cancer is not a communicable disease i.e. it doesn't spread from one person to another by touch,living together,eating together,working together etc.
About 21% of global cancer burden is caused by  infections. The incidence of infections related cancer is only 10% in the Western or developed countries. The incidence is a high 40% in Asian, African and Latin American developing countries. In general society and persons living in poor sanitary and hygiene conditions are at higher risk of getting carcinogenic infections. Chronic infections can lead to cancer. The key factors increasing cancer risk are : age of infection, co-infection, smoking, immunocompromised status, malnutrition and poor hygiene. Development of vaccines and antiviral and antiparasitic agents can offer a cost effective treatment and prevention to high cost anticancer drugs. Herpes, Papilloma and retroviruses are the most important human infectious carcinogens. Chronic infection with the bacteria Helicobacter pylori also causes stomach cancer.
(e) Immune System : If you are week in your defenses to protect your own territories,then you are always in danger of intrusion by enemies/diseases.
People with a poor immune system have an increased risk of developing certain cancers.This is because our body has a natural immunity against development and progression of cancers. For example,people with AIDS,or people on immunosuppressive drugs/therapy are likely to develop blood cancers,sarcomas (soft tissues cancer), and cervix cancers.
(f) Your Genetic Make-up : Your genes are the mirror images/reflections of your biological life chemistry.
There are more chances of developing cancers when your relatives (blood relations) have history of cancers.This risk increases when the number of relatives suffering with cancer increases.Common examples are cancers of breast ,thyroid,adrenals and large intestines (colon).We should be aware regarding the risk of development of these cancers and in consultation with a specialist get regular checkups at the defined age and time period.
Most cancers are probably due to a combination of factors.
Not everybody who comes in contact with a carcinogen or has an unhealthy lifestyle will develop cancer. For example,not all smokers develop cancer of the lung.In fact,we are all probably exposed to low doses of carcinogens a lot of the time.The body has certain mechanisms which may protect us from developing cancer.For example, it is thought that many cells which are damaged by carcinogens can repair themselves instead of turning cancerous and similarly the body's immune system may be able to destroy some of these carcinogen induced abnormal cells (who haven't repaired themselves) before they multiply and turn into a cancer.In many cases it is likely that a combination of of factors such as genetic make-up,exposure to a carcinogen,age,diet,the state of your immune system, a part to trigger a cell to become abnormal,and allow it to multiply 'out of control' into a cancer.
How is Cancer detected ?
Early signs of Cancer (CAUTION) :
*Change in bowel or bladder (stool or urine) habits.
*A sore or an ulcer or a wound that does not heal..
*Unusual bleeding or discharge anywhere in body..
*Thickening or lump in breast or elsewhere in body
*Indigestion or difficulty in swallowing or breathing
*Obvious change in size /color of a wart/mole/lump
*Nagging cough,irritation or hoarseness of voice....
Besides,these seven words of CAUTION, a few other constitutional symptoms may point towards cancer development like :
* loss of weight,
 * loss of appetite,
* undue fatigue,
* persitent breathlessness,
* increasing anemia or falling hemoglobin,
* appearance of jaundice in middle or old age,
* bleeding from any outlet of the body,
* pigmentation in mouth,over face or over any part of the body.
Some tumor/cancer markers to remember :
(1).Cancer Ovary :      CA-125, CEA
(2).Cancer Pancreas :     CA-19.9, CEA
(3).Cancer Breast :     CA-15.3, CA-27.29, HER-2/neu
(4).Cancer Prostate :     PSA, PAP 
(5).Cancer Colon :      CEA, p53
(6).Cancer Stomach :     CA-72.4, CEA
(7).Cancer Liver :      AFP, CEA
(8).Cancer Lung :     Cyfra-21.1, NSE
(9).Cancer Cervix :     HPV
(10).Cancer Placenta :     Beta HCG
(11).Cancer Testes :     AFP, Beta HCG 
(12).Cancer Thyroid :     Calcitonin, TG
(13).Cancer Adrenals :    VMA, Chromogranin
Cancer Diagnosis : 
2. Biopsy
3. Ultrasonography
4. Radio-imaging
5. MRI/CAT Scan
6. Tumor markers
How is cancer treated ?
1. Surgery
2. Chemotherapy
3. Radiotherapy
4. Combined therapy
Is Cancer Curable ?
A  simple answer to this question is YES. 
Yes cancer is curable when detected in the early curable stage. Although it is a very general statement but more than 80 % of cancers today are completely curable if treated early.
For a cancer to be curable there are 3 factors : 
1. Type of cancer
2. The stage of the cancer
3.How well does the patient finally respond to the therapy and his mental approach to the disease

A belief that "vaccine can cure cancer" is a myth. Vaccine can help against a disease caused by a germ like virus which later on can lead to cancer development.
Preventive measures for Cancer :
"seven wonders" 
 The risk of developing cancer can significantly be reduced through simple measures : 
1. Stop tobacco use and avoid exposure to second hand smoke.
2. Avoid or limit alcohol consumption.
3. Avoid excessive sun exposure.
4. Strengthen your immune system.
5. Maintain a healthy weight by healthy diet and regular exercise.
6. Protect against cancer causing infections.
7. Adopt regular cancer screening pro-gramme after 40 years of age.

I had highlighted about Breast cancer (the leading cancer worldwide)  in one of my older posts and now I am highlighting Cervix Cancer (the 2nd most common cancer worldwide and leading cancer in India) through following informative videos.
Please see and listen to them and spread the more and more information about this 2nd deadly killer worldwide.