Cancer at Bay
Cancer need not be a dreaded' word. Given the right education, right measures and sufficient resources, almost 50 per cent of cancer cases can be prevented.
A significant advancement in oncology is the better understanding of the evolution and natural history of cancer resulting in the concept of cancer prevention. Over 75 per cent of cancers are related to the environment in the widest sense, to the food we eat, the atmosphere in which we breathe, the habits we indulge in and the hygine we observe. Lifestyle factors are those over which the individual has a definite control tobacco use, alcohol, sexual behavioural pattern and diet.
The most prevalent types of cancer in women are uterine cervical cancer and breast cancer, constituting 47 per cent of all cancers. 49 per cent of cancers in men are tobacco related. The role of tobacco chewed or smoked in the causation of mouth, pharynx (throat), larynx (voice box), oesophagus (food pipe) and lung cancer is beyond doubt. Our own studies at the institute have shown that the risk of oral cancer is 84 times as great in the tobacco user as in the non-tobacco user. The heavy cigarette smoker is at 75 times greater risk of developing lung cancer.
Cancer of the uterine cervix, which constitutes nearly 30 per cent of all cancers in women, is indubitably associated with poor genital hygiene and sexual promiscuity. It is common in the lower socio-economic and uneducated group of women and in the developing countries. The incidence of cervical cancer is significantly lower in affluent countries. Uterine cervical cancer can be effectively screened and prevented. Genital hygiene plays a vital role in the cause of genital cancers both in men and women. Today "human papilloma virus" (HPV) is accepted as a major factor in cervical carcinogenesis. The genetic factor in carcinogenesis is real and well-documented in female breast cancer, ovary, endometrium and colo rectum. These inherited cancers tend to occur at an earlier age and are more aggressive. The genes causing breast cancers BRCA 1&2 have been identified.
Preventive measures
An important aspect of lifestyle that is increasingly being implicated as a factor in enhancing the risk of cancer is diet. Diet, especially meat and animal fat consumption, is important in increased risk for breast cancer, colorectum and a few others. Low fat intake and control of obesity can help in reducing the morbidity due to breast cancer. A high intake of dietary fibre is associated with a lower risk of colon cancer. Increased dietary nutrients like Vitamin C,E, and carotinoids are linked to cancer prevention.
Primary prevention of cancer is the elimination of the causative agents and can be most effective. Demographic registries have documented that 48 per cent of all cancers in men and 13 per cent of cancers in women are tobacco related and there is an increasing trend in tobacco-related cancers (TRC).
Secondary prevention in cancer means detection of pre-cancer and early cancer. Population screening has been successful in reducing mortality and morbidity in cancer sites like uterine cervix, breast and colo rectum.
Concept of health screening
Health screening is the obvious corollary in preventive action. It can be a positive step towards health insurance against certain types of cancer, namely uterine, cervical and oral cancer and to a limited extent, breast cancer. Screening is an annual examination of a healthy population for detection of asymptomatic disease. It can detect three to four times as many cases in the pre-cancer stage and also help in earlier detection of disease..
Cancer at Bay
By: Dr Izharul Hasan
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