Some Basic facts about Cancer
Cancer is as old as mankind. It was found in the mummy of Egypt from 5000 years back. Unfortunately, even now, people are unaware about its nature, its cause, its prevention and most importantly there are several mis-concepts which make the problem even more complicated.
What is Cancer?
Body has the inherent capacity of repairing a dead or damaged tissue by
multiplication of cells and there is a control system for this. When
there is lack of control, the cells multiply excessively and form a
lump. This is called tumour. This can be benign- where the lump is slow
growing, does not cause damage to the neighbouring structure and do not
spread to other organs and are usually not fatal. The other type of
tumour is obviously malignant (cancer), where the lump grows very
rapidly, involves the neighbouring and distant organs and can be fatal
if not treated early.
What are the common types of Cancer?
In male, where tobacco addiction is a common problem, the common cancers
are that of oral cavity, lung and prostate. In females, in rural
population the common cancer is that of uterine cervix, whereas that of
urban women is breast cancer.
What are the causes of Cancer?
Unfortunately, the causes in 2/3 of all cancers are still not clear, and several researches are going on worldwide to determine this. In 1/3, the causes are proved beyond doubt- of which the most important is tobacco in any form- smoking (Bidi, cigarette, hukka etc.) and smokeless (paan, paan masala, ghutka, khaini, jarda etc.). The other less common causative agents are diet (adulterated food, high fat and less of fruits, vegetables and vitamins, more intake of junk, fast, stored and charred food), sunlight (causes skin cancer especially in the white race), western lifestyle (lack of or delayed pregnancy and less breast feeding can cause breast cancer). For uterine cervical cancer the common causes are early and multiple children, multiple partners, low personal hygiene, infection by a virus (Human Papilloma Virus). In some cases (less than 5%), a genetic abnormality is found which can predispose to cancers in many members of the same family (mainly of breast, ovaries and bowel).
What are the symptoms of cancer?
Loss of appetite and body weight, an ulcer which is not healing, lump
which is rapidly increasing, persistent change of voice, bleeding with
cough, stool or urine, inte-rmenstrual bleeding, difficulty in
swallowing etc.
Some common
misconceptions:
Cancer means death- Most cancers if detected early can be cured completely.
Cancer is contagious
– it is not
Biopsy can cause cancer or spread of cancer- Biopsy or any surgery does
not cause a benign tumour to turn cancerous. Taking a small sample of
tissue (mostly done by Fine/ Wide bore Needle or a small punch forceps)
do not cause any spread. The doctors can guide you regarding the best
way of doing it. Biopsy is important before embarking on a major
surgery, radiotherapy or chemotherapy as the tumour may actually be not
malignant at all. Even if malignant, the treatment strategy is
completely different in different kinds of cancer, so it is important to
plan beforehand by knowing the nature of it.
Surgery in cancer causes spread of cancer- it is the reverse. The main
treatment for most cancers in early stage is to remove the tumour along
with some good healthy tissue margins and the neighbouring glands which
may be involved. Removing a tumour partially is always bad and is never
advisable. If the tumour is big and when complete surgical excision is
not possible, chemotherapy (anti-cancer drugs) or radiotherapy is used
to reduce the size and make it operable.
Cancer is hereditary- in 95% cases they are not. So there is no need to
panic if only one member in the family had cancer, as it may be just
accidental. However, if there are 2 or more members who are affected, it
will definitely be advisable to see an Oncologist who can assess the
risks and order relevant tests.
Chemotherapy is painful and causes severe vomiting and permanent hair-loss-
Although some strong chemotherapies which are administered in advanced
diseases may cause vomiting, diarrhoea, low White Cell count and hence
low Immunity etc., these can be counteracted by some preventive
medications. Hair-loss is only temporary and does not occur with most of
the chemotherapies.
Cancer can cause a very painful death- fortunately with different
medicines which are now available and also with radiotherapy in some
cases; pain can be very well controlled in advanced diseases where the
patient cannot be cured. A new modality is Interventional pain therapy
where the nerves conducting pain to the brain can be blocked by
injection at specific sites.
There is no diagnostic or treatment facility in Eastern India- this is
about time people of Eastern India realizes that there is no need to
travel to far south or west or outside India for management of cancer.
It is not only expensive to travel long distances, but causes
unnecessary mental stress on the patient, when they prefer to stay in
their locality and get maximum support from all the near and dear ones.
There are enough facilities available in Eastern India for all classes
of people. You may take help of different help lines, media and internet
to find out which one suits you most.
Take home messages:
Cancer is preventable by avoiding the risk factors, and can be detected
early if people come forward to the doctors with symptoms mentioned
above without ignoring them. There is no need to think that one should
not do tests as that may cause cancer or expose the fact that he or she
is harbouring cancer. On the contrary, it is prudent to detect a cancer
or a pre-cancerous area which can then be completely cured. The more it
is neglected the worse is the result and more aggressive and expensive
will be the treatment. Many organs like breast, limbs, larynx
(voice-box) etc. can be preserved in early stages with the new
modalities of treatment. It is not contagious, and hence it is important
that the families give maximum support to the victims rather than
staying away in fear.
Biopsies are advisable before embarking on a treatment and surgery is
the treatment in most of the cancers in the early stage. There is no
need to panic about radiotherapy and chemotherapy- in expert hands the
side-effects are minimum and can improve the results significantly. Even
in advanced stages symptom control can be well achieved with the
Palliative care team and different Support groups. Together we must
fight to remove all the misconceptions and try and prevent this
potentially preventable and curable disease.
(The writer is Immediate Past President of IASO, Medical Director
& Prof in Dept of Surgical Oncology, Saroj Gupta Cancer Centre &
Research Institute, Thakurpukur, Kolkata)