“There were an estimated 18.1 million cancer cases around the world in 2020, nearly one in six deaths, writes Maliha Fatema Zakir. Read on to know why it is a major challenge to tackle this issue.”
The estimated number of incident cases of cancer in India for the year 2022 was found to be 14,61,427. Cancer is quite common in both developing as well as developed countries, Cancer is a global disease and is spreading rapidly. Healthcare systems across the world are facing stiff challenges to tackle this issue. But why?
Cancer is a disease caused when normal cells become cancerous cells that multiply and spread. These cells create cancer clusters or tumours. Cancerous cells may break away from tumours, using your lymphatic system or bloodstream to travel to other areas of your body(malignant tumour).
The most common types of cancers are:
- Breast cancer is the most common type of cancer. It mostly affects women.
- Cervical cancer: It is the second-most commonly found cancer in women and affects the cervical canal and ovaries.
- Lung cancer: Lung cancer is the second most common cancer caused mostly due to tobacco. It also occurs along with oral cancers.
- Prostate cancer: This cancer affects 1 in 9 men.
- Colorectal cancer: Colon cancer and rectal cancer affect different parts of your digestive system.
- Blood cancers: Leukemia and lymphoma are the most common blood cancers.
- Skin cancer: Skin cancer screenings may be performed by a dermatologist if you have skin concerns or are at risk of skin cancer.
With improvements in cancer technology, we have been able to improve quality of life, but improvement in survival is still questionable. In low- and middle-income countries, patients with cancer generally have a poorer prognosis compared with patients in high-income countries; the reasons being lack of awareness, late diagnosis and inequitable access to affordable curative services. Lack of awareness contributes to the late reporting of cancer cases to the healthcare facility. For better survival rates of cancer patients, the knowledge and awareness of cancer and its screening are important. Screening leads to early detection and a better chance of survival. The practice of cancer screening is much less as compared to the awareness and attitude towards screening. Cancer awareness is likely to be associated with many other factors besides literacy rate; one of which was found to be level of income. So as a part of cancer awareness, every citizen needs to understand its symptoms, risk factors and other associated information.
Cancer is a complicated disease. You can have cancer for years without developing symptoms. Other times, cancer may cause noticeable symptoms that get worse very quickly. Many cancer symptoms resemble other, less serious illnesses. Having certain symptoms doesn’t mean you have cancer.
Some common early cancer symptoms include:
- Unexplained weight loss
- Chronic tiredness
- Persistent pain
- Fevers that occur mostly at night
- Skin changes, particularly moles that change shape and size or new moles
Left untreated, cancer may cause additional symptoms, including:
- Bruising or bleeding more easily
- Lumps or bumps under your skin that don’t go away
- Difficulty breathing
- Difficulty swallowing
- Skin changes, such as yellowing, darkening or redness of the skin, sores that won’t heal, or changes to existing moles
- Changes in bowel or bladder habits
- Hoarseness
- Persistent indigestion or discomfort after eating
- Persistent, unexplained muscle or joint pain
Screening is an important preventive measure in cancer control. Even though the national program in India has a screening component, it is yet to take root in most parts of the country. At present, most of the screening tests are available at higher centres only. The available screening methods for the population are also not adequately utilised. Efforts should be made to learn why such gaps occur in service delivery and utilisation, and for that, it is pertinent to understand the attitudes of people towards screening practices. Delay in health-seeking is also attributed to factors such as illiteracy, financial constraints, as well as myths and superstitions along with lack of awareness and these go hand-in-hand, most of the time. The most common reason for delayed healthcare seeking was the failure to recognize a symptom as suspicious.
TNM is the most widely used cancer staging system. T stands for primary tumour. N stands for lymph nodes and indicates whether a tumour has spread to your lymph nodes. M stands for metastasis when cancer spreads.
The specific stage is determined by a few different factors, including the tumour’s size and location:
Global Initiative: The International Agency for Research on Cancer (IARC) was created in 1965 by a resolution of the World Health Assembly, as the specialised cancer agency of the World Health Organization. As a part of creating awareness, World Cancer Day is observed on 4th February every year. Several National level organisations are also contributing to cancer awareness.
Stage I: The cancer is localised to a small area and hasn’t spread to lymph nodes or other tissues.
Stage II: The cancer has grown, but it hasn’t spread.
Stage III: The cancer has grown larger and has possibly spread to lymph nodes or other tissues.
Stage IV: The cancer has spread to other organs or areas of your body. This stage is also referred to as metastatic or advanced cancer.
Cancer treatment options include:
Surgery: The goal of surgery is to remove the cancer or as much of the cancer as possible.
Chemotherapy: Chemotherapy uses drugs to kill cancer cells.
Radiation therapy
Bone marrow transplant
Immunotherapy etc.
Some treatments cause side effects that last for years after treatment is completed. Many people benefit from palliative care that eases cancer symptoms and treatment side effects. The most common cancer treatment side effects are:
- Anaemia.
- Nausea and vomiting.
- Fatigue.
- Pain.
- Diarrhoea or constipation.
- Brain and nervous system problems.
- Chemical changes in your body.
Sometimes, cancer treatment doesn’t eliminate all cancerous cells. Those cells can become new cancerous tumours. Cancer that comes back, or recurrent cancer, may appear at the same place as the original cancer, in nearby lymph nodes or spread to organs and tissues far away from the original site. This type of cancer may have a high risk of reaching a chronic stage. Hence preventive measures and proper palliative care are required.
Palliative care, which focuses on improving the quality of life of patients and their families, is an essential component of cancer care.
Some palliative care during cancer could be:
- Establish good eating and exercise habits. Ask with a nutritionist for healthy menu ideas.
- Fatigue is a common symptom and treatment side effect. Pay attention to your body and rest when you need to, not just when you can.
- You may be living with cancer for a long time. That’s good news, of course, but chronic illness may be challenging. Talking to a mental health professional or finding a support group may help you navigate challenges.
- Medication to relieve symptoms and side effects.
- Other treatments, such as radiation therapy or surgery, to relieve symptoms and side effects
- Physical therapy and rehabilitation
- Support for family caregivers or children
Medical researchers estimate 5% to 12% of all cancers are caused by inherited genetic mutations that you can’t control. Acquired genetic mutations happen over the course of your life. Medical researchers have identified several risk factors that increase your chance of developing cancer.
Awareness about risk factors of cancer and its preventive aspects is essential for early detection through screening and treatment of the precancerous lesion. Deaths due to cancer can be prevented: between 30% and 50% of cancer deaths could be prevented by modifying or avoiding the key risk factors. Other key risk factors include tobacco use, alcohol use, diet, exposure to ultraviolet radiation, pollution, chronic infections, etc.
Risk factors:
- Smoking: Smoking cigarettes and cigars and using e-cigarettes increases your chance of developing lung, pancreatic, esophageal and oral cancer.
- A family history of cancer was mentioned as a risk factor for breast cancer. If cancer is common in your family, it’s possible that mutations are being passed from one generation to the next.
- Diet: Eating high-fat or high-sugar foods can increase your risk for many types of cancer. You’re also more vulnerable to disease if you don’t get enough exercise.
- Environment: Exposure to toxins in your environment — such as asbestos, pesticides and radon — can eventually lead to cancer.
- Radiation exposure: Ultraviolet (UV) radiation from the sun significantly increases your risk of developing skin cancer. Over-exposure to radiation treatment can also be a risk factor.
The rate of cancer can be reduced to some extent by undertaking some preventive measures like:
- Stop smoking. If you smoke, quit. If you don’t smoke, don’t start. Smoking is linked to several types of cancer — not just lung cancer. Stopping now will reduce your risk of cancer in the future.
- Follow a diet plan that’s healthy for you. If you want help managing your weight, ask a healthcare provider about nutritional guidance and weight management programs.
- Add exercise to your daily routine. Exercise may boost your immune system so it provides more protection against cancer.
- Avoid toxins including asbestos, radon and pesticides.
- Protect yourself against sun damage.
- Have regular cancer screenings.
- Schedule cancer screening exams. Talk to your doctor about what types of cancer screening exams are best for you based on your risk factors. This is the most important preventive step as it prevents the cancer from reaching a chronic stage and getting detected at an earlier stage.
- In case of a family history of cancer cases undergo genetic screening to find out traces of cancer possibilities.
- Ask your doctor about immunizations. Certain viruses increase your risk of cancer. Immunizations may help prevent those viruses, including hepatitis B, which increases the risk of liver cancer, and human papilloma virus (HPV), which increases the risk of cervical cancer and other cancers. Ask your doctor whether immunisation against these viruses is appropriate for you.
Inclusive health education regarding other risk factors of cancer is the need of the hour. Studies on cancer awareness and attitudes towards screening in India are limited. Awareness about cancers and cancer screening procedures will help in early diagnosis and subsequent treatment and a better outcome. General awareness of cancer was poor among the Indian population; similarly, it was also poor for curability, preventability and screening methods. Education and place of residence (rural or urban) plays a vital role in cancer awareness. Media, friends, relatives and health personnel are the common source of information for cancer-related information. The screening practice is poor. Screening practices can be improved by creating community-level awareness.
Global Initiative: The International Agency for Research on Cancer (IARC) was created in 1965 by a resolution of the World Health Assembly, as the specialised cancer agency of the World Health Organization. As a part of creating awareness, World Cancer Day is observed on 4th February every year. Several National level organisations are also contributing to cancer awareness.
More comprehensive awareness generation strategies need to be developed. As most of the cancer cases are diagnosed at a later stage, awareness about signs and symptoms can improve the health-seeking behaviour regarding cancer and uptake of screening procedures, subsequently the outcome of cancer patients.
Great article with proper research done by the writer. Great work