1. What is Cancer?
Cancer is a common
name for a group of diseases characterised by uncontrolled proliferation
of abnormal cells. Cell division is the mainstay of human life. Human
body is made up of several organs like brain, lung, liver, stomach
etc. and each organ is made up of cells. Organs and tissues are constituted
by cells characteristic of that organ. Cells divide for growth of
an organ, for repairing tissue damage and to maintain functions of
the organ. The divided cells are the exact replica of the parent cell.
Sometimes due to some faulty mechanism or due to factors which are
unknown yet, the divided cells are abnormal i.e., their structure
is not the same as that of its parent cells. They cannot discharge
the functions like the normal cells but requires the same food as
the normal cells. These cells start dividing and a large number of
abnormal cells are produced. As a result of the proliferation of abnormal
cells the body organs do not function normally and the persons nutrition
is impaired rapidly. These cells cluster to form lumps, swellings,
and sometimes produce ulcers in the respective organs. However in
the case of blood cancer -- Leukaemia - the abnormal cells start circulating
throughout the blood streams so, no visible lump or swellings are
observed. (Cancer is known by its different types like sarcoma, lymphoma,
leukaemia, myeloma, carcinoma etc.). The most important characterisitc
of cancer is that the cancer cells breakaway from the tissue or organ
of origin and starts spreading to other parts of the body through
lymphatic channels or cavities or blood vessels. They then deposit
themselves in other parts of the body where it grows again. This is
known as the metastasis. Because of this unique characterisitc it
becomes difficult to cure or to control cancer when it has spread.
2. How does Cancer start?
The exact mechanism
of transformation of normal cells to become cancerous is still not
known. However, several factors are known to produce cancer-like tobacco
in the form of smoking and chewing, alchohol, radiation, asbestos,
certain chemicals, excessive fat consumption, viruses etc.
3. Does a lump always mean
Cancer?
No. A lump can
occur in any part of the body which may or may not contain cancer
cells. Some of these lumps may grow to large sizes and produce ulcers.
Because of this, they interfere with normal functions of nearby organs.
However, they will not cause death and they can easily be removed
by surgery and usually will not recur. They donot spread to other
parts of the body. Such tumours are known as Benign tumours ie. harmless
tumours. Cancer also can occur asa lump or tumour. A cancer is known
as a malignant tumour. It is characterised specially by its potential
to spread to other sites and to infiltrate the organ.
4. What are the most common
Cancers seen in Indians?
Cancer affects
different body organs due to a variety of factors and in India there
are variations in the occurence and pattern of cancer. However, in
our men, the majority of all cancers are found in mouth and throat,
lung, stomach, gullet etc. and in women, they are found in large numbers
in uterus[cervix], breast, mouth and throat.
5. Is Cancer increasing in
our country?
In all Western
countries where accurate statistics are available, cancer is seen
to increase during the past 40 to 50 years. In our country also
this should be true. As more people live upto old ages and with control
of other diseases, more people would get cancer. Further, changes
to Western life style and environmental pollution due to industrialisation
etc. are also likely to contribute to an increase in cancer.
The occurence
of cancer is measured, in absolute terms, by the incidence rate. This
is a population based measure and indicates the number of new cancer
cases that occur every year in 100,000 population. In India, such
population based rates are not available for the entire country. However
they are available for the some large city's populations. According
to these annually around 70 new cancer cases will develop per 100,
000 population. This may appear to be a low rate but we consider 80
years as a life span, almost 16% of population will develop cancer
if they all live upton this age. Based on these, it is estimated
that almost 5 lakhs of persons will develop cancer every year in the
country and in any given year there will be almost 15 lakhs cancer
patients. As the population increases, this number also will increase.
In order to study the cancer occurences in our country, and to
monitor its trends, cancer registries have been started in several places
by the Indian Council of Medical Research. These registries study
not only the occurences and pattern of cancer in the community
but also the factors that are associated with the disease. Such information
are used for formulating and implementing the National Cancer Control
plan of India.
6. Are the frequent cancer
types similar in different countries?
No there are
great variations in the occurence and pattern of cancer in different
parts of the world. In India, the occurence of mouth and throat
cancer is highest when compared to other regions of the world. Stomach
cancers occur with high frequency in Japan and some East European
countries. Liver cancer is the frequent cancer in Africa. The predominant
cancer in certain areas of China is oesophageal cancer, in other places
it is Nasopharynx or Liver cancer. Lung, colon and breast cancers
predominate in the United States of America.
There is no scientific proof yet that cancer is a contagious disease.
7. Is Cancer Hereditary?
Certain cancers
are seen to occur in families. This does not mean that the disease
has been transmitted from parent to children through genetic material.
The same life style usually run in families and this could as well
be the reason.Scientists believe that if there is a hereditary component,
its effect is indeed very little.
8. Do Viruses cause Cancer?
There is good
evidence to suspect that viruses may cause cancer in humans - leukaemia,
nasopharyngeal cancer, liver and cervix cancer are considered now
as being caused by viruses.
9. Is Radiation a cause for
Cancer?
Radiation is widely
used to diagnose many diseases. Radiation is also a very successful
method to treat cancer. These are absolutely proper and safe
uses. However Radiation is extremely dangerous and can cause cancer
when not properly handled. Over exposure to X-rays, or byproducts
of atomic radiation can contribute to the development of cancer especially
leukaemia.
10.Does Tobacco Chewing or
Smoking cause Cancer?
Tobacco chewers
develop cancer of cheek, tongue, gums etc. They are chronic chewers,
often starting the habit at a young age of 15 or 18 years. They
keep the tobacco quid [pan] in the mouth for a long time and often
keep the quid even while asleep. Smoking cigarettes is the cause of
75% of all lung cancers and 25% of all cancers in the Western countries.
Smokers are also likely to develop cancer of the mouth, pharynx, oesophagus
[Gullet] pancreas and urinary bladder. In our country, almost 50%
of all cancer in men are caused by heavy tobacco chewing and smoking;
rather it is worse. The bidi contains more toxic harmful chemicals
than in cigarette which produces cancer.
Tobacco smoking
is also the major cause of heart disease, gastric ulcers, chronic
bronchitis, emphysema and often the smoker dies young.
Due to the husband's
smoking habits, his wife [passive smoking] is also at a high risk
for developing cancer of various organs. In closed environments like
bus, theatre, office, train and meeting halls smoking is dangerous
to non smokers also.
11.Does heavy Alchohol consumption
cause Cancer?
Heavy alchohol
consumption especially in the presence of smoking increases the risk
of certain cancers like cancer of tongue, throat, gullet, stomach
and liver.
12.How is Cancer Diagnosed?
The diagnosis
of cancer can be made only after a careful clinical examination and
several laboratory tests ate required to accurately know the
primary site of origin of cancer, type of cancer and to learn the
extent of spread of the disease.These are necessary for planning effective
treatment. Identifying cancer cells with the help of a microscope
in an aspirate of body issue or scrapings of fluids aspirated by a
needle and syringe is called cytology. The examination of a piece
of body tissue after processing is called biopsy and histopathology
examination. Endoscopes passed in to the body are used to diagnose
cancer of deep seated internal organs like oesophagus, stomach, intestines,
thoracic and abdominal cavities. For diagnosing leukamia, blood examination
is essential. Plain X-ray pictures are used to diagnose cancers of
bone. Some times special X-rays like Barium X-rays, angiograms etc.
are taken. Ultrasound scanning, CT scanning, NMR scanning and scanning
by radio isotopes are also used depending the site of cancer. Certain
biochemical tests are undertaken to diagnose mulriple myeloma. Generally,
the doctor will do two or three tests for a suspected cancer.
13.How is an early cancer detected?
One should know
the warning signals of cancer. These need not always be due to cancer,
but when a symptom is noted, promptly undergo a through medical
examination by a competent physician or cancer specialist. Secondly,
self examination methods and periodic self examination of mouth and
breast can detect many cancers in early or precancerous stages. In
case of ulterine cervix a simple cervical smear test high early detection.
14.How does early diagnosis
help?
When cancer has
not spread beyond its site of origin a complete cure is often possible.
When a cervix cancer is localised, almost 100% cure is possible
but when it has spread to nearby bladder or rectum, not even 20% will
live upto 5 years. Similarly, an early breast cancer when treated
adequately, would have a more than 85% chance of surviving more than
5 years whereas when it is spread to lungs less than 10% would survive
5 years. Thus early diagnosis ensure a better cure rate.
No pain is not
a symptom of early cancer, it is a symptom of advanced cancer.
15.Is it possible to prevent
cancer?
It is recognised
that some cancers can be prevented. Most mouth cancers can be prevented
by not chewing tobacco and most lung and throat cancers can
be prevented by not smoking. Certain cancers are produced by chemicals
used in industry. If workers are protected against contact with such
occupational factors, some cancers can be prevented.
A well balanced
diet with less fat and more green leafy vegetables, citrus fruits,
milk etc.can protect people. Above all, eventhough not all cancers
are preventable, many deaths due to cancer can be prevented by early
detection and proper treatment. A knowledge of the warning signals
of cancer helps one to get an early diagnosis and a successful treatment.
16.Can diet cause for prevent
cancer?
Many scientists
are now studying this factor to establish a cause - effect relationship.
It is generally suggested that a high fat diet can cause cancer of
Intestine, Colon, Rectum, Prostate, Uterus and Breast. In Japan the
use of salted pickles, is believed to be the cause for the high
stomach cancer rate. By the use of grilled meat reached oil, one consumes
significant quantities of certain chemicals that can produce cancer.
Certain food additives and colouring agents are also highly suspected
to cause cancer. Diet with plenty of fibre is shown to be protective
against Intestinal cancer. Studies in Japan and other western countries
have established that there is a strong protective effect for green
leafy vegetables, carrot, milk, citrus fruits etc. against many forms
of cancers. The American Cancer Society is now propagating the use
of fresh green leafy vegetables and fruits in their campaign against
cancer.
17.What are the symptoms of
mouth cancer and how can we detect the early mouth cancer?
Mouth cancer is
the commonest cancer in our country. The disease can arise in one
of the several structures with in the mouth like the inside lining
of cheek [commonest] tongue, gums, roof of mouth etc. It is commonly
observed that a mouth cancer starts as a pearly white patch in the
mouth which cannot be scraped off. Very often this is caused by chronic
tobacco chewing. All such white patches [leukoplakia] will not develop
into cancer, but some will certainly. So it is most essential such
patches are regularly observed and treated by competent doctors. One
can learn to examine the mouth using a mirror himself/herself
to see clearly the inside of cheek, tongue, sides and undersurface,
floor of mouth, the gums and areas joining the gums and cheek,
the roof of mouth and lips. Any red discolouration or white patches
or in fact any deviation from normal should be shown to the doctor
for his advice. An ulcer caused by sharp teeth, repeated injuries
to the tongue and cheek, an ill fitting denture producing constant
irritation and injury are also found to progress into cancer if left
untreated.
18.How is lung cancer detected?
The symptoms of
lung cancer only appear in a late stage. These are persistent cough,
blood in sputum, chest pain etc. The most prominent method for detecting
lung cancer is by routine chest x-rays. Sputum examination may also
reveal a lung cancer. It is to be noted that a lung cancer detected
is never an early cancer. Even with the best methods of treatment,
whether it is surgery, radiation or chemotherapy the survival rate
is very poor. The most effective way to control lung cancer is
by preventing its occurence by not smoking.
19.What are the Symptoms of
cervix cancer?
White discharge,
unusual or excessive bleeding during menses or between menstrual cycles
especially after sexual inter course or during postmenopausal years
are symptoms of cancer cervix. These need not always mean that cancer
is present, however, an expert medical examination is necessary
when such symptoms are present.
20.How is Uterine Cancer detected?
There are very
effective and simple ways of detecting cancer of the uterus. Curretings
[scrapings from the inner lining of the uterus] and the neck
of the uterus [cervix] can be examined under a microscope to detect
cancer. Tissue is sometimes removed from the suspected cancer area
for biopsy. Colposcope is an instrument used to examine the uterus
and to identify the correct areas for taking a biopsy.
21.What are the symptoms of
mouth cancer
Certain changes
in the cells take place years before they turn into cancer. Such changes
can be identified examining the cells which are collected from
the cervix uterus. The cells which are exfoliated [shred] from the
cervix are collected by a spatula. These are then examined under
a microscope. The process is named as Pap Smear test [named after
its inventor Dr. George Papanicolaou]. By this procedure a correct
diagnosis is arrived at in more than 95% cases. The procedure is simple
painless, takes less than 5 minutes and needs no medication or preparation
of the patient. Dysplastic changes, which may turn to cancer,
years later, can be identified and the process of cancer information
can be stopped. All married women should undergo this test and if
two annual consecutive tests are negative, one need to undergo this
test only once three years. By using this procedure in the population
several western countries have rapidly reduced the cervical cancer
incidence in their population.
This is a Cytology
test.
22.What are the factors that
increase the risk of Uterus Cancer?
Cancer of the
uterine cervix [neck of the uterus] is the commonest cancer in Indian
women. Early marriage and pregnancy, frequent deliveries, more than
one marital partner, poor genital hygiene and HPV virus are observed
to increase the risk of cervix cancer. Infertility, amenorrhoea
and certain hormones are observed to be a associated with the occurences
of cancer of the body of the uterus.
23.How can we control Cervix
Cancer?
Cervix cancer
is one of the cancers that can be controlled. This disease can be
prevented, can be detected early, and a 100% cure can be achieved
if treated in early stages. Certain high risk factors are known for
cervix cancer. These are early marriage, poor genital hygiene, and
more than one marital partner. Pap smear technique can detect early
changes in the cells which may ultimately become cancer if untreated.
The technique is simple and can be undertaken in doctor's offices.Smear
examination should be made a routine examinations as part of regular
health check up for married women. Popularisation of Pap smear
technique among the public is thus necessary for cervix cancer control.
Early cancer, when detected, should be treated promptly. Appropriate
treatment would ensure a hundred percent cure. Periodical physical examination
[Gynaecological] is also essential.
24.What is the best method
by which cancer is treated now?
The best treatment
method for cancer depends on several factors, of which the most important
are the site of cancer, type of cancer, spread of the disease
when diagnosed, general health of the patient etc. Some cancers are
best removed by operation and are cured by this method. For some other
types the best treatment is radiation: given externally, [Teletherapy]
which is administered with Cobalt or Linear accelerator units or by
inserting radioactive needles [radium,caesium. Cobalt etc.] into the
body [Brachy therapy] or by combining both external and brachy therapy
methods. Certain cancers are treated by drugs [chemotherapy]
only. Very often some cancers need all the three methods of treatment.
The treating doctor choses the best method considering several of
the above factors. In some cases surgery will remove a portion of
the tumour, then treatment is continued by radiation. Radiation is
given also to shrink the tumour so that a removal of the tumour by
surgery can be done later.
25.What are the side effects
of Radiation and Chemotherapy?
First it has to
be understood that all the side effects are temporary and will vanish
in course of time. Depending on the site of radiation treatment,
the symptoms will vary. Diarrhoea, dryness of mouth, mouth soreness,
difficulty in swallowing, loss of appetite and taste and abdominal
cramps are some of the side effects due to radiation. Chemotherapeutic
drugs also can cause severe discomfort. Loss of hair, nausea,
vomiting, diarrhoea, anaemia are some of the severee complaints. As
in the case of sickness caused by radiotherapy, the sickness caused
by chemotherapy also vanishes 2 to 3 weeks after completion
of treatment.
26.What are the warning signals
of cancer?
A sore or ulcer that does
not heal within 3 weeks with antibiotics especially in mouth. Pearly
white patches in the mouth. Inability to hold salty food in mouth.
Unusual bleeding or discharge
from any orifice.
Thickening or lump in
breast or elsewhere in the body.
Repeated abdominal cramps,
indigestion. Difficulty in swallowing which lasts more than 3 weeks.
Changes in bowel habits [Diarrhoea & Consumption] lasting for
more than 3 weeks.
Hoarseness of voice, nagging
cough; persisting even after treatment for 3 weeks.
Difficulty in urination,
blood in urine, especially if you are above 45 years of age.
Change in wart or mole.
Listlessness, anaemia,
intermittent fever which are not controlled by conversational medication.
Impairment in vision,
white patches the eye, often shining at night.
These
signs need not always be due to Cancer. But consult a specialist
doctor if you have any of the above symptoms
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