Cancer – The Disease You Should Know

Cancer is a dreaded disease; the name itself brings a sense of panic, anxiety and hopelessness not only in the patient but amongst the near and dear ones also.

It goes without saying that this is a serious disease but negative attitude is no answer. As in other spheres of life, a positive attitude with courage and determination to fight the disease is essential. It has been seen time and again that a motivated patient with smiling face not only is able to tolerate the prolonged, multipronged treatment plan easily but the ultimate outcome is also much better than in a sulking patient, not cooperative in the treatment plan.

A sense of Faith, Trust and Hope will go a long way to bring in cheers in the heart of the patient.

It is also necessary to have a fair degree of knowledge about the disease – CANCER – so that you are prepared to tackle the problems as and when they come. My present series of articles will give you basic knowledge of the disease in all its aspects – causation, warning signals, relevant investigations, treatment plans etc.

It is commonly believed that Cancer has become a very common disease.  It was supposed to be a disease of affluent and developed countries but it is not true anymore, presently it is spreading like a wild fire even in India. The main reasons for this apparent increased incidence being:

1.   The longevity of life has increased, at the time of partition in 1947 the average life span of an Indian was 32 years, presently it is 62 years, and cancer is commonly seen in older age group.

2.   Better diagnostic facilities.

3.   Awareness of the problem, hence, people visit doctors for relief and get diagnosed.

4.   Common killer diseases of past, like tuberculosis, small pox,  tetanus, dysentery , have been brought under control and these have been replaced by heart ailments, diabetes and cancer.

Indian Census about anything is not dependable, and this is true for prevalence of cancer also. Rough estimation is that 10 to 12 lakh new patients of cancer are seen every year in our country and add to this the existing patients, the cancer burden for the country as a whole becomes enormous. It is further estimated that one in 15 men and one in 12 women are likely to develop cancer of some type during their life time, although percentage wise this is still on the lower side compared to developed countries.

Cancer is known to affect people of all ages, does not discriminate between sex, social or financial status, and crosses all the religious barriers. But as you will see in my subsequent articles, a couple of cancers are less common in Muslims and a few cancerous diseases are more common in people of poor socio-economic conditions.

Cancer is also peculiar in the sense that cancer can affect any tissue and organ of the body – skin, muscles, bones, gastro-intestinal tract, lungs, liver and gall bladder, kidney, urinary bladder, brain and spinal cord etc.

             Cancer in Different Parts of the Body

The biological behaviour of cancerous diseases is totally unpredictable, some cancers like cancer of liver, gall bladder, lungs, brain are very rapidly growing and some, like cancer of prostate, skin are very slowly growing. As a matter of fact, the same type of cancer may have different progression rate and outcome in different people, and this depends upon many factors, some are known and others yet to be known.

A disease when it attacks the body produces symptoms  (complaints – like fever, cough, bleeding) which can be perceived by the patient and few signs (seen or felt by the patient or doctor – like jaundice, swelling in the body ) and timely detection of these symptoms and signs are the warning signals.  

WHO (World Health Organization) has proclaimed Seven Warning Signals for Cancer. Presence of any of these signals for more than 2 weeks and without any response to usual treatment should be a warning that everything is not fine and one needs to go to the doctor for diagnosis and subsequently for proper and effective treatment.

It should be clearly remembered that earlier the treatment started better is the result; just to give an example, a breast cancer patient in stage I has the chance of complete cure of more than 90% whereas a IV stage has not even a chance of 20%; so do not waste time if any of the warning signal is present, consult a specialist, it is better to rule out the presence of the disease rather than to carry on with it.  

The diagnosis of cancer has become more realistic, with the availability of newer diagnostic tools like Mammography / C.T. / M.R.I. / Nuclear Scans, Tumor markers, the presence of cancer can be suspected.

But the most important factor is the clinical examination by a competent and experienced doctor who should be able to suspect the presence of cancer and refer the patient for relevant investigations. In the absence of clinical suspicion, if the patient is sent away with antibiotics / vitamins /pain killers then the patient is sure to come back with an advanced stage of the same disease, and the outcome is not difficult to imagine.

Histopathological examination – biopsy, Cytological Examination,  FNAC (Fine Needle Aspiration Cytology), is mandatory for confirmation of the disease  and also for finding out the type of  cancer. It is not wise to start or avoid the treatment of a cancer patient in a suspected patient without histopathological confirmation.

The treatment of cancer has gone a sea change over the years, it is an era of multimodality treatment and depending upon the stage of the disease, type of cancer and choice of the treating consultant the treatment schedule has to be charted and followed.

Research data has conclusively established the importance of the specialist treating the cancer patient, i.e., it is important to select an experienced and competent doctor, who not only treats but also guides the patient through the illness. 

Regular follow – up through out the life span of a cancer patient is essential as the disease can reappear at any time, may be after days or may be after decades. A recurrence at the local site or in a distal organ can be detected only if one follows a regular routine of follow-up. A timely detection of recurrence can be treated effectively and with excellent results but as in primary case the importance of early detection can not be over emphasized    

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