Cancer - A Background

What is a Tumor?

A Tumor is the name for a lump usually solid and formed by an abnormal growth of cells (Termed Neoplastic). It often looks like a swelling. Tumor is not synonymous with Cancer.

Types of Tumors

• Benign
• Malignant (Cancers)

What is Cancer?

In some Tumours the cells have the power to undergo abnormal and uncontrolled cell division and these may spread to other parts of the body through the lymphatic system or the blood stream. The term Cancer is used for these Tumours.

Types of Cancers

• Carcinoma (Epithelial Tissue-Mouth, Lungs, Stomach, Liver Pancreas, Intestines etc.)
• Sarcoma (connective Tissue-Bones, Muscles)
• Leukemia & Lymphoma (Blood & lymph node Cancers)

Basic Staging of Cancers

• Early/operable: Stage I & II
• Locally advanced/inoperable: Stage III
• Metastatic: Stage IV

Remember:

Most Cancers are curable if detected early, so awareness is very important.

Symptoms of Some Common Cancers

Breast Cancer

• Breast lump
• Skin changes/ulcer over breast
• Nipple retraction
• Discharge/bleeding from nipple
• Swelling in axilla (armpit)

Head & Neck Cancers

• Non-healing mouth ulcer
• Swallowing difficulty
• Hoarse voice
• Chronic cough
• Hemoptysis (blood with sputum)
• Neck swelling
• Pain in throat

Lung Cancer

• Breathlessness
• Chest pain
• Chronic cough
• Hemoptysis

Digestive Tract Cancers

• Dyspepsia (acidity, indigestion, heartburn)
• Vomiting & blood-vomiting (hematemesis)
• Black stool (melena)
• Bleeding per rectum
• Lump abdomen
• Ascites
• Pain abdomen
• Pain during defecation
• Jaundice

Uinary Tract Cancers

• Hematuria
• Pain abdomen
• Frequency of urine & nocturia
• Pain during passage of urine (dysuria)

Gynaecological Cancers

• Bleeding PV
• Vaginal discharge
• Pain abdomen

Cancer Prevention

• NO SMOKING or chewing of tobacco (khaini/gutkha/paan/zarda) to prevent head & neck/lung/oesophagus/bladder Cancers
• Good diet, with less spice/salt/oil, more green leafy vegetables may prevent GI Cancers
• Barrier contraceptives & anti-HPV vaccine may prevent cervical Cancer
• Anti-Hepatitis B vaccine ,proper screening before blood transfusions & avoidance of needle sharing may prevent some liver Cancers
• Cervical, breast & colo-rectal Cancers can be effectively screened

Screening of Cancers

What is Screening?

Screening, in medicine, is a strategy used in a population to detect a disease in individuals without signs or symptoms of that disease.

Cervical Cancer Screening

Recommended for all women in age group (21-65 years). Preferably by means of HPV DNA testing every 3-5 years or at least a Pap smear every year

Colorectal Cancer Screening

Recommended for high-risk population (with first degree relatives who are colorectal Cancer patients). By means of fecal occult blood test (FOBT)-annually & flexible sigmoidoscopy-every 1-2 years, along with colonoscopy-every 5-10 years

Prostate Cancer Screening

Recommended for all men over the age of 45-50 years. By means of annual serum PSA (prostate specific antigen), a blood test.

Breast Cancer Screening

Recommended for all women between age 20-69 years. By means of Mammography, a special imaging of the breasts. This is ideally done annually using Xray (at or beyond age 40 years) or USG (for age 20-39 years), but even at 3-5 year intervals is still useful. In low-resource settings, even breast Self Examination (monthly) and/or clinical Breast Examination (6-monthly) by any trained healthworker are useful alternatives.

Diagnosing Cancer

What to do if you suspect you have Cancer?

• Consult your local GP
• You may need medical/surgical referral & investigations
• Best to attend multi-speciality hospitals

Cancer Diagnosis

• History
• Physical examination
• Imaging: X ray/USG/CT scan, etc
• Endoscopy
• Cancer is NEVER diagnosed by only clinical examination/imaging
• Biopsy proof is almost always necessary

After Cancer Diagnosis

• Do not lose heart & give up the fight
• Cancer has to be treated properly, like any other disease
• Always consult an oncologist if you can (surgical/medical/radiation)
• Do not listen to neighbours/acquaintances & quacks