THIRUVANANTHAPURAM: The theme of World Cancer Day this year as decided by the international union against cancer, ‘Not Beyond Us,’ provides hope for the future. The aim is to highlight the fact that solutions does exist across the world and we just need to reach out for that.
The majority of the people in the developed nations are well-informed about the diseases, the need of annual health check-ups or early detection strategies. Those patients who have proven cancers are looked after by nations like Germany, France, Scandinavian countries etc or the majority are under insurance cover in the USA, UK, Australia or New Zealand. The scenario in the developing nations is rather different. Health care allotments in the budget will never tally with the need; the awareness regarding diseases among the general population is minimal among urban as well as rural areas.
Cancer never strikes overnight. It takes a long span of time, sometimes several years, for it to manifest in recognizable pattern. The initiation, progression, metastasis and death occur in sequence.
This year, the UICC has recognized 4 different signs to be recognized by the common man to get an insight into the theme. The first being advice to healthy life choices as an absolute necessity. Cancer is said to be a tsunami among non-communicable diseases (NCD). The most important option as advised by UICC is change in lifestyle leading to prevention of cancer, thereby premature deaths can be reduced at least by 25 per cent by 2025. Even environment may trigger cancer.
There are four different factors that could be addressed as part of lifestyle choices to be adopted. The primary factor being dietary changes that is needed in our society. In fact, cancer prevention starts in the kitchen. Healthy diet should be one which has a judicious combination of vegetables 3-4 servings per day which provide both soluble and insoluble fibres, legumes as the richest source biologically acceptable proteins and the big beans which reduce cholesterol sugar and provide Vit E, coloured fruits and vegetables like carrot, beet root, tomato, grapes which actually work as anti-oxidants.
Cruciferous vegetables, broccoli, cabbage etc could be potent anticancer sources. Whole grain like rice and wheat with bran, which provide soluble and insoluble fibres, bran oil with Omega 3 fatty acids, Vit B12, fortified bread also is rich in bran.
However since cultivation dwindled, white rice took over and new generations are not aware that it contains only starch. The western world is changing their diet to brown rice and brown bread but we can hardly change.
Maida (all purpose flour) is also a true villain in carcino genesis. In spite of having potent carcinogen Benzene peroxide, it forms the staple food of Keralites at large. Its excess consumption is reported to be causing increased incidence of cancer in certain areas of this state.
Kerala is blessed with the production of spices. Ingredients like curcumin in turmeric, piperine of pepper, allicin in allium family, gingerine in ginger etc are potent anti-cancer agents. Curcumin is on trial as a preventive agent against breast cancer in Europe.
Tobacco is yet another villain .There are only two industries in the world which will kill its patrons. Tobacco is number one and alcohol forms the second. Alcohol is another life choice.
Exercise does wonders. It improves metabolism, regulates the hormonal milieu, burns calories, regulates cholesterol and sugar levels and prevents cancers.
The second theme is regarding the value of early detection. Early detection of cancer is the best possible method in cancer treatment in terms of outcome in all cancers. The advantages of early detection are many. It helps to preserve organs, avoiding ablative surgeries, reduces the cost of treatments, hospital stay, obviates unwanted radiotherapy and chemotherapy leading to better quality of life.
Self-treatments and assumptions play deadly game in this context. There are several warning signs for cancer but they are ignored even by educated people.
How is early detection implemented? Self-examinations of the oral cavity does not cause a single paisa! Any doubtful lesions like leukoplakia, or a red patch (erythroplakia) if appears which is a pre-malignant lesion, it could be easily detected. Just an abstinence from tobacco, without anytreatment could reverse the process. If at all we find an active lesion ulcer in its early phase a simple excision will be enough. A self-examination of the breast could detect early breast cancers.
The third theme emphasizes the need of effective cancer treatment for all disregarding the economic hardship or geography. The practical application of the same will depend on which stage the patient presented for treatment.
The fourth theme highlights the need of excellent quality of life in cancer care. No treatment could be rated as the best of all unless there is emotional, mental and physical well-being after the treatment both for the patient and family.
by Dr Thomas Varughese
(The author is head of the department of oncology, Renai Medicity, Ernakulam).