THIRUVANANTHAPURAM: Yet another National Cancer Awareness Day quietly passed by on Monday. Since 2014, November 7 has been marked on the calendar to raise awareness about various cancers, their symptoms and treatment in India. And this is vital for good reason.
According to the Indian Council of Medical Research’s National Cancer Registry Programme (ICMR-NCRP), there were 14.6 lakh cancer cases in the country in 2022, and this number is expected to increase to 15.7 lakh by 2025.
In Kerala, the cancer incidence stood at 169 cases per 1 lakh population last year. Experts attribute the high rate to factors such as an ageing population and, of course, lifestyle changes. “We don’t have accurate statistics on cancer cases in Kerala, as there’s only one proper cancer registry in the state, and that is in the capital city. This registry keeps a count of cases from Kollam and Thiruvananthapuram,” says Dr Mintu Mathew Abraham, consultant medical oncologist, PRS - Karkinos Cancer Centre, Thiruvananthapuram.
“As per rough estimates, Kerala saw over 60,000 new cancer cases last year.” In a recent Express Dialogues session, top oncologist Dr V P Gangadharan noted a similar figure. Over 120 cancer cases were being registered daily in Kerala, he said.
Amid other factors, he highlighted that changing food consumption patterns were a concern, and particularly flagged the much-glorified parotta and beef combo. “There is certainly an issue with maida. If these items are part of our daily lifestyle, that’s where the trouble starts. Our diet has gone wrong,” he stated.
“People often point to the lifestyle of Westerners, and their primarily meat-based diet. However, we forget that their diet also includes a significant portion of vegetables, which is not the case here. Red meat poses problems. Besides parotta, obesity and a low-fibre diet contribute to health issues.”
Dr Aju Mathew, oncologist and founder of i HOPE an NGO in Kochi concurs. However, he adds that parotta cannot be singled out as a “villain”. “Yes, food is certainly a significant factor. It’s advisable to avoid regular consumption of parotta as well as beef. Excessive consumption of red meat is unhealthy. But it’s okay to have them in moderation,” he says.
“It is important to maintain a balanced diet and add various dietary components. Besides food, it’s an unhealthy lifestyle that leads to cancer.” Sedentary way of life, increased exposure to smoking, higher consumption of fatty and junk food, elevated levels of stress, and sleeplessness are common risk factors observed these days. As a result, breast, rectal, colon, and lung cancers have become more prevalent. Dr Aju stresses the importance of adopting a healthier lifestyle and remaining vigilant for symptoms. “According to a recent study, the onset of colorectal cancers among youngsters is on the rise in India,” he notes.
“It’s crucial to be alert to symptoms displayed by the body. Also, getting hepatitis B and HPV vaccines can prevent certain cancers caused by the human papillomavirus (HPV)”. Consultant medical oncologist Gayatri Gopan also highlights the availability of vaccines for certain cancers and the importance of prevention. “Vaccinations are available for cancers caused by the HPV virus, including cervical, vaginal, vulvar cancer, and oropharyngeal malignancies. These cancers can result from unsafe oral sex, smoking, and drug use. Anyone between the ages of 9 and 26 can take the vaccination,” she says.
Common cancer types in men include lung, prostate, head and neck, and colon malignancies, she adds. In women, breast cancer, thyroid, cervix, and ovary cancer are more prevalent.
Can cancers be cured?
Dr K Pavithran, a professor of medical oncology at Amrita Hospital in Kochi, insists that cancers can be cured if detected in the early stages. He emphasises the importance of prudent screening methods and raising awareness to enable early detection.
He notes that, in Kerala, thyroid cancer is becoming more common after breast cancer. “Since thyroid, breast, and prostate cancers tend to progress slowly, many individuals may not seek early diagnosis,” says Dr Pavithran.
‘Women affected more’
Stigma is a major barrier that can lead to delayed diagnosis and increased mortality rates, say experts. Similar to the stigma associated with mental health, cancer patients often face societal pressures.
“Women tend to be affected more,” says Dr Pavithran. “I have encountered multiple situations where women deliberately delay diagnosis and treatment due to family reasons, such as their children’s education or marriage, as well as concerns about their spouse’s health. Many do so to avoid potential societal judgment. People still find it difficult to discuss cancer openly..”
According to experts, cancer patients can lead a fulfilling life during treatment if they maintain a positive attitude. Once treatment begins, cancer patients often become conscious of changes in their physical appearance, such as hair loss and alterations in their skin colour. “These concerns can lead them to withdraw from social functions and gradually become isolated,” Dr Gayatri says. “Additionally, when cancer is diagnosed, society may blame the patient’s lifestyle choices. Such accusations can be counterproductive.”
In the war against cancer, raising awareness through campaigns and educational programmes is crucial, she adds. “Health, as a subject, should be introduced in schools. It would also be greatly beneficial if institutions can provide nutritious, fibre-rich meals to students,” says Dr Gayatri.
The role of food
Rajiv Ambat, CEO of NuvoVivo Centre for Obesity, Lifestyle Disorders, and Research, recommends a dietary approach focused on whole grains, fibre, and antioxidant-rich foods that can help eliminate free radicals. Taking note of the increasing intake of maida by Malayalis, he explains: “Maida lacks fibre content. Untreated maida has a yellowish tint and, to make it whiter, bleach components such as benzoyl peroxide are added. This forms the by-product alloxan, which is carcinogenic.”
Rajiv points out that it is the quality and quantity of calories that matter. “Aim for a plate consisting of 50% fibre, 25% protein, and 25% carbohydrates,” he says. “Avoid processed, deep-fried, and smoked foods, as excessive cooking can produce acrylamide, a known carcinogen. While food choices play a role, it’s crucial to consider a combination of factors – primarily a healthier lifestyle.”
Food plan
Add more of a high-fibre diet and increase intake of antioxidants. Switch to a millet-based diet to keep obesity and diabetes at bay.
Body self-awareness
Notice the odd changes that happen in one’s body, such as unexpected weight loss, bowel habit alterations, change in voice, lumps in the body (especially breasts in the case of women), and non-healing ulcers.