 |
FREQUENTLY
ASKED QUESTIONS
|
 |
|
|
|
| |
FAQ's |
 |
|
|
|
Q. What causes cancer? |
|
A number of agents have been implicated in causing
cancer. A large proportion of cancers are caused
by living habits and environmental carcinogens:
|
|
Tobacco: causes
cancer of the mouth, throat (pharynx), voicebox
(larynx), food pipe (esophagus), lung, pancreas,
kidney, urinary bladder, and uterine cervix. At
least 90% of lung cancer deaths are due to smoking.
|
|
Alcohol: Increases
the risk of cancers of mouth, pharynx, larynx and
esophagus by increasing the permeability of the
mucosa to various carcinogens especially tobacco. |
|
Ionizing radiation:
well established as an etiologic factor in the development
of leukemia. |
|
Environmental exposure:
Asbestos exposure can cause cancers of the lung,
pleura and abdominal peritoneum. Excessive exposure
to solar ultraviolet radiation dramatically increases
the risk for skin cancers. |
|
Viruses and bacteria:
Chronic carrier state of Hepatitis B virus increases
significantly the risk of developing liver cancer.
Viruses of the HPV & HSV family cause carcinoma
of womb's mouth (cervix) and carcinoma of the oral
cavity, the commonest cancer types seen in India.
Helicobacter pylori is associated with increased
risk of developing stomach cancer. |
|
Chemical agents:
A number of cancers are related to increasing use
of potentially carcinogenic chemicals in various
aspects of life. These chemicals get to our body
through air, water, food, etc. Air pollution caused
by various sources can increase the risk of cancer.
Carcinogenic chemicals in air can come from automobiles
and industries and affect the lung. Exposure to
certain chemical agents like benzene increases substantially
the chances of developing cancer esp. bladder cancer.
|
| Dietary
habits and body habitus:
Obesity
and high intake of fat, animal protein (particularly
red meat), salt-cured foods, and nitrate/nitrite
additives in the diet does seem to increase the
risk of development of cancer. |
| |
|
Q. How do these agents cause
cancer? |
| The
functioning of all parts of the human body at all
levels is governed and controlled by the genes.
The genes can be thought of as a large and elegant
software or information store, which controls the
development of human body and its normal functioning.
The genes are responsible for cell multiplication,
cell growth and cell death. All cancers are caused
by some abnormality in the genes. Abnormalities
in the genes or mutations arise because of different
agents which can cause damage to the genes such
as chemicals, radiation, viruses, etc. |
|
A lot of research is going on to find out the complete
genetic basis of cancer and this is likely to lead
to new treatment options in future. |
| |
|
Q. How to protect one self
from cancer? |
 Tobacco
should not be used in any form whether smoking or
smokeless |
| Alcohol
in moderation, say social drinking, one-two small
30 ml pegs of whisky, five days a week, is permissible.
However drinking alongwith smoking is very unsafe
as it sharply increases the risk of cancer. |
| Avoid
direct exposure to noon sun; use hat, full sleeves,
sun screen lotions and avoid noon sun bathing. |
| A
well-rounded diet, low in saturated fats and high
in fresh fruits, vegetables and fiber starting as
early in life as possible does have impact on reducing
the incidence of cancer. |
| Proper
sexual hygiene and oral hygiene should be achieved
alongwith regular examinations. |
| Regular
exercise helps to reduce the risk of cancer esp.
colon cancer |
| |
|
Q. How do I know about my
risk of developing cancer? |
| A
large proportion of cancers is life-style related.
The chances of developing cancer depends upon choice
of foods, smoking habits, drinking habits, personal
hygiene standards and exposure to certain agents
at workplace environment. (One should visit for
medical counseling to a cancer specialist and identify
whether one belongs to high risk group of people
likely to suffer from cancer and get adequate investigations |
| |
|
Q. Why is cancer in India
almost always detected in late stages? |
| Majority
of patients are free of pain and other symptoms
in the early stages. This asymptomatic stage leads
to a delay in seeking medical attention and allows
disease progression unchecked. There is also a reluctance
to entertain and accept this diagnosis even when
there are obvious pointers in this direction. As
a result, most patients present with advanced disease.
|
| |
|
Q. How can cancer be detected
at early stages? |
| Cancer
can be detected in the early stages by Screening
and by seeking prompt medical attention for any
worrying symptoms. |
| Screening:
refers to examination and investigation of persons
without any symptoms or signs suggestive of cancer
with a view to detect cases of cancer before they
cause symptoms. It is expected that by this approach
cancers can be detected at a very early stage and
thus lead to a much higher chance of cure. Screening
has been found to be effective in early detection
of cancer of the breast and uterine cervix, the
two commonest cancers in women. Screening has also
been found to be effective in prostate cancer, a
common cancer of elderly males and. cancer of the
large intestine (colon or rectal cancer) . |
|
Screening
for breast cancer is by breast self examination,
annual clinical examination by a specialist and
mammography (x-ray of the breasts done using special
x-ray machines) starting at an appropriate age.
|
|
Screening
for cancer of the uterine cervix involves examination
by a specialist and a test called the pap test which
is a very simple test without any discomfort. |
|
Screening
for prostate cancer involves examination by the
specialist, a blood test for prostate specific antigen,
and TRUS (transrectal ultrasound of the prostate).
|
|
Screening
for cancer of the large intestine involves examination
of stool samples for present of blood (occult blood
testing) and examination by a specialist. . |
| |
|
Q. How does early diagnosis
change the outcome? |
| Detecting
cancer at the earliest, especially at pre-cancer
stage, is very likely to yield best chances of lifetime
cure, with much shorter treatment time, much less
cost and much less toxicity from the treatmenth.
|
| |
|
Q. What are cancer warning
signals? |
| Lump
or swelling: A swelling or lump is a
symptom of cancers of superficial body parts such
as skin, breast, muscles, bones, etc. For breast
cancer, which is the commonest cancer of women all
over the world, a lump in the breast is the symptom
in more than 90% of cases. |
| A
sore that doesn't heal: A wound, ulcer
or sore caused by cancer does not heal on its own
or with dressings. Ulcers in the mouth and in the
back passage are especially worrying. |
| Recent
change in a wart/mole: The features of
this are a change in size, itching, bleeding, ulceration,
etc. |
| Unusual
bleeding or discharge: Cancer of deeper
parts of the body can lead to bleeding or discharge.
Cancers of the uterine cervix in women is a very
common cancer in India. It causes dirty vaginal
discharge and bleeding. Bleeding may be spontaneous
or after intercourse. Similarly bleeding with urine
and stools can be a sign of cancers of the urinary
tract (kidneys, ureter or bladder) and intestines
(large intestines, small intestines). Cancers of
the lung often manifests with coughing of blood. |
| Changes
in bladder or bowel habits: Difficulty
in passing urine, poor stream, etc can be because
of cancers of the prostate. Similary, constipation
with or without episodes of diarrhea, passage of
mucus with stools, etc can be a symptom of intestinal
cancer. |
| Nagging
cough or hoarseness: Nagging, persistent
cough is common feature of cancers of the lung and
larynx.. Change in voice is a common feature of
cancer of the larynx and it can also occur due to
lung cancer. |
| Difficulty
in swallowing or dyspepsia: Difficulty
in swallowing is a common feature of cancer of the
esophagus (foodpipe) which is a common cancer in
India. It starts with difficulty in eating solid
food and progresses until it is difficult to swallow
liquids or even saliva. Loss of appetite, heaviness
after meals, nausea and vomiting are common features
of cancer of the stomach. |
| Presence
of these signs should prompt the patients to seek
medical attention. It is important to realize that
no symptoms or signs of cancer are exclusive. Similar
symptoms can be and are often caused by noncancerous
diseases. However, whenever a possibility of cancer
exists, the specialists should be consulted to exclude
the diagnosis of cancer. |
| |
|
Q. How is cancer treated?
|
| Treatment
of cancer is a rapidly evolving field as a result
of the intensive research work being done in cancer
centers all around the world. Basically, three main
approaches to treatment of cancer are used: surgery,
radiation, and, drugs. Correspondingly, three main
types of cancer specialists are there for treating
cancer: surgical oncologists, radiation oncologists,
and medical oncologists. |
| The
treatment of cancer is described as a multimodality
approach as a large number of patients need to be
treated with a combination of the approaches available.
Thus, some patients may need only one modality of
treatment, some need a combination of two modalities
and some need to be treated with all three modalities
to achieve the best results. |
| |
|
Q. How
patient and family should act once a family member
is detected having cancer? |
| All
issues of treatment strategies should be settled
before starting any one therapy. Hasty start after
consulting only one speciality, getting under investigated,
leaving treatment midway, undergoing inappropriate
surgery, lesser radiation sittings and low dose
chemotherapy, can definitely compromise chances
of permanent cure. |
| Such
hasty start may allow patient and attendants to
feel falsely secure and may yield initial temporary
cure. |
| |
|
Q.
What patient and family should know from the cancer
doctor? |
|
Before the start of anti cancer treatment it is
imperative to know the extent of cancer spread and
its origin. One should also be aware of the benefits
and risks of treatments and possible consequences
if no treatment is taken. It should be clearly known
that what will happen if no treatment is taken and
how the given treatment choices will change the
natural history of cancer. It should be clarified
that how long the patient is going to live with
or without treatment. Patient should know cost effectiveness
of various treatment possibilities, planned breakes
and follow up schedule. |
| |
|
Q.
Which speciality doctor patient should meet to get
anti-cancer treatment? |
| There
is no single doctor as wrongly conceived by general
public as an "all round cancer specialist." No doctor
is qualified enough to deal with all the three cancer
specialities of cancer surgery, cancer radiation
and cancer medicine. It is emphasized that all cancer
care seekers should seek opinion of at least three
cancer specialists (Tumour Board / Planning board)
available. In India, there are specialists with
DM in cancer medicine, MCH in cancer surgery and
MD or DNB in radiation therapy. To get quick and
correct decisions seek opinion of all the three
cancer experts (Not one). A "Total Plan" clarifying
the role of all three treatment specialities should
be designed. |
| |
|
|
