What is Cancer

Cancers covers a wide range of diseases with abnormal growth of cells. As in initial stages it doesn’t show any sign and symptoms so without any check, cells or disease keep on growing and many times leads to untimely death .They can grow anywhere in the body and it is not an age specific ,socio economic strata and race specific disease.. The spread of Cancer is the leading cause across world for morbidity and mortality .According to recent studies its been predicted that the number of Indians suffering from cancer will increase to 29.8 million in 2025 from 26.7 million in 2021.

Types of Cancers –
  • 1- Carcinomas –It spreads in the cells of skin or lines the mouth, throat, lungs, and organs.
  • 2- Sarcomas – usually found in Bones, Muscles, Fibrous tissues and some organs
  • 3- Leukemia – Found in the blood, the bone marrow, and The spleen
  • 4- Lymphomas – Found in Lymphatic System.

Most Common Cancers in Men –

  • 1- LungCancer
  • 2- Prostate Cancer
  • 3- Colo- Rectal cancer
  • 4- Stomach cancer
  • 5- Liver cancer
  • 6- Mouth Cancer

Most Common Cancers in Women

    1- Breast Cancer
  • 2- Cervix Cancer
  • 3- Colo Rectal Cancer
  • 4- Stomach Cancer

The cancer may spread according to the Socio economic strata , geographical conditions.

Mouth cancer is common in Indian sub continent but not in western countries. Main reason for the same is high quantity consumption of Chewable Tobacco like Gutkha, Paan, Paan Masala , Khaini etc .

In low social economic societies the cervix cancer are very common due to poor genital hygiene Colo – rectal cancers are very common in societies consuming more of fatty food and less fiber in diet.

Common causes of cancer are are as follows:

Tobacco - Tobacco consumption is one of the most common causes of cancer mortality across the world. Cancer causes 22% of deaths worldwide according to studies by WHO. It is of 2 Types – Smoking and Smokeless. Most lung cancers are associated with smoking and passive smoking. The more we smoke more is the risk of cancer. In India, smokeless consumption of tobacco is most common. Smokeless tobacco consumption includes Guthka, Paan ,Paan Masala, Khaini, betel, Tobacco is the root cause of cancers of the Lung, Mouth, Throat, Kidney, Pancreas, Esophagus, Liver, cervix, ovary, bowel, and stomach. Tobacco has 4000 chemicals mixed out of which 200 are very harmful and 70 are carcinogenic. 50% of tobacco users may have one or the other tobacco-related disease which takes up their life.

Areca Nut – It is known as Supari in India. It may be consumed alone or in combination with betel leaf, catechu, and slaked lime. Its powdered form is mixed with other ingredients also known as pan masala and if tobacco is mixed known as Gutka. High consumption; leads to sub mucosis fibrosis a pre-condition of initial cancer in which the opening of the mouth decreases gradually and leads to Oral Cancers.

Alcohol – Alcohol itself is associated with several cancers, the risk of which increases with the increasing quantity of alcohol consumed. Smoking along with alcohol gives much worse effects than consuming them alone. Alcohol use is a risk factor for many cancer types including cancer of the oral cavity, pharynx, larynx, esophagus, liver, colo-rectum, and breast.

Pollution – This includes the environmental pollution of air, water, and soil with carcinogenic chemicals. Exposure to these chemicals can occur through air and drinking water. Chemicals like arsenic cause contamination of drinking water and can result in lung cancers. Household air is polluted by coal fires which cause lung cancer. Besides, contamination of food with aflatoxins can also cause cancer.

Lifestyle factors – Factors like unhealthy eating habits and lack of physical activity in the modern era increase the risk factor for cancers. High body mass index is associated with cancers of the esophagus, colo-rectum, breast, endometrium, etc. Excessive consumption of red meat is associated with colorectal cancers. Healthy diets including vegetables, salads, and fruits have been found to decrease the risk of developing certain cancers.

Obesity – It is one of the common causes of many diseases and is most often seen in Obese patients having excessive Fat Accumulation In the body.BMI anything above 30 refers to obesity and may lead to an increase in the risk of Cancers. Obesity can cause Heart Problems, diabetes, cancers of the colon, breast, esophagus, pancreas ,endometrium, etc.

Occupational exposure – Chemical exposure due to occupation may cause higher incidences of Cancers associated with specific substances like –Asbestos, silica, tannin devices, cadmium, ionic radiation, and dust of coal and aluminum production units are the most common occupations associated with various cancers. So proper knowledge and education are to be provided to the employees working at the sites to prevent this. Common cancers include lung, skin, bladder, blood, etc.

Biological agents – Few bacteria, viruses, and parasites, are also responsible for certain cancers like Human Papilloma Virus (HPV) for cervical and oropharyngeal cancers,Hepatitis B & C associated with Liver cancer, stomach cancer is due to H Pylori as well

Screening for cancer

As in this present scenario of increasing cases of Cancer it is most widely advised to get the screening of cancers on regular basis specially if you are aged above 40 or chronic smoker or alcohol consumer, or family history of any kind of cancer. Screening helps in detecting early stage of cancer before reaching to any sign and symptoms and get it treated at earliest.

Breast Cancer – A mammogram is used to screen a breast cancer where xray imaging shows the stage of cancer development. It should be done in early ages if there is an family history of Breast Cancer . Along with this a self examination of breast help in detecting any kind of Lump or swelling

Cervical Cancer - Pap smear is one of the simple technique used to detect the cervix cancers in women. In this a smear is taken from cervix and then a microscopic evaluation is done to look for pre cancerous or cancer cells. Women above 35 year and above are advisable to go for the test as advised by your consultant.

Oral Cancers – These can detected by easily visible patches if any one having and not healing for more than one month and must be advised to go for screening. Its of 2 types Lucoplakia (White Patches ) and Erythroplakis ( Red Patches). To detect any cancerous cells a biopsy is taken to check any type of Maligancy.The most commonly seen in persons consuming any form of chewable or non chewable tobacco or smoking.

Colo-rectal cancers – The family history of Colo-rectal cancer is very common to spread to family members and need screening on regular intervals. Another common cause is Inflammatory Bowel Disease. Feces with intra occult blood or colonoscopy is performed as screening test for them.

Diagnosis -

Physical Examination - A through patient history with signs and symptoms to assessed by the consultant.
Radiology – After physical examination a number of radiological tests like X Ray , Ultrasound, CT scan , Mri Scan ,PET CT are used to evaluate the lesions.
Biopsies – If any lesion is found in radiological test a small part of lesion is taken out and send for histopathology examination.
Once the diagnosis confirmed the presence of Cancer cells further treatment is planned according to the reports and its stages.

Treatment –

The treatment may depend using only one Modality or combination of modalities by evaluating the patient condition. The available modalities for the treatment of Cancer are –
Palliative Care.

Now as we know what are cancers and how they spread and there treatment , its important now to know what we can do to prevent it . Let’s discuss-

Prevention Of Cancer – What to do –

1- Tobacco Consumption Cessation – The most deaths in cancer are due to Tobacco Consumption and can built-up 20% of total death due to Tobacco. So living a Tobacco free life can save lots of Lives so Quit Tobacco. There are lots of Tobacco cessation programs available at various Government and Private center to get rid of this habit.
2- Alcohol consumption Cessation - Another big reason of Cancer is Alcohol consumption so to quit alcohol and living healthy life with lots of physical activity and inclusion of fruits and vegetables in diets reduces the chances of developing the cancers.
3- Genital or Oral Hygiene – To reduce the HPV spread which causes cervix or orophayngeal cancers its most important to maintain a good genital or oral hygiene. Also giving the prick of Vaccination to adolcent girls also protect them from cervix cancer.
4- Pollution control, Workplace Precaution education will help in reducing the chances of cancer related to these factors.
5- Virus related Cancer – Hepatitis B virus infection which may be spread by infected blood infusion a proper precautions must be taken to reduce this.
6- Family History Cancer – A proper education about the risk associated with family members , sign and symptom’s must be given so early onset of cancer can be treated at its initial stage .

Tumors -

Cancer refers to unregulated and unrestricted proliferation * of cells. Clinically it is seen in the form of a growth. Neoplasm is an abnormal mass of tissue growing in an uncoordinated way and persisting even when the stimuli responsible for growth has been removed. A tumor is said to be benign when its characteristics are considered relatively harmless suggesting that it wouldn’t spread to near-by or distant areas, can be operated easily and doesn’t risk the patient’s life significantly. Malignant tumors are collectively referred to as cancers, derived from the Latin word for crab, because they involve the tissues in a manner similar to a crab. Malignant tumor can invade and destroy adjacent structures and spread to distant sites (metastasize) to cause death. Not all cancers cause death, if detected early and treated properly, some cancers can be cured.

Cancers result from certain changes at the molecular level in response to various external or internal stimuli (Figure 1). Such genetic change (or mutation *) may be acquired by the action of environmental agents or it may be inherited in the germ line. Environmental agents include: Physical carcinogens * - ultraviolet and ionizing radiation Chemical carcinogens - components of tobacco smoke, aflatoxin, asbestos, arsenic etc Biological carcinogens - viruses, bacteria or parasites. Malignant neoplasms have features, such as excessive growth, local invasiveness, and the ability to form distant metastases (Figure 2, Table 1). The various key changes that occur in a cancer cell are- capacity to proliferate without any growth signals, resistance to growth inhibiting signals, resistance to regular cell death mechanisms, formation of new blood supply ability to involve surrounding tissues, metastasis to distant organs (Figure 3) and failure in repair of damaged DNA.

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Written by:

Dr. Akshat Malik

Cancer Care / Oncology, Surgical Oncology , Head & Neck Oncology

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