Beware And Be Aware – Cancer Is Not Warfare

A 34 year old gentleman, in the prime of his career as a management professional in a big firm, walks into my out-patient clinic for a seemingly innocuous complaint of left lower abdominal pain.

However, he had a strong family history of cancer, living alone and with poor dietary routine as well as increased consumption of processed food. So, I advised a CT scan – probably an over-cautious approach as per many of my colleagues but, turns out to be colon cancer. My team operated on him and he is currently on adjuvant chemotherapy treatment after surgery.

It will probably not appear worthwhile to talk of cancer in today’s time, when the world is already distressed about COVID. However, you may be surprised to know that cancer claims 5-6 times more lives EVERY YEAR than COVID has, so far, during the entire pandemic across the globe. Owing to fear, superstitions and taboos as well as the misunderstandings, we seldom talk freely about cancer and this allows it to continue working as a silent killer.

Cancer is in-fact a more threatening pandemic in our world and it needs urgent attention and collective effort from all of us to control it.  

Cancer takes approximately 10 million lives every year.

As a caregiver, and even for all of you who may or may not have been touched by it, it is disheartening to know that more than 30% of these deaths could have been avoided – YES, I am saying this based on scientific evidence, personal experience as well as available data with the international organizations.

Most of the cancers in the body have 4 stages

The first to third stages are localized or relatively localized and the stage 4 is where the disease is already in the system away from the localized organ. Currently, a lot of patients reach doctors with advanced stage 3 or 4 cancer, especially in developing countries. The prognosis or the chances of long-term survival significantly go down at advanced stages.

Hence, the key to reducing these poor outcomes as well as deaths due to cancer is to either prevent it or at least detect it early. It is with this intention that a formal awareness drive has been already been started by me with my team of EDUSURG CLINICS on World cancer day, which has been welcomed by the union of international cancer control (UICC).

This drive began as a video series on cancer prevention and focused on gastrointestinal tract cancer with each video aimed at making the viewers aware of what the organ does in the body, how it produces symptoms, what are the risk factors of the particular cancer are and how to prevent it or detect it early. Following this, two of my colleagues working on breast cancer cases are now a part of this drive and their videos have been added to the playlist. You can access all the videos for free by clicking on the link here.

So, if you also share the intent and identify with this mission of reducing cancer cases and deaths in our society, let us now see, how this motto can be easily incorporated into our lifestyle to help prevent or detect and treat cancer early in our family, society and community.

The first part is to “Be Aware” of the risk, the symptoms and the markers of cancer so as to take preventive measures.

BE AWARE

Misconceptions

There are a lot of misconceptions regarding cancer in our society such as

• Cancer is contagious – This misconception leads to community segregations and creating outcasts.
• Cancer can be prevented by reducing sugar intake – This misconception leads to unnecessary dietary changes
• Stage 4 cancer is not treatable – A misconception that leads to despair
• Cancer prevention is not possible – A very dangerous misconception
• I can never be affected by cancer – The typical “denial”
• He/she has cancer, he/she is cursed, did something to cause the cancer or has a bad character – This makes “cancer” akin to “Voldemort” in Harry Potter - A misconception leading to stigma, fear, and mislabeling.

These misconceptions need to be cleared as soon as possible by spreading awareness in society. Prevention of cancer or curative intervention by early detection is possible only by being aware of its causes, risk factors as well as the red flag signs of cancer.

Being aware is the key to avoid misconceptions and fear.   

Common risk factors

The second important point is to be aware of its risk factors and make lifestyle modifications to minimize the risk of cancer.

Common risk factors that are involved in many cancers in the body are tobacco/alcohol consumption, obesity/physical inactivity, processed food and infections such as hepatitis B and C in liver cancer, Human Papillomavirus in cervical cancer, helicobacter pylori for gastric cancer, and so on. If we avoid these risk factors, our individual risk, as well as the cumulative cases, can go down by 25-30%.

Reduce your risk

Common lifestyle measures as highlighted below can easily help in cancer prevention and reduction in cases by 25-30%. These include the following:

• Exercise: 30 minutes of exercise daily and 200-250 minutes of exercise across a week are beneficial for a healthy and active life.
• Stop or reduce alcohol consumption to bare minimum acceptable levels.
• Stop Smoking/Tobacco consumption completely – There is no bare minimum accepted level here.
• Do not ignore a family history of cancer: If there is a first or second degree relative with cancer in the family, you should have a discussion about familial/hereditary risk so that you can enter a selective screening program and if cancer unfortunately arises, it can be detected early and treated/cured. I have discussed this in detail in this video on large intestine cancer as it is particularly important in that cancer in the gastrointestinal or the digestive tract.
• The infective risk factors can be easily combated by treating the infections or preventing them by vaccination. Examples include curing hepatitis C or vaccination against Hepatitis B to prevent liver cancer, vaccination against human papillomavirus to prevent cervical cancer, and so on.

The goal here is to individualize screening in the presence of risks as that will be the best possible way, in my opinion to actually reduce the number of cases or at least the number of advanced cases in our community.

If you identify yourself at risk or at least have a doubt regarding your risk please contact your doctor, it is the best small step that can be taken in this direction.

BEWARE

Listen when your body tries to talk – Red flag signals

Cancer can arise in anyone, and this is irrespective of the above factors. Hence, the third important aspect of being aware after prevention is early detection and for this, please BEWARE of the following red flag signs of cancer

• A non-healing ulcer in the mouth or anywhere in body – especially ulcers for greater than a month
• A cough that lasts greater than a month
• Changes in voice
• Difficulty in swallowing or drinking
• Loss of appetite (Not feeling hungry), unintentional weight loss
• Change in bowel/ bladder habits,
• Blood in stools or urine or through vagina (non-menstrual)
• Swelling anywhere in body    

If any of these are noticed, a doctor should be consulted so as to achieve a diagnosis. Here, it is important to know that though, these are significant symptoms of cancer, they are not always indicative of cancer. So do not be afraid, but, consult a doctor. Being aware of these signs can help you reach the doctor early.

Avoid despair and fear

If cancer is diagnosed, your awareness can help you reach the doctor early. Do not be scared and do not lose hope as treatment is now possible for all stages of cancer – YES, there is treatment available for all stages of cancer. This can include various combinations of surgery, chemotherapy and radiation along with good nutrition, physiotherapy and cancer counseling. I dwell on the treatment options in detail as well as follow-up patterns in our further videos as well as discussions like this one. So, do join our drive on youtube and help in this initiative of spreading the light of knowledge to remove the darkness associated with cancer.

The motto of “Be aware and Beware” will help us all in reducing the cancer disease in our community.

I have not labeled cancer as a war and this initiative as a fight as “IT IS NOT”.

Cancer does not need to be unduly given glory as many of us have seen it being done so far. Cancer is just a disease and we need to keep it at that. Labeling it as a fight, losing a battle, winning the war are all attitudes that can bring negativity or false positivity in everyone involved in this, be it the patient, his or her family as well as the treating team.

So, let us all be aware and know cancer to avoid calling it a war, let us all not be afraid of cancer, as now, we know that it is a disease that can be prevented, cured or controlled. Be aware and spread awareness and join us in this fight against cancer as together we can reduce cases in our society and lead a healthy and happy life with each other.

Dr Gunjan Desai

Gunjan Desai is a gastrointestinal and liver and pancreas surgeon, specializing in cancer surgeries of these organs with life experiences in Gujarat, Delhi and Mumbai in India. He is a member of Royal college of Surgeons (England). He is passionate about surgery, prose and poetry, painting, meditation, playing keyboard music and towards furthering “medical education” rather than training. The inclination towards teaching and spreading awareness in the world we live in, on various medical and surgical issues, has culminated in establishment of EDUSURG CLINICS PVT. LTD. wherein, he is one of the directors and an educator.

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