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After more than 3 decades of Medical Oncology practice, now I am firmly convinced about the importance of preventive cancer.
We cure a very small percentage of cancer patients and in others it is at its best a prolongation of useful life. Even when we achieve a cure it is many times at a great financial and organ loss. In general the popular notion that cancer is the greatest misfortune that can descend on man is true.
The only cost effective way of dealing with cancer is to prevent it. Wherever the etiology is firmly known, prevention is possible. Where cause is not known, screening the high risk groups for cancer can detect precancerous conditions or early chances and cure rates can be high. The best person to advise prevention in my opinion is an oncologist who will be in a privileged position to be in touch with family, and friends of a cancer patient, who will be amenable to preventive advice.
At least 40% of cancers are tobacco related and are perfectly preventable. About 30 – 40% are related to wrong diet, obesity, lack of exercise, and wrong sexual practices. These require a change of lifestyle and this change also is possible to achieve. Some common cancers are virus induced and vaccination will be the perfect answer for their prevention.
Cancer arises from a loss of normal growth control. In normal tissues, the rates of new cell growth and old cell death are kept in balance. In cancer, this balance is disrupted. This disruption can result from uncontrolled cell growth or loss of a cell’s ability to undergo “apoptosis”. Apoptosis, or “cell suicide,” is the mechanism by which old or damaged cells normally self-destruct.
Cancer can originate almost anywhere in the body. Carcinomas are the most common types of cancer that arise from cells that cover the external and internal body surfaces. Sarcomas are the cancers arising from the supporting tissues of the body like bone, cartilage, fat, muscle etc. Lymphomas are cancers that arise from the lymph nodes and tissues in the body’s immune system. Leukemias are cancers of the immature blood cells that grow in the bone marrow and tend to accumulate in the bloodstream.
Cancers are capable of spreading through the body by two mechanisms- invasion and metastasis. Invasion refers to the direct migration and penetration by cancer cells into the neighboring tissues. Metastases refer to the ability of the cancer cells to penetrate lymphatic and blood vessels, circulate through the bloodstream, and invade normal tissues elsewhere in the body.
70-75% of the patients are preventable. In the rest, 25% many of them can be detected early if screened regularly. Cancers related to tobacco like lung cancers, head and neck cancers, pancreatic cancers, and bladder cancer are preventable if the patient does not use tobacco or stops using tobacco. About 30% of the cancers are related to obesity, wrong diet and lack of exercise. These cancers like colon cancer, breast cancer, and prostate cancer can be reduced by the right lifestyle intervention.
About 15-20% of cancers are related to infection either a viral infection like HPV, EBV, or Hepatitis B and C viruses. Cancer of the uterine cervix, liver cancer, and some head and neck cancers can be prevented by vaccination against these viruses. Some bacterial infections also can cause cancer as exemplified by stomach cancer and stomach lymphoma caused by H Pylori. Lack of physical exercise can be responsible for 15% of the cancers directly and several other cancers indirectly.
Published Article By Dr Radheshyam Naik:
- A Narrative Review of the Risk Factors for Preventive Cancer and Opportunities: Current Status, Future Perspectives and Implications for India
https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0041-1731092.pdf
- Characteristics of tobacco consumption among cancer patients at a tertiary cancer hospital in South India-A cross-sectional study