Things to know about Cancer: Prevention and Early Detection1

P. Priyadarshi, MBBS, MD, FRCP (Edin)

Up to fifty percent of all cancers are preventable. Moreover, most of the cancers are curable if diagnosed early. Hence it is desirable that all of us know how cancers can be prevented or diagnosed early. Lifestyle modification goes a long way in preventing cancer. Lifestyle changes: 1. About twenty percent of cancers are caused by smoking. Alcohol too causes 3.5% of all cancers. It is recommended that one should refrain from tobacco and restrict alcohol intake. The permissible daily limit of alcohol is 60 to 90 ml of spirits (whisky, rum, gin, vodka) for men and two thirds of that for women. One bottle of beer equals 60 ml of whisky. A goblet of wine (100 ml) equals 30 ml of whisky. 2. Regular physical activity and the maintenance of ideal body weight, along with a healthy diet reduce cancer risk. Obesity and physical inactivity cause one third of cancer deaths. One must exercise or walk three hours a week. 3. Carcinogens are chemicals which produce cancers. All foods, especially fats, produce carcinogens on heating at very high temperatures (deepfrying, barbecuing etc.). Boiling is safe. A low fat and low sugar diet is desirable for cancer prevention. Sugar does not cause cancer itself. But high intake of refined sugar disturbs body metabolism in such a way that cancer growth is promoted. 4. High fibre diet prevents a large number of cancers (cancers of colon, stomach and breast). Diet should provide high amount of fibre in each meal. Fresh fruits, carrot, legumes like beans and peas, green leafy vegetables and almonds contain lot of fibre. Fruits and vegetables also provide antioxidants which protect body against cancers. 5. Red meat (beef, pork, lamb) are known for their pro-cancer effects. They should be avoided. Fish can be taken, provided it is cooked in minimum of oil. 6. Healthy cooking practices reduce incidence of many cancers. Frying, barbequing and high temperature microwaving are not good. Boiling, poaching and steaming are good.
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The article was published in the May 2010 issue of the Eternal India journal, published by India First Foundation, 5 Hailey Road, New Delhi.

7. Diet should contain micronutrients in good amounts. Such micronutrients include vitamin D, vitamin E, resveratrol, vitamin B (especially B12). 8. Too much of stress causes cancer. Relaxation techniques especially yoga, meditation and pranayam have proven role in cancer prevention. 9. Sex with multiple partners causes cancer of cervix in women. Where the woman has a single partner, but her male partner has multiple sex partners, cancer risk is still high. It is because cancer of cervix is caused by Human Papilloma Virus, which spreads by sexual contact. Pap Smear Test can detect very early cancers of cervix. All sexually active women should have this test annually. 10.Screening for certain cancers is pragmatic, and for others not. Apart from Pap Smear mentioned above, women should also have screening for breast cancer. Self-examination of breast three-monthly, by a doctor annually and by mammography annually after the age of forty is recommended. 11.All normal people should not be screened for other cancers, because they are expensive. Screening tests should be done if a patient shows any symptom of cancer or has any particular risk factor. The symptoms and signs of cancer are shared by common benign conditions. It needs to be reemphasized that only a fraction of people having these signs or symptoms will actually have cancer.

Warning signs of Cancer: 1. Change in bowel or bladder habit. Recent onset of constipation often followed by diarrhoea in someone above fifty years of age should be investigated properly. Some of such patients may have cancer of colon. Other features of cancer of colon are: blood in stool (whether visible or occult) and iron deficiency anaemia. Change in urine habit is commonly caused by enlargement of prostate gland (Benign Prostatic Enlargement). Yet some of them may have cancer of prostate, which needs to be ruled out if the prostate looks nodular in ultrasound or to the examining finger of the doctor. 2. An ulcer in mouth or skin that does not heal. Mouth cancers are usually, but not always, proceeded by a white patch lasting months or years. Skin cancers usually occur in the sun-exposed areas. 3. Bleeding (other than normal menstrual) from natural orifices (rectum, bladder or vagina). Vaginal bleeding after sexual intercourse. Bleeding from vagina in between two menstrual cycles. Any vaginal bleeding after

menopause. Blood in stool or urine. Iron deficiency anaemia of unknown cause. 4. Thickening or lump in the breast tissue. 5. Painless enlargement of testicles. 6. Difficulty in swallowing. 7. Swollen lymph nodes (gaanth, gilti) in any part of body especially neck or axilla. 8. Chronic indigestion, loss of appetite, abdominal pain and significant weight loss. A weight loss of more than ten percent of original weight over last six months is significant weight loss. 9. Obvious change in size or colour in a wart or mole. 10. Nagging cough or hoarseness of voice, which is not cured by treatment within one month. 11. Headaches and dizziness, more particularly if associated with vomiting. 12. Chronic bone pains in back or pelvis. 13. Fevers of unknown origin, where infections and auto-immune disorders have been ruled out.