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Written By: Editorial Team | Published : February 4, 2023 12:36 PM IST
Cancer is known to kill more than 10 million people a year globally. It is a disease which can affect any individual of any age group. Though treatment of this disease has made headways in several aspects, the challenge continues towards making it accessible and affordable to the general population. With every passing year, 4th February is commemorated as World Cancer Day and is focused on a particular theme. Like last year, this year's theme "Close the care gap in cancer care" remains the same. There are conflicting explanations as to why human beings fall prey to cancer. Several substances, tobacco, alcohol, areca nut, dietary deficiencies, radiation exposure , excessive sunlight , industrial pollutants , viruses , occupational hazards have all been implicated. In fact, on a daily note, we are all exposed to many substances, which are known carcinogen.
Being a lifestyle disease, cancers can be averted in 30-50 per cent of the cases. Tobacco (smoke / chewable) consumption cause 50 per cent of male cancers and 25 per cent of female cancers. Head and neck, lung, stomach, kidney, colon, bladder, prostate, cervix and blood cancer to name a few. Alcohol, on the other hand, is known to predispose an individual to head and neck , breast , GIT and liver cancers. Obesity per se also inflicts cancerous changes in the breast, oesophagus , colo-rectal, pancreas , kidney , gall bladder, uterus and ovaries.
Many a times the probable factors are not well defined. But with extensive research, performed in various parts of the world, causes are being looked into at the level of genes. We have been able to identify various mutations in the genetic make-up of individuals, which have contributed to their predilection for this disease. Quite often talked about is the BRCA gene mutation, which is known to predispose individuals to breast , ovary , prostate , colorectal and pancreatic cancer. Patients with these mutations tend to have a strong family history. Here, normally, a genetic counselling of the various members is done and treatment line explained prior to the appearance of the disease.
Treatment of cancer has seen a sea change. The newer developments have aimed at individualizing treatment accounting for the differences in people's lifestyle, gene and environment. Precision medicine or personalised medicine as it is called, tailors the treatment of every individual according to his body's state with respect to the disease and lately is being considered as an innovative weapon to defeat cancer. Insights into tumor biology, advances in artificial intelligence ( AI ) , genetic engineering and sequencing have all made therapies so targeted that the devastating side effects of the treatment have been brought down. Relapse and recurrences, which make a common story with cancer, probably would become a thing of the past.
The AI technology , has lately found a role for screening masses especially for breast cancer, which is so rampant in urban women.
Immunotherapy, which uses the individual's immune system to fight the disease has moved to the forefront in the treatment. Wide spread disease with poor survival have had miraculous outcomes with this treatment protocol.
Recently studied CART T cell therapy which makes the immune cells hunt down and kill the cancer cells has been declared as a success in the treatment of Leukemia.
Modification of environmental and lifestyle risk factors can prevent 50% of these diseases.
The fight with cancer often may be a never-ending story with a few. Most patients are filled with negative emotions. Psychological fears of various kinds tend to overpower them. Fear of disfigurement, fear of dying, sense of isolation, employment issues, overbearing financial burden continue to haunt them. Despite all advancements which help treat the body, cancers have to be treated through a holistic approach. Mind and soul are to be treated in conjunction with the physical body. Meditation, yoga, destressing exercises all have now become part of the treatment profile.
Though the field of oncology has grown in leaps and bounds, unfortunately half the world's population lacks access to essential health care services. Education, geographical location, age, gender, disability, and economic condition all come in the way of delivering good health care. Lack of awareness, lack of preventive measures and health programmes all contribute to dismal results which further generates fear towards the fight against cancer.
All said and done, the enigma of cancer will continue to elude the scientific community. There will be questions and situations, which will continue to haunt the clinicians and will remain as constant stimulus for on-going research trials.
(This article is authored by Dr. Tapaswini Pradhan, Senior Consultant, Head and Neck Cancer Surgeon, Indraprastha Apollo Hospital, New Delhi)
