Understanding cancer risk

The earlier cancer is detected, the more treatable it is. Some of the symptoms to watch out for


Photo: iStockphoto
Photo: iStockphoto

According to the National Institute of Cancer Prevention and Research, the reported number of cases of people living with some type of cancer in India is around two and a half million. Every year, over 700,000 new patients are registered and over 500,000 die of different cancers. With World Cancer Day, observed on 4 February, just behind us, it’s clear that though the numbers are rising steeply, awareness of the disease remains so poor that diagnosis is delayed. Rohit Nayyar, director, surgical oncology, at the Asian Institute of Medical Sciences in Faridabad, near Delhi, says late detection is one of the main causes of mortality.

B.S. Ajaikumar, chairman and practising oncologist at the HCG (Healthcare Global) Hospital in Bengaluru, says it’s important to be aware of the symptoms, risk factors, prevention strategies and treatment options available. “Right information is the key as detecting and treating cancer at an early stage can significantly reduce the mortality rate and tame the numbers,” he says.

Here’s some information on the more common cancers.

Lung cancer 

Symptoms

Persistent cough, chest pain, blood in the sputum, weight loss, muscle aches

The numbers

In India, lung cancer constitutes 6.9% of all new cancer cases and 9.3% of all cancer-related deaths in both sexes; it is the commonest cancer and cause of cancer-related mortality in men.

Top risk factors

Smoking, second-hand smoke, pollution, radiation exposure

Age group

It occurs mainly in older people. About two out of three people diagnosed with lung cancer are 65 or older; less than 2% are younger than 45.

Cut the risk

Stop smoking. Reducing exposure to pollution also helps; you can use sophisticated masks like the N95.

Treatment

Chemotherapy, radiotherapy or a combination of both.

Did you know?

Women get lung cancer too, contrary to the general belief that they don’t because fewer of them smoke; it is the No.1 killer cancer in women in developed countries.

Expert: Sidharth Sahni, senior consultant (surgical oncology), Indraprastha Apollo Hospital, New Delhi.

Ovarian cancer

Symptoms

Mild abdominal pain/swelling, vaginal bleeding, low backache, sudden changes in periods.

The numbers

Ovarian cancer is the leading site of cancer among women after cervix and breast cancer. At HCG’s Bengaluru centre, we see around 200 new cases of ovarian cancer annually.

Top risk factors

Obesity and family history. Prevalence of mutations involving the BRCA1 and BRCA2 genes can increase the risk.

Age group

Predominately 40-60.

Cut the risk

Eating a healthy diet with plenty of fruits, vegetables and wholegrains helps, birth control pills also cut the risk. Check with your doctor—if you have a strong family history she might suggest tests for BRCA1 and 2.

Treatment

Usually a combination of surgery and chemotherapy. For advanced cancer, biologic therapy and intraperitoneal therapy that involves delivery of anti-cancer drugs directly into the peritoneal space (abdominal cavity) have shown significant success.

Did you know?

Like breast cancer, it is a lifestyle disease, so anti-obesity measures and a low-fat diet help cut the risk substantially.

Expert: B.S. Ajaikumar, chairman and practising oncologist, HCG Hospital, Bengaluru.

Breast cancer  

Symptoms

A painless lump, redness or other visible differences (size or shape) in one or both breasts, a change in nipple appearance or size, or discharge.

The numbers

Nearly 1.7 million new cases were diagnosed worldwide in 2012, of which 144,937 were in India. One of every two women diagnosed with breast cancer in India dies.

Top risk factor

Keeping weight in check could help prevent 25-32% of breast cancers.

Age group

Women of any age, but the risk increases after the age of 40 and is highest in women over the age of 70.

Cut the risk

Researchers wrote in the JAMA Oncology journal in 2015 that 300 minutes of exercise every week help cut the risk.

Treatment

Surgery, radiation therapy and chemotherapy are the common treatment modules. A single shot of targeted radiation (operative radiation therapy) is now becoming popular since there are fewer side effects like fever, stomach upsets and hair loss.

Did you know?

Men get it too.

Expert: Rohit Nayyar, director, surgical oncology, Asian Institute of Medical Sciences, Faridabad.

Cervical cancer

Symptoms

Abnormal bleeding (even when periods are not happening), painful urination, unusual vaginal discharge, pelvic pain.

The numbers

In India, about 75,000 women die of it annually—this constitutes 27% of the global mortality.

Top risk factor

Infection by the human papillomavirus (HPV). Those with a compromised immune system are at a higher risk.

Age group

This cancer is usually diagnosed at a younger age than others; the peak age for developing cervical cancer is 47.

Cut the risk

Safe sex, quitting smoking helps. (A yearly pap smear (conventional/liquid-based cytology) with or without the HPV test helps catch it in time.

Treatment

The most common treatment for cervical cancer is surgery (removal of the cervix) and/or a combination of chemotherapy and radiotherapy (chemo-radiation).

Did you know?

All boys and girls aged 11-12 can get vaccinated against HPV. If not, catch-up vaccines are recommended for males till the age of 21 and for females till the age of 26.

Expert: Shilpi Agarwal, professor, department of pathology, Lady Hardinge Medical College, New Delhi.

Prostate cancer 

Symptoms 

There are no early symptoms usually but when they do appear, they tend to be urinary symptoms, like frequent urination. In the advanced stage, severe bodyache, swelling of the feet, loss of appetite and weight may be noticed. 

The numbers 

It is the second most common form in men.

Top risk factors 

Besides family history and advancing age, men who smoke and consume a lot of red meat or high-fat dairy products could be at a higher risk.

Age group 

Men under 45 rarely get it. 

Cut the risk 

The PSA (prostate-specific antigen) blood test and DRE (digital rectal examination) should begin at the age of 50 for those with no symptoms and no family history and at 40 for those with a family history.

Treatment 

The best treatment for localized prostate cancer is a radical prostatectomy operation. And, depending on the stage and age of the patient, radiotherapy, hormonal treatment and chemo could be options. 

Did you know?

Prostate cancer patients are at a higher risk of osteoporosis.

Expert: N.P. Gupta, chairman, Medanta Kidney and Urology Institute, Medanta: The Medicity, Gurugram.

Colorectal cancer

Symptoms

Diarrhoea or constipation lasting more than two weeks, blood in stool, abdominal swelling, unexplained weight loss.

The numbers

In 2008, the last figures available, this was the third most common cancer in men (663,000 cases, 10.0% of all cancers), and the second in women (570,000 cases, 9.4% of all cases), worldwide. Rates have been low in India but population-based time trend studies are showing a rising trend.

Top risk factors

Alcohol drinkers, smokers, people who have had ulcerative colitis disease or who have a history of diabetes or constipation are at an increased risk.

Age group

It can occur in teenagers and young adults, but the risk is highest for those aged 40-60.

Cut the risk

A lot depends on lifestyle, activity level and diet. You can literally bring this cancer on yourself.

Treatment

Surgery is an option for cancers confined within the wall of the colon. Chemotherapy is used in more advanced stages.

Did you know?

A diet high in fibre, vegetables, fruits and wholegrains is linked to a decreased risk.

Expert: Radheshyam Naik, head, bone marrow transplant, HCG Hospital, Bengaluru.

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