The cost of cancer is high, and the suffering that accompanies it, staggeringly steep. “We all think that with cancer, genes is where the trouble often begins. But the fact is that only about 5% of cancers are hereditary. There are other culprits (lifestyle factors) which increase the risk tremendously," says J.B. Sharma, senior consultant, medical oncology, Action Cancer Hospital, Delhi.

“A survey of people who underwent preventive healthcare check-ups at our centres (in Mumbai, Pune, Bangalore, Delhi and Hyderabad) between January-September 2013 revealed rising incidence of breast cancer in women. One in 22 women in urban areas and 1 in 60 women in rural areas were found to be suffering from breast cancer, and only 5-10% of these cases were found to be hereditary. We found a strong interplay of lifestyle factors," says Kanchan Naikawadi, a preventive healthcare expert and director of Pune-headquartered healthcare company Indus Health Plus Pvt. Ltd. The total number of people they surveyed was 25,961. “Eating right, exercising, not smoking, maintaining the right weight, taming stress and staying aware can keep you safe from various cancers more than you think. And to prevent cancer in your later years, you must begin making these changes right now," she adds.

Prevent it

“The list of cancers that can be prevented is long and includes lung cancer, cancer of head and neck, breast cancer, cervical cancer, liver cancer. Prevention is actually the way to go," says Dr Sharma.

Naikawadi says weight is an important factor too. “Obesity radically alters the cellular micro-environment of mammary glands and makes it favourable for the growth of tumours, which increases the risk of getting breast cancer. Delay in having a child (and thus delayed breastfeeding) also raises the risk," she explains.

Apparently, the problem starts very often in the gut; the activity of microbiota (trillions of bacteria in our gastrointestinal tract) is closely related with the risk of cancer. “Thousands of abnormal cells with genetic mutations are generated every day in our body. Our immune surveillance system plays a critical role in clearing these cells to prevent the development of cancer. Our stress-ridden lifestyles, arbitrary use of antibiotics and unbalanced diets can kill some of the friendly bacteria residing in the gut and weaken our immunity," explains Rajeev Kumar, director, oncology, Rockland Hospital, Delhi. “Having probiotics (these are orally ingested beneficial bacteria) is an effective way of undoing this damage and promoting recovery of normal gut microbiota," he adds. A November review, Probiotics As Efficient Immunopotentiators: Translational Role In Cancer Prevention, published in the Indian Journal of Medical Research clearly summarizes the human clinical trials where the Lactobacillus Casei strain Shirota has provided benefits against cancer development.

Regular exercise helps in preventing cancer. “Cancer cells cannot thrive in an oxygenated environment so it helps to exercise daily in fresh air. Deep breathing also helps to get more oxygen to cells," says Jai Gopal Sharma, head, preventive oncology department, Rajiv Gandhi Cancer Institute and Research Centre, Delhi. Another effective way to battle cancer is to starve the cancer cells by avoiding foods that help them multiply. “Cancer cells thrive on sugar, acidic environment (a meat-based diet is acidic, so cut down on it) and toxins (eat fresh leafy vegetables and fruits; these are loaded with antioxidants, which help prevent cancer)," he adds.

Detect it

Dr J.B. Sharma recalls the case of a 38-year-old woman who came to him after observing a small lump in her left breast. “The lump was found to be malignant and thankfully her disease was detected in the first stage and timely surgery treated her successfully," he says. What saved her was the fact that she was aware and used to conduct regular self-examinations.

Unfortunately even today 70-80% of cancer patients are diagnosed at a later stage, when treatment becomes extensive and expensive, and the prognosis is poor. “That is because cancer awareness is still very poor. Also, many cancers remain asymptomatic for a long time and most are painless to start with. Besides, in India, the myth that biopsy spreads cancer is still prevalent. On the contrary biopsy/FNAC (fine needle aspiration cytology) is the only way to be 100% sure of being able to diagnose most cancers," says Dr Kumar. Early detection of the disease in the gastrointestinal system is possible through an endoscopic ultrasound (EUS), which provides high-clarity images. “EUS can take images of the inner layer of the organs and doctors can detect the cancer at a very early stage," says Naresh Bhat, consultant, department of gastroenterology, Columbia Asia hospital, Bangalore.

“India now also has a single test (tumour profiling test) that can diagnose cancer using multi-gene mutational analysis. Tumour profiling tests are currently available for lung, breast, biliary tract (pancreas, bile duct and gall bladder), ovarian, thyroid, colorectal and urinary tract cancers and acute leukaemia and melanoma at the Rajiv Gandhi Cancer Institute and Research Centre in Delhi," says Dr Jai Gopal Sharma.

Genetic testing is also now available in India and is a good option for those who have a strong genetic probability. “For breast cancer, we have BRCA1 and BRCA 2 gene testing; for colon cancer we have APC and MLH1, MSH2, MSH6, PMS1, or PMS2 gene testing; and for retinoblastoma, Rb gene testing" here; and for other cancers, p53 gene testing," says Dr J.B. Sharma. The cost of the tests is around 40,000-45,000 for each type of cancer; high-end labs like Oncquest Laboratories Ltd based in Delhi, and Reliance Life Sciences in Mumbai and Bangalore—have pick-up centres across India.

Stay alert

“Don’t ignore prolonged fever, sudden loss of weight, fatigue, loss of appetite, headache, giddiness, and chronic abdominal problems like indigestion, bloating, chronic constipation," says Dr Jai Gopal Sharma. Warning signs of cancer also include: a change in bowel or bladder habits, a sore that does not heal, indigestion or difficulty in swallowing, an obvious change in wart or mole, a nagging cough or hoarseness, unusual bleeding or discharge, thickening or lump in breast or elsewhere. “Symptoms like these do not mean that you have cancer but it is very important to rule out cancer in such situations," says Dr Kumar.