Prevention
and control of cancer
Prevalence of cancer mortality due to this malignant
disease has been on the increase since the beginning of 20 th century
in western countries and recently also in eastern countries including
India. This increase was mainly attributed to improved diagnostic
facilities and methods,a better knowledge of the disease and better
experience of doctors,an increased consciousness of the people
prompting to seek more medical advice,increased suspicion index among
physicians and finally to the aging population. We have no authentic
statistics for incidence in our country but hospital records show
that it is rising.
Cancer
is synonymous with malignant disease,which is characterized by
abnormal growth of cells of the body of other parts to start a new
nodule there. At present cancer is mainly divided into 4 groups
viz, cancer affecting epithelial cells,sarcoma affecting connective
tissue cells,lymphoma affecting lymphatic tissues and malignant
growth of lymphoid cells,Leukemia affecting blood cells(blood
cancer),however,each sub- divisions is not entirely one disease,but
is believed to be a group of various diseases,with some common
factors like an abnormal cell growth being a factor invariably common
to all types of cancer .The dividing line is not clear between normal
and cancer cells,and invasive erosion of the surrounding tissue..many
benign tumors show some characteristics of local malignancy and some
others are benign in the early stages but turn malignancy a wide
unknown region lies in between malignancy and benignity, malignant
disease can affect any tissue and any part of the body,some tissues
show a higher affective than others,some tissues are more prone
than others to get metastatic deposit,some primary growths show a
particular predilection for some particular parts of the body.
Early
detection and treatment
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Early
detection,diagnosis and treatment has been the mainstay of the
concept of prevention of cancer because firstly the known methods of
treatment can result in high cure rate,at least a high years of
survival rate,.Secondly, all our other preventive measures at present
depend upon epidemiological information collected from the patients.
The early detection and follow up reveal the carcinogenic
factors,precancerous conditions and their progress and provide
material in the form of the patient and biopsy for further study the
early diagnosis and treatment halts or limits the spread of cancer
and disability.
Follow
up of all cases treated is an essential part of the anticancer pro
gramme because after the 5 years cure promised by early proper
treatment, a number of them develop recurrence and secondaries in
vital organs like brain and lungs.
Cytology and mass radiography have helped in the detection of early
cancers. many cancers originating in epithelial tissues at a very
early stage exfoliate cells showing characteristics of malignancy,in
many case much before any detectable lesion appear cytological test
was first developed,and has been applied most successfully and
extensively,for early detection of cancer of the cervix and can now
be used in the early detection of lungs cancer 1960 to 1970 in
western countries like USA the mortality rate from lung cancer
exceeds mortality from pulmonary tuberculosis,therefore,this routine
technique is often used in tuberculosis wards and follow up persons
found to have or suspected pulmonary disease on mass chest x-ray
survey ,further application of cytological test to cancers of
gastric,pro static,bladder and other organs and systems now being
unexplored radiography is also being used for detection of cancer of
upper gastrointestinal tract after a preliminary examination of older
age males for occult blood in stools,anemia,those who show positive
findings are given full radio graphic examinations and cytological
examinations wherever applicable of radioisotopes in the detection of
some of later,and some cancers is also being rapidly developed.
Specialized
Hospitals equipped with administrative,technical and professional
resources for diagnostic,therapeutic,epidemiological and research
work are needed at various places. for routine periodical
checks of the apparently healthy persons are necessary to be
established at central places. also help to stimulate the
professional and public interesting these central places field teams
can be sent out. All can be referred for further studies to the
centers by these teams and private profession this purpose a high
suspicion index has to be created in all .sufficient literature in
order to acquaint them with early signs of malignancy and
precancerous conditions in easily accessible parts of body viz
skin,rectum,breast,female genital parts and information regarding
common carcinogenic factors should be made available.
Mas
screening envisages periodic examinations of population,usually
restricted to persons of 30 years and over,to detect early cancer and
precancerous states. The periodicity of such examinations will vary
according to the resources available,but they should be repeated as
often as practicable. Such mass surveys are ideal in cancer
prevention pro-grammes but throw an enormous burden on available
medical man power and resources. Therefore,scope of mass examination
can be determined only in the light of health and economic condition
in a country,but in the long run may prove to be cheaper than the
treatment of established diseases.
Primary
prevention-Even if all the existing cases were detected we have no
facilities to treat even ten percent of them,detection by mass survey
itself and then dealing with all the detected cases are formidable
tasks. It is,therefore,necessary to use the available knowledge for
primary prevention of cancer in its precancerous stage .primary
prevention can be affected by:(a)Detection,recognition and prompt and
appropriate treatment of precancerous conditions.(b)Elimination of
protection against genetic factors known or believed to be involved
in carcinogens-is.
Precancerous
conditions:These has been identified in many instances. These
conditions do not show clinical,histological,or cytological evidence
for longtime,but subsequently become malignant. Signs and symptoms of
precancerous lesions are recognizable by the alert patient himself in
many sites including the skin,mouth,pharynx,stomach,colon,female
reproductive organs and breasts. The public may be in possession of
knowledge and that may cause them to seek medical advice. The persons
above 30 years should get periodical check even if there is no sign
and symptom of diseases,namely discharge of blood or serous fluid
from any of the natural openings,unexplained mass in anywhere in the
body,alteration in bowel habits and appetite,sudden difficulty in
swallowing persistent and progressive cough,unexplained loss of
weight or fatigue,rapid growth,ulceration and bleeding.
Carcinogen:
identification,living and working environments,cancer education and
research are important per-requisite for cancer prevention.
