Many people, especially the ones without knowledge of medical science, believe the word cancer to be synonymous with ‘end of life’.
As doctors, when we are faced with the grim prospect of discussing the diagnosis of cancer with a patient, we try to the best of our abilites, never to use the term ‘cancer’. Instead, we rely heavily on its counterparts – tumor, growth, mass. We do this to leave room for the patient, so they can try to comprehend their illness on their own terms; we buy just enough time to be able to walk them through their understanding of what is going on in their bodies and what we can do to alleviate their suffering. But above everything else, in our efforts to avoid the term cancer, what we are really trying to do, is to make the patient believe that the diagnosis of cancer is life-altering but not always life- ending; as with all other medical maladies, there is always hope, a silver lining, a new therapy, a new research trial.
Sometimes, doctors need that hope as much as their patients.
February 4th is recognized as World Cancer Day. It is a day dedicated to raising awareness about cancer, addressing stigmas and misinfomation regarding the disease and encouraging its prevention, detection and treatment. Around 12. 7 million people discover that they have cancer every year and around 7.6 million die because of it. Like most chronic illnesses, cancer comes with its own set of misdirected views, opinions and conclusions.
Around 400 B.C., Hippocrates is said to have named masses of cancerous cells karkinos — Greek for crab, possibly because the swollen veins around certain tumors resembled the limbs of a crab.
Simply put, cancer is the term applied to a large family of diseases that involve abnormal cell growth of the body’s own cells with the potential to invade or spread to other parts of the body. When cancer from one place, spreads to other parts of the body, like a lung tumor that sends its cells into the brain, it is said to be malignant. However, when it stays confined to its place of origin, it is benign and hence, less destructive. Not all cancers are incurable. Over the last few decades there have been significant advancements in medical science and research that have led to the development of an array of new therapies that have proven to be promising, extending life expectancy in some cancers that were previously fatal, by years.
Previously, a B-cell acute lymphoblastic leukemia, affecting children and young adults was thought to be deadly and devastating. There are now new drugs available in the market, that genetically alter the patients own cells to fight the cancer, leading to long periods of time where the disease does not resurface and possibly even cured. This is a form of immunotherapy, where medicines target your own immune system to make it strong enough to fight cancer. It has the potential to transform the treatment of cancer and is a field that is rapidly progressing.
I recently read an article about how a teenager lost his uncle to pancreatic cancer. One of the most deadly cancers, with a five year survival rate of just 7%. And in his grief and confusion, trying to understand the disease, he spent his time in his own research, eventually coming up with a new way to detect the cancer very early on, at a stage where there is a chance of 100% cure with intervention.
Source: smithsonianmag.org
Like I said. There is hope. And there are brilliant minds in the world dedicated to the pursuit of studying the disease, understanding its causes and finding innovative, targeted treatments.
So what can we do?
When it comes to cancer, the best treatment is prevention. There are a lot of changes we can make in our daily lifestyle that could protect us from cancer.
These things include:
- Not smoking or using any form of tobacco, as there have been significant studies linking tobacco and cigarette smoking to lung and oral cancers.
- Enjoying a healthy, balanced diet. Eat organic food; most pesticides have been linked to a various number of cancers. Fruits, vegetables and foods rich in fiber lower the risk of developing cancer. Take care of your body, obesity contributes to the development of cancer as well as it promotes inflammation in the body. Chemicals called nitrates and nitrites are often used to preserve processed meat. In the body nitrites can be converted into cancer-causing chemicals called N-nitroso compounds (NOCs). The presence of these chemicals may explain why many studies have found that processed meat increases the risk of cancer more than red meat. Cooking meat at high temperatures such as grilling or barbecuing can produce cancer-causing chemicals called heterocyclic amines (HCAs) and polycyclic amines (PCAs).
- Breastfeeding reduces the mother’s risk of developing breast cancer.
- Vaccination of children against Hepatitis B and HPV is important. Hepatitis B can lead to liver damage that can trigger a cascade of events that could end up in liver cancer and certain strains of HPV are linked to cervical as well as oral cancers.
- Avoid too much sun. Always use sun protection to prevent UV radiation from causing skin cancers.
- Be physically active amd limit alcohol intake.
- Most importantly, take part in organized cancer screening programs.
Not only is prevention important, it is also imperative to be aware of the risk factors and symptoms of cancer as well.
A woman who’s mother, sister or grandmother had breast cancer should periodically self examine and get investigated for the gene that runs in families that contributes to the development of breast cancer. Some forms of colon cancer are also hereditary. Hence, it’s important to be aware of the diseases that a relative has and how it can affect you, especially if the likely source is in the genetics.
A more educated question to ask the doctor, as a family member of a patient suffering from cancer would be, “Could it be genetic? If so, how can we get screened for it?”
Despite the presence of state of the art technology like radiographs and gene testing, people are better attuned to changes in their bodies and as a result, should always self examine, watching out for symptoms that could indicate that something is wrong.
These symptoms include, but are not limited to:
- Rapid, unexplained weight loss or gain.
- Vaginal bleeding after menopause – that is mostly benign but about 10% of the cases are due to endometrial cancer.
- Abnormal vaginal bleeding before menopause, example in between cycles of menstruation or after intercourse – that could signal cervical or endometrial cancer.
- Pelvic pain that is persistent, uncomfortable and associated with indigestion, gas, bloating and cramps.
- Appetite loss.
It is always better to seek advice from a health care professional when you cannot make sense of your symptoms because not every one of them means you have cancer. Self diagnosis can be worrying and unsettling for the patient, especially when it is inaccurate.
Artwork by Rebecca Mock
For those who live with cancer, Kate Bowler says it best in her article: ‘What to say when you meet the angel of death at a party.’
“I am not dying. I am not terminal. I am keeping vigil in the place of almost death. I stand in the in-between where everyone must pass, but so few can remain.”
It is perhaps, one of the most catastrophic things in life, having to grapple with a disease that is as relentless as the human spirit to fight it. As someone once said, cancer is a word, not a sentence. The diagnosis can be life changing, but it does not mean that we give up. Let us say to those fighting cancer, I stand with you and to those who have lost the fight, we honor you and to those who won the fight, lets embrace and cherish life. There will always be hope and each day of every year, more efforts to find lasting therapies.
“Even if I’m dying, until I actually die, I am still living.”
― Paul Kalanithi, When Breath Becomes Air
About the author:
Ramsa Rana is a medical doctor, recently graduated from medical school. Rana is passionate about pursuing a career in medical science. Rana believes that life isn’t about avoiding suffering but embracing it, till you can make sense of it.
Contact: ramsarana65@gmail.com
