The month of February sheds light on a very important subject: Cancer. It’s in February that we celebrate World Cancer Day. It falls on February 4. Cancers have become a serious threat to health all over the world, Sri Lanka is no different. World Cancer Day focuses on raising awareness on cancer prevention. This week’s edition of the Health Capsule joins in raising awareness on cancer prevention. This is why we spoke to two medical professionals regarding this malady. Dr. Jayantha Balawardana, Senior Counsultant Oncologist, Radio Therapist and Senior Lecturer at the Kothalawala Defence University shared his medical expertise on the disease, answering all questions related to cancer. Dr. W.D. Deepika Wijesinghe, Medical Officer, Base Hospital, Homagama, explained how cancers are detected and patient are sent for treatment.
Dr. Balawardana explained what a cancer is. “Cancers are abnormal growths in the body that seem to have no control. In the human body, cells divide according to a regular pattern with some control and limitation. The body cells divide only when necessary. There are instances when cells start dividing uncontrollably due to various factors. The division is not relayed by any regulation. This is what we call a cancer,” explicated Dr. Balawardana. He further explained that it develops into a malignant tumor. This malignant tumor starts destroying the organ of its origin and later starts spreading to other organs, eventually spreading throughout the body. This could lead to grave consequences such as multi organ failure and become fatal.
According to Dr. Balawardana, the most common type of cancer among Sri Lankan women is breast cancer whereas it is bowel and lung cancers with regard to males in this island. Cervical cancers in women used to be on the rise, but with increased awareness and the treatment now available in the island, cervical cancer has reduced. Oral cancer used to be high among men, but with time it has shown a reduction.
Causative factors 
There are various causes for cancers. Dr. Balawardana mentioned various factors that could lead to cancers. “One such reason is the type of food that is included in your daily diet. The excessive consumption of animal fats and red meats could increase the probability of developing bowel cancers. Processed food is also a cause for stomach cancers. Foods that lead to obesity should be avoided as much as possible. Obesity has led the way for numerous cancers in patients which includes very commonly present cancers such as breast cancers, bowel cancers, and thyroid cancers amongst various other types of cancers,” he stated.
He accentuated that environmental pollution has become a strong cause behind the prevalence of lung cancers. This is more commonly seen in industrialized and urban areas rather than rural locations. Radiation is another cause for cancers. The ozone layer of earth’s atmosphere prevents harmful UV rays of the sun from reaching earth by absorbing them. However with the increasing depletion of this protective layer due to human activities, more of the sun’s rays reach the earth’s surface. Therefore we are directly exposed to the radiation which could induce skin cancers.
“Hormonal factors of the body are said to be a reason for the occurrence of cancers especially in women. Unmarried women, women with no children or even women who have children in their later years, are said to be vulnerable to several cancers, the predominant type being breast cancer. Tobacco, smoking and alcohol are reasons that give way to lung and oral cancers. Viruses are another causative factor for cancers. The human papilloma virus or HPV causes womb cancers in women. The AIDS virus HIV is also indirectly a causative factor of some cancers. There are liver and bladder parasites that could lead to liver and bladder cancers. Certain drugs induce cancers. Finally genetics, where changes in genes and a family history of cancers are seen, also have an impact as a causative factor,” listed Dr. Balawardana.
Cardinal signs
Symptoms of cancers may vary according to the type of cancer. However Dr. Balawardana stressed that there are cardinal signs that could raise alarms in you warning about the disease. Early detection aids the treatment process. A patient may suffer from one or more of the following symptoms. “These may include a long standing cough, a long standing change in the voice, voice becomes course, difficulty in swallowing, unexplained fever, enlargement of glands such as lymph, unnecessary lumps in parts of the body, bleeding from the nipple, irregular bowel habits, bleeding when urinating or bleeding from the rectum, sudden change in beauty spots (indication of a severe condition known as melanoma), unexplained loss of weight and cervical bleeding after sexual activity,” he warned.
After diagnosis of the patient’s condition, treatments will be carried out. Treatments vary according to the type of cancer, but some generalized treatment methods can be considered. “Performing surgeries and operations is common. Chemotherapy, radiotherapy, immunotherapy, and novel therapy are other treatment methods. There are cancers that are 100% curable. There are certainly some nasty cases of cancer as well, but cancers are potentially curable. Early detection is the key,” the oncologist said.
Early Detection
As preventive methods there are steps that we can take to ensure the prevention of cancer. By making sure to avoid causative factors (previously mentioned) you can go a long way in preventing the disease. “At the first signs of any of the above mentioned cardinal signs, one must seek medical advice. There are screening programs available for breast and cervical cancers for women. Blood and other tests are easily available to keep your health condition updated. Oral hygiene should be looked into and it’s important to have regular check-ups,” he said. Our main focus should be towards leading a healthy lifestyle. Following a healthy diet and life practices like taking regular exercise and keeping weight under control are essential. Avoid alcohol and smoking. Regular screening will help early detection.
Dr. Balawardana assured that cancer patients should not dread the disease. He stressed on the importance of early detection. “Through early detection one third of the cancers can be prevented. Another one third of cancers can be treated successfully while the remainder can be addressed using novel treatment. Patients should not think that cancers are a social stigma or remain in denial. Seek timely medical attention and you will be fine,” he accentuated.
Medical attention
When you encounter certain health issues, you might always seek out your family doctor, a general physician first. A cancer is a condition you may not want to be diagnosed with understandably. Dr. Wijesinghe explained how patients, upon general consultation, are directed for screening with the view of diagnosing for cancer.
She explained that there is a reason that the disease is called ‘cancer’.
“The word ‘cancer’ originates from the Greek language where cancer means crab. Just like a crab can crawl all over the place, the disease spreads throughout the body. And so the disease was called such. To prevent the cancer from spreading it is necessary to treat the condition early and for that diagnosis is essential,” she added. Dr. Wijesinghe explained how patients are directed for diagnosis and treatment. “When a patient complains about certain symptoms and if a suspicion of a cancer arises, we direct them for various tests. We check the patient’s health, family history and examine them. The conducting of investigations and tests such as x rays, CT scans, PET scans, biopsies, blood tests are various methods advised in diagnosing the patient’s condition. Under strong suspicions or affirmation of the disease, the patient is directed to a specialist consultant under whose supervision they’ll receive treatment from experienced consultants,” she mentioned.
Increasing awareness
She further stated that at present Sri Lanka is in a healthy position when it comes to cancer awareness. “Sri Lanka is showing improvement in terms of cancer awareness. Various treatments are also available for cancer. There is a vaccine for cervical cancer against the human papilloma virus. Girls are advised to get the vaccine at age 13. AIDs can also lead to cancers. Sri Lanka is active in raising awareness on AIDS. Children should be educated. Parents should be made aware. There are various means and methods through which cancer awareness is widely operated. Media plays an important role in this as well. By raising awareness, the public is made more vigilant regarding signs and symptoms. Their eyes are opened to the importance of early detection and they will realize that help is always available. By shedding light on the vaccinations and precautions that can be taken, cancer threats can be further reduced. Educating the people and raising awareness are the main pointers in the path to cancer prevention,” she concluded.
