World cancer day

About World Cancer Day

World Cancer Day, held on February 4th, is a global unifying initiative led by the Union for International Cancer Control (UICC). It was started on the common foundation that the entire world should unite together in the fight against the global cancer epidemic. UICC is working to reimagine a world in which millions of preventable cancer deaths are avoided and everyone has equal access to life-saving cancer treatment and care, regardless of who they are or where they live.

What is cancer?

Cancer is a disease in which certain cells in the body grow uncontrollably and spread to other parts of the body. It can begin almost anywhere in the human body, which contains trillions of cells. Human cells normally grow and multiply (a process known as cell division) to form new cells as the body requires them. Cells die when they become old or damaged, and new cells replace them. When this orderly process fails, abnormal or damaged cells grow and multiply when they should not. These cells can combine to form tumours, which are tissue lumps. Tumors may or may not be cancerous (benign). Cancerous tumours invade nearby tissues and can travel to distant parts of the body to form new tumours (a process called metastasis).

Etiology of cancer

Cancer arises from the transformation of normal cells into tumour cells in a multi-stage process that generally progresses from a pre-cancerous lesion to a malignant tumour. These changes are the result of the interaction between a person's genetic factors and three categories of external agents, including:

Physical Carcinogens

Chemical Carcinogens

Biological Carcinogens

Cancer incidence rises dramatically with age, most likely due to an accumulation of risks for specific cancers that rise with age. The accumulation of overall risk is combined with the tendency for cellular repair mechanisms to become less effective as a person ages.

Types Of Cancer

Cancer is classified based on the type of cell where they originate

Carcinoma

A type of cancer that arises from epithelial cells. The most common types of cancer in this group are breast, prostate, lung, and colon cancer.

Sarcoma

Sarcoma is a type of malignant soft tissue or bone tumour and other connective tissues that support and surround organs.

Lymphoma

Lymphoma is a cancer that affects the lymphatic system, which runs throughout the body and can therefore occur anywhere.

Myeloma

Myeloma starts in plasma cells. This cancer has the potential to impair a cell's ability to produce antibodies.

Brain and spinal cord

These are central nervous system cancers. Some are harmless, while others can multiply and spread

Leukemia

It is a type of cancer that affects white blood cells and bone marrow. Leukaemia is classified into Myeloid Leukaemia and Lymphocytic Leukaemia

Global prevalence of cancer

According to World Health Organization (WHO) estimates for 2019, cancer is the first or second leading cause of death before the age of 70 in 112 of 183 countries and ranks third or fourth in another 23.
According to GLOBOCAN 2018 approximately 45% of cases were in Asia (which has 59.5% of the world’s population), 26% in Europe (9.8% of the world’s population), 14.5% in North America, 7.1% in Central/South America (the Americas, North and South, account for 13.3% of the world’s population), 6% in Africa (16.9% of the world’s population), and 1% in Australia/New Zealand (0.5% of the world’s population)

Incidence of cancer in India

Cancer is an important public health problem with 8 to 9 lakh cases occurring every year.
At any point of time, it is estimated that there are nearly 25 lakh cases in the country.
Every year about 4 lakh deaths occur due to cancer. 40% of the cancers in the country are related to tobacco use.
Cancers namely those of oral and lungs in males and cervix and breast in females account for over 50% of all cancer deaths in India.

Signs and symptoms of cancer

As there are so many different types of cancer, the symptoms vary depending on where the disease is located. However, there are some key signs and symptoms to be aware of, such as

Unusual lumps

Coughing

Changes in bowel habit

Unexpected bleeding

Unexplained weight loss

Fatigue

Pain or ache

New Mole

Difficulty Urinating

Appetite Loss

Heartburn

Heavy Night Sweats

Diagnosis of cancer

Malignant tumours can be diagnosed via various methods which includes

Physical exam

During a physical exam, your doctor may look for abnormalities that may indicate the presence of cancer, such as changes in skin colour or enlargement of an organ.
Laboratory tests

Urine and blood tests, for example, may aide doctor in identifying abnormalities that may be caused by cancer. A common blood test called a complete blood count, may reveal an unusual number or type of white blood cells in people with leukaemia.
Imaging tests

Noninvasive imaging tests allows to examine bones and internal organs. A computerised tomography (CT) scan, bone scan, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, ultrasound, and X-ray are some of the imaging tests used to diagnose cancer.
Biopsy

During a biopsy, doctor collects a sample of cells for laboratory testing. A sample can be collected in a variety of way and Which biopsy procedure is best for patient is determined by the type of cancer and its location. A biopsy is usually the only way to definitively diagnose cancer.

TNM Classification of Malignant Tumors is a globally recognised standard developed by the Union for International Cancer Control for determining the extent of cancer spread (UICC). It is a classification system for the anatomical extent of tumour cancers. It is widely accepted on a global scale for many solid tumour cancers, but it does not apply to leukaemia or central nervous system tumours. The majority of common tumours are classified using the TNM system.

Prevention of cancer

Cancer risk can be reduced by:

Avoid the use of tobacco
Maintaining a healthy body weight.
Eating a healthy diet, including fruit and vegetables.
Doing physical activity on a regular basis.
Avoiding or reducing consumption of alcohol.
Getting vaccinated against HPV and hepatitis B.
Ensuring safe use of radiation in health care.
Reducing exposure to air pollution.

Treatment

Treatment of malignant cancers with drugs is a relatively new development, having begun after 1940 with the use of nitrogen mustard, but progress has been rapid, both in revealing disease pathobiology and in the discovery of new drugs. The latest innovations target growth factors, specific signalling pathways, angiogenesis, tumour antigens, etc. to introduce a different spectrum of drugs. Attempts have also been made to identify optimal combinations, treatment strategies, and patient support measures. Cancer chemotherapy is now recognised as a valuable treatment option and a highly specialised field that must be managed by oncology specialists working with a multidisciplinary team. In malignant diseases, drugs are used with the aim of:

Cure or prolonged remission

Chemotherapy is the primary treatment modality that can achieve cure or prolonged remission

Palliation

Gratifying results are obtained (shrinkage of evident tumour, alleviation of symptoms) and life is prolonged by chemotherapy.

Adjuvant chemotherapy

Drugs are used to mop up any residual malignant cells (micro metastases) after surgery or radiotherapy.

Coping from this emotional dread

The experience of the diagnosis of cancer is one of the most traumatic and revolutionary events that has ever happened to the patient. Independent of prognosis, the diagnosis brings with it a change in patient’s self-image and in his/ her role in the home and workplace.
One can opt for following methods if he/she is diagnosed with cancer or is undergoing treatment for the same

Learn enough about cancer to make an informed treatment decision. Ask your doctor about your cancer, including treatment options and, if desired, your prognosis. As you learn more about cancer, you may become more confident in making treatment decisions.
Maintain contact with friends and family. Keeping close relationships will help you deal with your cancer. Friends and family can offer emotional support if you are overwhelmed by cancer.
Find someone to talk to. Find a good listener who is willing to hear your hopes and fears. It could be a family member or a friend. Concern and understanding from a counsellor, medical social worker, clergy member, or cancer support group may also be beneficial.

The Theme for WORLD CANCER DAY, 2023 is in consonance with this alarming situation and CLOSING THE CARE GAP to provide equity in access to cancer care.