Rohilkhand Cancer Institute

Prevention is better than cure.

There is no denying the fact that treatment technology has transformed so much from incurable disease to personalised treatment protocols and painless care that it has made the cancer treatment journey an endurable one. Even with the latest innovation in cancer treatment that has achieved near-cure success, it still affects the quality of life of an individual after and during the therapy sessions.

We will look into the aspects of cure and prevention and why is a prevention step ahead of cancer diagnosis and treatment. For this, we need to understand the implications impacted by cancer on the patient and his caregiver’s life.

  1. Financial Implications – According to the latest WHO data, India has a cancer mortality rate of 79 per 100,000 deaths. Also, cancer mortality is projected to increase to over 900,000 deaths by the end of this decade. In India, out-of-pocket expenditure on cancer treatment is among the highest for any ailment. More so, it is higher in private facilities than in public facilities. This expenditure is more than 20% of the annual per capita household expenditure of the majority of households in India. The cost remains high for almost all cancer management. In socioeconomic situations like India, people simply cannot afford it.
  2. Social Implications – Cancer does not just affect an individual but the entire family. Cancer diagnosis, treatment, and sessions of chemo and radiotherapy take a long time for not only the person affected but also the person’s family. In India, the majority of households have a single earning member, and if in case the breadwinner is the patient then there is a huge financial and social implication for the family. There is also a compromise in the quality of life of the patients post-treatment, which further puts a socio-economic burden on the entire family. These days, with the advancement in treatment techniques reduction in side-effects of treatment and proper rehabilitation of patients post-treatment, the quality of life is not a big challenge and is well maintained.
  3. Emotional Implications – Talking of objective assessment of psychological implications because of cancer in our country, it was found in a study from Bangalore, that psychiatric morbidity ranged from 41.7% to 46%, with the most common disorders being anxiety and depression. Depression rates ranged from 4.4% to 89.9% and anxiety rates ranged from 1.2% to 97.8%. This wide range could be due to the heterogeneity in sociodemographic factors. India is a plural society in terms of religion, social class, literacy, place of stay, and family structure, and all of these have implications for the occurrence of emotional distress following the diagnosis of cancer. Such high incidences of psychological distress are not only prevalent in patients but are also seen in their caregivers. This makes a great impact on the entire family of the cancer patient.

Looking at these aspects which get affected from the time when cancer is diagnosed, to the time when treatment begins and ends and also after the entire treatment, makes us realize the great importance of preventing cancers and detecting them early so that an individual’s life is not affected to such an extent.

About prevention:  

The five most prevalent malignancies in our nation that affect men are big bowel, stomach, prostate, lung, and head and neck. These include breast, ovarian, stomach, cervix, and oral cancer in women. When combined, these malignancies represent over 47% of all cancer cases, and they are all avoidable. Therefore, being aware of the preventive measures for these malignancies can spare us from the overall harm that tumours cause, as previously indicated.

primary prevention aims at a set of interventions that keep a cancerous process from ever developing. It includes health counselling and education, environmental controls, and product safety as examples. Secondary prevention is that set of interventions leading to the discovery and control of cancerous or precancerous processes while localized, i.e., screening, early detection, and effective treatment.

Primary Prevention:  The majority of malignancies in humans can be prevented by quitting alcohol and smoking, which are examples of pertinent primary prevention. Any kind of smoking is harmful. Smoking is a contributing factor in both active and passive forms. Smoking even one puff increases one’s risk of acquiring cancer. Risk never goes away, but it does go down dramatically when you stop. In a similar vein, the danger drastically lowers but never zeroes after giving up alcohol. These two main offenders not only play a significant role in the development of cancer, but they are also to blame for several other illnesses, including diabetes, heart disease, hypertension, renal failure, and liver failure.

Secondary Prevention: 

A very important contribution to early diagnosis and treatment is done by secondary preventive measures which mostly include screening tests. By definition, screening means checking for cancer (or for conditions that may become cancer) in people who have no symptoms.

Screening programs have shown good results in cervical cancer prevention in our country. It is done with the help of simple tests like Pap Smear or HPV DNA/RNA in samples of cells taken from the cervix. It is done in females of sexually active age group and has been shown to decrease deaths due to cervical cancer by 30%.

Screening with the help of Mammography and Self-breast examination has shown good results in detecting early breast cancers. Mammography of both breasts is a simple low-dose X-ray procedure that can help detect lumps/swelling in the breasts. It has to be started after the age of 50 years or early in some cases and to be continued every 2 years.

World Health Organization (WHO) has given 7 warning signs of cancer which should alarm any person and seek medical advice if these symptoms persist for more than two weeks. These are:

  1. Change in bowel and bladder habits
  2. Any sore anywhere in the body that doesn’t heal
  3. Unusual bleeding or discharge from any opening in the body
  4. Unexplained weight loss or loss of appetite
  5. Difficulty in swallowing or chronic indigestion
  6. Lumps anywhere in the body
  7. A nagging cough or persistent hoarseness of voice

over and above these symptoms, we should also keep a watch on Anemia (fall in the blood).

With all the above information in mind, it is rather safe to understand how better is cancer prevention in saving time, and money, and avoiding all that suffering. We should not forget the fact that cancer if diagnosed and treated early, has cure rates of around 90% in some cases. With modern diagnostic and treatment techniques that minimize treatment side-effects, even the cancers diagnosed in late stages could be treated successfully while maintaining a sound quality of life. So let’s not fear cancer, rather understand it better and fight it in a spirited way.

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