World Cancer Day (February 4th.) is a good day to seriously relect on this dreaded disease. It does not spare anyone. Statistics reveal that while the incidence of Cancer in females is higher, the mortality in males is much higher. Cancer, which can be broadly defined as the uncontrolled growth of abnormal cells at the cost of normal cells, kills more than 600,000 people annually in India. Further, the prevalence of Cancer is increasing in our society, to the extent that it is now being dubbed as a Lifestyle disease. Lifestyle factors have been linked to a variety of malignancies. The risk factors – thankfully modifiable - include: smoking, tobacco, alcohol, unsafe sex, junk food and excess weight, coupled with a reduction in the consumption of fresh fruits and vegetables. Age, genetics, familial history and environment (pollution, pesticides) are the other risk factors.
As in most diseases, early detection is crucial for the successful treatment of Cancer. In a very interesting study, Dr. Sanghamitra Pati of PHFI presents factors impacting Cancer treatment. The average time, from the first recognition of unusual and unexplained signs/symptoms to having the first consultation with either family members or friends, is 271 days. An average of 340 days (nearly 1 year) is the time taken to have a first consultation with an allopathic doctor - and then there is an additional 19 days before referral to an Oncologist for investigations. It seems that, because of low awareness and low screening, people tend to ignore the symptoms. Let us remember: 80% of the cases are detected in late stages, when Cancer is terminal; 70% of patients die within the first year of detection.; 71% of patients die young - in the age group of 30-69 years; Rs. 72,000 crores is the estimated GDP loss due to healthy lives being lost due to Cancer.
To deal with this scourge, it is very important to undergo screening and preventive health checks at regular intervals. Screening detects abnormalities before they become clinically apparent, allowing for intervention either before Cancer develops or at an early stage, when treatment is most often effective. Prevention strategies focus on modifying the environmental and lifestyle risk factors that promote Cancer. It is estimated that 50 percent of Cancer is preventable. At Stage 0, Cancer is 100% curable. With over 1 million new Cancer cases being diagnosed every year, it is important to focus on prevention. Lifestyle changes are critical, and they also protect against other chronic diseases (cardiovascular disease, stroke and diabetes. General Lifestyle (change) recommendations include:
- Saying No to tobacco - Tobacco use is the most preventable cause of Cancer, and accounts for 21 percent of worldwide Cancer deaths. Smoking is also implicated as a causative factor for leukemia as well as cancers of the oral cavity, nasal cavity, paranasal sinuses, nasopharynx, larynx, esophagus, pancreas, liver, stomach, cervix, kidney, large bowel and bladder.
- Being physically active - Physical activity is inversely related to the risk of Colon and Breast cancers.
- Maintaining a healthy weight - Excess weight increases the risk of many cancers.
- Eating a diet rich in fruits, vegetables and whole grains, and low in saturated fats/transfats.
- Limiting alcohol - Alcohol intake, even in moderate quantities, increases the risk for Colon, Breast, Oesophageal and Oropharyngeal cancers.
- Protecting against sexually transmitted infections - HPV, HCV, HTLV1, HIV, EBV and H Pylori have been linked to human cancers. Exposure prevention, screening, vaccination for HPV, and early treatment for abnormal cervical findings and HIV infection, can help prevent Cancer.
- Avoiding excessive exposure to the sun.
- Undergoing regular screening for Breast, Cervical and Colorectal cancers.
Be(a)ware and Prepare.
Cancer treatment can be very expensive - it could cost INR 2.5 to 5 lakhs to start with. In some cases it can go up to INR 20 lakhs. I have known of people who borrowed money to pay for Cancer treatment. Therefore, it is very important to not only prepare physically, but also financially. It is important to take adequate insurance for oneself and family. Fortunately, innovative insurance products are available today - like standalone critical illness covers, which even cover Cancer. In addition to a base medical policy, one should also take a Top Up insurance cover.
(Kindly consult your doctor and financial planner for advice specific to you)