Cancer upsurge in Pakistan

Rawalpindi

It is estimated that about 300,000 new individuals suffer from cancer every year in Pakistan that adds up to the existing pool of millions of cancer patients who are already under treatment.

Globally over 14 million new cases of cancer are reported every year which are expected to rise about 70 per cent over the next two decades. Cancer kills about 100,000 people in Pakistan every year. Currently, 8.2 million people die from cancer worldwide every year; out of which 4 million die prematurely, aged 30 to 69 years.

There are number of reasons for this increase, the four main ones being a longer life expectancy, more accurate diagnosis, alarming prevalence of Hepatitis B and C and the rise in cigarette smoking. Lack of awareness among public about various aspects of the problem is a leading cause of damages due to cancers.

Head of Community Medicine at CMH Lahore Medical College Professor Dr Muhammad Ashraf Chaudhry expressed this while talking to ‘The News’ in connection with World Cancer Day which is observed on February 4 around the globe.

He added that about one third of cancer deaths are due to five leading behavioural and dietary risks including high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use and alcohol use.

Every cancer type requires a specific treatment regimen which encourages one or more modalities such as surgery, and or radiotherapy or chemotherapy, he said.

It is important that Pakistan lacks severely facilities for treatment of cancer patients. Current facilities are merely providing health care to 40,000 patients, only leaving majority to wander in different corridors of hospitals. Diagnostic and treatment facilities are not accessible to around 60,000 of population every year, said Dr. Ashraf.

Furthermore, there is a lack of facilities for even palliative care, the treatment to relieve symptoms caused by cancer. Palliative care can help people live more comfortably. It is particularly required in places like Pakistan with a high proportion of patients with advanced stages where there is little chance of cure. Thus there is a need to establish new palliative care facilities in the country, said Dr. Ashraf.

Cancer affects everyone – the young and old, the rich and poor, men, women and children and represents a tremendous burden on families and societies. Cancer can be defined as the uncontrolled growth and spread of cells. It can affect almost any part of the body. The growth often invades surrounding tissues and can metastasise to distant sites. Lung, stomach, liver, colon, prostate and breast cancer cause the most cancer deaths each year.

Studies reveal that aging is the fundamental factor for the development of cancer. The incidence of cancer rises dramatically with age. More and more people around the world are exposed to cancer risk factors like smoking, poor diet and sedentary lifestyles.

According to Dr. Ashraf, one possible promoter in food is fat, especially saturated fat from animal products like red meat. Tobacco use, pan, ‘chalia’, alcohol use, physical inactivity, being overweight and obese, exposure to occupational (for example asbestos) carcinogens, radiation (ultraviolet and ionising radiation, excessive X-Rays etc), low fruit and vegetable intake, excessive consumption of red and preserved meat, estrogens tablets, genetic factors, having unsafe sex, infections from hepatitis B, hepatitis C, HIV, human papiloma viruses, Helicobacter pylori, urban air pollution and indoor smoke from household use of solid fuels are major risk factors of cancer, he said.

This year the theme of World Cancer Day is “We can. I can.” World Cancer Day will explore how everyone- as a collective or as individuals-can do their part to reduce the global burden of cancer. Just as cancer affects everyone in different ways, all people have the power to take various actions to reduce the impact that cancer has on individuals, families and communities. World Cancer Day is a chance to reflect on what you can do, make a pledge and take action.

To a query, Dr. Ashraf said at least one-third to 40 per cent of all cancer cases are preventable, mainly by not using tobacco, using healthy diet rich in fresh, green vegetables and fruits and being physically active (30 minutes daily walk), avoiding alcohol, narcotics, and most importantly obesity and preventing infections that may cause cancer.

He added that prevention offers the most cost-effective long-term strategy for the control of cancer. Vaccination against human papilloma virus (HPV) and hepatitis B virus vaccination (HBV) will prevent cervical and liver cancer respectively, he said.

He added that avoiding excessive exposure to solar ultraviolet radiation, use of sunscreen, wide-brimmed hats, large sunglasses, and protective clothing are effective preventive measures against skin cancer.

If prevention fails, catch it early. Cancer’s seven warning signals (CAUTION) are: change in bowel or bladder habit, a sore that does not heal, unusual bleeding or discharge, thickening or lump in breast or elsewhere, indigestion or difficulty in swallowing, obvious change in wart or mole and nagging cough or hoarseness.

Unfortunately in Pakistan, a large number of cancer patients present at an advanced stage due to lack of awareness, said Dr. Ashraf.

About one-third of the cancer burden could be decreased if cases were detected and treated early. Some of the most common cancers – including breast, colorectal, oral cancer and cervical cancer – have high cure rates when detected early and treated. The aim is to detect cancer when it is localized, said Dr. Ashraf.

Talking of prevention, he said educating and informing individuals and communities about the links between lifestyle and cancer risk is the first step in cancer prevention. Reducing tobacco use will significantly decrease the global burden of a large number of cancers. Individuals can limit their intake of red meat and avoid processed meat, he said.

Special efforts are required to improve knowledge of cancer, counter misinformation and reduce stigma among all communities. Diagnosing cancer at its earlier stages and seeking timely care can save lives, concluded Dr. Ashraf.