A Message to All

A Message to All

Cancer kills more people globally than tuberculosis, HIV and malaria combined.

World cancer day was observed last week, on 4th February; it aims to save millions of preventable deaths each year by spreading awareness about cancer, and pressing governments and individuals across the world to take action against the disease.

World Cancer Day was founded by the Union for International Cancer Control (UICC) to support the goals of the world cancer declaration, written in 2008. The primary goal of the world cancer day is to significantly reduce illness and death caused by the cancer by 2020. UICC is a global consortium of more than 470 cancer fighting organizations in over 120 countries.

Diagnosis of cancer always brings in it the wake feelings of misery, pain, and helplessness, heavy and often futile expenditure. Diagnosis of cancer is considered one of the most feared diagnosis because despite advances in every scientific field including medicine, cancer continues to be a life altering event. Approximately 10 million patients are getting diagnosed with cancer every year in the world of which more than 6 million die. In 2010, nearly 55% of the global cancer burden was seen in low income and middle income countries. In 2020, it will rise to around 70%. Cancer kills more people globally than tuberculosis, HIV and malaria combined. As per WHO estimates, number of cancer related deaths will rise to 10 million by the year 2020; of these 70

% will be from developing countries. Cancer is one of the 10 leading causes of death in India. Nearly 2-2.5 million Indians suffer from cancer at any given point of time. Cancer pattern varies widely in different geographic regions and in different population graphs depending upon environmental, dietary, genetic and social-economic factors. For example, in India cancer of cervix and oral cavity cancers are very common. While as in Kashmir, Cancer of esophagus, stomach and lung are common, however,  the trend is changing. Lung cancer is among the top 10 cancers globally followed by breast cancer. In India breast cancer followed by cancer in cervix is among top 10 cancers. In Kashmir cancer esophagus was ranking No. 1 in both males and females from the last three decades as per the Hospital Based Cancer Registry data at Sher-i-Kashmir Institute of Medical Sciences. This cancer registry was started in 1984 at SKIMS since the inception of department of Radiation Oncology. A study conducted in the department enrolled 14420 patients during 2009-13 and it was observed that cancer of esophagus continues to be No. 1 when both the genders are combined together, accounting about 20.49% of all the cancers followed by lung cancer accounting 20.19%. Breast cancer is at No. 4 accounting 9.50

% of all cancers. Kangeri cancer continues to be among top 10 cancers accounting 3.7% though there is a marked decrease observed over last ten years. Surprisingly, it was also observed that lung cancer has surpassed cancer esophagus in males accounting 25.83% for last 5 years (2009-13) versus 18.44% of cancer esophagus. Similarly breast cancer has overcome cancer esophagus in females by a narrow margin of 0.65% for the last 5 years. Breast cancer constituted 21.90% versus esophagus constituting 21.25%. Cancer cervix which is among top 10 cancers in India ranking No. 2 does not figure in top 10 cancers in Kashmir. Top 10 cancers seen in Kashmir for the last 5 years include esophagus, lung, stomach, breast, NHL, colon, GE junction, Ovary, rectum and Skin. 

Gastro intestinal cancers account 38.5% of all cancers. Most common cancers seen in Kashmir occur above 40 years of age. Possibly the interaction with the carcinogens start at an early age because it takes 15 to 20 years for a normal cell to become a cancerous cell after getting continuously irritated by risk factors. What is a risk factor? A risk factor is anything that increases the chance of getting a disease. Some risk factors can be changed, stopped or modified but others cannot be. Risk factors like age, sex and family history (genetic factors) cannot be changed, but in these cases one should be aware about symptoms of disease and should undergo screening and regular checkups so that the disease can be recognized and diagnosed as early as possible because cancer is curable at an early stage. Risk factors related to lifestyle like tobacco, alcohol, diet can be stopped and modified. Cancer is also strongly associated with poor social and economic status. Cancer is also seen highest in groups with least education. If these factors are taken care of, cancer incidence can be decreased to a large extent. Rise in lung and breast cancer in Kashmir hints towards the adoption of western lifestyle. Smoking is a major risk factor in lung cancer and is seen in 80% of the active smokers and 20% of the passive smokers. During the last decade, there was a 17% decline in tobacco consumption in developed countries whereas there was a rise by 15% in developing countries including India. Around 700 million children breathe in the tobacco polluted air. There are no safe levels of exposure to second hand smoke. At the same time alcohol intake in the valley is also on a rise. When these two risk factors combine together the chances of getting cancer becomes manifold. The atmosphere in Kashmir getting polluted since last 2-3 decades justifies the fact of increase in cancer incidence. The cancers cases have increased from 2869 to 3900 from the year 2009 to 2014. It seems that more than 5000 cases will be diagnosed with cancer by 2020. It does not mean only 5000 individuals but 500 families and dynasties will be suffering from this dreadful disease of which more than 60% of cancers are tobacco related.

Here is a message on this day to all, particularly to parents; protect your children from active or passive smoking, teach children to stay away from smokers, drug addicts and alcoholics, avoid smoking and allowing others to smoke in your home or car. Do not smoke while pregnant or in vicinity of someone who is pregnant. Keep your children away from restaurants or other indoor public places that allow smoking. Allow your children to take active part in sports, do regular exercises in order to prevent overweight and obesity. Give your children nutritious food in the form of fresh fruits and vegetables. Health is easier to preserve than to repair.

drnazirkhan@rediffmail.com