One of the most agonizing illnesses one can have is cancer. In whatever form, it can not only impact adversely on our physical bodies, but trigger painful mental and psychological reactions due largely through fear : fear of having to go through radiation or chemotherapy which might cause hair loss and other unwelcome side effects. Fear of becoming singled out as a ‘cancer patient’ in a society where in certain areas people still cling to myths and prejudices , despite the fact that due to more awareness , most people have begun to shed their prejudice, and learned to empathize not sympathize with cancer patients.
Cancer also poses a formidable economic burden on the family, when a breadwinner is afflicted with the disease, on the state, where most patients receive free treatment, and on the country as a whole due to the loss of manpower resources. On the plus side, cancer is also preventable, and even curable if detected early and treated promptly. Most males and females now have facilities to get themselves tested free of charge at any of the Healthy LifeStyle Centres, Well Women Clinics set up in the island, or at most the main secondary and tertiary care hospitals where access to the latest equipment, including Ultra sound Scan, upper gastro intestinal endoscopy (UGIE), colonoscopy, mammography, etc are being installed by the Health Ministry. In addition, help of nongovernmental organizations including several civil organizations and individuals have contributed to high end diagnostic and follow up care equipment including Pet Scan. Unfortunately, not many persons make use of such facilities, the more affluent preferring to visit the private sector hospitals. There have also been some ground breaking innovations that augur well for cancer patients in the future, such as, the detection of a single blood test which could detect, with up to 98% accuracy at least eight different types of cancer, even if the patient had no symptoms .
The Sunday Observer spoke to Consultant Community Physician of the National Cancer Control Program, Dr Suraj Perera for more insights into the general causes of cancer, its current prevalence in Sri Lanka and the kind of services offered to patients at the Cancer Early Detection Centre of National Cancer Control Program at Narahenpitia, Colombo 5 and elsewhere.
Excerpts...
Q. A ground breaking blood test for early cancer detection was reported very recently. The new research suggests that a single blood test could now detect up to 98% accuracy in patients without symptoms and diagnose at least eight different types of cancers from ovarian to breast cancer. The assessment known as Cancer SEEK is said to pick up on DNA shed by mutating cells into blood. Your comments?
A. This is an innovative research finding of a research group at the John Hopkins University, USA. The finding of this study was recently published in the ‘Science’ online version. Eight cancer types can be detected (ovarian, liver, stomach, pancreatic, esophageal, colorectal, lung or breast) through a blood test, ‘liquid biopsy’.
The basis is identifying cancer-related DNA and proteins in the blood. This innovation may lead to develop a universal blood test for routine cancer screening in future.
Q. Researchers and study author Prof. Bert Vegelstein from John Hopkins University, US have said, the test represents, “the next step in changing the focus of cancer research from late stage disease to early stage disease which is critical to reduce cancer deaths in the long term”. Do you agree?
A. Yes. In cancer control we have three targets. They are (1) Reduce the cancer incidence (reduce no. of new cancer cases) (2) reduce mortality due to cancers (reduce number of cancer deaths) (3) reduce the suffering due to cancer (improve the quality of life of cancer patients and their family members).
Q. So, of these three, to reduce cancer deaths, we need to detect cancer as early as possible and offer prompt treatment. Then, the chance of total cure would be more. The more intensive interventions may not be required. Suffering is less. Q. At the same time, we have news that a new cancer drug that could stop the disease in its tracks is being developed in a European study. The unnamed medication injects a specific enzyme that feeds the spread of tumours by binding the membrane of rapidly multiplying cells. Your comments?
A. This new anti cancer drug binds to the rapidly multiplying cells. Therefore, the spread of disease is controlled. This is a targeted therapy, a new approach in targeting individual chemicals that cause cells to divide and multiply.
Q. With so much research and exciting developments taking place outside Sri Lanka, tell us what new developments have taken place right here in our own country?
A. The two developments in relation to early detection and drug therapy are still at research level. These need to be further improved to be introduced to routine practice.
Q. Are these new technologies available to the public? Where?
A. New technologies are gradually introduced to the health system.
Q. Unfortunately, many people it seems, still don’t know even the basics about cancer although it is so widely prevalent in Sri Lanka. ? So on behalf of our readers let me ask you a few general questions on cancer. Firstly, what is cancer?·
A. Cancer is a generic term for a large group of diseases that can affect any part of the body.· Other terms used are ‘malignant tumours’ and ‘neoplasm· Cancer is an abnormal, uncontrolled and purposeless growth of cells in the body, which can occur at any place of the body.· It has the potential to invade adjacent tissues and migrate to a distant body site through blood or lymph vessels and grow in the new site.
Q. What are cancer cells? How do they develop?
A. Cancer starts as a genetic abnormality in a single cell which pass through many stages, ultimately developing into a cancer. The process takes several years to complete with progressive accumulation of multiple genetic changes.
Q. Are there different types of cancer? What are they? ( explain in detail)
A. Cancers (Malignant tumour) can be classified into different types based on their cell type origin (A.) Carcinoma – cancer developing from epithelial tissue (B) Sarcoma – cancers of the connective tissue (C) Lymphoma– Cancer of the lymphatic system (D) Leukaemia – blood cancer (E) - Brain and spinal cord cancers
Q. What are the commonest cancers found in Sri Lanka?
Please see Table 1
Q. Who are most at risk, age wise and gender wise?
A. With advancing age, the risk of getting cancer is increased .This applies to both genders. The effects of unhealthy lifestyle and unhealthy environment is aggregated. Then, the chances of genetic mutations is high, and the chance of repairing genetic mutations are low.
Q. According to your latest statistics how many cancer patients have these conditions ?
Please see Table 2
