The rise in cancers globally and in Sri Lanka has become a matter of deep concern to health officials battling to halt this disturbing trend by encouraging people to have themselves screened and detected for any warning symptoms early.
Many of them have repeatedly pointed out, some cancers are detected at the late stages- not allowing health workers to offer curative care. Furthermore health care costs are high for advanced cancer care when cancers are detected at a late stage, they also point out.
The Sunday Observer spoke to Dr Suraj Perera, Consultant Community Physician National Cancer Prevention Programme of Ministry of Health to find out the latest data on common cancers in Sri Lanka , what caused the incidence to rise, how they could be detected and most importantly how they could be prevented.
What the common cancers in Sri Lanka are, the current incidence rates per specific cancer across the country, and who according to gender were most vulnerable to such cancers, the Sunday Observer asked.
In reply he said, “About 33, 000 cancers are detected per year in Sri Lanka. Oral cancer (about 2200), lung cancer ( about 1300), Colon (bowel) cancer (about 1300), Oesophagus (about 1100) and Prostate (about 1000) are the commonly diagnosed cancers among males in Sri Lanka. Breast cancer (about 4500), thyroid cancer (about 2300) Colon cancer (about 1300) Cervical cancer (about 1100), Uterine cancer (about 1000) Ovarian cancer (about 1000) are the commonly diagnosed cancers among females in Sri Lanka.
To our query as to what caused most of these cancers he said that the main risk factors were betel chewing, tobacco smoking and alcohol intake.
Can we prevent these cancers?
“”Yes,” he said .
To our request on how they could be prevented, elaborating on each specific cancer, he said, “ Some of the cancers can be prevented through healthy lifestyles. Most of the oral cancers can be prevented if we can stop betel chewing, tobacco smoking and alcohol intake. Most lung cancers can be prevented through avoiding tobacco smoking, minimising indoor ( smoke coming from firewood burning, smoke coming from domestic industries) and outdoor ( minimizing exposure to diesel fumes arising from vehicles, avoiding open burning of plastics and polythene, minimising industrial hazardours fumes ) air pollution. Colon cancers can be minimised through healthy food habits (increase consumption of plant origin foods, minimise sugar, fat and salt containing foods, minimising consumption of fast foods, and consumption of processed meat ) and avoiding tobacco smoking. Most of the oesphagus cancers can be reduced avoiding tobacco smoking, betel chewing, alcohol intake and practicing these health dietary habits, while most of the cervical cancers can be prevented through HPV vaccination and practicing responsible behaviour of both males and females,. “ he emphasised. .
However, said, “For some cancers even though some preventive measures are available, emphasis is more on early detection of cancer since these cancers can be detected at the earliest possible opportunity where curable treatment can be offered with minimal intervention.”
Since breast cancer is the commonest cancer among females in Sri Lanka, with early detection being cited as the key to successful treatment, we asked him to describe early detection measures available for breast cancers for the benefit of our readers.
In response he informed, “As mentioned, the earliest commonest cancers among females is breast cancers. If breast cancers are detected early, they can be treated successfully. In Western countries they have minimised deaths due to breast cancers through early detection and completion of treatment. Considering our resource limitations we too can do the same thing by maximising the utilization of the breast cancer early detection program in Sri Lanka. Let’s begin with breast self examination. Every female needs to be aware of her breast .She must know what is normal for her and what is abnormal for her. This can be done with the help of some easy breast examination tests that they can do themselves. Instructions regarding this are now provided free by the health care staff especially at the Well Women Clinic, Healthy Lifestyle centres and Breast clinics. Following these instructions self breast examination will empower all Lankan females to take control over their own bodies , in this case, their breasts. If they find any abnormality like a lump or bleeding or change in their breasts, they need to rush to the nearest medical centre for further assessment without delay. In addition, clinical breast examination is conducted by the health care staff at the Well Women Clinic and Healthy life style centres. Generally females above 35 are invited to obtain these services, therefore females need to attend since these services are available in close proximity at the health institutions. If abnormalities found will direct for further assessment to surgical clinics / breast clinics
Medi snips also asked him to tell us about another cancer in women which has shown a slight increase recently - cervical cancer.
What is Cervical cancer? We asked.
He said, “Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.When exposed to HPV, the body’s immune system typically prevents the virus from doing harm. In a small percentage of people, however, the virus survives for years, contributing to the process that causes some cervical cells to become cancer cells.You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.””
Asked where these screening tests were available he said, “Cervical cancer screening is offered at the Well Women Clinics throughout the country coordinated by the Medical Officer of Health in each respective area. Married females are invited by the public health staff to attend cervical cancer screening at the age of 35 and 45. The service is free of charge.
Oral cancer is also a common cancer . Give us your comments on this.
In response he said, “Any person who is having any risk- behavior of oral cancer – betel chewing, smoking, alcohol intake, eating arecanut products need to visit a Dental Surgeon for proper oral examination. All Dental Surgeons are adequately trained for clinical oral examination with special emphasis on early identification of oral cancers or oral potentially malignant disorders (OPMD). In addition, if a person is having persistent whitish or reddish oral lesions, unhealed ulcers, alteration of oral sensations or difficulty in opening oral cavity, those need to consult a dental surgeons.”
His message to the public?
“Every person needs to be aware of what is normal and abnormal for him or her. If there are any abnormal signs they need to contact the closest medical officer ( or family doctor ) or health care institution. They will assess and direct if further assessment is needed.
The abnormalities may be;
Persistent difficulty in swallowing (dysphagia)
Alteration of bowel habits
Passing of dark coloured faeces
Per rectal bleeding
Difficulty in passing urine / passing blood with urine
Persistent hoarseness of voice
Continuous fever with night sweats
Unexplained weight loss
Persistent loss of appetite
Having these symptoms may not confirm having cancer Since some of the symptoms may arise due to non-cancerous conditions too. But they need to be verified by a proper assessment,” he said.
Asked for a hot line or number which readers could reach for more information he said, “If further information is needed m they can visit National Cancer Control Program website www.nccp.health.gov.lk (Contact number 0112368627) . They can also visit the Cancer Early Detection Centre located at Narahenpita Colombo 5, which is a joint project of National Cancer Control Program and Rotary Club of Colombo.