July 30 - Aug 05, 2007

Cancer is one of the frequently talked about and most feared diseases that falls under the genre of lifestyle diseases that have evolved, rather rapidly, in the past two decades.

The disease, which was earlier - in its initial years of discovery dubbed as the death sentence for the person diagnosed with it, has now become more manageable, thanks to the fervent efforts of researchers and oncologists. Though science has made rapid strides to evolve many preventive and curative strategies to fight cancer, it has not been able to break the fear and confusion that surrounds a person when diagnosed with the disease.

One of the recent concerns plaguing the field of cancer study or Oncology is the increasing number of women who are being diagnosed with Cancer. The number of cervical, breast and oral cancer deaths in women are on rise. While breast cancer is the most common cancer among women, cervical cancer comes a close second and is a leading cause of cancer-related death in women in underdeveloped countries. Studies further confirm that the world over, for all cancers combined, prevalence in women is higher than in men.


Cancer, in simple terms, occurs when cells divide in an uncontrolled manner. The human body is made up of different tissues and each tissue has its individual cellular structure. The cells in the tissues are lost through wear and tear and are constantly replaced by a process called cell division. Normally, cells divide - and produce the exact number of cells required - only when the body needs more cells. In cancer, however, cells divide for no apparent reason. In time, they form a mass of extra tissue and become big enough to be noticed as a growth or tumor. A tumor can be benign - harmless - or malignant - bad. Benign tissues are rarely a threat to life, unless in a major organ. These do not invade the surrounding tissue and do not spread. They can usually be removed and do not come back. But malignant tumors grow into the surrounding tissue in a process called invasion. Cancer cells also break away from a malignant tumor and enter the blood stream or lymphatic system. This is how cancer spreads from the original tumor to other tissues and organs. The spread of cancer is called metastasis.


Though the exact cause is unknown, there are various theories on what could lead to the condition. The viral theory says that a cell becomes cancerous when infected by a virus. The immunological theory says that an abnormal cell survives to become a cancer because the body's defenses somehow break down. The chemical theory rests on the evidence from animal tests that certain chemicals cause cancer by altering the genetic make-up of a cell. These are known as carcinogens; tobacco smoke is one. Relation is also known to cause cancer.

Cancer has many causes, some of which are still unknown.

However, research on cancer continues. Using the molecular data from the Human Genome Project, scientists at the Cancer Research Centre at Massachusetts Institute of Technology have identified the gene-rhoC-that causes cancer cells to break away from the original tumor and form new tumors in other parts of the body. This gene triggers the sequence of events that lead to a secondary tumor.

Unusual bleeding or discharge, blood in the vaginal discharge or bleeding after intercourse, a lump in the breast or elsewhere, a sore that does not heal, changes in bowel or bladder habits, hoarseness or cough, indigestion or difficulty in swallowing and change in the size of a birthmark or mole are warning signals of cancer in women.


Women who are aged between 20 and 40 years should make it necessary to get them checked for cancer every three years apart from regular easy-to-do home examinations to stay alert to warning signs of cancer. For cancer, be it of the breast or the uterus can be cured if detected early enough.

Some cancers that are common in women are oral cancer, oesophageal cancer, leukaemia, buccal mucosa, malignant lymphoma and thyroid cancer, besides breast cancer and cancer of the reproductive system.

Leukaemia: Commonly known as blood cancer and characterized by tumors in the bone marrow. In this condition, an abnormally large number of white blood cells are produced, thereby inhibiting the production of blood cells. Causes could be radiation, exposure to certain chemicals, a certain virus, drugs and hereditary factors. Symptoms include low fever and anaemia, loss of weight and appetite. Treatment involves radiation therapy, chemotherapy and surgery to remove enlarged spleen. Bone marrow transplant is also recommended.

Oral Cancer: Caused by radiation, excessive exposure to sunlight, sharp edges of broken teeth brushing against the inner lining of the mouth, chewing tobacco and high deficiency of Vitamins A and B. Symptoms include white or red patches in the mouth, sores that don't heal even after treatment, thickening or hardening or swelling in the mouth and difficulty in opening the mouth. Radiation therapy and surgery followed by radiation are the common modes of treatment.

Oesophageal Cancer: This type is also quite common in societies not following healthy lifestyle. Food habits are the main cause; consumption of very hot or very cold food, spices, chillies, animal fat, preserved meat and fish, paan, deficiency of Vitamins A and B, exposure to radiation and virus. Symptoms include difficulty in swallowing, weight loss, loss of appetite, vomiting, blood in the stool, which is dark in colour.

Lymphoma: Malignant tumors of the lymph nodes, most often in the lymph nodes of the alimentary canal, thymus and bone marrow. Also occurs in the brain, liver and kidney. Lymphomas are of two kinds. Hodgkin's disease and non-Hodgkin's disease. Symptoms are low fever and anemia, swelling of glands most often on one side of the neck, loss of weight and appetite, and weakness. Chemotherapy and radiation is possible in both cases. Surgery to remove affected lymph glands is possible only in Hodgkin's disease.

Pakistan has the highest rate of breast cancer in Asia, and Pakistani women were becoming vulnerable to this deadly disease due to multiple reasons. More and more cases of cancer are being reported in various hospitals and disturbing fact is that women in younger ages are also becoming victims of this deadly disease, experts said.

'In the past, we came across breast cancer among middle-aged women. But today even girls in their 20s and 30s are getting this ailment', the experts pointed out.

Social customs and taboos make it quite difficult for the rural women to come forward and disclose their condition to healthcare professionals. "This is one reason why the cases are not detected in early stages."

Generally obese women of above 40 years, those who may have borne children at later age or those who may be avoiding breast-feeding their babies are at high risk of developing this disease.

Women who were slim and tall seemed to be especially predisposed to cancer. The women belonging to families which had breast cancer in their history were also quite vulnerable. "Such women should go for mammography every couple of years."

Cancer therapy that cures the disease also affects patients' quality of life. Unfortunately this aspect is ignored most of the times.

"Although, the cure rate in cancer has increased but quality of life of the patient is also important for all those who get cured and those who don't," experts said.

Cancer requires holistic approach to restore the physical, emotional, social

and spiritual need of individuals suffering from the disease and their family members through a comprehensive oncology rehabilitation programme. "A cancer patient suffers severe pain very often. He /she is hopelessly lonely and dejected. Besides this the stress on the family, with the associated emotional disturbances, financial problems and social isolation makes every living moment in his/her life miserable.

In the country like Pakistan where cancer is on rise, there is a need for a multi-specialty programme, which aims at giving better quality of life to people suffering from all kinds of cancer apart from focusing on the need for early detection of cancer and the quality of the patient's life post- treatment. Nevertheless, a cancer patient is subject to various treatments like radiology, chemotherapy etc., resulting in both physical and psychological side effects. Rehabilitation helps the patients and their families to cope with the traumas of the disease by providing holistic care and counselling to them.