Cancer

Breast Cancer Awareness: The Modifiable Risk Factors

The risk factors of breast cancer causes can be modifiable and non-modifiable. Read the non-modifiable risk factors of breast cancer. The modifiable risk factors are related to lifestyle and can be addressed by women. As, these are modifiable, it is possible to reduce risk of developing breast cancer by modifying the risk factors in your favor. Your effort to prevent/reduce risk of breast cancer development should be concentrated towards modifying the modifiable risk factors of breast cancer causes, in your favor and reduce the risk. Nothing can be done with the non-modifiable factors, except screening for breast cancer regularly (yearly) to detect breast cancer as early as possible.

What are the modifiable risk factors of breast cancer?

The modifiable risk factors of breast cancer causes are the number of children, alcohol consumption, breast feeding, obesity, physical activity, hormone replacement therapy after menopause, use of DES (diethylstilbestrol) and use of oral contraceptive pills (OC pills).

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Breast Cancer Awareness: The Non-modifiable Risk Factors

The month October is the breast cancer awareness month (annual international breast cancer awareness campaign organized by major breast cancer charities to raise funds and increase awareness). I thought it prudent to write something about breast cancer and make people aware of the risks of breast cancer, so that they can take some steps in reducing and preventing breast cancer. Breast cancer is one of the leading causes of cancer deaths among females. Breast cancer can also occur among males, albeit less frequently and rarely in compare to females.

Good news about breast cancer is that the survival rate is very good in breast cancer patients, although it can not be cured. In respect to survival/cure, breast cancer can be placed next only to skin cancer, where it is possible to cure if diagnosed and treated at the initial stage, especially squamous cell skin cancer, where metastasis (spread to other distant organs from its primary site) is rare.

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Mesothelioma and Asbestos

Mesotheloima is a rare neoplasm (cancerous neoplasm) that arises from mesothelial cells lining the parietal and visceral pleura of the lungs. Mesothelium is the protective lining that covers most of the internal organs (including lungs) of the body.

The commonest site of mesothelioma is the pleura, which is the outermost lining of the lungs and the chest wall. But mesothelioma can occur at any site where mesothelial cells lining is present like peritoneum, heart etc.

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The Global Magnitude of the Problem of Cancer

Cancer afflict all the communities throughout the world. At present more than 11 million people are diagnosed with cancer and more than 7 million people die due to cancer every year, throughout the world. More than 30 million people are living with cancer at present. In term of incidence, the most common cancers are Lung cancer (12.3% of all cancer), breast cancer (10.4%) and colorectal cancer (9.4%). In terms of death from cancer the most common cancers is Lung cancer (17.8% of all deaths due to cancer).

For a disease, the relationship of incidence to mortality rate is an indication of prognosis. Similar incidence and mortality rate is indication of essentially fatal condition. That is why lung cancer accounts for most deaths from cancer (1.1 million) in the world annually, because its incidence and mortality rate is similar and it is invariably associated with poor prognosis. On the other hand for breast cancer appropriate management can be effective in avoiding fatal out come. That is why although it is second in term of incidence but in terms of mortality it is ranked 5^th .

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Cancer control (Secondary prevention)

Secondary prevention comprises the following measures:

(1) Cancer registration:

Cancer registration is a sine qua non for any cancer control programme. It provides a base for planning the necessary services and for assessment of the magnitude of the problem of cancer. Cancer registries are of two types: hospital-based and population based registries.

(a) Hospital-based registries: The hospital-based registry includes all patients treated by a particular institution, both inpatients and out patients. Registries collect data as recommended by WHO in the “WHO Handbook for Standardized Cancer Registers”. If follow-up is long-term, hospital-based registries can be of considerable value in the evaluation of diagnostic and treatment programmes and also for research. Since hospital population will always be a selected population, the use of hospital-based registries for epidemiological purposes is limited.

(b) Population-based registries: The best thing to do is to set up a “hospital-based cancer registry” and extend it to a “population-based cancer registry”. 2-7 million is the optimum size of base population for population based registry. The aim is to cover the complete cancer situation in a given geographic area. The data from such registries alone can provide the incidence rate of cancer and serve as a useful tool for initiating epidemiological enquiries into causes of cancer, surveillance of time trends and planning and evaluation of operational activities in all main areas of cancer control.

(2) Early detection of cases:

Cancer screening is the main weapon for early detection of cancer at a pre-invasive (in situ) or pre malignant (cancerous) stage. Effective screening programmes have been developed for cervical cancer (Papanicolaou smear, known as pap smear), breast cancer (mammography) and oral cancer. Like primary prevention, early diagnosis has to be conducted on a large scale. But it is possible to increase the efficiency of screening programmes by focusing on high-risk groups. but there is no point in detecting cancer at an early stage unless facilities for treatment and after care are available. Early detection programmes will require mobilization of all available resources and development of a cancer infrastructure starting at the level of primary health care, ending with complex cancer centers or institutions at state or national levels (tertiary health care).

(3) Treatment:

Treatment facilities should be available to all cancer patients. Some of the cancers are amenable to surgical removal, while some others respond favorably to radiation or chemotherapy or combination of both. Since most of the known methods of treatment have only complementary effect on the ultimate outcome of the patient, multi-modality approach to cancer control has become a standard practice in cancer centers. In the developed countries cancer treatment is geared to high technology. For those who are beyond the curable stage, the goal must be to provide pain relief. A largely neglected problem in cancer care is the management of pain. The WHO has developed guidelines on relief of cancer pain “Freedom from cancer pain” is now considered a right for cancer patients.