Cancer

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Heredity, poor nutrition and diet and prolonged continuous exposure to different substances like fats, tobacco, radiation and chemicals are factors that cause Cancer.

Cancer is a large group of diseases characterized by uncontrolled growth and spread of abnormal cells.

Normally, the cells that make up the body reproduce themselves in an orderly manner so that worn-out tissues are replaced, injuries are repaired and the body stays healthy.

Occasionally certain cells undergo an abnormal change and begin a process of uncontrolled growth and spread. These cells may grow into masses of tissue called tumors. Some tumors are benign and others malignant (cancerous).

Cancerous cells invade and destroy normal tissue. These cancer cells may remain at their original site (localized) or may invade distant or neighboring organs (metastasis or direct extension). If left untreated, cancer may spread throughout the body (advanced cancer stage) and usually results in death. Because cancer becomes more serious with each stage of its growth or spread, it is important to detect cancer as early as possible.

Cancer can occur at any age. In the Philippines, 3.2% of all cancer cases occur in the pediatric age group (0-14 years). However, cases strikes more frequently with advancing age, and 75% of all cancers occur after 50 years old.

It has been estimated that about 188.6 persons per 100,000 Filipinos now living will eventually have cancer. One of every 5 Filipinos who live to age 74 will get cancer. Deaths from cancer are placed to 90 people a day or about 4 every hour.


Contents

The Danger Signs

One third of all cancers are preventable if detected early.

  • Change in bowel or bladder habits.
  • A wound that does not heal.
  • Unusual bleeding or discharge.
  • Thickening or lump in breast or elsewhere.
  • Indigestion or difficulty in swallowing.
  • Obvious change in wart or mole.
  • Nagging cough or hoarseness.
  • Unexplained anemia.
  • Sudden unexplained weight loss.


Common Cancer Sites

Here are the top 10 leading cancer sites for both sexes in the Philippines. This is based on the 1993 official and updated statistics of 62,630 cancer cases in the country.

Lung Cancer

Constitutes 14.7% of all cancers in the Philippines. It is more commonly seen in urban areas, and increases after age 35.

Cigarette smoking causes lung cancer. Non-smokers who are continuously exposed to tobacco smoke in enclosed spaces are also at risk.

Unfortunately, there is no effective early detection method for lung cancer. Majority of patients are diagnosed at an incurable stage.

Warning signals of lung cancer are a persistent cough, blood-streaked sputum, chest pain, recurring pneumonia or bronchitis, among others.

Breast Cancer

The leading cancer site among women getting 13.5% of all total cancers. It increases after age 30.

Family history of breast cancer, age over 30 years and women who never had children are risk factors. Contrary to beliefs, however, contraceptive pills do not cause breast cancer.

The warning signs include breast changes that persist such as a lump, thickening, swelling or dimpling. A sore in the nipple or nipple retraction is suspicious. A breast mass in a woman 30 years or above should be biopsied.

Early detection include a monthly self-breast examination and annual health worker breast examination. Mammography, however, is recommended for women under 50 years old particularly those with personal and family history of breast cancer.

Liver Cancer

Composes 7.6% of all cancers. The incidence increases at age 40.

Studies point to a casual relationship between Hepatitis B virus (HBV) carrier state and liver cancer. Primary liver cancer is much more common where HBV carriers are prevalent, such as the Philippines.

Other factors implicated are heavy alcohol consumption. prolonged intake of aflatoxin and other chemical carcinogen.

Warning signs include abdominal pain, abnormal weight loss, weakness and loss of appetite.

For the occasional patient seen in an early stage, surgery can be curative. Majority of cases, however are seen in an incurable stage.

Uterine Cervix Cancer

Makes up 7% of all cancers in the country and its incidence rises starting the age 30.

The most important risk factor is sexual promiscuity of either the woman, the male partner or both. This is because cervix cancer is associated with the presence of viruses, notably the human papilloma virus. The more sexual partners a woman or the male partner has, the greater the risk of being exposed to the virus.

Symptoms of cervix cancer include unusual vaginal discharge and irregular painless bleeding not associated with menstruation, post-coital, post-douching or post menopausal bleeding.

The highly effective screening method for early detection of cervical cancer is the regular Papanicolau (Pap) Smear.

Leukemias

Constitute to 4.7% of all cancers in the Philippines.

Exposure to high doses of radiation, continuous and prolonged exposure to certain chemicals have been blamed for increasing the risk of leukemia.

Warning signs include easy fatiguability, pallor, weight loss, easy bruising, frequent nose bleeding or repeated infections, especially among children. Symptoms of acute leukemia appear suddenly Chronic leukemia may progress slowly with few symptoms.

There is no practical screening method for leukemia. Early detection of symptomatic patients, particularly in children, should be aimed for. Peripheral blood smears and bone marrow examination confirm the diagnosis in suspicious cases.

Some forms of leukemia, particularly Acute Lymphocytes Leukemia in children, are highly curable by chemotherapy.

Stomach Cancer

Makes up 4.5% of all cancers in the country. The incidence begins to rise starting at age 50.

Evidence suggests that gastric cancer may be linked to diet, salty food, smoked fish, pickled vegetables.

Gastric cancer progresses silently to an advanced stage before symptoms alert the physician or the patient. Early symptoms include indigestion, dyspepsia, loss of appetite, and anemia. Weight loss, difficulty in swallowing, vomiting, and abdominal mass suggest an advanced stage.

Again, there is neither an effective method of primary prevention nor early detection of stomach cancer.

Colon Cancer

Totals to 3.8% of all cancers. It increases markedly after the age 50.

Personal or family history of colon cancer and polyps in the colon, and inflammatory bowel disease are risk factors. Evidence suggests that colon cancer may be linked to a diet high in fat and deficient in fiber content.

Warning signs include a change in bowel habits such as recurrent diarrhea and constipation, particularly with the presence of abdominal discomfort, weight loss, unexplained anemia, and blood in stool.

Unfortunately, early colon cancer is asymptomatic, and there is still no efficient screening method of early detection.

The mistaken obsession of physicians with amebiasis and other forms of inflammatory bowel diseases had for decades been a major factor that had delayed diagnosis of colon cancer. The wider availability of antidiarrheals, antibiotics and amoebecides may have ave worsened the situation. Many doctors still insist on giving vitamin preparations and hematinics for chronic unexplained weight loss and anemia.

Thyroid Cancer

The most common cancer of women at ages 15 - 24. It constitutes 3.7% of all cancers in the country.

History of neck radiation during childhood is considered to be the risk factor of thyroid cancer.

It is characterized by a hard mass in the anterior neck; nodules of the thyroid in men; sudden rapid enlargement of a ong-standing goiter in older patients; cervical lymph node enlargement; hoarseness, difficulty of swallowing, and difficulty of breathing associated with goiter.

Almost 95% of thyroid cancer in the Philippines are Well Differenciated Carcinoma, and are highly curable by appropriate surgery alone. Radioactive iodine is the main mode of treatment for metastatic lesions.

Rectum Cancer

Makes up 3.2% of all cancers in the Philippines. Rectum cancer increases markedly at age 50.

Personal or family history of rectal cancer and polyps in the rectum are risk factors. Meanwhile, a diet high in fat and deficiency in fiber is also implicated, but the evidence is not yet as strong as that of colon cancer.

Warning signs include change in bowel habits, transanal bleeding, unexplained weight loss, anemia, and blood in stool.

Early diagnosis should be aimed for. An annual rectal examination is recommended starting at age 40. A proctosigmoidoscopy every 3 to 5 years after age 50 should be considered following two annual examination with negative results.

Early rectum cancer is curable by surgery.

Nasopharynx Cancer

Placed at 3% of all cancers in the country with incidence higher among males than in females. Its risk factors include Chinese descent and previous infection with Epstein-Barr virus.

Warning signs include bloody nasal or postnasal discharge; nasal obstruction; ear pain, .fullness of unilateral otitis media; cervical lymphnode enlargement. For more extensive disease, symptoms include headache, bulging of one eye, double vision, hoarseness and difficulty in swallowing.

Patients who have these symptoms should undergo nasopharyngoscopy and biopsy of cervical lymph nodes for early detection.

Radiotherapy is the principal treatment of nasopharynx cancer.


Other Leading Cancer Sites

  • Ovary (2.9%)
  • Prostate (2.7%)
  • Oral (2.5%)
  • Lymphomas (2.3%)
  • Pancreas (1.8%)
  • Bladder (1.8%)
  • Corpus Uteri (1.6%)
  • Bone (1.4%)
  • Brain, Nervous System (1.3%)
  • Larynx (1.3%)
  • Kidney (1.3%)
  • Connective Tissues (1.3)
  • Esophagus (1.0%)


Cancer in Children

Cancer among children comprises 3.2% of all cancer cases. Leukemias are the most common. Other cancer sites include brain and nervous system, retina, lymph nodes, kidneys, bone and soft tissues, gonadal and germ cell site.

Malignancies in children are difficult to detect because it may present similarly as other common childhood diseases. Parents should have their children undergo regular medical check-up and be alerted on the following symptoms which may be associated with cancer in children: prolonged, unexplained fever or illness; unexplained pallor; increased tendency to bruise; unexplained localized pain or limping; unusual masses or swelling; frequent headaches, often with vomiting; sudden eye or visual changes; sudden or progressive weight loss.

Management of childhood cancers is usually by a combination of surgery, radiotherapy and chemotherapy. A five-year survival rate markedly vary according to the sites of origin of the tumor.


Leading Cancer Sites in Males

  • Lung
  • Liver
  • Prostate
  • Stomach
  • Leukemias
  • Nasopharynx
  • Colon
  • Rectum
  • Lymphomas
  • Oral


Leading Cancer Sites in Females

  • Breast
  • Cervix
  • Lung
  • Ovary
  • Thyroid
  • Leukemias
  • Liver
  • Colon
  • Stomach
  • Corpus Uteri


Treatment

If detected early and treated properly, the following common cancers can be cured: Breast, Cervix, Colon, Rectum, Oral, Thyroid and Prostate. These comprise 36.5% of all cancers.

For most cancers detected early, surgery is the main mode of treatment.

In certain sites of the body like cervix, oral cavity, larynx and breast, small cancerous tumors can also be cured by radiotherapy.

For some cancers, comprising 10% of all cancer deaths per year, chemotherapy can be curative. These include choricarcinoma, leukemia and lymphoma.

However, there are cancers that can neither be prevented nor detected early. All cancer patients with distressful symptoms can have adequate palliative care that can result in an acceptable quality of life.

Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and psychological, social and spiritual problems are provided.

Palliative care offers support systems to help patients live as actively as possible until death and helps the family cope during the patient's illness and in their own bereavement.

The family is the unit of care in palliative medicine, and the home is the ideal location of palliative care.


Reference

  • Adriano V. Laudico. Health Beat Magazine Issue no. 3. Department of Health of the Philippines. (Accessed on May 28, 2010).