What is cancer?Cancer is a vicious uncontrolled growth of tissues that is characterized by the loss of cell control. Normally, each cell in the body regulates how large and how fast it should grow, die and regenerate, in every organ (stomach, lung, kidneys, etc). Carcinogens (cancer causing agents) that invade the organ in the body takes away that cell control. This results in a rapid abnormal and excessive growth of the cells way beyond their normal size leading to the formation of a malignant tumor in the particular organ it grows in, with propensity to spread to adjacent tissues and to distant organs (example: cancer of the lungs spreading to the brain, or cancer of the breast metastasizing to the liver or bones).
What causes cancer?The basic underlying cause is the constant, repeated irritation or injury to body parts or organs, leading to changes in the DNA and loss of cell controls. Examples: cigarette smoking as the cancer-causing irritant to the breathing apparatus including the trachea, breathing pipes and the lungs, urinary bladder, kidneys, pancreas. Another irritant is animal (saturated) fat from the red meat we eat, causing cancer of the colon, breast and uterus. Alcohol is linked to cancer of the digestive tract, breast and liver. More than 75% of all cancers are associated with only 3 factors, diet, tobacco and alcohol. There are theories that implicate virus, weakened immune system, radiation, chemicals, etc. as the probable cause of cancers, but there is no doubt that the 3 factors mentioned above are associated with more than three quarters of all cancers in man. If we can control those 3, we can prevent most cancers known to man.
Do artificial sweeteners and coffee cause cancer?Some years ago, there were questions raised as to whether artificial sweeteners (aspartane, saccharin, etc) and coffee were carcinogenic. Todate, no evidence exists to prove that they cause cancer.
Is cancer life-threatening?Generally, yes. When we talk about cancer, it implies a malignant tumor that could potentially kill. And many of them do. However, there are certain cancers, like some skin cancers or some type of lymph node or throat malignancies, that respond well to current surgical, chemotherapeutic or radiation treatment. In children, leukemia, lymphoma, sarcoma are curable when detected early. As a rule, we must treat all types of cancers as lethal diseases, and therefore it is best to prevent their occurrence.
Are cancers preventable?While there are a number of cancers that are not preventable, there are many that can be predicted and even prevented. Examples of these are cancer of the lungs, esophagus, pancreas, kidney, urinary bladder and throat among those who smoke, melanoma (cancer of the skin from chronic and prolonged exposure to sunlight), mesothelioma (cancer of the inner lining of the chest wall from exposure to asbestos), cancer of the mouth and throat from chewing betel nut (nga-nga), etc. If we think about it, there are many things we can do to prevent cancer, and that many cancers have been caused by unhealthy practices people did to themselves. Smokers, for instance, know that tobacco cause a variety of deadly cancers, and yet they continue to smoke.
Are there cancers that are curable?Most cancers detected at an early stage (before it has spread) are potentially curable. This is the reason why one should report to his/her physician any lumps or bumps, sores or non-healing wounds, or abnormal bleeding or discharge, unexplained cough or weight loss. A prompt medical check-up in this situation is essential, if early diagnosis is to be made. Better than this is to have a yearly medical check-up, which should include, among others tests, chest-ray, breast (Mammography), vaginal (Pap Smear) and rectal examination among females, chest-ray, prostate, and rectal examination among males. Majority of the "cancer cures" were among patients who sought preventive medical care annually and were diagnosed and treated early. Early detection is the key in the fight against cancer.
Can self-examination help detect cancers?Yes, a significant number of malignant growths were first discovered by the patient himself/herself or by the spouse or a family member. Self-examination (breasts among females; testicles among males; for sores, discharges, or lumps and bumps in the neck, armpit or groin or anywhere in the body) is a good habit one should practice and do about once a week. As you feel your body parts frequently, you will be familiar with their normal appearance, consistency and size, and discern more easily when changes or abnormalities take place.
Does age play a role in cancer development?Yes. Age impacts the incidence and mortality of cancer. In the United States, the incidence doubles every five years after age 25. Prostate, colon and stomach cancers peak between ages 60-80, while others (like acute lympoblastic leukemia) have a peak incidence from birth to age 10.
How about the role of geography?In Japan, the incidence of breast and colon cancer is low, but the incidence among Japanese immigrants to the United States is higher and approximates that of the native Americans, obviously from diet and lifestyle changes. Eating red meat, smoking cigarettes, and lack of exercise are the significant factors in the role of geography in the causation of cancers.
Does eating red meat increase cancer risk?Yes. There is no question that eating animal fat, especially from red meat, is a significant factor which increases the risk of people developing cancer (colon, breast, uterus, etc.) One third (33%) of the 500,000 cancer deaths each year in the United States is due to this dietary factor. This is well documented in medical literature. Now, what medical science does not know at the present is who among those who eat animal fat would develop cancer, and who would not. The same thing with smoking. This is why physicians recommend avoidance of red meat and cigarettes to everyone, since we have no way to predicting who could indulge in them "safely."
What are chemical carcinogens?Chemical carcinogens include exposure to arsenic, chromates, asbestos (lung cancer), aromatic amines (bladder cancer), benzene (leukemia), nickel (lung and nasal sinus cancer), vinyl chloride (liver cancer), alcohol (esophageal and oropharyngeal cancer), tobacco (lung, esophageal, urinary bladder, head and neck cancer), betel nuts (oropharyngeal cancer), and, ionizing radiation (lymphomas, aplastic anemia, multiple myeloma, thyroid cancers).
What are the available treatments for cancer?There are various treatment modalities available, depending on the organ and cell-types of the different cancers. In brief, among them are chemotherapy, radiotherapy, hormonal therapy, whole body irradiation, combined therapy and surgery. Those interested in the details of each regimen should discuss this with their family physician or oncologist.
How do we prevent or lower our risk of developing cancer?
Prevention is the best way to maintain good health and well-being. More especially so when dealing with a serious illness like cancer. As one grows older, one begins to realize that, indeed, health is wealth, and that the adage is not merely a cliché. Next week, we shall devote our entire column to the strategy in cancer prevention. Don't miss it. This could save your life and those of your loved ones.
Our readers are invited to send in their medical questions for possible inclusion in future issues of this column. Mail your questions to the author at Heart to Heart Talk, c/o Cebu Cardiovascular Center, Cebu Doctors' Hospital, Osmena Boulevard, Cebu City, Philippines, or e-mail them to philip@chua.net
Philip S. Chua, M.D. is Chairman of Cardiovascular Surgery of Cebu Cardiovascular Center at Cebu Doctors' Hospital, where he and his team do open-heart and coronary bypass surgery. He is Cardiac Surgeon Emeritus in Northwest Indiana, U.S.A. and shuttles to Cebu every other month to do cardiac surgery with his team. He was a Denton A. Cooley Cardiac Surgery Fellow at the Texas Heart Institute in Houston. Dr. Chua is a weekly columnist of Cebu Daily News, MALAYA Philippine national daily, Southern Leyte Times, HealthNEWS Magazine of the Manila Times, Essence Magazine-Cebu, The Filipino Reporter of New York, The Philippine News of California (national edition), and the Pinoy Monthly of Chicago. He is past president of the American Heart Association (NWI), the Association of Philippine Physicians in America (APPA) and the Society of Philippine Surgeons in America (SPSA). His email address is philip@chua.net.