A positive approach to cancer

Published : 1:27 pm  June 5, 2015 | No comments so far |  |  (1202) reads | 

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Millions of people are suffering severe health conditions owing to the cmancer menace. Cancer can invade your very being and may attack you under different disguises. To name some breast cancer, oral cancer and lung cancer are some of the commonest that attack the human immune system. Sri Lanka has witnessed a growing trend in the number of cancer patients recorded over the past few years. However if proper measures are taken and the pre-stages of cancer were determined ahead of time there remains a possible chance of fighting back the disease successfully. It is within this context that more light will be shed on the concept of cancer and how it has contributed to the deterioration of human health.


 

Origin of cancer
Cancer or malignant cells is the uncontrollable cell division in the human body resulting in the malfunction of an organ or a number of organs. Consultant Specialist of the National Cancer Hospital Dr. Jayantha Balawardene defined how cancer invades the human immune system, its causes and preventive measures against cancer.


“The human body is made of cells, basically of three types. The first among them are cells that never divide like the brain cells. The second divides only on demand when the need arises. The cells found in liver are one such example. Thirdly, we have cells that continuously divide. They are found in the skin, germ cells and bone marrow. Cell division takes place according to an organized manner, in a controlled rate and to a certain extent. The uncontrollable cell division which is both unstoppable and purposeful could eventually lead to the local, regional and distance destruction of the body,” Dr. Balawardene said.

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Local Disease is the first stage of cancer where the uncontrollable spread of cells is limited to one organ. Its spread to regional organs results in the Regional Destruction whereas Distance Destruction or Metastatic Disease occur when the disease spreads to distant organs of the body. In most cases the final result could be death caused due to multi organ failure.

 


Reasons for  increasing rate of cancer
Dr. Balawardene said that the rate of cancer has increased significantly due to two main reasons. He noted that they have witnessed a drop in the number of oral cancer patients. Elderly people are vulnerable to cancer owing to old age. “We have managed to conquer a lot of communicable diseases successfully. This became a reality thanks to the availability of effective medicine. Old age and ecological factors have contributed to the increasing rate in cancer,” he said.


Ecological factors such as environmental pollution, radiation, smoking, unhealthy food habits and women being unmarried for a long period are the second major reasons for the increasing rate of cancer. Unhealthy food habits and excess consumption of animal fat and processed food has also increased the rate of cancer.

 


Causes of cancer
From the rapid trend of consuming processed food, to being exposed to radiation, lighting a cigarette to uncorking a bottle of liquor and so on, the causes of cancer could be due to innumerable reasons. Stressing on the unhealthy food habits embraced by modern society, Dr. Balawardene explained how an individual succumbs to cancer owing to bad food trends.


“Extensive consumption of animal fat has been identified as a cause of cancer in the breast, ovary and bone. Animal fat constitutes the very essence of a western type of diet. With the end of the Second World War, many Japanese migrated to the West and were gradually getting accustomed to the western dietary system. After a decade many Japanese migrants were diagnosed with cancer mainly because they who used to consume more seafood had eventually replaced it with more animal fat consumption” he said. Compared to animal fat, seafood are enriched with nutritious value and are much healthier.


Apart from animal fat, processed and canned food manufactured long before they sit on the store room shelves as much as junk food can augment the chances of causing cancer. Such unhealthy food habits have been evident as a root cause that challenges the health of man. It is certainly not late to retrace one’s steps back to a healthy dietary system that gives more prominence to an abundance of fresh fruits and vegetables and less animal fat consumption.

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Industrial activities that expose individuals to both chemical radiation and environmental pollution could lead to dire consequences causing cancer. For an instance lung cancer is high among those engaged in industrial activities in comparison to rural areas. It is vital that protective masks are used and proper precautionary methods are used when working on such sites that are environmentally hazardous. Smoking, chewing betel and extensive liquor consumption has adversely affected the human immune system causing lung, oral and bowel cancer. Despite major awareness campaigns launched by health organizations curtailing the habit of smoking and betel chewing, there appears to be much more to do to spread the word of prevention against cancer.


Sri Lanka has witnessed a significant increase in the number of breast cancer patients reported over the past few years. Women of the modern society are driven more by industrialism and are laborious on their pursuit to earn a decent living before settling down for marriage or delivering babies. In some cases they resort to the use of birth control hormones and pills and delay pregnancy. Dr. Balawardene said that a woman stands a fair chance of preventing herself from being vulnerable to breast cancer if she bears a baby before the age of thirty and pointed out that the failure to do so is one of the ecological factors that have contributed to the rise in breast cancer patients in Sri Lanka.

 


Cardinal signs of cancer and prevention
Cancer if detected early can be treated accordingly and what is most important in this procedure is to identify the pre stages of cancer. 1/3 of the cancer can be prevented and cured if detected early. To begin with long standing cough, vaginal discharge and having fever for a long period can be listed as some warning signs of what is to come. The change in voice, incurable wounds in the mouth and skin, loss of weight and lack of appetite can also be attributed as early symptoms of cancer. However it is needless to get alarmed unnecessarily the moment these symptoms appear since they could be changes that take place due to another health aspect as well. In the event any of the above symptoms prevails for quite a long period it is advisable to seek immediate medical attention from a qualified doctor. Since prevention is better than cure it is always advisable to abstain from the risk factors that would make one vulnerable to cancer.

 


Helping Hands – Are the efforts to help the ill adequate?
The International Agency for Research on Cancer predicts that the annual new cases of cancers are expected to rise from 11 million to 16 million by the year 2020, with 70 per cent of them coming from developing countries.


Research shows that cancer remains the second leading cause of death in many countries of the world.


Respiratory Cancers alone rank at no 7 on the world’s 10 leading causes of death with a staggering 1.5 million deaths reported in the year 2014. It is estimated to cost the global economy $180 billion every year.


With such devastating numbers in sight, it is clear that preparation is inadequate, not just at a national level as even the international community is simply unable to combat a global epidemic of this scale and nature. Questions rise; Do we have sufficient doctors, nurses, facilities, to diagnose to treat cancer patients? Do we have sufficient funding, or is the funding put in priority for more cancer research, for more cancer diagnosis, screening, and treatment?


Screening for cancer has become more complicated in recent years with evolving guidelines and theories that sometimes conflict. There is nothing more confusing, challenging and trying for a patient diagnosed with cancer, especially in a country such as Sri Lanka with an aging population. This is why groups in addition to the national healthcare services aim to ease confusion and hardships and to encourage more discussion on the subject, in an attempt to help our nation alleviate cancer.


The Cancer Care Association of Sri Lanka (CCASL) is one such government registered NGO which functions with the aid of volunteers only. The organisation concentrates on cancer, patients affected with cancer and palliative care for such patients.


Speaking to the Daily Mirror, Secretary of CCASL Hasitha Premathilake said that the organisation currently handles two major projects; a home based palliative care unit and a hospice for the terminally ill in Kurundankulama attached to the Anuradhapura Teaching Hospital Cancer Unit.


“Awareness on cancer and its dangers is much better. We rarely come across patients refusing treatment or seeking alternative medicine.” Mr. Premathilake said.


 “It is a sad situation when patients could have been treated and saved if the cancer had been detected at an early stage, especially in cases of breast cancer” he said.


The association also conducted a great number of awareness programmes and also organizes training programmes for healthcare professionals involved with the treatment of cancer patients.


The Sri Lanka Cancer Society (SLCS) is the country’s oldest organization which aims to relieve the country of the devastating scourge of cancer. They envision a cancer free Sri Lanka according to the Chairperson of Public Education Committee of SLCS Mrs. Merle Weerasinghe. The society has taken up the challenge to educate the public with their untiring efforts through various means.


“We have conducted a series of programmes to help raise awareness especially among school children, from art competitions to poster campaigns. For example, the young don’t see the undesirable effects smoking can cause decades from now. We are trying to make people live their lives in a manner that they can prevent cancer. This is one of our key responsibilities.” Mrs. Weerasinghe said. In addition to raising awareness the society also provides funds for the healthcare team employed at “Shantha Sevana” of the National Cancer Institute where terminally ill patients are sent for treatment and care during their last days.


“We have so many areas that we help cancer patients with. We even provide recovered patients in need with allowances. There is a Canteen Committee which regularly provides refreshments for the patients in the wards of the hospital in Maharagama. There are so many ways in which the public can help us and our cause, be it a simple donation or other special efforts they have in mind. Generous persons are welcome at our office in Bullers Lane where we can further discuss how to help these patients.” Mrs. Weerasinghe added.

 


‘Food consumption play a major role in causing cancer’ -Dr. Wijesooriya
Dr. Garusinghe Wijesooriya, Director National Cancer Hospital Maharagma is of the opinion that the causes of cancer cannot be confined in one specific area. Cancer and the way it affects an individual can vary with sex and age.


“The most common form of cancer among women is breast cancer. If we analyse the changes in a woman’s lifestyle we can see a number of changes that can contribute to cancer.

 

"With such devastating numbers in sight, it is clear that preparation is inadequate, not just at a national level as even the international community is simply unable to combat a global epidemic of this scale and nature. Questions rise; Do we have sufficient doctors, nurses, facilities, to diagnose to treat cancer patients? Do we have sufficient funding, or is the funding put in priority for more cancer research, for more cancer diagnosis, screening, and treatment?"

 


“Women bear a lesser number of children nowadays. At the same time they also consume a lot of drugs, in the form of hormonal treatments for family planning purposes. They take hormonal treatment even when they cannot conceive. These drugs have great potential in causing cancer. Even though pharmaceutical companies contradict this fact, the risks of hormonal treatments causing cancer are of great concern. When it comes to males, the most common form of cancer is oral cancer and this is caused by poor oral hygiene, betel chewing, alcohol consumption and smoking.” Dr. Wijesooriya said.


According to Dr. Wijesooriya food consumption patterns also play a major role in causing cancer. There was a time we used to have fresh fruits and vegetables for consumption and most of it was home grown. Today it is a world of instant food. A great amount of junk food with monosodium glutamate (MSG) better known as the flavour enhancers Ajinomoto are consumed by a majority. The harms of MSG and their links to cancer are proven with scientific research.

 


Gravely inadequate awareness of cancer
The issue of cancer is addressed by two main bodies under the Ministry of Health in Sri Lanka. The National Cancer Institute in Maharagama addresses the treatment of cancer patients while the Cancer Control Unit deals with efforts in preventing cancer.
Preventive measures undertaken by the Cancer Control Unit include awareness programmes that are dedicated to changing a person’s lifestyle so that they can prevent the deadly illness and can enable them to take effective measures in early detection of cancer. They take the form of media advertisements, group discussions and awareness campaigns.


However the untiring efforts of the Cancer Control Unit in raising awareness have resulted in a less than desired outcome.
Dr. Wijesooriya believes that the public are still not aware of cancer and the harm it brings about.


“The public still isn’t aware. Awareness is very important in combating this disease. Even though this disease has a very long history, action was taken to prevent this illness only recently. The only concern we had was the treatment of cancer.

 This is an area where the public can contribute. Donations can be made to our hospital not only through funds. The public can either help us with prevention of cancer or treatment of cancer.


The Maharagama Cancer Institute is equipped with three mammogram machines which can be utilized for the purposes of screening of cancer. But Dr. Wijesooriya says that these machines are underutilized despite the hospital performing these procedures free of charge. With the rising number of breast cancer among females, women who are identified as having a high risk of cancer should be flocking to screening centres provided by the Cancer Control Unit in Cancer Units island wide. Sadly this is not the situation simply because women are unaware of the grave risk they face.

 

"Cancer if detected early can be treated accordingly and what is most important in this procedure is to identify the pre stages of cancer. 1/3 of the cancer can be prevented and cured if detected early. To begin with long standing cough, vaginal discharge and having fever for a long period can be listed as some warning signs of what is to come"

 


“There are a number of educational awareness programmes that we can be helped with. We would be happy to help groups who are interested in raising awareness be it as a small religious group or at a large social gathering. Sadly it is not something I see happening too often” he added encouraging the public to help as individuals or groups in any capacity possible, noting that any form of aid is always welcomed by the institute.

 


The government’s effort
“We receive a great number of donations, as the Director of this Institute I am thankful to the public for their concern for this hospital and their generous donations. The donations are now handled by me directly, and are registered here. We maintain a special register here where we categorize the donations in for drugs, for repairs and renovations of equipment and finally for the building of the new unit or other special programmes such as religious programmes for children.”


Asked about the support extended from the Ministry of Health Dr. Wijesooriya explained the brunt the Ministry bears to provide care for the patients at this hospital.


“We get tremendous support from the Ministry. They liaise with major donors to benefit this hospital in numerous ways. The construction of the new unit adjoining the main building is also a result of the untiring efforts of the ministry. 1/4th of the cost of this Rs. 1200 million project is borne by the Ministry and the remainder is funded by Ahmed Tea Private Limited. This is a state of the art of the cancer treatment facility complete with modern technology and utilities on par with those used in developed countries.


We are happy to say that the government spends 1.5 million rupees per patient each year for their specific drugs. This is excluding the cost for patient’s investigation, radiotherapy, consultation and their usual drugs. Even a heart patient having undergone bypass surgery does not need or receive this kind of expense” Dr. Wijesooriya explained.

 


Future plans for the hospital
The hospital is equipped with only 934 beds but the patients warded,  exceed 1100. The congested wards clearly have an issue in accommodating the overflow of patients.


The long queues and seating arrangements on clinic days are a matter of concern for the patients and staff alike.  However Dr. Wijesooriya believes that the construction of the new building will ease these issues to a great extent. He also has plans to restructure most of the hospital’s procedures in order to give patients the best care possible.


“I have identified three areas of the queues for clinic sessions that needs re-shaping; patient registration, doctors’ consultations and receiving treatment.


As the first step we have computerized all patient records of registration at the hospital. We are the first hospital to do so in the country. Both clinic and admission patients’ records are computerized upon registration.”

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As for consultation Dr. Wijesooriya explained that consultant doctors in the clinic and the number of clinic days must be increased. “We are also planning to have clinic sessions in the evenings too. That will make it two sessions per clinic day and will greatly help in minimizing the long queues. We also plan to rearrange the entire clinical sessions so that patients are given an appointment with a specific time and date, instead of having to wait in a queue for their turn. When these measures are introduced the issue of the long queues will be lessened by a great extent.”


Dr. Wijesooriya’s ambitious plans for the hospital are nothing but laudable. Although the question remains if doctors would be willing to sacrifice their private consultation hours in order to serve these plans.

 


"We are happy to say that the government spends 1.5 million rupees per patient each year for their specific drugs. This is excluding the cost for patient’s investigation, radiotherapy, consultation and their usual drugs. Even a heart patient having undergone bypass surgery does not need or receive this kind of expense”
Dr. Wijesooriya explained"


 


Asked about cases of misdiagnosis Dr. Wijesooriya ensured that there aren’t noticeable cases of misdiagnosis at the hospital. “For a state hospital we have the latest technology available for cancer screening, diagnosis and treatment. We have the laboratories and theatres of the highest standards and the best consultants. Each patient whether they have been treated elsewhere or not will undergo preliminary investigation at this hospital. Thus the chances of patients being misdiagnosed are very minimal.”


“We will be starting bone-marrow transplants at this hospital from the end of August this year which will be a milestone in Sri Lankan medical history. We have a medical team comprising doctors, nurses who have been trained in Australia.

 


Is the hospital ready to battle the numbers?
According to the hospital’s Director, the Maharagama Cancer Institute cannot cope with the country’s cancer patients alone which is why the government is trying to establish Cancer treatment units at a provincial level. According to the Cancer Control Unit every province has a Cancer Treatment Unit with the basic treatment facilities including chemotherapy and radiotherapy. However patients still prefer to seek medical attention at Maharagma, no matter how far they have to travel.


Patients do not need to go abroad for treatment because we have the best treatment facilities in this country for free. We even prescribe drugs that some countries such as India, UK or even Singapore would not prescribe because these drugs are very expensive. No other country gives these for free; we are the single country spending this kind of money on cancer patients. There are also newly developed drugs that aren’t even prescribed to patients in the UK on account of their expense but we prescribe them here and provide them free of charge,” he added speaking of the remarkable efforts of this hospital.