Malabar Cancer Care Society Kannur

• Cancer results because of the derangement of the normal cell repair process in the body.
• All life starts as a single cell, half from mother and half from father.
• This primordial cell divides, grows and multiplies repeatedly to produce cells identical to the mother cell, thus forming cell groups which differentiates in to many types of tissues and organs, ultimately creating a whole being
• Cells have prefixed lifespan and die off at the end of it. This programmed cell death is called apoptosis. Exceptions are the nerve cells, heart muscle cells and skeletal muscle cells
• This whole process of cell division, multiplication and death, which continues throughout the lifespan of the individual, programmed and controlled by the genes [cancer suppressor gene] present in each cell.
• When this control is lost due to damage of the cancer suppressor gene, creation of abnormal cells may result. This is called mutation.
• Mutation [creation of daughter cells with genetic make-up different from mother cells] can happen when there is constant and continuous irritation or injury on rapidly dividing cells as during a repairing process.
• Mutation, thus, may lead to the creation of cells devoid of death warrant, resulting in unbridled multiplication and growth, to form a tumour, destroying the organ by crowding out the healthy cells and then invading other organs through blood or lymphatic stream.

Benign

localized. Do not spread locally or outside the origin of the organ

Two types:

• Solid tumours
• Cysts [abnormal growth filled with liquid or semisolid substance]

Malignant

spreads within the organ of origin and to other remote organs through blood or lymph stream.

Three types:

• Solid Tumours [breast, lung, brain, liver, pancreas etc.]
• Ulcers [mouth, throat, stomach, bowel, bladder etc.]
• Hematological [leukemia, myeloma, lymphoma]

Premalignant [Pre-cancerous]

Abnormal cells that have not yet turned cancerous but are highly likely to.

Depending on the cell of origin

• Carcinoma [from lining membranes like skin, mucosa]
• Sarcoma [from connective tissue like muscle, bone, fascia
• Hematological [from blood cells]

Depending on the organ of origin

Breast, liver, lungs, brain, bone, uterus, ovary, prostate etc.

Depending on controllability

• Preventable tobacco induced, vaccine preventable, life style mediated etc.
• Curable those detectable in early stages. Those which can be screened
• Incurable those which are usually diagnosed in late stages

• Unusual bleeding from orifice
• Non healing ulcers
• Lumps and growths
• Unexplained weight loss
• Nagging / recurring urinary symptoms
• Swallowing difficulty
• Alteration in voice
• Intermittent, recurring, long standing fever
• Recent changes in already existing moles warts etc.
• Constant indigestion
• Alteration in bowel habits
• Patches over skin, mouth etc.
• Headache, bone pain

We are what we eat

• Ideally a balanced food plate should have 25% carbohydrate as whole grains [rice, wheat, oats, and millets], 25% protein as meat, eggs, pulses, grams and 50% vegetables and fruits. Plus small amount of healthier oils.
• Avoid / restrict junk food, red meat, processed food, high saturated and trans fats, beverages. Limit salt and sugar.
• Avoid ‘There is no safe level for alcohol consumption as per World Health Organization.
• Avoiding over eating is paramount. Balancing one’s daily food intake with one’s daily caloric requirement is the recipe for good health. Maintain BMI between 18.5 and 24.9. To calculate BMI weight in Kg divided by height in inches squared.

“Consume food as if medicine,lest, you end up consuming medicine as if food”

• India accounts for about 1/3 of oral cancer world wide
• 30% of all cancers in India
• Most prevalent cancer in men
• Lowest in Kerala. Highest in West Bengal.
• Nagging / recurring urinary symptoms
• May affect any part of oral cavity.
• Symptoms: non healing ulcer, difficulty in mastication, restriction in opening of mouth
• Sometimes presents as a whitish patch [called leukoplakia], or as thickening of the oral mucosa [called sub mucous fibrosis] both of which are pre-cancerous state.

What to do

• Oral hygiene
• Avoidance of known carcinogens like tobacco, betel, areca nut, alcohol
• Regular self-oral examination

Commonest cancer in women [25%]

5 to 10 % are inherited, mediated by the genes BRCA 1&2

What to do

Breast Self-Examination

is the best tool for early diagnosis, every month by every woman.

• Step 1: Inspect for any alteration in color, texture and shape of the breasts in front of a mirror in good light with arms

  • On the sides
  • Placed on hips
  • Raised sideways
  • Above the head
• Step 2: Feel with the palm side of the middle three fingers [not finger tips] the entire breast area and the arm pits in a systemic manner for any swelling or irregularity
• Step 3: Pull and squeeze the nipples to look for retraction or discharge

Clinical Breast Examination [CBE]

USG, Mammography or both in all suspected cases or even otherwise as periodically.

Imaging

Get examined by an expert if suspected or even otherwise periodically.

Histological confirmation

Histological confirmation of suspected lesions by FNAC [Fine Needle Aspiration Cytology] or biopsy [core, punch or excision]

Treatment

Prompt, correct and complete

Follow up

Regular, periodic as advised.

Breast Cancers in Males

Male breast cancer is a rare but significant disease, accounting for less than 1% of all breast cancer cases.

Due to low awareness, it is often diagnosed at a later stage compared to female breast cancer, which can impact outcomes. However, when detected early, the prognosis is similar to that in women. Early detection and increased awareness are essential to improve survival rates in men with breast cancer.

Second most prevalent cancer in women.

Caused by a virus, the Human Papilloma Virus [HPV] through sexual contact

Detectable in pre-cancerous stage.

An effective vaccine available.

What to do

• Vaccination at the stipulated age
• Screening by PAP Smear test or VIA-VILI test or HPV test. Get screened every 2 to 3 years between 30 and 55 years [in Asian set up]
• Treat the precancerous condition by cauterization
• Treat the confirmed cases promptly, correctly and completely
• Regular periodic follow up

Ulcers, patches, indurations

Skin cancers are relatively low in incidence in India. Less than 1% UV rays from prolonged exposure to sunlight is the causative factor.

4 types

• Squamous cell carcinoma [SCC]. More common in India. Good prognosis, especially if detected early.
• Basal Cell Carcinoma [BCC] Rarely spreads. Very good prognosis
• Merkel Cell Carcinoma [MCC] Rare but aggressive
• Melanoma. The most aggressive skin cancer. Starts from melanocytes, the pigment cells that give colour to the skin.

Any swellings, growth or node on the body surface

Like goitre, dermoid cysts, lymph nodes, sebaceous cysts, warts,

What to do

Imaging, FNAC, Scraping, Biopsy

There are hundreds of cancers that can affect the human body. But all are not detectable in the early stages. Out of this, only some cancers can be screened early. Out of this, only a few can be screened in a peripheral set up.

So MCCS has targeted four most important cancers.

• Oral: India has 1/3 of global load.
• Breast: Most prevalent women cancer and India leads
• Cervix: The second most common woman cancer.
• Skin & body surface: Though relatively low in incidence it can be easily screened.

Above four categories of cancers make up about 60% of total cancer load

MCCS initiated Comprehensive Cancer Control Programmes way back in 1989, conceived various innovative cancer care initiatives planed and successfully implemented empowering communities and enhancing lives.

“MCCS’s 36 years of unparalleled initiatives in comprehensive cancer care”