Cancer

To detect cancer the onco-surgeon, undertakes a biopsy i.e. a small piece of tissue from the suspicious lump, which is examined by a pathologist who confirms the cancer and classifies it. The patient then undergoes relevant investigations to define the correct stage. In case the disease appears confined to an organ e.g. breast, tongue, lung etc. (Stage I), part or whole of it may be removed, in which case no further treatment may be required. If, however, some disease still remains behind (Stage II or III), radiation therapy would be administered. If that particular cancer is known to extend microscopic spread to remote organs like the lymph glands, liver, lungs or bones called ’secondaries’ or ‘metastases’ (Stage V), the patient would require chemotherapy to attempt a complete cure.

The medical oncologist selects the most effective drug combination for a particular cancer and supervises the treatment. Most of the drugs are administered as an intravenous drip, hence the procedure may be long but not painful. The commonest side-effects include nausea or vomiting which are easily controlled. Besides, transient fall of blood parameters and hair loss are also common, the magnitude of which also depends on individual sensitivity. Almost all patients get their hair back within six months. Chemotherapy has dramatically improved the outlook of cases of childhood leukemia, certain sarcomas, breast cancers and Hodgkin’s disease etc. that were considered incurable some decades earlier.

Radiotherapy : It helps more than 70 per cent of all cancer patients to get cured or obtain relief from pain or bleeding in advanced stages. It consists of either external therapy with X-rays or Gamma- rays or internal therapy called ‘brachytherapy’, where radioactive needles are directly implanted into the tumour. External beam therapy takes a few minutes daily and about five to six weeks to complete an entire course during which, besides the tumour, a large number of normal cells also receive radiation. While the latter suffer only temporary harm due to their capacity to recover, cancer cells are damaged permanently. In due course of time, the normal cells not only regain their function completely, but also regrow to cover up the gap left by the destroyed cancer cells. Today, radiotherapy is planned and executed with the help of dedicated computers to get an optimum ratio between therapeutic and undesirable effects.

The side-effects of radiotherapy result from its action on the normal cells in the treated region. Hence, patients with mouth, throat or food-pipe (esophagus) cancers develop soreness or ulcers in their inner lining, leading to difficulty in swallowing while abdominal reactions manifest as diarrhoea, cramps or vomiting. Majority of these effects are temporary and would subside within three to six weeks of completion of therapy. The skin of the treated area may show hair loss without any other damage.

Although different cancers respond variously, nearly 80 per cent of ill cancers can be completely cured with standard therapy, if detected in stages I or II. Unfortunately, most of our patients come with advanced disease due to personal neglect or poor awareness on the part of primary care physicians. While most of these cases cannot be cured, the quality of their remaining life can be improved with modem palliative and rehabilitative care. Multipronged efforts including media support are desirable to create greater awareness among the people and care givers to promote early detection and prompt therapeutic intervention. Well-equipped facilities for cancer treatment are few in India and exist mainly in only about a dozen Regional Cancer Centres, besides a few medical colleges.