In two days’ time the global community will gather to raise awareness among people about one of the most traumatic and debilitating diseases one can experience in their lifetime- namely ‘Cancer’. The good news is that recent technological advances have made it possible for cancer specialists to reduce the number of new deaths due to cancers and control the spread of the disease in those who already have it.
World Cancer Day is observed on February 4 every year to raise awareness among people about this disease, how to prevent it, detect early, available treatments, and provide education about the disease. Led by the Union for International Cancer Control (UICC), the event is a global initiative that aims to support the cancer community, to reduce the global cancer burden, promote greater equity, and ensure that cancer continues to be a priority in the world health and development agenda. To mark the 20th anniversary of World Cancer Day, UICC will be releasing the results of an international public opinion survey on cancer. Conducted by Ipsos, the survey includes more than 15,000 participants across 20 countries in the first multi-country public survey on cancer perceptions in a decade.
‘I Am and I Will’ , the theme of World Cancer Day 2020 reiterates the previous themes based on the UICC goals in support of the World Cancer Declaration written in 2008, by reducing the number of cancer patients by 2030 and the death rate from it, while focusing on debunking myths and prejudices about the disease so as to encourage people with cancer to seek early treatment. As the UICC emphasises, “ Cancer people have all the rights to live like a normal person and they must feel self-respect and get a normal environment in their home and society.”
The Sunday Observer spoke to Consultant Community Physician from the National Cancer Control Program ( NCCP), Dr. Suraj Perera to tell our readers what cancer is, how it is detected, and how those at high risk of getting the disease can prevent it with some simple home exercises. With the increase in the number of new breast cancer cases, the following guidelines he offers in this interview with the Sunday Observer will be of particular interest to all women irrespective of age.
Excerpts…
Q. As the global community shines its light on another ‘World Cancer Day’ on February 4, this year’s theme, ‘I Am and I Will,’ is of special relevance to all those who are not afflicted by the disease, and those living with it as the final aim is to reduce the number of premature deaths from cancer by one third by 2030. While many people know about cancer they are still ignorant about the basic facts of preventing it. Tell us what type of cancer has the highest prevalence rate in Sri Lanka and why?
A. In a year about 23,000 to 25,000 new cancer patients are identified in Sri Lanka. Over the years, the annual incidence of cancers are gradually increasing in Sri Lanka too. Annually about 14,000 deaths (about 10 % of total deaths in year) occur due to cancers. Breast, oral, cervical, lung, colo rectal, oesophagus cancers are the commonest cancers in Sri Lanka.
Q. Is breast cancer on the rise? Do you see a significant surge in the past decade? What is the latest data you have according to hospital registrations?
A. Breast cancer is the commonest cancer among females and is increasing over time. About 3,500 breast cancers are detected a year among females and about 70% breast cancers detected among the post menopausal women after the age of 50. However about 30 % of breast cancers are detected before the age of 50 (pre menaupasal age).
Q. Age wise and gender wise, who are most at risk of getting cancer – men or women?
A. Oral, lung, oesophagus, and colo rectal are the commonest cancers among males while breast, cervical, thyroid, and ovarian cancers are the commonest among females. Common male cancers are preventable since oral, lung and oesophageal cancers occur due to tobacco smoking, betel chewing and alcohol intake.
Q. Diabetes and cancer. Is there a link ? According to new research those with type 2 diabetes which is very common in Sri Lanka especially among older women, is being linked to cardiovascular diseases, hypertension, stroke and cancer .
A. Recently conducted research reviews (Systematic review) revealed that there is a link between diabetes and cancer.
Q. To get back to our theme this year, tell us how a woman can take charge of her body and prevent cancer using some simple home exercises.
A. Physical inactivity is also one of the contributing risk factors for cancers especially post menopausal breast cancer, uterine (womb) and colo rectal cancers. Also physical inactivity leads to overweight and obesity. Therefore, females need to be physically active throughout their life to minimize cancer risk.
Q. How old should a woman be to begin these exercises? In her 30s? 40s? When she reaches menopause?
A. In addition to reducing the risk of cancer, being physically active would minimize the risk of heart attacks, diabetes, high blood pressure, stroke, etc. Therefore, females need to be physically active throughout the life course. Physical activity needs to be promoted from the preschool and school level onwards.
Q. Obesity has been quoted as a reason why Lankan women who have pear shaped bodies and fat around the tummy are potential candidates for diabetes, cancer and other noncommunicable diseases. Your comments?
A. Obesity is considered as a modifiable risk factor for the occurrence of cancer especially breast, uterine and colon cancers.
Q. A Healthy diet- what role does this play in reducing risk of cancer in women?
A. Healthy diet will prevent overweight and obesity. Since healthy diet contains more leafy vegetables and fruits, increasing fibre, micro nutrients including vitamins and minerals, it will minimize the risk of developing cancer.
Q. Sri Lanka has an abundance of vegetables and fruits as well as fresh fish. However, consumption is very low. What is your advice on the best local foods a woman should eat to prevent breast cancer e.g. those with high fibre and low natural sugar, etc?
A. Even though there is no consistent strong evidence of unhealthy dietary practices increasing the incidence of breast cancer, it is always better to take vegetables and fruits which contain fibre and micro nutrients. It would also help minimize obesity among females. Post-menopausal obesity and being overweight increase susceptibility to breast cancer
Q. Interventions by the Health Ministry to raise awareness among the public regarding cancer, especially breast cancer?
A. National Cancer Control Program of the Ministry of Health has taken several measures to raise awareness on breast cancer and early detection. Females are empowered to identify early breast abnormality by empowering them to ‘be breast aware’. In addition self-breast examination and clinical breast examination are promoted for early detection of breast cancer through leaflets, posters, banners, bill boards, electronic media campaigns and motivational talks by primary health care teams.
Q. Do you have screening facilities at the healthy lifestyle centres around the island?
A. Currently there are more than 1,000 healthy lifestyle centres functioning throughout the country to promote healthy lifestyles and active interventions. In those centres also self breast examination is taught and clinical breast examinations are conducted to identify early breast abnormalities. Also nearly 1,000 Well Women Clinics in the country provide similar services for early detection of breast cancers in addition to the cervical cancer screening program targeting 35 and 45 year old females.
Q. Plans for the future? Do you think your goal to reduce 1/3 of premature deaths due to cancers in year 2030 is workable? If not what are the gaps you like to see filled?
A. To achieve the target of reducing premature deaths, we need to prevent preventable cancers. In addition, we need to detect cancers early and offer definitive treatment. The Health Ministry has expanded cancer treatment services up to district hospital level. Cancer specialists are available in 23 districts. Follow up cancer clinics are conducted in almost all the districts. Through these proactive approaches it would be possible to reach the goal in year 2030.
Q. Have you a word of advice to give our readers ?
A. When we consider cancer as a disease entity about one third of cancers can be prevented through healthy lifestyles and healthy environment. Another one third of cancers can be detected early and successfully treated.
Of the balance one third, cancers can be treated successfully to ensure the quality of life of the patients and family members. Therefore individuals living with cancer too can look forward to enjoy a better quality of life .