Dr Sandeep Kaul
Cancer is a dreaded disease, and rightly so because hitherto treatment was vague and patients were generally doomed to die of it. Advances in surgical technique and adjuvant treatment have now made cancer a treatable and possibly curable disease in early stages. Women suffer nearly half the burden of cancer even though they are not pre-disposed to the conventional causative factors like tobacco and alcohol. The causal factors in women are generally age, lifestyle,hereditary, infections and environmental factors. Social factors, especially inequalities, are major determinants of cancer burden in females, with poorer females more likely to die of their disease than affluent ones.Cancer can have profound social and economic consequences for the people of India, often leading to family impoverishment and societal inequality.
Common cancers and their screening
Females generally postpone their first contact with a health facility, leading to a delayed diagnosis in an advanced stage. Unfortunately, the four most common cancers afflicting females can be screened and diagnosed at an early stage. Firstly, Breast cancer, can be screened by monthly self-breast examination, annual clinical examination and mammograms after the age of 50 years. Second, cervical cancer, a sexually active female should undergo a pap smear every three years from the age of 21 years and co-testing with HPV after the age of 30 years. Third, ovarian cancer, can be diagnosed by having a high clinical index of suspicion in a female presenting with vague abdominal symptoms, early satiety and a timely investigation by tumour markers and an ultrasound examination. Fourth, uterine cancer, presents as inter-menstrual or postmenopausal bleeding usually in an obese elderly female. The sad common denominator in all these cancers is that they can all be diagnosed early with minimal effort and cured by surgery.
How is cancer treated?
Once a patient is suspected of having symptoms of cancer, a general evaluation followed by a staging workup including a tissue biopsy is done. Once the diagnosis has been confirmed, treatment options are discussed and if possible an appropriate radical surgery is planned. Radical surgery for cancer is the only curative treatment modality for solid organ cancers. Radical cancer surgeries require a centre where trained surgical oncologist interact with their medical and radiation oncology colleagues and have adequate post -operative ICU care to obtain best results. The first attempt at treatment is generally the best chance of cure as recurrence is resistant to most forms of treatment. After surgery the patients are followed up by designated protocol and undergo adjuvant therapy (chemotherapy, radiotherapy, targeted therapy) as needed.
Role of women in cancer prevention
Women have a central role in the fight against cancer, not only can they encourage their family members to change to a healthy lifestyle (abstinence from smoking/alcohol, healthier food habits, exercise) leading to cancer prevention, they can also be an observant family member who encourages an early medical consultation for a possible cancer symptom leading to early detection and cure. We must therefore, empower women with knowledge and use them as our sentinels in the war on cancer.
(The author is a surgical oncologist at SMVD Narayana Hospital, Kakriyal)
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