The incidence of cancer is rising across the world, including India and Goa. India records around 1.57 million new cancer cases annually, while Goa reports approximately 1,700 new cases every year.
Several factors contribute to this rising trend such as increased life expectancy, improved methods of diagnosis, better control of infections, changes in diet and lifestyle, the emergence of new infections, new genetic mutations, microplastics, radiation, pollution, insecticides, pesticides, chemicals, the use of hormones in poultry and cattle, smoking, vaping, pan, narcotics and alcohol all play a role. Other important risk factors include lack of exercise, sedentary lifestyles, unhealthy diets, fast foods, aerated drinks, preserved, processed and refined foods, stress, inadequate sleep and obesity.
India and Goa need affordable cancer screening, diagnosis, treatment and palliative care. Health education on cancer risk factors, prevention, screening and early diagnosis should be promoted in schools, colleges, panchayats, municipalities, the print and electronic media, government agencies, NGOs, clubs and religious organisations.
The warning signs of cancer include a persistent cough, hoarseness of voice, difficulty in swallowing, changes in bowel habits, indigestion, headache, unexplained weight loss, loss of appetite, shortness of breath, a sore or ulcer that does not heal, blood in the urine, stools or sputum, bleeding from any site, a lump in the breast or elsewhere, and changes in the colour, size or shape of a mole. If these symptoms persist for more than a month, medical consultation is essential. A doctor will take a detailed personal and family history, conduct a clinical examination and advise appropriate investigations. Many such cases may not be cancer, but it is important to rule it out.
Cancer develops through a combination of genetic, environmental and lifestyle factors. Although cancers are increasingly being seen in younger individuals and around 10 per cent of cases may have a family history, it must be clearly understood that most cancers are neither hereditary nor contagious. Only about one per cent is hereditary or genetic. New cancers, classifications and disease entities continue to be identified. Cancers are graded and staged, and those detected at Stage I, or even earlier at the microscopic stage with a low grade, are often curable. This highlights the importance of screening programmes that identify precancerous and early cancerous lesions.
Vaccination also plays a significant preventive role. Human papillomavirus (HPV) vaccines given to boys and girls between nine and 14 years of age help prevent cancers of the cervix, vagina, anus, penis, and the head and neck. Hepatitis B vaccination helps prevent liver cancer. Research on newer cancer vaccines continues.
Laboratory investigations include blood counts, ESR, renal function tests, liver function tests and amylase. Blood tumour markers include PSA, CA-125, CA 19-9, CA 15-3, CEA, alpha-fetoprotein, chromogranin, HE4, beta-HCG, calcitonin, LDH, NSE and thyroglobulin.
Women should undergo pap smears, visual inspection with acetic acid, colposcopy, colpomicroscopy and HPV DNA testing beginning at 25 years of age and repeated every three years. Pelvic ultrasound and CA-125 testing are advised for women aged 45 years and above. Men above 50 years should undergo PSA testing, per rectal examination and sonography at regular intervals.
Breast cancer screening includes monthly breast self-examination, annual clinical examination, mammography, digital mammography, sonography and MRI where indicated. Liquid biopsy, which analyses circulating tumour DNA, remains under clinical trials.
Diagnosis is confirmed through FNAC, scrapings, fluid cytology and biopsy. Personalised therapy, newer drugs, preventive medicine, robotic and laparoscopic surgery, image-guided procedures, advanced radiotherapy, chemotherapy, immunotherapy, transplants and CAR-T therapy are becoming increasingly important.
Goa requires continuous public education, sustained cancer screening and prevention programmes. Mobile cancer screening and diagnostic units staffed by trained medical and paramedical personnel should regularly serve rural areas and villages. Palliative care services also need to be expanded across the state.
Cancer is the second leading cause of death after cardiovascular disease. According to the World Health Organisation, nearly 92 per cent of people globally will be affected by the impact of cancer at least once during their lifetime.
Prevention remains the most effective strategy. A healthy diet rich in fruits, vegetables, whole grains, cereals, green leafy vegetables, tomatoes, turmeric, garlic and ginger should be encouraged. Fast foods, red meat, smoked and pickled foods, hot dogs, potatoes, and sugary aerated drinks should be avoided. Maintaining a healthy weight through regular exercise, drinking adequate water, practising relaxation, and reducing screen time are equally important.
Cancer has social, emotional, financial, psychological, physical and mental consequences. Preventing it, detecting it early and treating it promptly is a shared responsibility. Together, we must fight cancer.
(The writer is professor of pathology, former head of department and former dean, Goa University, and president, South Asian Academy of Cytopathology and Histopathology)
DR R. G. WISEMAN PINTO
The incidence of cancer is rising across the world, including India and Goa. India records around 1.57 million new cancer cases annually, while Goa reports approximately 1,700 new cases every year.
Several factors contribute to this rising trend such as increased life expectancy, improved methods of diagnosis, better control of infections, changes in diet and lifestyle, the emergence of new infections, new genetic mutations, microplastics, radiation, pollution, insecticides, pesticides, chemicals, the use of hormones in poultry and cattle, smoking, vaping, pan, narcotics and alcohol all play a role. Other important risk factors include lack of exercise, sedentary lifestyles, unhealthy diets, fast foods, aerated drinks, preserved, processed and refined foods, stress, inadequate sleep and obesity.
India and Goa need affordable cancer screening, diagnosis, treatment and palliative care. Health education on cancer risk factors, prevention, screening and early diagnosis should be promoted in schools, colleges, panchayats, municipalities, the print and electronic media, government agencies, NGOs, clubs and religious organisations.
The warning signs of cancer include a persistent cough, hoarseness of voice, difficulty in swallowing, changes in bowel habits, indigestion, headache, unexplained weight loss, loss of appetite, shortness of breath, a sore or ulcer that does not heal, blood in the urine, stools or sputum, bleeding from any site, a lump in the breast or elsewhere, and changes in the colour, size or shape of a mole. If these symptoms persist for more than a month, medical consultation is essential. A doctor will take a detailed personal and family history, conduct a clinical examination and advise appropriate investigations. Many such cases may not be cancer, but it is important to rule it out.
Cancer develops through a combination of genetic, environmental and lifestyle factors. Although cancers are increasingly being seen in younger individuals and around 10 per cent of cases may have a family history, it must be clearly understood that most cancers are neither hereditary nor contagious. Only about one per cent is hereditary or genetic. New cancers, classifications and disease entities continue to be identified. Cancers are graded and staged, and those detected at Stage I, or even earlier at the microscopic stage with a low grade, are often curable. This highlights the importance of screening programmes that identify precancerous and early cancerous lesions.
Vaccination also plays a significant preventive role. Human papillomavirus (HPV) vaccines given to boys and girls between nine and 14 years of age help prevent cancers of the cervix, vagina, anus, penis, and the head and neck. Hepatitis B vaccination helps prevent liver cancer. Research on newer cancer vaccines continues.
Laboratory investigations include blood counts, ESR, renal function tests, liver function tests and amylase. Blood tumour markers include PSA, CA-125, CA 19-9, CA 15-3, CEA, alpha-fetoprotein, chromogranin, HE4, beta-HCG, calcitonin, LDH, NSE and thyroglobulin.
Women should undergo pap smears, visual inspection with acetic acid, colposcopy, colpomicroscopy and HPV DNA testing beginning at 25 years of age and repeated every three years. Pelvic ultrasound and CA-125 testing are advised for women aged 45 years and above. Men above 50 years should undergo PSA testing, per rectal examination and sonography at regular intervals.
Breast cancer screening includes monthly breast self-examination, annual clinical examination, mammography, digital mammography, sonography and MRI where indicated. Liquid biopsy, which analyses circulating tumour DNA, remains under clinical trials.
Diagnosis is confirmed through FNAC, scrapings, fluid cytology and biopsy. Personalised therapy, newer drugs, preventive medicine, robotic and laparoscopic surgery, image-guided procedures, advanced radiotherapy, chemotherapy, immunotherapy, transplants and CAR-T therapy are becoming increasingly important.
Goa requires continuous public education, sustained cancer screening and prevention programmes. Mobile cancer screening and diagnostic units staffed by trained medical and paramedical personnel should regularly serve rural areas and villages. Palliative care services also need to be expanded across the state.
Cancer is the second leading cause of death after cardiovascular disease. According to the World Health Organisation, nearly 92 per cent of people globally will be affected by the impact of cancer at least once during their lifetime.
Prevention remains the most effective strategy. A healthy diet rich in fruits, vegetables, whole grains, cereals, green leafy vegetables, tomatoes, turmeric, garlic and ginger should be encouraged. Fast foods, red meat, smoked and pickled foods, hot dogs, potatoes, and sugary aerated drinks should be avoided. Maintaining a healthy weight through regular exercise, drinking adequate water, practising relaxation, and reducing screen time are equally important.
Cancer has social, emotional, financial, psychological, physical and mental consequences. Preventing it, detecting it early and treating it promptly is a shared responsibility. Together, we must fight cancer.
(The writer is professor of pathology, former head of department and former dean, Goa University, and president, South Asian Academy of Cytopathology and Histopathology)
