Today is the World Cancer Day. Like the last two years, the theme of this day is ‘we can, I can’. In view of the need for reducing the spread of cancer as a disease and the treatment of patients, it was set to celebrate World Cancer Day on 4 February each year. The decision was taken at a coordinated meeting of the International Organization of UICC or the Union for International Cancer Control and several other organizations. Every year more than 8 million people die from cancer worldwide. This day is celebrated to save millions of lives and to make people aware about this killer disease.

It is really alarming that 47% and 55% of total death caused by cancer occur in the developing countries. Experts fear that if the effective measures are not taken from now on, this situation will further deteriorate by 2030. For this reason various meetings, seminars or conferences, rallies, banners-festoons, posters are made so that the general people can know more and may be more aware of this.

In our country, the government and non-government organizations do these tasks also to raise awareness of cancer and to encourage its prevention, detection, and treatment. The common risk factors for getting cancer are smoking, obesity, not eating or eating less vegetables or fruits, not doing physical work, drinking alcohol, living unsafe sex, air and environmental pollution, passive smoking, excessive sunlight contact and also some hereditary risk factors.  One of the preventive measures for cancer is to take human papiloma and hepatitis vaccines and be aware of known risk factors. Generally, people infected with cancer are often negligent; even some societies are untouchable to them.

Many people think that it is a contagious disease and the patient’s attendants will be affected. We all should know that the cancer patients must not be treated apart. Rather we should treat them with all. They have all rights to live with everyone else and to associate with everyone. They can fulfill all their wishes like everyone else. They should be treated as normal and not be neglected socially. They should have full respect and social dignity. On the other hand there is no need to show extra sympathy to them again. Rather, positive behavior and speech will help to get back to their mental stability.

One of the reasons for observing Cancer Day worldwide is to get everyone out of these misconceptions and everyone should know about the causes, symptoms, prevention and treatment of this disease. We have a lot of misconceptions about cancer as well as its treatment. There is always a talk of spending a lot of money in cancer treatment. But most people have no idea how expensive it is.

To treat cancer disease, chemotherapy, radiotherapy and surgery are required. The cost of surgery in Bangladesh is less than any other country of the world. The chemotherapy in our country also does not cost millions of taka like abroad. The breast cancer treatment costs around thirty thousand to one lac taka here only. This figure is not for everyone, but fewer in many cases. Earlier, our country did not have the facility for bone marrow transplant, but now it is possible in 10 lac taka only in this country.

Depending on the stage of cancer or expansion of the disease the treatment cost varies. The first thing to know is that the disease is at which stage and then the patient needs to be treated accordingly. If the diagnosis of disease in the initial stage is done, the cost and complications of treatment are reduced and the success rates are too high. Many types of cancer are now cured. If the disease spreads to different parts of the body, the treatment becomes complicated and the rate of success is also decreased.  In most cases, cancer causes in the elderly patients. Therefore, like cancer, other diseases for example hypertension, diabetes etc. have to be treated properly. Cancer is one of the non-invasive diseases.

Cancer cannot be completely cured. However, it can be possible to prevent the risk factors from doing so. If the symptoms of the disease can be identified before diagnosis of cancer, then the treatment chances can be increased. This is called screening.  Due to the provision of screening in the developed countries, they can be detected in the early stage of the disease.

For this reason, the success of treatment of developed countries is more. The screening system in our country has recently been started. The public should be made aware of this screening so that they come forward to make the screening procedures. Once the cancer treatment is finished, it does not solve all problems. The disease can come back anytime.  That is why after the treatment, regular follow up should be done and as soon as the disease is returned the treatment can be started.

However, it takes a lot of time in our country for cancer to diagnose, because there is no chance of examining histopathology in all the district cities of our country. For this reason, one needs to go to divisional cities or where there are medical colleges. After the disease is diagnosed, its intensity will be known. This means that it has spread to other places or not in the body.

For this reason, ‘PET CT’ will be required. Thus, the decision of the treatment after diagnosing the stage of the disease can be started. Cancer treatment requires surgery, radiotherapy, chemotherapy, hormone therapy, immune therapy, triggered therapies, gene therapy etc. A patient may need all these treatments in the field. Before applying any method, you should know if the patient has physical fitness. That is why you should see heart, lung, liver, kidneys and blood cells are ok. If someone has diabetes, high blood pressure, asthma or any other disease, then he should need extra precautions. Then, at every stage of the treatment, you should see if all is well, whether it is responding to the treatment or side effects. This requires further testing. At the end of treatment, there should be regular follow up also.

Cancer is a complex and incurable disease. Many people cannot be treated because of expensive treatment. Therefore, the mode of lifestyle and some changes in eating habits and regular screening can be performed for its prevention first. Basically, there are seven ways of preventing cancer which includes:

1. Avoid tobacco. Any type of smoking can increase the risk of cancer. Smoking increases the risk of lungs, bladder, kidney and cervical cancer. Chewing tobacco such as Gul, Jarda etc. cause mouth and throat cancer. So by escaping this poison you can get rid of many cancers.
2. Get healthy food. If you are cautious about eating, you can get rid of many other diseases besides cancer. For example, lot of fruits, vegetables and grains will help to prevent cancer. Eat less oil and also eat less animal fats especially the beef and muttons. Although these are high in calories, but weight increases, thereby increases the risk of heart disease and other diseases also. Moreover, intake of alcohol may cause kidney, liver, lung and breast cancer.
3. Control weight properly. Keep your weight control according to your age and height. For this reason, regular exercise as well as balanced diet is must. Do at least 30 minutes of physical work in the day. More weight can be the cause of breast cancer and kidney, prostate gland and lung cancer also.
4. Stay away from the sun ray. Avoid sunlight from 10am to 4pm especially because during this time, the intensity of sunlight is highest.
5. Take antidote vaccine. Presently, some cancers are also called sexually transmitted diseases. Vaccination against some viruses will help you to avoid cancer. For example, hepatitis B vaccine prevents liver cancer. Those who are at risk for sexually transmitted diseases must take this vaccine. In addition, human immunodeficiency virus vaccine can be prevented from cervical cancer.
6. Change the risky behavior. Safe sex life will help you to survive from many cancers such as uterus, sebaceous and oral cancer. Those who are polygamous must use condoms and vaccinations are necessary for them. But changing this habit is possible to be safe. Besides, many injections of the same index help in the spread of diseases such as cancer and AIDS. Those drug addicts are at risk of these diseases.
7. Take the initiative to diagnose the disease at the very beginning, which we call screening. This means that the cancer of these places can be detected easily or initially by examining breast exams or skin, intestines or colon, prostate and cervical through the help of physicians and themselves. These cancers can be cured if detected early on.

So it can be seen that if you are warned about a little or you take action, the killer cancer can be prevented. In the developed countries, the screening issue has become quite widespread. It is possible to launch it in our country if we are a little aware. Our awareness can protect us from this disease. As the disease progresses rapidly due to cancer, it should be taken urgently to increase public awareness on this issue. World Cancer Day is a great opportunity to spread it and its harmful aspects through world media.

Dr. A K Lutful Kabir, Associate Professor of Pharmacy, University of Dhaka
E-mail: lutful@du.ac.bd