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85,000 die of cancer in Pakistan every year



Wednesday, February 04, 2009
Muhammad Qasim

Islamabad

Cancer is a leading cause of death globally, particularly in the developing countries like Pakistan where less than 50% of the population is literate and the prospects of having good knowledge about the cancers seem poor.

Cancer is emerging as a major health problem in the country. Pakistan like other developing countries in the region is facing a double burden of diseases with a significant incidence of cancers and a rising trend in risk factor’s profile and incidence itself. The precise incidence, mortality rates, number of new cancer cases and number of deaths annually for Pakistan are not known however according to WHO estimates, as many as 61,624 incident cases and 42,624 cancer deaths annually in males and 75,095 incident cases and 43,188 deaths annually in females are reported.

In Pakistan, a large proportion of cancers presents at an advanced age. Health experts believe that lack of awareness about cancers, their signs and symptoms, is one of the major causes of delayed presentation. Experts say that awareness and education of masses is necessary to combat cancer, which is alarmingly increasing in the country.

“At least one-third to 40% of all cancer cases are preventable, mainly by not using tobacco, healthy diet and being physically active and preventing infections that may cause cancer,” said Professor of Community Medicine at Islamabad Medical and Dental College, Dr. Muhammad Ashraf Chaudhry, while talking to ‘The News’ Tuesday in connection with World Cancer Day which is observed on February 4 all around the globe. “Prevention offers the most cost-effective long-term strategy for the control of cancer.”

Talking of risk factors, Dr. Ashraf said that aging is the fundamental factor for the development of cancer. “The incidence of cancer rises dramatically with age. Lifestyle and environmental factors and the things we eat, drink, whether we smoke or exercise, how much sun we get and where we live have a powerful effect on cancer risk. One possible promoter in food is fat, especially saturated fat from animal products like meat,” he said. Tobacco use, pan, chalia, alcohol use, physical inactivity, being overweight and obese, exposure to occupational (e.g. asbestos) carcinogens, radiation (e.g. ultraviolet and ionising radiation), low fruit and vegetable intake, excessive consumption of red and preserved meat, high fat diet, genetic factors, having unsafe sex, infections from hepatitis B, hepatitis C, HIV, human papiloma viruses, helicobacter pylori, urban air pollution and indoor smoke from household use of solid fuels are major risk factors of cancer.

To a query, Dr Ashraf said that tobacco is the single largest preventable cause of cancer in the world today. “It causes 80-90% of all lung cancer deaths, and about 30% of all cancer deaths in developing countries. A comprehensive strategy including ban on tobacco advertising and sponsorship, tax increases on tobacco products, and cessation programmes can reduce tobacco consumption and can minimise incidence of cancers.” He added that cancer might affect anyone - the young and old, the rich and poor, men, women and children - and it represents a tremendous burden on families and societies.

Cancer is the uncontrolled growth and spread of cells. It can affect almost any part of the body. The growth often invades surrounding tissue and can metastasise to distant sites. Lung, stomach, liver, colon and breast cancer cause the most cancer deaths each year.

Dr Ashraf said that cancer’s seven warning signals (CAUTION) are: change in bowel or bladder habit, a sore that does not heal, unusual bleeding or discharge, thickening or lump in breast or elsewhere, indigestion or difficulty in swallowing, obvious change in wart or mole and nagging cough or hoarseness.

Talking of control on the disease, Dr Ashraf said that four basic components of cancer control are prevention, early detection, diagnosis and treatment, and palliative care. Dietary modification is an important approach to cancer control because there are many promoters and inhibitors in food.

Scientists believe that the food we eat is very important in the growth, or the prevention of cancer. Diets high in fruits, vegetables, whole grains, tomatoes, beans, pulses and legumes and avoiding processed foods high in fat, salt and/or sugar and sugary drinks, have a protective effect against many cancers. “Do not remove skin of fruits, potatoes, pears and apples etc. Avoid fried foods and bakery items. Limit your intake of salty foods such as pickles, nimco, chips etc.

Mothers should breastfeed their infants for at least six months. This practice offers cancer protection to both mother and the child. Drink at least 8 to 10 glasses of water a day,” said Dr Ashraf adding taking multi-vitamin is also not a bad idea.

He added that regular physical activity and maintenance of healthy body weight, along with a healthy diet might considerably reduce cancer risk. “Vaccination against human papiloma virus (HPV) and hepatitis B virus vaccination (HBV) might prevent cervical and liver cancer respectively.” Dr Ashraf believes that avoiding excessive exposure to solar ultraviolet radiation, use of sunscreen, wide-brimmed hats, large sunglasses, and protective clothing are effective preventive measures against skin cancer. “Asbestos can cause lung cancer, aniline dyes have been linked to bladder cancer and benzene can lead to leukaemia. The prevention of certain occupational and environmental exposure to these and other chemicals is another element in preventing cancer.”