C The Big

Early de­tec­tion is im­per­a­tive when it comes to can­cer. We speak to the ex­perts about risk fac­tors, symp­toms and when you should see a doc­tor

Expatriate Lifestyle - - Health, Fitness & Wellness - Words Pa­trick Loh Photo by istockphoto

Can­cer is a killer, even though it doesn’t set out to be so. All it takes is for just one cell to de­cide that it would rather mul­ti­ply more than it should, and start grow­ing out of con­trol. This then forms a tu­mour, which can be be­nign or ma­lig­nant. A be­nign tu­mour only starts to cause prob­lems if it grows so big that it puts pres­sure on nearby tis­sues; but a ma­lig­nant tu­mour is much more dan­ger­ous as it ac­tively at­tacks the body. Can­cer can hap­pen any­where in the body and it’s dif­fi­cult to treat be­cause it’s caused by our own cells go­ing rogue. This means that any treat­ment that could kill the can­cer­ous cells may also end up dam­ag­ing our nor­mal, healthy cells. How­ever, there are mul­ti­ple ways to treat it and get­ting a di­ag­no­sis of can­cer is not an au­to­matic death sen­tence. As with many dis­eases, the best way to fight it is by adopt­ing healthy life­style habits and try­ing to pre­vent it from hap­pen­ing in the first place.

Colorec­tal can­cer

Age is a big risk fac­tor for colorec­tal can­cer, says Dr Christina Ng, Med­i­cal On­col­o­gist at Sun­way Med­i­cal Cen­tre and the founder of Em­pow­ered, a can­cer ad­vo­cacy so­ci­ety. “Those who are aged 50 and above are at the high­est risk. Most colorec­tal can­cers are di­ag­nosed over the age of 60.” Ac­cord­ing to her, your risk of colorec­tal can­cer dou­bles if your fam­ily has a his­tory of hav­ing mem­bers di­ag­nosed with the can­cer be­fore 60 years old. The younger they are when di­ag­nosed, the higher the risk.

Colorec­tal can­cer can be present for sev­eral years be­fore symp­toms ap­pear; th­ese in­clude pass­ing bloody stool, per­sis­tent di­ar­rhoea or con­sti­pa­tion, lower ab­domen cramps and un­ex­plained weight loss. How­ever, it’s im­por­tant to note that th­ese symp­toms may not be due to can­cer. For in­stance, blood in the stool may be due to stom­ach ul­cers, Crohn’s disease or haem­or­rhoids. If symp­toms per­sist for more than two weeks, see a doc­tor im­me­di­ately.

The most ef­fec­tive pre­ven­tion of colon can­cer is the re­moval of pre­can­cer­ous polyps (small bumps) be­fore they turn can­cer­ous, but there is no need to worry un­less they are of the ade­noma type, which can be tu­mours and can de­velop into colorec­tal can­cer over time. “Polyps can of­ten be com­pletely re­moved us­ing a tool dur­ing a colonoscopy,” says Dr Christina.

Peo­ple who have had ade­no­mas should have reg­u­lar screen­ing tests as it can help lower your chances of get­ting colorec­tal can­cer. “Reg­u­lar screen­ing tests are rec­om­mended for those aged 50 and above or younger if you have other risk fac­tors for colorec­tal can­cer,” she ad­vises. Life­style changes play a huge part as well. Visit the gym reg­u­larly and add more greens to your diet. Cut back on smok­ing, al­co­hol and oily food.

Lung can­cer

Lung can­cer af­fects men and women all around the world. “Glob­ally, lung can­cer kills 1.5 mil­lion peo­ple an­nu­ally and re­mains a lead­ing killer can­cer re­gard­less of na­tion­al­ity or eth­nic­ity,” says Dr Anand Sa­chithanan­dan, Con­sul­tant Car­dio­tho­racic Sur­geon with a spe­cial in­ter­est in lung can­cer at Sun­way Med­i­cal Cen­tre.

“There are two main groups of pri­mary lung can­cers; non-small cell lung can­cer and neu­roen­docrine tu­mours, which ac­count for 80 per cent and 20 per cent of cases re­spec­tively,” he says. Such pri­mary tu­mours arise from the lungs it­self but may spread to the brain, bone, lymph nodes, adrenal glands or liver by the blood­stream or lym­phatic sys­tem in a process called metas­ta­sis. Sec­ondary lung tu­mours arise from dif­fer­ent or­gans in the body like kid­ney, colon and breast, be­fore spread­ing to the lungs.

Any can­cer is an in­ter­ac­tion be­tween car­cino­gens – an en­vi­ron­men­tal and di­etary risk fac­tor that trig­gers a can­cer­ous path­way – and a ge­netic pre­dis­po­si­tion. Ac­cord­ing to Dr Anand, each of us has a dif­fer­ent thresh­old or trig­ger be­fore a mu­ta­tion re­sults in a can­cer­ous process.

In re­cent years, cases of lung can­cer have in­creased among non­smok­ing Asian fe­males sim­ply be­cause there is an over-ex­pres­sion of the epi­der­mal growth fac­tor re­cep­tor gene in th­ese in­di­vid­u­als. The can­cer af­fects Malaysian Chi­nese twice as much com­pared to non-chi­nese Malaysians re­gard­less of age and gen­der.

Glob­ally, lung can­cer kills 1.5 mil­lion peo­ple an­nu­ally and re­mains a lead­ing killer can­cer”

In Malaysia, ci­garette smok­ers con­sti­tute 80 to 90 per cent of lung can­cer suf­fer­ers. “Ces­sa­tion of smok­ing is the sin­gle most im­por­tant and pre­ventable step in at­ten­u­at­ing the risk of de­vel­op­ing lung can­cer,” says Dr Anand. Pre­vi­ous scar­ring of the lungs from tu­ber­cu­lo­sis, em­phy­sema, pro­longed ex­po­sure to as­bestos, ex­po­sure to radon gas and pas­sive smok­ing con­trib­utes to the risk as well.

What are the symp­toms of hav­ing lung can­cer? “They in­clude a troublesome per­sis­tent cough for more than two weeks, voice hoarse­ness, re­cur­rent chest in­fec­tions, haemop­t­y­sis, un­ex­plained weight loss and chest pain,” says Dr Anand.

Early stage lung can­cer is usu­ally best treated with surgery to re­move tu­mours. Af­ter suc­cess­ful surgery, the pa­tient may re­quire chemo­ther­apy, im­munother­apy or ra­dio­ther­apy to re­duce the chance of a re­cur­rence.

Gastrointestinal can­cer

Gastrointestinal can­cer is com­mon among food-lov­ing Malaysians. It’s as deadly as colorec­tal can­cer but is the sev­enth most com­mon can­cer in the age group of 50 and above, ac­cord­ing to Dr Ramesh Gu­runathan, Up­per Gastrointestinal & Obe­sity Surgery at Sun­way Med­i­cal Cen­tre.

Gen­er­ally food plays an im­por­tant causative fac­tor, and life­style habits like al­co­hol con­sump­tion and smok­ing come right af­ter. Pre­ven­tive mea­sures like go­ing for reg­u­lar med­i­cal ex­am­i­na­tions for those who are high risk are cru­cial.

Gas­tric can­cers are more com­mon in Malaysians, es­pe­cially the Chi­nese, com­pared to ex­pats. “This is due to the na­ture of food and the preva­lence of a type of bac­te­ria called Heli­cobac­ter Py­lori, which is a can­cer-re­lated bac­te­ria among Malaysian Chi­nese,” says Dr Ramesh. While ex­pats – es­pe­cially from the West – might have a low in­ci­dence of gas­tric can­cer, colorec­tal and oe­sophageal can­cers are com­mon among Cau­casians.

“En­doscopy is a fairly easy way to de­tect early gastrointestinal can­cers,” Dr. Ramesh says. If you are di­ag­nosed early, you’ll also need im­me­di­ate treat­ment as there is a high chance of cur­ing it. Treat­ments in­clude non­sur­gi­cal and sur­gi­cal meth­ods, chemo­ther­apy and ra­dio­ther­apy.

No mat­ter what type of can­cer you might be at risk of, al­ways go for reg­u­lar check-ups. See a doc­tor when­ever you feel any changes in your body as early de­tec­tion means a bet­ter chance to heal. EL

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