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Cancer remains a major public health threat in Pakistan

By Muhammad Qasim
February 05, 2016

Rawalpindi

In last 25 years, Pakistan has witnessed a significant increase in number of cases of various kinds of cancers and the threat claimed not less than 100,000 lives in 2015.

The number of deaths from cancers particularly from lung cancer in males and breast cancer among females is also on the rise in the country. Apart from many other factors, lack of awareness among public about various aspects of the problem is a leading cause of damages due to cancers.

Studies reveal that every year, nearly 300,000 new cases of various kinds of cancers are reported from across the country that adds up to the existing pool of millions of patients of cancer undergoing treatment in Pakistan.

According to health experts, there are number of reasons for the rise in number of cases of cancers though the four main causes include longer life expectancy, more accurate diagnosis, alarming prevalence of Hepatitis B and C and the rise in tobacco use.

Pakistan lacks severely facilities for treatment of cancer patients and various studies have shown that less than 40 per cent of all cancer patients in the country are able to receive health care while diagnostic and treatment facilities are not available to over 60 per cent patients.

Pakistan lacks facilities for even palliative care, the treatment to relieve symptoms caused by cancer. Palliative care can help cancer patients live more comfortably and it is particularly required in the country as a high proportion of patients are living here with advanced stages of cancers with little chance of cure.

It is need of the time to work for establishment of new palliative care facilities at least in all cities of the country and to create sufficient awareness among public on how to minimise the losses caused by cancers in Pakistan, said Head of Community Medicine at CMH Lahore Medical College Professor Dr Muhammad Ashraf Chaudhry while talking to ‘The News’ in connection with World Cancer Day which is being observed on February 4 around the globe.

The theme of World Cancer Day this year is “We can. I can.” The campaign will help raise awareness to show public that everyone can do a lot in fight against cancer. We can stop stigmatising cancer patients, can encourage schools to educate children on how to prevent cancers and can demand government to increase funding for establishing cancer treatment facilities. The campaign stresses on individuals to stop smoking, learn about preventive measures and the ways and means to fight cancer.

Professor Ashraf said that cancer affects everyone -- the young and old, the rich and poor, men, women and children and 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 metastasize to distant sites. Lung, stomach, liver, colon, prostate and breast cancer cause the most cancer deaths each year, he said.

He said that four basic components of cancer control are prevention, early detection, diagnosis and treatment and palliative care. At least one-third to 40 per cent of all cancer cases are preventable, mainly by not using tobacco, using healthy diet, rich in fresh, green vegetables, and being physically active with 30 minutes daily walk, avoiding alcohol, narcotics, and most importantly obesity and preventing infections that may cause cancer. Prevention offers the most cost-effective long-term strategy for the control of cancer, he believes.

To a query, he said aging is the fundamental factor for the development of cancer. The incidence of cancer rises dramatically with age. Life style and environmental factors 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, he said.

He added that one possible promoter in food is fat, especially saturated fat from animal products like red meat. Tobacco use, ‘pan’, ‘chalia’, alcohol use, physical inactivity, being overweight and obese, exposure to occupational carcinogens like asbestos, radiation like ultraviolet and ionizing radiation and excessive X-Rays, low fruit and vegetable intake, excessive consumption of red and preserved meat, estrogens tablets, high fat diet, genetic factors, having unsafe sex, infections from hepatitis B, hepatitis C, HIV, human papilloma viruses, Helicobacter pylori, urban air pollution and indoor smoke from household use of solid fuels are major risk factors of cancer, said Professor Ashraf.

He said everyone should be aware of cancer’s seven warning signals which include 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. “Tobacco is the single largest preventable cause of cancer in the world today. It causes 70 per cent of all lung cancer deaths, and about 30 per cent of all cancer deaths in developing countries.”

He said 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, he said.

He said that vaccination against human papilloma virus (HPV) and hepatitis B virus vaccination (HBV) can prevent cervical and liver cancer respectively. 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, he said.

He added that if prevention fails, catch it early. Unfortunately in Pakistan, a large number of cancer patients presents at an advanced stage due to lack of awareness. About one-third of the cancer burden could be decreased if cases were detected and treated early. Some of the most common cancers -- including breast, colorectal, oral cancer and cervical cancer -- have high cure rates when detected early and treated. The aim is to detect cancer when it is localised, he said.

He said that there is a dire need for a clear national strategy to be formulated on urgent basis in Pakistan to control the spread of cancer. Media should also play its part to create awareness about cancer among the general public. Pakistan still has a long way to go before it can truly claim a breakthrough in its fight against cancer, he said.