Facts/Myths About Cancer

Facts / Myths About Cancer

After the open revelation by the actress Angelina Jolie about her double mastectomy, suddenly there seem to be a new anxiety among people about the disease. Within days of receiving this news another business man in London, aged 53 and father of two has opted for prostate gland removal operation. Since the decision about mastectomy has been taken by a superstar, the gravity of the entire situation has taken a new turn. Thus, it leaves a big question-are these operations going to be more common? How should be problem be redressed?

Hence it would be of great significance to know the number of deaths caused by cancer. According to WHO reports it is the leading cause of deaths in the entire world accounting for 7.6 million deaths (nearly 13%of all deaths, 2008 reports) every year. Of them, lung, stomach, liver, colorectal, breast and cervical cancer account to majority of cancer deaths. Nearly 30% of cancers occur due to five behavioural habits- like high Body Mass Index, low intake of fruits and vegetables, lack of physical activity, tobacco and alcohol use. It is alarming to note that nearly 22% of all cancers and 70% of global lung cancers are caused by tobacco alone.

Coming back to the issue of the mastectomy, we first need to look at its significance, its need, affordability, reliability of the cancer tests and the surety (of cancer avoidance). There are so many aspects to be considered before arriving at the decision. The most important factor to be considered is the incidence of cancer among the first-degree members of the family, like sister or the mother, in case of breast cancer. This increases the risk of cancer by three fold in case of breast cancer. The gene BRCA 1 and 2 are the genes responsible for the malignant tumours. They produce DNA stabilising proteins and carry on housekeeping function in many tissues but are found in higher levels in breast tissue. When the genes undergo mutation, normal functioning of the proteins is affected. Thus, the cell become defective and leaves a scope for abnormal multiplication of cells resulting in cancers like ovarian and pancreatic cancer; testicular, prostate and a rare form of breast cancer in men. Though so much study has been carried on these genes, BRCA screening data failed to arrive at clear results. Genes are just crucial factor for testing the level of the risk but they alone are not the only means for occurrence of cancer. Only 5-10% of breast cancers are inherited. There are nearly 100 gene mutations for BRCA1 and 2 and the level of risk in case is not clearly known. Moreover, the incidence is often affected by the life style of the individual and the environmental factors as well.

Well, there are several less expensive methods can be followed to keep the risk at bay. Those include annual mammography after 40 years of age for women, physical examination of breasts; annual MRI scan can reveal minute details of the microscopic malignant tumours, use of anti-cancer drug tamoxifen may reduce the risk by 40% to 50%.

In countries like India, where the awareness about the disease itself is much less, gene testing is still in infancy. There are very few people who are ready to take the tests. Tests are often advised to the people who have genetic disposition for the disease. The psychological stress of the tests puts the patients in a very difficult situation. Genetic counselling helps to cope up with the stress to certain extent. But unfortunately, counselling sessions are very expensive and the personnel are not so well trained in India.

In case of Jolie, the gene mutation she carried has put her at risk of breast cancer at 87% and to ovarian cancer at 50%. After mastectomy, doctors predicted that her risk fell from 87% to 5%. Removal of breasts doesn’t seem to reduce the incidence of ovarian cancer. Ovarian cancer is considered to be deadlier and harder to detect. The prophylactic oophorectomy –removal of ovaries, surgery is less complex. Removal of ovaries drastically reduces the levels of estrogen, this can halt or slow the breast cancers as they need the hormone to grow. But this might fuel other forms of cancer.

Unlike Americans, Indians are not very aggressive in seeking prophylactic treatment. What needs to be understood is that every patient is different and what has been an individual decision (in case of Jolie) may not hold good for all the persons.

@ Copyrights reserved.