It starts as a single cell and grows into a merciless disease that claims millions of lives year after year. Cancer, as the disease is called, is now one of the leading killers around the world. It accounts for 6 million or 12 percent of deaths globally, according to the Geneva-based World Health Organization (WHO).
Fifty-eight percent of those who succumbed to cancer come from developing countries. In the Philippines, cancer is the third leading cause of morbidity and mortality—after diseases of the heart and the vascular system.
The Department of Health (DOH) reports that the six most common sites of cancer among men are lung, liver, colon/rectum, prostate, stomach and leukemia. In comparison, the six most common sites among women are breast, cervix, lung, colon/rectum, ovary and liver.
For every 100,000 Filipinos, some 189 people are afflicted with cancer while four die of cancer every hour, according to a study conducted by the University of the Philippines’ Institute of Human Genetics, National Institutes of Health.
Based on recent data released by the health department and the Philippine Cancer Society Inc. (PCSI), nine people are diagnosed with cancer every hour.
“Cancer remains a national health priority in the country with significant implications for individuals, families, communities and the health system,” the health department points out.
But there’s a good news. President Duterte recently signed the bill that seeks to implement a national framework to fight cancer. On February 14, he affixed his signature to Republic Act 11215 or the National Integrated Cancer Control Act.
The new law states that it “shall adopt an integrated and comprehensive approach to health development which includes the strengthening of integrative, multidisciplinary, patient, and family-centered cancer control policies, programs, systems, interventions and services at all levels of the existing health-care delivery system.”
In addition, the law aims to establish the National Integrated Cancer Control Program, which seeks to prevent deaths caused by cancer by providing “affordable and accessible” medical treatment.
Health experts said there are more than 100 types, but all have in common: an uncontrollable growth and spread of abnormal cells. Many people mistakenly believe a diagnosis is a death sentence.
Cancer, which comes from the Greek word karkinos, which means “crab,” is a group of cells that has lost its normal control mechanisms and has an unregulated growth,
“Cancerous [malignant] cells can develop from any tissue within any organ,” explains The Merck Manual of Medical Information. “As cancerous cells grow and multiply, they form a mass of cancerous tissue—called a tumor—that invades and destroys normal adjacent tissues.”
The term “tumor” refers to an abnormal growth or mass; it can be either cancerous or noncancerous. Cancerous cells from the primary (initial) site can spread (metastasize) throughout the body.
Science tells us that each time a human cell divides, it must replicate its DNA, a biochemical manuscript some 3 billion characters long. In the course of transcribing such a lengthy document, even a skilled typist could be expected to make mistakes, and cells, like typists, occasionally err. The mistakes they make are minor and quickly repaired by proteins that serve as miniature mechanics.
More often than not, cells with defects in their DNA will continue to divide, eventually forming small growths.
“The more cell-division cycles an organism undergoes, the more likely it is to accumulate colonies of abnormal cells, each of the offspring of a single progenitor,” wrote Time science writer J. Madeleine Nash. “By the time humans reach middle adulthood, then their bodies contain millions of cells that have taken at least one step toward cancer.”
The US National Cancer Institute gives this information on the differences between normal cells and cancer cells: “Cancer cells differ from normal cells in many ways that allow them to grow out of control and become invasive. One important difference is that cancer cells are less specialized than normal cells. That is, whereas normal cells mature into very distinct cell types with specific functions, cancer cells do not. This is one reason that, unlike normal cells, cancer cells continue to divide without stopping.”
On how cancer develops, the Merck manual gives specific details. “Cancerous cells develop from healthy cells in a complex process called transformation,” it explains. “The first step in the process is initiation, in which a change in the cell’s genetic material [in the DNA and sometimes in the chromosome structure] primes the cell to become cancerous. The change in the cell’s genetic material may occur spontaneously or be brought by an agent that causes cancer [carcinogen].”
Carcinogens include many chemicals (arsenic, asbestos, benzene, and nickel, to name a few), tobacco, viruses, radiation and sunlight. A person exposed to a carcinogen (by breathing, eating or touching it for long periods) does not necessarily mean he or she will certainly be afflicted with cancer, the PCSI said. “It only increases the possibility,” it added.
“However, not all cells are equally susceptible to carcinogens,” the Merck manual says. “A genetic flaw in a cell may make it more susceptible. Even chronic physical irritation may make a cell more susceptible to carcinogens.”
Promotion is the second and final step in the development of cancer. “Agents that cause promotion are called promoters,” the Merck manual says. “Promoters may be substances in the environment or even some drugs [such as barbiturates]. Unlike carcinogens, promoters do not cause cancer by themselves. Instead, promoters allow a cell that has undergone initiation to become cancerous. Promotion has no effect on noninitiated cells. Thus, several factors, often the combination of a susceptible cell and a carcinogen, are needed to cause cancer.”
“What makes cancer very dangerous is that if not detected early and treated promptly, cancer cells have the capability of spreading not only by direct infiltration of the immediate surrounding area, but also transfer and grow in distant areas by passing through the blood stream and the lymphatic system,” one of the country’s noted oncologists once pointed out.
The most important factor that affects the chances for the cure of cancer is the stage at which it is detected. Two out of six cancer cases in the Philippines are cured, medical experts claimed. “But three out of six could have been cured, if only diagnosed earlier,” they maintained.
Among men, prostate cancer tops, while breast cancer is the No. 1 among women. “This disease is a traitor,” said an oncologist of breast cancer, which killed film director Marilou Diaz-Abaya and Hollywood actress Ingrid Bergman. But he added that “when detected early, it can be cured.”
By cured, the oncologist meant that there has been no activity for five years. “But even after 20 years, nagigising iyan,” the doctor said. “So, I advise my patients to go for regular check-ups even with the family doctors. Early detection is still the key—breast or any other kind of cancer.”
The PCSI, a private social welfare organization, said there is no such thing as cancer for the rich and cancer for the poor. “People in the urban areas, however, have higher risk of getting cancer,” it said in a statement. “Whether or not there are less cases in the rural areas is hard to tell. Generally, cancer cases in remote barrios are not reported.”
Because cancer is more likely to be cured if treated early, it is critical that cancer be discovered early. “Some symptoms may give early warning of cancer and should, therefore, trigger a person to seek medical care,” the Merck manual says. “Fortunately, most of these symptoms are usually caused by far less serious conditions. Nonetheless, the development of any of the warning signs should not be ignored.”
Some of the warning signs are general; that is, they are vague changes that do not help pinpoint any particular cancer. Still, their presence can help direct doctors to perform the physical examinations and laboratory tests necessary to exclude or confirm a diagnosis. Other symptoms are more specific and steer doctors to a particular kind of cancer or location.
Some warning signs of cancer, according to the Merck manual, are weight loss, fatigue, night sweats, loss of appetite, new and persistent pain, recurrent nausea or vomiting, blood in urine, blood in stool (either visible or detectable by special tests) and sudden depression.
Other common signs and symptoms of cancer are recurrent fever, chronic cough, a recent change in bowel habits (constipation or diarrhea), changes in the size or color of a mole or changes in a skin ulcer that does not heal, and enlarge lymph nodes.
“Cancer may be present in very many ways: as a lump, some change in body function, bleeding, anemia or weight loss,” says The New American Desk Encyclopedia. “Less often tumors produce substances mimicking the action of hormones or producing remote effects such as neuritis.”
Neuritis is any disorder of the peripheral nervous system, which interferes with sensation, the nerve control of muscle or both.
“Cancer is a complex disease, but other viral diseases have been nearly wiped out through vaccination,” commented the Professional Health Media Services. “Perhaps such a vaccine [or vaccines] will be developed to prevent cancer. But until such vaccines are developed, there is much that a person can do about cancer.”
Medical scientists claim cancer is neither infectious nor contagious. In fact, it is not hereditary, assured most oncologists. “The fact that cancer has occurred in a family is no cause for anxiety,” they stressed. “But people whose close relatives have cancer should have more regular checkups because of familiar tendency.”
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