As per my personal weekly maintenance ritual I visited one of my favourite beauty spots. The ladies in this salon have groomed me since my internship days and at this point I muse to myself if I have poured out the medical syllabus to them answering their bottomless pit of health related questions! As I settle into the chair and the first question comes nice and easy…. ‘So Doc ma babies bali bwanji (Doc how are the children)?’ After the formalities of answering that question, the pressing issue comes out quick, fast and straight to the point ‘ Elo manje ci cancer camene ici ni cicani? (And now what is this thing called cancer?). It turns out one of the ladies recently lost a close friend to an aggressive form of breast cancer and the news out there is that a cancer diagnosis is equivalent to a death sentence. We go on to discuss cancer and I realise that myths and misconceptions are ripe and ready in the community. So we set on the path to demystifying cancer at least in this beauty parlour.
What is cancer? Cancer is a diverse group of diseases that is characterised by the uncontrolled division of cells of a particular organ in the body. These cells have the ability to spread from their place of origin to other parts of the body. This is called metastases. Think of it as cancerous cells are cells with ‘bad manners’ not respecting the social norms of the body. Any part of your body has the potential to give rise to a cancer. In fact cancer can even arise in the blood system. The fundamentals of understanding cancer, as a layperson, are to know that our bodies are made from a blueprint called genes. When a mistake happens in our blueprint it can give rise to cancer cells, which behave badly as described above. Sometimes this mistake runs in the family and can be passed down from generation to generation. More often than not this mistake can happen ‘out of the blues’. However, there are some factors that surround us that can facilitate this ‘mistake’s’ manifestation into a cancer. We call these risk factors and they can be modifiable (changeable) and non modifiable. Modifiable risk factors are those that we can influence such as choices in food and lifestyle. Non-modifiable risk factors cannot be altered like a person’s age and sex.
In Zambia the most common cancers are cervical cancer, prostate cancer, breast cancer and Kaposi Sarcoma. We do see a whole range of other cancers such as colon, rectum, stomach, liver, lung and skin cancers. And remember cells of any part of the human body can become cancerous so I have not even come close to exhausting the list. Even though there are common things to discuss about all cancers, each type has its own peculiarities that we shall demystify in the coming weeks through this column.
Moving from the doom and gloom of cancer lets unravel the positive things that we can do about cancer. Firstly there are things that we can do to keep cancer from developing, conquering and colonising in our bodies. This is called cancer prevention. Prevention can be primary or secondary. According to the International Agency for Research on Cancer the following levels of prevention exist, primary, secondary and tertiary. ‘Primary prevention is the prevention of disease by reducing exposure of individuals to risk factors or by increasing their resistance to them, and thus avoiding the occurrence of a disease event. Examples of this are vaccinations against viruses that may facilitate cancer development such as HPV and Hepatitis, or removal of polyps to prevent colon cancer. We even have extensive surgeries such as removal of breasts, ovaries and colon for these that have a very strong family predisposition to developing cancers of these organs. ‘Secondary preventionis the early detection and treatment of disease.’ Currently we have 5 big cancers that screening and early detection has proven to make a difference. These are cervical, breast, colon, lung and prostate cancers. Though I must quickly add that in the recent years the scientific community has questioned the effectiveness versus harm of prostate cancer screening which we will cover in the coming issues. Screening activities are an important component of secondary prevention. ‘Tertiary prevention is the use of treatment and rehabilitation programmes to improve the outcome of illness among affected individuals.’
Across the spectrum of these prevention terms the common factor is optimisation of the immune system to keep your body from succumbing to the disease. Effective ways of boosting your immune system are diet, exercise and stress reduction. However these alone cannot fight cancer alone when it has developed into a full-blown disease. One needs appropriate treatment, which indeed can be unpleasant, but it is necessary. It is also prudent to mention that some treatments are aimed to make your immunity super strong and this is the direction of cutting edge immunotherapy.
As we discussed this topic with my salon ladies as to why cancer happens, diet resonates as a big part in cancer prevention. There is a common saying that you are what you eat. It cannot be truer. Food is a very important source of substances, such as antioxidants, that help us fight disease and cancer in general. However certain foods in excess can also promote cancer. Observing the right kind of diet is a whole preoccupation and lifestyle that needs to be adopted amongst us. It is also the one of cheapest yet pivotal form of primary cancer prevention secondary to exercise. In a nutshell a diet as close to nature as possible with as much variety day by day is a good bet to getting it right for you and your loved ones. Next is exercise. I had to stop in mid-sentence as almost all the ladies in the salon burst in to laughter when I mentioned exercise. They happily informed me with all the walking to work and running onto buses they do it is probably not a topic I should consider myself an expert. I happily smile and keep to my lane knowing even though I have been shut down today, in the coming weeks we will tackle it as we demystify this Pandora called cancer.