By Sola Ogundipe
You can, I can” is the theme for World Cancer Day 2017, today February 4, which takes a positive and proactive approach to the fight against cancer, highlighting that solutions do exist and that they are within reach. According to the World Health Organisation, WHO, over 100,000 Nigerians are diagnosed with cancer annually, and about 80,000 die from the disease; this comes to 240 Nigerians every day or 10 Nigerians every hour, dying from cancer. The Nigerian cancer death ratio of 4 in 5 is one of the worst in the whole world.
The WHO reveals that cervical cancer which is virtually 100 per cent preventable kills one Nigerian woman every hour. Breast cancer kills 40 Nigerians daily while prostate cancer kills 26 Nigerian men daily. These three common cancers alone, kill 90 Nigerians daily. This alarming death rate is mainly due to poor infrastructure to deal with the problem.
Cancer is a class of diseases characterized by out-of-control cell growth. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected. Cancer harms the body when altered cells divide uncontrollably to form lumps or masses of tissue called tumours (except in the case of leukemia where cancer prohibits normal blood function by abnormal cell division in the blood stream).
Tumours can grow and interfere with the digestive, nervous, and circulatory systems, and they can release hormones that alter body function. Tumours that stay in one spot and demonstrate limited growth are generally considered to be benign.
More dangerous, or malignant, tumours form when two things occur: a cancerous cell manages to move throughout the body using the blood or lymphatic systems, destroying healthy tissue in a process called invasion that cell manages to divide and grow, making new blood vessels to feed itself in a process called angiogenesis.
When a tumour successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a serious condition that is very difficult to treat. Cancer is one of the most common causes of death in Nigeria.
Types of cancers
There are over 200 different types of cancers. Every organ in the body may develop cancer, considered to be one of the leading causes of morbidity and mortality worldwide. The financial costs of cancer in Nigeria exceeds $500 million in medical costs and lost productivity annually. The most common sites of cancer among men are lung, prostate, colon, rectum, stomach and liver. The most common sites of cancer among women are breast, colon, rectum, lung, cervix and stomach.
How cancer spreads
Scientists say cancer cells spread as a result of their adhesion (stickiness) properties. Certain molecular interactions between cells and the scaffolding that holds them in place (extracellular matrix) cause them to become unstuck at the original tumor site, they become dislodged, move on and then reattach themselves at a new site.
Causes of cancer
Cancer is ultimately the result of cells that uncontrollably grow and do not die. Normal cells in the body follow an orderly path of growth, division, and death. Programmed cell death is called apoptosis, and when this process breaks down, cancer begins to form. Unlike regular cells, cancer cells do not experience programmatic death and instead continue to grow and divide. This leads to a mass of abnormal cells that grows out of control.
Genes – the DNA type
Cells can experience uncontrolled growth if there are mutations to DNA, and therefore, alterations to the genes involved in cell division. Four key types of gene are responsible for the cell division process: oncogenes tell cells when to divide, tumor suppressor genes tell cells when not to divide, suicide genes control apoptosis and tell the cell to kill itself if something goes wrong, and DNA-repair genes instruct a cell to repair damaged DNA.
Cancer occurs when a cell’s gene mutations make the cell unable to correct DNA damage and unable to commit suicide. Similarly, cancer is a result of mutations that inhibit oncogene and tumor suppressor gene function, leading to uncontrollable cell growth.
Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. Theses free radicals damage cells and affect their ability to function normally.
Genes – the family type
Cancer can be the result of a genetic predisposition that is inherited from family members. It is possible to be born with certain genetic mutations or a fault in a gene that makes one statistically more likely to develop cancer later in life.
Cancer and other medical factors
As we age, there is an increase in the number of possible cancer-causing mutations in our DNA. This makes age an important risk factor for cancer. Several viruses have also been linked to cancer such as: human papillomavirus (a cause of cervical cancer), hepatitis B and C (causes of liver cancer), and Epstein-Barr virus (a cause of some childhood cancers). Human immunodeficiency virus (HIV) – and anything else that suppresses or weakens the immune system – inhibits the body’s ability to fight infections and increases the chance of developing cancer.
Treatment & prevention
There are conflicting reports about cancer prevention. Sometimes the specific cancer-prevention tip recommended in one study or news report is advised against in another. In many cases, what is known about cancer prevention is still evolving. However, it’s well-accepted that chances of developing cancer are affected by the lifestyle choices you make.
Cancer treatment is a huge problem, so prevention is best. Nigerians spend $500 million annually on treatment abroad. Unfortunately, the outcome for Nigerians who embark on cancer-related medical tourism is often poor, because of late detection. Cancer constitutes a preventable major drain on our human and financial resources. According to WHO, one- third of all cancers can be prevented; another one- third can be effectively cured with early diagnosis; whilst palliative care can improve the quality of life of the last third.
Cervical cancer in particular, underscores the fact that cancer is preventable, and epitomizes the cost-effectiveness of investing in preventive health care. It is the easiest of all cancers to prevent. Cervical screening is the best cancer screening test in the history of medicine and the most cost effective of all medical screening tests.
The screening is painless and takes only about 5 minutes. The tissue changes that lead to cervical cancer usually develop very slowly (over a period of about five to thirty years). Screening can find these changes before cancer develops. Pre-cancer changes are easy to treat by an outpatient procedure lasting 15 minutes. Consequently, cervical cancer is now a disappearing disease in the western world, while it remains the number one cancer killer of African women.
Screening & early detection
One of the ways to reduce cancer mortality rates is to improve early diagnosis strategies. This is the message. There are two ways of improving cancer detection: screening and early diagnosis. While screening seeks out asymptomatic cancers or precancerous lesions without symptoms, early diagnosis is the identification of symptomatic cancer cases in the very early stages of the disease.
Some simple lifestyle changes can make a big difference. Consider these seven cancer prevention tips.
Don’t smoke – Using any type of tobacco puts you on a collision course with cancer. Smoking has been linked to various types of cancer — including cancer of the lung, mouth, throat, larynx, pancreas, bladder, cervix and kidney. Chewing tobacco has been linked to cancer of the oral cavity and pancreas. Even if you don’t use tobacco, exposure to secondhand smoke might increase your risk of lung cancer. Avoiding tobacco — or deciding to stop using it — is one of the most important health decisions you can make. It’s also an important part of cancer prevention. If you need help quitting tobacco, ask your doctor about stop-smoking products and other strategies for quitting.
Eat a healthy diet – Although making healthy selections a the shops and at mealtime can’t guarantee cancer prevention, it might help reduce your risk. Eat plenty of fruits and vegetables. Base your diet on fruits, vegetables and other foods from plant sources — such as whole grains and beans.
Avoid obesity – Eat lighter and leaner by choosing fewer high-calorie foods, including refined sugars and fat from animal sources. If you choose to drink alcohol, do so only in moderation. The risk of various types of cancer — including cancer of the breast, colon, lung, kidney and liver — increases with the amount of alcohol you drink and the length of time you’ve been drinking regularly.
Limit processed meats – Eating large amounts of processed meat can slightly increase the risk of certain types of cancer. Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts might have a reduced risk of breast cancer. The Mediterranean diet focuses on mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts. People who follow the Mediterranean diet choose healthy fats, like olive oil, over butter and fish instead of red meat.
Maintain healthy weight and be physically active – Maintaining a healthy weight might lower the risk of various types of cancer, including cancer of the breast, prostate, lung, colon and kidney. Physical activity counts, too. In addition to helping you control your weight, physical activity on its own might lower the risk of breast cancer and colon cancer. Adults who participate in any amount of physical activity gain some health benefits. But for substantial health benefits, strive to get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic physical activity. You can also do a combination of moderate and vigorous activity. As a general goal, include at least 30 minutes of physical activity in your daily routine — and if you can do more, even better.
It is believed that cancer risk can be reduced by avoiding tobacco, limiting alcohol intake, limiting UV ray exposure from the sun and tanning beds and maintaining a healthy diet, level of fitness and seeking regular medical care. Screening can locate cervical cancer, colorectal cancer and breast cancer at an early, treatable stage.