Yes, you can win the battle vs cancer

The number of people suffering from cancer could soar by 50 percent in 2020, according to a World Health Organization report published in April 2004, which called for a global strategy to stem the rise of the Big C. In the Philippines, the year-long campaign on cancer awareness for 2005 is spearheaded by the Philippine Cancer Society (PCS), under the able leadership of its president, Dr. George G. Eufemio. Another significant event this year was the opening of the Philippines’ most modern, world-class cancer diagnosis and treatment facility at the Cardinal Santos Medical Center last month.

The estimated 10 leading cancer sites and new cases of cancer in 2005 among Filipino males are: 1) lung – 13,273, 2) liver – 5,660, 3) colon/rectum – 4,737, 4) prostate – 4,254, 5) stomach – 2,368, 6) leukemia – 2,243, 7) nasopharynx – 1,990, 8) oral cavity – 1,563, 9) non-Hodgkin’s lymphoma – 1,468, and 10) larynx – 1,464.

In Filipino women, the estimated 10 leading cancer sites and new cases of cancer this year are: 1) breast – 14,043, 2) cervix uteri – 7,277, 3) lung – 3,965, 4) colon/rectum – 3,848, 5) ovary – 3,283, 6) thyroid – 2,766, 7) liver – 1,969, 8) leukemia – 1,959, 9) corpus uteri – 1,777, and 10) stomach – 1,564.

The figures are scary but despite the grim forecast backed by a litany of trends and unhealthy lifestyles that promote the disease, the report carries a message: It doesn’t have to be this way. Fighting some of the main cancer-causing agents – tobacco consumption and infections – and promoting a healthy diet could head off a third of new cancer cases while another third could be cured by early detection and treatment.

"We don’t need new science," saiys Dr. Bernard Stewart, co-editor of the 351-page World Cancer Report and a cancer expert at Australia’s University of New South Wales medical school. "Rather, what we need is focused and urgent action by government and health workers, and people themselves, to help manage the global burden. It is felt that societies must now change their priority from treatment and detection to prevention," the report says. So here’s a guide to two of the major cancers and what you can do to dodge them:

Breast

It’s the cancer that Filipino women are most likely to get (25.6 percent). Still, only lung cancer claims the lives of more women, thanks to its dismal survival rates. Due to better awareness about the disease, death rates appear to have dropped following earlier diagnosis and treatment. But that’s little comfort to the loved ones of the 6,357 Filipino women expected to succumb to this illness this year.

• Lowering your risk. Among the risk factors you can’t change: Women with a sister, mother, or daughter who has had breast cancer have two to four times the average risk of getting the disease. And the older you are, the higher your risk, up until age 80, when the risk levels off. Hormones play a critical role. Estrogen promotes breast cancer, so the longer women are exposed to it, the more vulnerable they are. That’s why women who start menstruating at a young age (under 12) or who stop late (at age 55 or older) have a higher risk.

"Research on fruits and vegetables, fat, meat or dairy foods, and organochlorine pesticides hasn’t panned out," says Regina Ziegler of the US National Cancer Institute’s Division of Cancer Epidemiology and Genetics. "And it’s too simple to say that soy is protective." Soy’s plant estrogens may act like estrogen rather than compete with the hormone. "So we can’t rule out that soy increases breast cancer risk."

The strongest lead: "Obesity is now widely accepted as a risk factor for breast cancer, and that’s a big change over the past few years," Ziegler explains. "Heavy women have a lower risk of premenopausal breast cancer, but once women hit their 40s, and certainly by their 50s, being overweight increases their risk." How excess weight might make women more vulnerable is still uncertain. Estrogen is one part of the story. Fat cells convert hormones called androgens into estrogens, which raises a woman’s risk. Researchers are also looking at lack of exercise as a risk factor. "Physical activity probably reduces the risk of breast cancer, but we don’t know exactly how much you need," says Ziegler.

The only other consistent link with diet: "Alcohol, even in moderation seems to increase the risk," she adds. However, alcohol may not raise the risk of breast cancer in women who get at least 30 mcg. a day of the B-vitamin folate (folic acid). In one study, women who drink one serving of alcohol a day and took a multivitamin – which typically supplies 400 mcg. of folate – had a 25 percent lower risk of breast cancer than those who didn’t take a multivitamin.

• Warning signs. Mammograms should detect the earliest signs, but women may also detect a lump, thickening, swelling, distortion, or tenderness in the breast, irritation or dimpling of the skin, or pain, scaliness, ulceration, or retraction of the nipple.

Colon And Rectum

Roughly nine out of 10 colorectal cancers are preventable. What’s more, most tumors start out as polyps, or benign growths, in the colon. Remove them before they turn into cancer and you prevent the disease. Screening tools like colonoscopies have made it easier to do that.

• Lowering your risk. "There’s a long list of behaviors that can lower your risk of colorectal cancer," says Tim Byers of the University of Colorado Health Sciences Center. Byers is co-chair of the American Cancer Society’s Nutrition and Physical Activity Guidelines Advisory Committee.

Although most people expect to see a fiber-rich diet heading the list, recent trials have found no fewer polyps in people who were told to eat fiber-rich grains, fruits, and vegetables than in those who were not. Still, Byers maintains that "the biggest body of evidence suggests that fruits and vegetables are protective."

Other studies find a higher risk in red-meat-eaters, smokers, and people who drink more than one serving of alcohol a day. In contrast, folate seems to lower colon cancer risk. And few people realize that extra pounds pose a threat to your lower gastrointestinal tract. "Weight control and staying physically active – either alone or in combination – can lower your risk," says Byers. "Some researchers argue that the risk only drops with vigorous physical activity, but many studies show that the biggest risk comes from being sedentary. If you just get off the couch and do something, your risk begins to drop."

And although fiber doesn’t seem to lower the risk of new polyps, other things have. "Calcium supplements and aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen seem to lower the risk by 10 to 20 percent," says Byers.

Still, he adds, the long list of behaviors that lower your risk gets trumped by screening. Even if you aren’t overweight or sedentary, and you eat fruits and vegetables and take aspirin, calcium, and a multivitamin with folate, you should still be screened to see if you’ve got polyps.

"Screening could mean a colonoscopy every 10 years once you’re 50 or a flexible sigmoidoscopy every five years. "It’s worth changing your behavior to lower your risk," says Byers. "But the risk never drops enough that you don’t need screening."

• Warning signs. Blood in stool or rectal bleeding, a change in stool shape, a cramping pain in the lower stomach, an urge to have a bowel movement when there is no need to have one.

Take-Home Message

Yes, cancer rates are set to increase at an alarming rate in the coming years, but we can make a difference by taking action today. Studies suggest that simple measures like proper nutrition and adopting a healthy lifestyle could help cut new cases of cancer significantly.

But the take-home messages are these: One-third of all cancers are preventable. Another third of all cancers can be cured if they are detected early. And all cancer patients with distressful symptoms can be treated today with adequate palliative care that can result in an acceptable quality of life.

Yes, you can beat cancer!