Concept, genealogy and significance of national cancer awareness day

By Dr. Shaikhali M Barodawala,

He who knows not and knows not that he knows not, is a fool, shun him; 

He who knows not and knows that he knows not, is a student – teach him; 

He who knows and knows not he knows, is asleep – awaken him. 

He who knows and knows that he knows, is wise – Follow him

We can identify ourselves with each of the above statements during various stages of our life and Cancer awareness is no different.

National Cancer Awareness day commemorated on the birth anniversary of Marie Curie (November, the 7th) and World Cancer Day (February, the 4th) remind us of our collective goals of Early detection and Awareness. This year’s World Cancer Day theme is “Close the Care Gap”

Cancer is the second leading cause of death globally, accounting for an estimated 9.6 million deaths. In India, according to the latest Globocan data, Oral cavity, Lung, Colorectal, Stomach, Oesophageal cancer were the most common types of cancer in men, while Breast, Cervix, Ovary, Oral cavity, Colorectal cancers were the most common among women. Similar incidence trends were also observed during the last 2 years.

The key to battling this would be “Early detection” and ‘Being Aware’ of the various type of Risk factors, Screening programs, Treatment modalities and Recent advances. 

Print or Digital/social media campaigns must target the masses as awareness is yet poor among the general population. This may lead to poor uptake of screening modalities and cause delay in diagnosis and hence treatment. 

Risk factors like Tobacco and Alcohol, related to or having causal associations with many cancers have been well documented as well as extensively covered in the media. Other examples include exposure to UV radiation, chemical carcinogens, carcinogenic viruses (like HPV, EBV, HBV and HCV etc), Hormones like oestrogen and progesterone and chronic inflammatory conditions, obesity and lifestyle related.

While most cancers are sporadic, one should also be aware of Hereditary / Familial cancer (5 to 20 % of all cancers) which means being born with a genetic mutation, or change, that makes one more likely than usual to get cancer. Detected through Genetic testing (analysis of genes, chromosomes, or proteins) it’s knowledge can help predict the risk of getting a disease, identify carriers, diagnose and find out the likely course of a disease.

Genealogy is the science of establishing a family tree, an attempt to trace our roots, ancestry and origins, gain insights into our past and use this information the address concerns of the future. Cancer Genealogy is its application to oncology. Obtaining a detailed family history and looking out for certain phenotypic and genotypic characteristics would be the first steps in identifying the risk. The type of cancer(s), age at diagnosis, lineage (maternal or paternal side), ethnicity, affliction of first and second degree relatives, results of any previous cancer-related genetic testing are documented. 

The most well-known examples are the Hereditary Breast and Ovarian Cancers (HBOC), associated with BRCA 1 and 2 genes and Lynch Syndrome (increased risk of developing colorectal and endometrial cancers) associated with Mismatch Repair genes. Their identification in patients and their families, getting screened at regular intervals and opting for preventive treatments in order to mitigate the risks is known. Disseminating this knowledge would get more people/families to screening programs and thus help our medical fraternity, society and nation to battle them better. 

Cancer screening modalities include a combination of blood tests like serum tumour markers, radiology investigations like Mammography, CT and MRI scans, Check endoscopies / colonoscopies, Cytology and Tissue (histopathology) examination and of course the correlation and corroboration of this information by the medical specialist. 

The most well-known example is that of Cervical cancer screening for women in the reproductive age group, which is the Pap smear combined with HPV DNA testing that has helped bring down the incidence by manifold, especially in the last 25 years (The Molecular Pap). Breast cancer screening by dedicated Mammography vans and ambulatory services have had their impact too.

However, this along with information about other cancers needs more media coverage in order to make the National Cancer Awareness Program a more effective and percolative tool, targeting Early detection, allowing patients access to early treatment and care, thereby attempting to improve Disease Free Survival and reducing morbidity – mortality rates.

(The author is MD, Consultant Surgical Pathologist, Metropolis Healthcare Ltd. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)