Eulalee ThompsonA DIAGNOSIS of cancer still causes pangs of fear and dread in a patient. This reaction is understandable since cancer is the second leading cause of death in Jamaica, and medical science, after all these years, has not yet identified its cause and therefore cannot create a cure.
They know that a tumour develops when there is abnormal multiplication of cells. The tumour is benign when it is restricted to a single site but when adjoining tissues are invaded by the multiplying cells then it becomes malignant or cancerous. The scientists, however, are not sure why the cells multiply abnormally. Some associations have been made between malignancy and diet, biology, chemical agents, the environment and genetics.
But, in the meantime, there are actions that individuals can take against a cancer threat. Dr. Denise Chevannes-Vogel, Jamaica Cancer Society's (JCS's) administrative director, says that the population can focus more on lifestyle adjustments, prevention and early detection by doing regular screening tests.
A screening test is, for example, the regular PAP smear examination to detect cervical cancer; the digital rectal examination and PSA (prostate specific antigen) or the breast self examination and mammograms to detect malignant lumps in the breast.
"Many cancers are preventable through the control of tobacco use, diet, infection and environmental pollution. It is estimated, for instance, that infections - many potentially preventable - cause 15 per cent of cancers worldwide and 22 per cent of cancers in the developing world," she said.
Also, millions are dying of cancer every year because they use tobacco and new cancers are being created each year when people smoke.
Dr. Chevannes-Vogel said that early detection of most cancers will result in a more favourable outcome and the treatment of many pre-cancerous conditions will actually prevent the development of cancer. Early detection is of particular importance to people with a genetic predisposition to certain types of cancer or whose lifestyle and employment put them at high risk for cancer.
The statistics indicate, however, that even while the incidence of some cancers is increasing fewer Jamaicans are opting to take the screening tests. The experts believe that some of them are afraid of what the results might be, others are unaware of the tests or have difficulty accessing them.
Cancer Awareness Month 2001 is focusing on four cancers - colorectal, breast, cervix and prostate.
Colorectal cancer, Dr. Chevannes-Vogel said, is the third most common cancer in men and women. Preliminary data from the Jamaica Cancer Registry indicates an 18.6 per cent increase of this cancer in women in 1993 to 1997 over the previous period 1988 to 1992 while in men the increase was 0.7 over the same period. Risk factors include a personal or family history of colorectal cancer or polyps; a high-fat and/or low-fibre diet; inadequate intake of fruits and vegetables and physical inactivity.
Breast cancer can be effectively controlled, Dr. Chevannes-Vogel said, when it is diagnosed early. There are in fact, many survivors of this cancer in Jamaica. Simply being a woman puts one at risk for this cancer. The JCS advocates that all women do a baseline mammogram between the ages of 35 and 39 and then an annual mammogram from the age of 40. The mammogram will indicate whether there is a lump in the breast.
Cervical cancer is the second most common cancer in Jamaican women but Dr. Chevannes-Vogel emphasised that it was the most common cancer in women aged 15 to 24 years in Kingston and St. Andrew.
"This is an unacceptable statistic given that a simple screening test (the PAP Test) can detect abnormalities up to 10 years before they degenerate into cancer. However, a study recently found that 90 per cent of women who die from cervical cancer have never been screened," she said.
Prostate cancer is the most common cancer in men and all men are at risk. Dr. Chevannes-Vogel said that the most common risk factor is age with more than 75 per cent of men positively diagnosed being older than 65. She said that there is some evidence that a diet higher in animal fat, may partly be the reason for a difference in the incidence of prostate cancer between countries. She also identified a genetic association and a family history of this cancer as risk factors.
Observe bodily changes
DR. DENISE Chevannes-Vogel, Jamaica Cancer Society's administrative director indicates that early detection of cancer refers not only to the laboratory tests, but simple observations, by each person, of bodily changes. Here are some symptoms to look for:
Change in your bowel or bladder habit, bleeding from the rectum are linked to colorectal cancer.
A sore that does not heal, but gradually gets bigger; an old mole that changes in size or colour; an old lesion on the skin that begins to grow are may be symptoms of skin cancer.
Lumps or thickening in the breast; deformity in the nipple may be symptoms of breast cancer.
Difficulty in swallowing may be linked to cancer of the oesophagus.
A persistent cough; transient sneezing; spitting blood may be linked to lung cancer.
Abnormal bleeding, spotting or abnormal discharge may indicate cervical cancer.
Episodes of vaginal bleeding which is not related to the regular menstruation cycle may be linked to cancer of the uterus.
Blood in the urine, urinating more frequently may be linked to cancer of the bladder.
Blood in the urine, tiredness, loss of appetite and weight may be linked to cancer of the kidney.
Hoarseness that cannot be explained, then later, difficulty breathing may be linked to cancer of the larynx.
Persistent distress in the upper abdomen; loss of appetite and weight may be symptoms of stomach cancer.
An ulcer or wart on the lip may indicate cancer.
A rough area in the mouth, later an ulcer and burning when eating highly-seasoned food may be symptoms of cancer of the mouth and tongue.
Fever, pallor, blood into the tissues and generally vague symptoms may indicate blood cancer (leukaemia).
