Cancer : Q&A with Apollo’s Dr Anil D’Cruz

1) How can we detect cancer in its very early stage?

Asha Borse
Mumbai

Cancer can be detected in an early stage by us being aware of the warning signs, the early symptoms, and the early manifestations of cancer. Any change in bowel or bladder habits, any new lump or thickening, particularly in the breast of a lady as she gets older, if you have unusual bleeding from any orifice of the body, be it the nose, be it in the cough, be it in urine, be it in stools, or in females bleeding through the vagina, indigestion, bloating of the stomach, the abdomen, or all signs that you may be harboring an abdominal cancer.

Lung cancer is the commonest and if you’re a smoker, a nagging cough, change in voice, could indicate early lung cancer. Head and neck are the commonest cancers in our country and amongst that oral cancer is particularly common.

Any growth or a patch in the cheek, particularly for a tobacco user, needs the patient to be seen by a specialist to diagnose cancer at its early stage.


2) What are the symptoms of cervical cancer?

Juli Anandraj
Pune

Cervical cancer usually manifests in the form of abnormal bleeding in a woman. Post intercourse or post coital bleeding, bleeding in a lady after menopause, any abnormal bleeding that a lady may have between periods, or if the periods are heavier and longer than normal.

As the cancer grows, there could be a watery discharge per vagina, and this could be foul odor or may also contain blood, all caused by secondary infection. Dyspareunia, which is known as pain during sex, or a heaviness in the pelvis or pelvic pain, is also a sign of cervical cancer.


3) Are there any preventive steps against breast cancer?

Lakshmi Bhave
Mumbai

Breast cancer is commoner in women who are overweight or obese. Stay within a healthy weight for your height and age. Breast cancers are also linked indirectly to smoking and alcohol.

So, it’s safest to avoid these two habits. You need to be active, burn calories to stay within the fitness zone. Breast cancer is also common among ladies who don’t breastfeed their children. So, the longer you breastfeed, the better it is to avoid breast cancer.

Also, excessive hormones, particularly after menopause, if avoided, could help in a lower incidence of breast cancer.


4) What are the lifestyle changes we can take to prevent cancer?

Janardan Shingh
Bhopal

The three most common causes of cancer are one, habits. So, if you stay away from tobacco and alcohol, it will reduce 40% of the cancers that we get which are directly caused by these two habits.

The second is infection, human papilloma virus known to cause cervical cancer, hepatitis virus known to cause liver cancer, HIV infections known to cause lymphomas and Kaposi’s sarcoma and the Epstein -Barr virus known to cause nasopharyngeal cancers. Avoid viruses, you can take preventive measures as in for HPV and for hepatitis we have a vaccine. HIV and the HPV can also be avoided by having protected sex, safe sex and not multiple partners. The third common cause of cancer you can prevent is obesity.

If you are heavier for your weight, these people have a higher incidence of at least five to six cancers, particularly in females. And the last thing is to eat healthily. Diets rich in Vitamin A, C and E, that is green leafy vegetables, colored fruits are chemo preventive. Green tea, Haldi or Cumin are also preventive against various forms of cancer.


5)What are the different stages of cancer?

Abhishek Mukarjee
Kolkata

Cancer basically is of four stages. The stages are stage 1, which is usually small and limited to the organ. As it gets bigger in size, it becomes stage 2. It may come out of the capsule of the organ. Stage 3 is generally when it involves surrounding structures, that is, the organ itself and draining lymph nodes, and stage 4 is when it spreads to other parts of the body. By and large, these are broad staging. They are different stagings for different cancers. Some have age, some have various type of grades incorporated into it, and it’s difficult to give staging in a short answer to a question that has been asked for particular cancers.

6)What are the treatment options available for cancer?

Nikita Talani
Mumbai

Basically, we have solid cancers which affect organs and liquid of blood cancers that affect the blood and the lymph nodes. These are commonly leukemia and lymphoma. Usually, liquid cancers or blood and lymphoma cancers are treated with chemotherapy with or without radiotherapy. There are other forms of treatment of these cancers which sometimes are used such as bone marrow transplant and lately what we call the CAR T -cell therapy. Solid organ cancers are treated by and large by surgery and radiotherapy. Both of these, when indicated, are curable. Chemotherapy is used to supplement and increase the success rate of surgery and radiotherapy. The fourth arm, which has now come in use is biological agents that target various receptors on the cells and immunotherapy which works on the immune mechanism. They are called checkpoint inhibitors helping in the treatment of cancers.

7)What are the potential side effects of cancer treatments?

Divya Balan
Kerala

The side effects of cancers depending on the modality used. Surgery entails risk of anesthesia, but more importantly, risk of function and cosmoses because parts of the organ affected are removed. Example, a lady might have cosmetic problems when a part of the breast is removed. Someone might have a part of the jaw removed or a limb removed. The side effects of radiotherapy are raised that act on the cancer and surrounding tissues. If radiotherapy is given to the face, it can cause darkening of the face, malfunctioning of the salivary glands that come in the field. They can cause hoarseness of voice because of effects on the voice box. They can cause damage to the cartilage. You give on the breast in a lady radiotherapy. It can affect the blood vessels of the heart or the heart muscle. Chemotherapy acts on all multiplying cells. So, there is hair loss, fall in blood counts.

People in the reproductive ages have lower fertility because of damage to the testes and ovaries. And also, there can be Myo Cocytus. That means the intestinal lining can get inflamed, resulting in nausea, vomiting, loose motions. Sometime a fall in blood counts which occurs with chemotherapy can be very life-threatening because the white blood cells fall low and make the patient susceptible to infection.

8)Are there any specific dietary recommendations for cancer patients?

Poonam Gupta
Bihar

When healing from cancer or even before therapy, you need to stay hydrated, have a diet rich in proteins and calories, because most of the treatments take us into what we call a negative catabolic phase, and having a diet rich in proteins and calories will be very, very helpful. Also, diets rich in vitamin A, C and E are chemo-preventive, and therefore diets rich in colored fruits and vegetables are beneficial. Avoid fats, avoid trans fats, which are not only unhealthy for cancer treatment, but also for other non -communicable diseases as well.


9)How can I ensure that I am receiving the best possible care for my cancer?

Stanley Nathan
Mumbai

You can ensure you’re getting the best possible care for your cancer by first staying aware of the warning signs coming at an early stage. Choose your doctor very carefully. The doctor should be a specialist, not only in cancer, but a specialist in the type of cancer for which you seek treatment.

Medical science has shown that if you have a doctor who specializes in treatment, what we call vertical or side specialization, they have better outcomes than those that are general oncologists. We also know that doctors who do a particular procedure or hospitals that have that procedure running in larger numbers have better outcomes.

You can also get better outcomes by choosing a health centre that has the best infrastructure, be it support for surgery, by way of robotic or laparoscopic if required, rather than open, by way of fine radiotherapy machines that can give minimal side effects, and by institutions that have full support for the full range of chemotherapy that include good daycare facilities, adequate nursing staffs to manage the complications, those that are adept for bone marrow transplant and CAR T -cell therapy. Research literature has also shown that institutions that partake in academics and research have better outcomes than pure community -based centres.