In an attempt to put an end to cancer

On the world cancer day which is observed on 4th February every year with this year theme ‘I Am and I Will’ the experts from medical industry share their insights and awareness about the cancer. 2020 marks the halfway point of the 3-year ‘I Am and I Will’ campaign - by Neha Wagle, Sub-Editor.

February 4th known as World Cancer Day, when organisations and people around the world unite to raise awareness about cancer and work to make it a global health priority. Projected 9.5 million people worldwide were expected to die from cancer in 2018 – about 26,000 cancer deaths a day – and that number is predicted to grow.

Around the world, communities’ present seminars, walks, hold public information campaigns and other events to raise awareness and educate people on how to fight cancer through screening and early detection, through healthy eating and physical activity, by quitting smoking, and by urging public officials to make cancer issues a priority.

‘I Am and I Will’ is a call-to-action influencing for personal commitment and represents the power of individual action taken now to impact the future. World Cancer Day is a campaign built to boom, motivate change and mobilise action long after the day has passed. A multi-year campaign offers a chance to create long-lasting impact by increasing public-facing contact and engagement, more opportunities to build global awareness and impact-driven action.

Understanding the connection between chronic inactivity and heightened risk of most type of Cancers
Dr Boman Dhabhar, HOD & Senior Consultant – Medical Oncology, Fortis Hospital, Mulund says, “Diet, physical inactivity and weight are all interlinked, ultimately leading to obesity, which is defined as Body Mass Index more than 30 kg/m2. In Breast Cancer, Colorectal Carcinoma, Prostate Carcinoma and Endometrial Carcinoma, obesity at the time of diagnosis is linked to poor outcomes.”

The American Cancer Society and the American College of Sports Medicine for Cancer Survivors recommend that maintaining a healthy weight and then opting of physically active lifestyle, i.e. at least 30 minutes of moderate to vigorous physical activity for five or more days of the week, and eating a healthy diet, positively benefit the quality of life of Cancer survivors. Growing evidence also suggests that sedentary behavior, time spent engaged in activities such as TV watching and computer use, maybe independent risk factors for developing Cancer as well as a poor prognosis in Cancer survivors, which has been shown in a few meta-analysis also. “As regards to patients who are already diagnosed with Cancer, for example Breast Cancer, who are on Hormonal Therapy like Aromatase Inhibitors and are obese, have higher incidence of recurrence. Patients on Chemotherapy who engage in moderate physical activity are known to have a better quality of life by reducing Cancer-associated fatigue and lethargy. Endometrial Cancer patients who are Obese and Diabetic are known to have poor outcome as compared to their non-diabetic non-obese counterparts,” Dr Dhabhar shared.

Cancer mortality is higher among men than it is among women, yet awareness about cancer is low in men
Dr Donald Babu, Surgical Oncologist, Hiranandani Hospital Vashi-A Fortis Network Hospital, says, “Studies conducted worldwide show that men are 40 per cent more likely to die from Cancer, it was also observed that men are 16 per cent more likely to get the disease than women. However, there is no substantial biological reason as to why men should be more susceptible.” Let’s look at two possible explanations for this phenomenon. Lifestyle factors include unrestrained smoking, drinking, rapidly increasing weight, and no exercise; all of these are noted risk factors for several types of Cancer. Secondly, men also tend to hide their symptoms, or simply don’t understand the symptoms, which means by the time they are diagnosed with Cancer, it is in advanced stages. Also, women tend to be in frequent contact with health professionals, as against males, which means their health related queries are never answered or at a much later time.

“Men need to take charge of their health too, six-monthly or yearly check-ups are important, speaking to your doctor about unusual symptoms is important, and lastly, being aware of risks associated with Cancer is important,” Dr Babu shared.

Data Collected
To raise awareness of cancer and to encourage its prevention, detection, and treatment, World Cancer Day is led by the Union for International Cancer Control (UICC) to support the goals of the World Cancer Declaration, written in 2008. Ahead of the World Cancer Day, Metropolis Healthcare Ltd has collated a data of cancer tests that it conducted in Mumbai in the year 2019.

Metropolis Healthcare Ltd, tested 57,052 samples for cancer in 2019 in Mumbai. The data of given samples indicates that about 9 per cent (5151) of these samples were diagnosed with cancer. Out of these 9 per cent (5151), 3.84 per cent (2191) were tested positive male cases whereas 5.17 per cent (2952) were positive female cases. Amongst females, breast cancer (1008 females) was reported maximum number of times followed by cancer of the cervix (302 females), GI Tract (342 females) and hematolymphoid cancer (296 females).

Amongst males, Cancer of the GI tract (399 males) was reported maximum number of times followed by Head & Neck (366 males) and Hematolymphoid (489 males). Prostate Cancer also contributed to a considerable percentage amongst males (293 males).

An age-group wise segregation revealed that a bulk of the positive cases were reported positive amongst the 51-60 and 61-70 age group followed by 41-50 age group.

Commenting on the data, Dr. Kirti Chaddha, Sr. Vice President – GRL Operations & Medical Affairs and Sr. Consultant Oncopathologist, MD, PDCC (Oncopath & Oncohemat), Metropolis Healthcare Ltd said, “In Maharashtra, we have seen the age-groups of 51-60 and 61-70 are more prone to cancer than others. In females, the incidences of breast cancer are rising. The exact cause of rising breast cancer is not known. However, there are benefits for women who exercise regularly, maintain a healthy weight, do not smoke and have a low intake of alcohol.”

She added, “Breast cancer cannot be prevented, but if it is diagnosed early then it becomes easier to treat. Under doctor’s supervision, or through home-screening, the regular breast screening from the age of 30 onwards would be beneficial.”

Tech-based solution
While tobacco use has fallen significantly in countries like the United States over the last decades, tobacco dependency persists in India at alarming levels. According to the Global Adult Tobacco Survey (2016-17), nearly 30 per cent of all Indian adults use tobacco – Cigarettes, beedis, and pipe tobacco, along with smokeless tobacco like snuff, snus, and dissolvable tobacco products are widely prevalent. This addiction persists despite a majority of Indians’ being fully aware that tobacco use is harmful. Half of all smoking and smokeless tobacco users are planning to quit tobacco – but few are equipped with the tools to do so successfully. It’s a dire predicament, with the resulting diseases such as lung, oral and esophageal cancers claiming the lives of lakhs of Indians.

To address this challenge, Mumbai-based ACI Cumballa Hill Hospital and Asian Cancer Foundation has joined hands with health tech startup Hopscotch Health to design a structured program called ‘Tobacco Minus’, for tobacco users for over a period of 6 months. The tailor-made program consists of monitoring via a smartphone app, consultations, and counseling sessions.

Padmashri Awardee Dr. Ramakant Deshpande, Onco Surgeon & Chairman of Asian Cancer Institute, highlighted, “According to the World Health Organisation, (WHO), tobacco kills more than 8 million people each year. Over 7 million deaths are a result of direct consumption, whereas 1.2million is the result of passive smoking. It is the need of the hour to help people overcome tobacco addiction via cessation programs. Tobacco dependency invites a plethora of health problems such as lung and oral cancer, tooth and gum diseases, Chronic Obstructive Pulmonary Disease (COPD, asthma, heart disease, oral infections, bronchitis, and even gastrointestinal issues.”

Ms. Pranjal Dange, Psycho Oncologist Dr. Rajiv Yadav, COO, ACI, Varun Deshpande, Director, Hopscotch HealthDr Sanjay Sharma, Director, ACI Ms. Avanti, Dr. Deepak Parikh, Director, Asian Cancer Foundation & Dr. Arun.

He added, “The ‘Tobacco Minus’ program will make it easy for doctors and counselors to keep track of the health of the patients. Stopping nicotine usage can cause withdrawal symptoms and that also can be managed through this program.”

Varun Deshpande, Director at Hopscotch Health said, “The ‘Tobacco Minus’ program is a 6-week quit plan, that will guide a tobacco user towards quitting tobacco through in-person consultations with psycho-oncologist and a smartphone app that monitors the user’s craving and moods. The app can perform daily check-ins; provide daily inspiration or information on coping strategies, and request information from the user to personalise their experience further. The user can notify the app if they’re feeling a craving, in order to receive a mitigation strategy based on established coping strategies.”

“The app has been designed using insights from the forefront of behavior change and technology development. It is a testament to the power of technology to help people lead healthy lives, more effortlessly. We’re proud to partner with ACI Cumballa Hill Hospital to reduce the burden of tobacco-related deaths, and improve the quality of life of the patients,” concluded Varun.

Conclusion
World Cancer Day is a powerful single event that extends its consequences throughout the whole year. The ‘I Am and I Will’ campaign has a strong message that empowers people, engaging them in an amazing level of commitment, raising collective awareness concerning cancer prevention.