World Cancer Day is celebrated on the 4th of February every year to spread awareness about cancer. The primary intention is to involve everyone in helping Create a Future without Cancer. To achieve this goal, it is time to act now. Awareness about what cancer is, the risk factors, the causative factors, its prevention and screening and lifestyle modification for elimination of cancer-proneness are some of the principal goals of the awareness drive on this day.
Progress made in the fields of basic and applied sciences of biology, physics, chemistry and information technology have enabled us to dive deep into understanding how cancer is caused. Such advances at the sub-cellular and molecular level have not only given us extraordinarily precise diagnostic tools to pin-point what could be wrong, but has also empowered us to seek tools to prevent and treat it.
Progress in cancer biology and immunology has enabled us to equip the body prevent certain virus induced cancers: for example, vaccination against the Human Papilloma Virus to prevent cervical, genital and oropharyngeal cancers and against Hepatitis B Virus to prevent cirrhosis of the liver and subsequent liver cancer.
Using precision diagnostics like PET_CT Scans, we can now map cancer spread and the response to treatment very precisely. We can now target the ‘driver mutations’ that induce and sustain cancers – switching them off to stop the cancers from growing and finally disappearing.
An ability to detect minute traces of disease, using molecular tests like RT-PCR and next generation sequencing, has helped us to discontinue treatment in such diseases like chronic myeloid leukaemia and limit therapy in several blood cancers and childhood cancers.
Advances in treatment include personalisation of cancer treatment, tailored to the driver mutation of every single patient, thus avoiding collateral toxicity to normal organs and tissues that do not share the cancer causing gene. Such treatments include several ‘mabs & nibs’, antibody drug conjugates as well as ‘precision bombing’ using radionuclide tagged drugs and antibody drug conjugates.
Artificial intelligence and robotics have helped the surgeon and radiation oncologists execute several hitherto-impossible surgeries and radiation protocols that improve cure rates while limiting resection or exposure of normal tissue to radiation, respectively.
We are now able to bring several advanced cancers under the ambit of prolonged control with good quality of life. This is made possible with a combination of multidisciplinary team of experts opining on a personalised road map for the diagnosis, treatment and follow up of the patient – surgeons, radiation oncologists, medical oncologists, nuclear medicine specialists, radiologists, physicists, anaesthesiologists, pathologists, cancer nurses, cancer pharmacists and physiotherapists – all working towards the cancer patient’s seamless management.
The theme for World Cancer Day is to answer the simple question, ‘What can I do?’ Thus, whatever be one’s walk of life or profession, every citizen has a role to play in achieving the goal of a cancer free world. Everyone must make an attempt to understand that many cancers are preventable, several can be screened for, especially in cancer family syndromes and most are easy to treat, when detected early. The easiest approach is to take every girl in the family for HPV vaccination, adult women for breast and cervical cancer screening, all tobacco users for oral cancer screening and cessation clinic, maintaining ideal weight, increase intake of fruits and vegetables and evolve a sustainable exercise plan.
(The author of the article is D Raghunadha Rao MD DM FAPAS FRCP FACP Medical Oncologist, KIMS ICON Hospitals, Visakhapatnam)
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