What is a Cancer?

Our bodies are made up of cells which, normally reproduce and grow in certain limit under body controls. However, this process sometimes goes wrong and cells reproduce and grow in bulk with both external factors (tobacco, infectious organisms, chemicals, and radiation) and internal factors (inherited mutations, hormones, immune conditions, and mutations that occur from metabolism). These expansions or abnormal lesions can be anywhere in the body and normally called growth or mass. The growth or the mass can be benign (if doesn?t spread to adjacent or distance organ) or malignant or cancerous (if it has ability to spread to adjacent or distance organ).These causal factors may act together or in sequence to initiate or pro­mote the development of cancer.

Cancer is a disease in which abnormal cells grow & reproduce uncontrollably and invade nearby tissues by spreading to other parts of the body through blood streams and lymphatic systems hindering the activities of the normal cells

Scope / fact about Cancer

 Cancer figure among the leading causes of morbidity and mortality worldwide, with approximately 14 million new cases and 8.2 million cancer related deaths in 2012, where more than 60% of world?s total new annual cases occur in Africa, Asia and Central and South America. These regions account for 70% of the world?s cancer deaths. Furthermore the number of new cases is expected to rise by about 70% over the next 2 decades.

Among men, the 5 most common sites of cancer diagnosed in 2012 were lung, prostate, colorectal, stomach, and liver cancer whereas in women the 5 most common sites diagnosed were breast, colorectal, lung, cervix, and stomach cancer.

Cancer is increasingly recognized as a critical public health problem in Africa. While communicable dis­eases continue to burden African populations, it is becoming clear that non communicable diseases also require the attention of those whose goal is to ensure the health of Africans. According to the International Agency for Research on Cancer (IARC), about 715,000 new cancer cases and 542,000 cancer deaths occurred in 2008 in Africa. These numbers are projected to nearly double (1.28 million new cancer cases and 970,000 cancer deaths) by 2030 , simply due to the aging and growth of the population and also adoption of behav­iors and lifestyles associated with economic development, such as smoking, unhealthy diet, and physical inactivity.

In Ethiopia, there is no country wide cancer registry, but based on Addis Ababa cancer registry; a total of 5701 cancer cases registered from September 2011 to August 2014. Among those 3820 (67%) were females and 1881 (33%) were males. The most common type of cancers among females were cancers of the breast (33%), Cervix uteri (17%) and Ovary (6%), while among males cancers of colorectal (19%), Leukemia (18%) and prostate (11%). Based on the study done on the Pattern of Cancer in Ethiopia (1998 ? 2010 ), by Tikur Anbessa Specialized Hospital Oncology Center , the most common malignancy in female was gynecological malignancy (47% ) followed by breast carcinoma (26%). Ca uterine cervix found to be the most common malignancies among all gynecological malignancies whereas in men Head and Neck malignancy  found to be the leading malignancy(22%) followed by sarcoma (15%), Gastrointestinal (12%), Hematology malignancies and urogenital (9% )each and Thyroid (5%).

Risk factors of Cancer

Tobacco use, alcohol use, unhealthy diet and physical inactivity are the main cancer risk factors worldwide. Also some chronic infections are risk factors for cancer and have major relevance in low- and middle-income countries. Furthermore Hepatitis B virus (HBV), Hepatitis C virus (HCV) and some types of Human Papilloma Virus (HPV) increase the risk for liver and cervical cancer respectively. Also Infection with HIV substantially increases the risk of cancer such as cervical cancer.

Modifying and avoiding risk factors

More than 30% of cancer deaths could be prevented by modifying or avoiding key risk factors, including:

  • tobacco use
  • being overweight or obese
  • unhealthy diet with low fruit and vegetable intake
  • lack of physical activity
  • alcohol use
  • sexually transmitted HPV-infection
  • infection by HBV
  • ionizing and non-ionizing radiation
  • urban air pollution
  • Indoor smoke from household use of solid fuels.

Tobacco use is the single most important risk factor for cancer causing about 20% of global cancer deaths and around 70% of global lung cancer deaths. 

In many low-income countries, up to 20% of cancer deaths are due to infection by HBV and HPV.

Prevention strategies

  • Increase avoidance of the risk factors listed above.
  • Vaccinate against human papilloma virus (HPV) and hepatitis B virus (HBV).
  • Control occupational hazards.
  • Reduce exposure to non-ionizing radiation by sunlight (UV).
  • Reduce exposure to ionizing radiation (occupational or medical diagnostic imaging)

Treatment

A correct cancer diagnosis is essential for an adequate and effective treatment because every cancer type requires a specific treatment regimen which encompasses one or more modalities such as a surgery, and/or radiotherapy, and/or chemotherapy, where the primary goal of every treatment is to cure or to considerably prolong life. Improving the patient’s quality of life is also an important goal which can be achieved by supportive or palliative care and psychological support.

References

  1. World Cancer Report 2014
  2. Ferlay J, Shin HR, Bray F, Forman D, Mathers CD, Parkin D. GLOBO-CAN 2008, Cancer Incidence and Mortality Worldwide: IARC Cancer-Base No.10 [Internet]. Lyon, France: International Agency for Research on Cancer. 2010; Available from: http://globocan.iarc.fr.
  3. World Health Organization. World Cancer Report 2008. Lyon: International Agency For Research on Cancer;2008.3.
  4. Int J Cancer Res Mol Mech Volume 1.1: doi http://dx.doi.org/10.16966/2381-3318.103  22 May, 2015