Don’t dread cancer, get treated

The Wednesday calendar at my radiation oncology clinic at UT Southwestern Medical Center in Dallas was overrun with patient appointments and other clinical obligations.

As I browsed the long list of lung cancer patients on my schedule, I noticed a young Indian couple entering one of the waiting rooms. Their age took me by surprise as most of my lung cancer patients are at least in their 60s and 70s. I heard from them about how their lives had been turned upside down by the stage IV lung cancer diagnosis in a 40-year-old non-smoker.

It’s a fact that many non-smokers develop lung cancer, often at earlier ages than patients who have been heavy smokers. While chatting with the patient and his wife, I realised that they had not shared the news with their teenage daughters or other close family members. The emotional, financial and physical burden of the disease and treatment were squarely on the shoulders of the patient and his spouse.

In the case of most of my American patients, the entire immediate and extended family and various friends would be involved in providing the patients and their family with physical and emotional support, in effect becoming a community of helpers who lift them forward and upward in their fight against this scourge.

Cancer, this six-letter word dredges up the fear of the dreaded known unknown — a disease whose name we hear on an almost daily basis, but which still sometimes seems to elude the understanding of even the most brilliant physicians and researchers in the world.

It has clawed its way into all our lives and we all know either a family member, acquaintance, colleague or friend who is suffering or has suffered from the ailment in the past. No gender, age group or socioeconomic class is immune from it and it touches everyone’s lives with a seeming impartiality.

The disease itself has been around for many millennia and human beings have always lived with it and succumbed to it. Early texts by physicians in Greece, Egypt, Rome and India mention the disease.

The Greek physician Hippocrates coined the term ‘carcinoma’ to describe tumours. It was commonly considered a disease without a cure and usually radical and extremely painful surgeries were carried out to remove the tumour from the body.

The past couple of centuries saw brilliant innovators and scientists change the world of science and medicine in ways that could not have been imagined by our ancestors.

Discoveries like vaccines, antibiotics, anaesthesia and inventions like X-ray, MRI, etc., changed the face of modern medicine. Many advances were also made in understanding the many types of cancer and the best treatment methods that could lead to higher survival rates and a better quality of life for patients.

Early diagnosis

Cancer is nothing but a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread to different tissues and eventually to different organs.

Cancer originates in any body when there are changes to the genes that control the way our cells function. These changes may be due to environmental exposure to tobacco, asbestos, radon gas or even ultraviolet rays from the sun. These genetic causes may also be inherited from parents or other family members, which is why we sometimes see multiple members of the same family suffering from the same type of cancer.

Prevention and early diagnosis of cancer have reduced mortality rates and improved outcomes in cancer patients more than anything else.

Some of these include efforts made by doctors and governments to reduce and eliminate tobacco use, educating society about effective screening tests such as mammograms and pap smears, encouraging the use of sunscreen as a deterrent against skin cancer and fighting obesity, which has been identified as an underlying cause of certain cancers like uterine cancer, oesophageal cancer, colorectal cancer, etc.

Post-diagnosis, the most important decision that lies ahead for the patient is that of identifying the right doctors/hospital for treatment and the right course of treatment based on the disease, level of progression, etc. Patients must look for unbiased second opinions if necessary and educate themselves as much as possible about their disease. Look to find a physician who specialises in the exact cancer that you suffer from.

A cancer-specific hospital is the first and best choice for treatment. If that is not an option, try to find a reputable hospital which offers all forms of cancer treatment such as surgery, chemotherapy and radiation therapy. A good supportive infrastructure with qualified and well-trained medical professionals can make all the difference in prognosis and progression of the disease.

The word cancer is still equated with death, despite increasing survival rates. With all the advances in the field of oncology, patients are increasingly able to live a full life and participate in activities they enjoy during and after treatment.

(The writer is a radiation oncologist and an Assistant Professor at the University of South Weston Medical School)