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  arrow Misconceptions


Common Misconceptions about Cancer:

Mention the word “cancer” to Malaysians and three words would probably pop into their heads: incurable, pain and death. About a third of cancers are curable yet few people (including doctors) know this. Pain is not inevitable when cancer strikes. And even when there is pain, much can be done about it. Many other misconceptions about cancer abound. "We don't know what causes cancer." Of course we do. "Food has everything to do with cancer." Wrong again! In this article, we will ask (and answer) common questions about cancer:

  We don't know what causes cancer.
The human body is made up of billions of cells. Cells have nuclei, which house their reproductive apparatus, i.e. DNA. Mistakes are made when cells reproduce. Occasionally, such mistakes accumulate and eventually the daughter cells form new blood vessels, invade neighbouring tissues and spread throughout the body. Consequently, vital organs get disrupted and the patient (if untreated) dies. We know the big picture. We are still fleshing out this picture with details.

  Does smoking cause cancer? And is cancer a lifestyle disease?
There is no doubt whatsoever that smoking will increase your chances of contracting lung cancer (and half a dozen other types of cancers). Excessive alcohol consumption may lead to cirrhosis, which may lead to liver cancer. Beetle quid chewing (fortunately a dying habit) causes mouth cancer. Unfortunately, at least two thirds of all cancers cannot be linked to a particular lifestyle or causative agent. That does not mean we should not count our calories, load up on fresh fruit and vegetables and hit the gym. In any case, a good lifestyle will do wonders for your heart, psyche and sex life.

  Doctor, what food should I avoid?
Food is not the most important cause of cancer. Neither is it an important modality in the treatment of cancer. It is important that cancer patients observe a diet high in protein, calories and vitamins while undergoing treatment. However, that is a far cry from saying that "this food will prevent cancer" or "that food will cause cancer!"
Click the link for articles concerning Cancer and Diet

  I don't want to undergo cancer treatment because 'good' cells are killed
Cancer treatment is a judicious combination of surgery, radiotherapy, chemotherapy and molecularly targeted therapy. There is no such thing as medical treatment (for any disease, including cancer) that is devoid of side effects, just as there is no such thing as a free lunch. However, most side effects of cancer therapy are temporary, reversible and manageable. Much progress has been made in the control of nausea and vomiting, which is a frequent side effect of treatment. 'Growth factors' (G-CSF, erythropoietin) are available to combat bone marrow suppression, which is another common side effect of cancer therapy. And the list goes on… If cancer is left untreated, there will be great suffering. Death will ensue within two years in most cases.

  What about alternative therapy?
What about it? There is no alternative civil engineering, no alternative computer technology and no alternative chemistry. Any treatment for cancer has to be subjected to the rigours of scientific enquiry. This inevitably means a slow, laborious, intellectually honest process that starts in the laboratory, proceeds onto animal studies and finally studies on humans. There is only medicine that works and has been proven, and medicine that is not proven and may not work

  Is cancer contagious?
The simple answer is no. You cannot 'catch' cancer from a patient by touching him or by sharing his utensils and personal effects. Cancer is not spread by air, water, injections and other vectors. Certain cancers are linked to viruses, such as the Human Papilloma Virus and cancer of the cervix, and Hepatitis B and C and cancer of the liver. Immunisation plays an important role in the prevention of liver cancer and clinical trials are on the way for the former (cervix). That certain cancers are causally linked to viral infection does not at all make cancer patients infectious. Cancer patients need all the care and compassion they can get. They should not be shunned. On the contrary, a hug and a kiss will go a long way to alleviate their suffering.

  Isn't cancer a very painful disease?
Cancer can be very painful, especially if cancer tissues directly infiltrate bones and nerves. However, this is not inevitable. More important is knowing that pain management has come a long way. Most pain can be controlled by following an algorithm (a logical stepwise sequence to achieve a goal) recommended by the World Health Organisation. Many new analgesic preparations and adjunctive drugs (or drugs used in parallel) are available. Pain is much less of a problem today.

  Is cancer inherited?
Only about 10 per cent of cancers can be inherited. Even if you are unfortunate enough to have parents afflicted with this subset of cancer, you may still not get cancer. Remember, you inherit the risk, not the cancer. What you really need is counseling and preventive measures.

  My sex life is over now that I have cancer
Far from it! We aim to fully rehabilitate a cancer survivor. And sex, being the sublime expression of human love and emotion, is so very important. There is absolutely no reason why a cancer survivor cannot have a fulfilling sex life with counseling.

  Finally, can we find a cure for cancer?
Let us re-phrase that question: Can we find a cure for the two thirds of cancer that are not cured at present? Remember, one third of cancers are cured. Most patients who have their cancer diagnosed early in stage I (confined to the organ of origin) or stage II (only the first station of nodes are involved) are cured by existing modalities and technologies. We are talking here of 70 to 90 per cent cure rates. What about the rest, i.e. the two thirds of cancer patients who are not cured? Researchers now know a lot about the genetic basis of cancer and consequently the chemical messages cancer cells send to other cells. In the future, instead of telling someone 'You have liver cancer', we may say to that person 'Your cancer has a defect in the ras (an oncogene) pathway so you need compounds that are effective for this pathway.' The other theme is (molecularly) targeted therapy. We already have drugs in Malaysia that specifically target receptors (mainly growth factor receptors) found on cancer cell surfaces. These drugs are effective and have few side effects. Only a few patients in a few clinical scenarios are suitable candidates for such therapies. However, the future is bright and many more such therapies are in the pipeline. The wisest approach to the cancer problem is prevention, early diagnosis, appropriate therapy and palliative care. So much is available and so much more is expected in the coming decades.

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  By Dr Albert Lim  

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