Written by: Zama Ngcoya

October is celebrated around the world as Cancer Awareness month, in which the plight of cancer is highlighted, and those that have fallen victims to this disease are remembered. Although this disease has been in existence for many years, it is still one that is very taboo in most communities and misunderstood by many.

Journalismiziko consulted with radiation oncologist from Hopelands Cancer Centers, KZN, Dr Robert de Bruyne who shared some light on what cancer is.

“Cancer encompasses a wide spectrum of malignant diseases characterized by uncontrolled growth and spread of mutant cells. As these cells increase in number they produce growths or lumps called tumour masses which will ultimately occupy and destroy organs. Cancer that form growths are called solid malignancies. Some cancers develop in the blood and overwhelm the bone marrow which produces the circulating blood cells. These are called haematological cancers,” said de Bruyne.

He further stated that not all cancers are the same.

“There are so many different types of cancers that have different courses and prognoses. In other words, not all cancers are the same. For example there are several different types of cancer that arise in the lungs. The course and treatment of lung cancer is very different from that of prostate cancer. Translational research is an exciting area of medical research aimed especially at better understanding the critical defects that give rise to cancers at molecular and genetic level. This vital research is helping medical science develop treatments that are more specifically targeted to the myriad of different cancer types. To complicate matters breast cancer for example will be treated differently according to certain biomarkers that predict for sensitivity and response to chemotherapy versus alternative treatments aimed at manipulating hormones to suppress breast cancer growth,” added de Bruyne.

“Triggers that may induce mutations giving rise to cancers are called carcinogens or mutagens. In many cases we are not able to identify the specific cause of cancer. But in some instances there clearly associated mutagens. Common mutagens are viruses and parasitic infections, industrial chemicals, exposure to ionizing radiation, exposure to tobacco smoking, excessive alcohol intake, exposure to ultraviolet rays from the sun, certain unhealthy foods, hormonal and genetic factors,” said de Bruyne, when asked about the most common causes of cancer.

“A few examples are viruses like Human Papilloma Virus (HPV) which are sexually transmitted and give rise to cancer of the uterine cervix in exposed women. Human Immunodeficiency Virus (HIV) is associated with development of many kinds of cancer like Kaposi’s Sarcoma, Cervix cancer and lymphomas.  Exposure to industrial chemicals like aromatic hydrocarbons, example in the paint and printing industry may result in developing lung cancer or bladder cancer. Tobacco smoking is the most common cause of lung cancer as well as cancer of the mouth and throat. Exposure to ionizing radiation example in a nuclear disaster situation can cause cancer, commonly blood cancers like leukaemia. Ultraviolet rays from the sun can cause skin cancers, in vulnerable populations, like malignant melanomas. Diets that are high in processed meats have been associated with cancer of the colon. The bilharzia parasite can cause a type of bladder cancer. Hormone replacement therapy and gene mutations may increase risk of breast cancer,” he added.

Below are the most common types of cancer diagnosed in South Africa:

• Prostate cancer is the most commonly diagnosed cancer in men.
• Breast cancer is the most common cancer diagnosed in women.
• Lung cancer due to tobacco smoking.
• Cancer of the cervix portion of the womb (uterus) in women due to sexually transmitted HPV and HIV (promiscuity and unprotected intercourse are strong risk factors).
• Kaposi sarcoma of the skin in HIV sufferers,
• Colon and rectal cancer,
• And cancers that affect the lymphatic system called lymphomas.

Cancer is prevalent in all parts of the world. The types of cancers encountered, however varies geographically. Reasons for this are complex, but some factors to note are demographic differences in population, diet and culture, genetic factors and climate differences. Cervix cancer for instance is more common in less affluent communities, melanoma skin cancer is more prevalent due to environmental factors in Australia, prostate cancer is even more common in Americans of African descent, which is most like a genetic predisposition. HIV related cancers are more prevalent according to the prevalence in affected populations.

The age group which is most likely to suffer from cancer, is influenced by the kind of cancer to which is being referred.

“Prostate cancer is more commonly diagnosed later in life, between the ages of 55 to 80yrs. Cervix cancer may affect younger women soon after onset of sexual activity, typically in the 25-50yr age group. Cancer of the testes affects younger men usually between the ages of 20-40yrs. Certain, fortunately rarer, cancers may occur more in infants and small children like nephroblastomas, retinoblastomas and neuroblastoma. However the majority diagnosed with cancer are in the older population 45yrs + with a steady rise in incidence as age increases,” said de Bruyne.

The race group to which cancer is most prevalent is dependent on many factors and links back to demographic and socio-economic circumstances as well.

De Bruyne added that some of the methods which can be implemented by one to avoid getting include avoiding tobacco smoking, practice “safe sex”, eat healthy foods and limit the amount of processed foods, get into a healthy lifestyle mindset and exercise regularly, take precaution when spending time outdoors, use sun protection, and in industrial settings where one may be occupationally exposed to chemicals, or dusts that are potentially carcinogenic, there should be occupational health initiative in place to conduct regular screening checks on exposed workers.

As a means to avoid the spread of cancer any futher, de Bruyne advised readers to immediately seek help.

“Seek early medical attention if , a lump has appeared or a spot on the skin has appeared or is undergoing a change, you are experiencing unintentional weight loss, loss of appetite, change in bowel habits or become jaundiced, there is inexplicable bleeding from the vagina or a watery discharge, you notice blood in the urine or stool, you have difficulty passing urine, there is persistent abdominal bloating or inexplicable enlargement in girth, you have difficulty swallowing foods or liquids, hoarseness, shortness of breath or chronic dry cough particularly if you are a smoker, you develop neurological symptoms like slurred speech, sudden hearing or visual loss or loss of taste, loss of sensation or function in any part of your body or severe headaches or loss of cognitive function or suffer a seizure (fits), you have a persistent pain,” he concluded.