World Cancer Day: History, Objectives and Significance

If you are worried about any of these signs or symptoms, it is vital that you immediately schedule an online consultation with either an oncologist, or a gynaecologist, have all your queries sorted out, and get proper guidance regarding ovarian cancer.

Causes of Ovarian Cancer:

It is uncertain what causes ovarian cancer, but researchers have identified factors that may enhance the risk of the disease. Doctors acknowledge that ovarian cancer develops when cells in or near the ovaries undergo DNA changes (mutations). A cell's DNA contains instructions that teach the cells what to do. The changes cause the cells to grow and multiply rapidly, forming a mass (tumour) of cancer cells. Cancer cells continue to live while healthy cells die, invading neighbouring tissues and breaking off from the original tumour, allowing it to spread to other parts of the body.

However, there are a few risk factors that can increase the likelihood of developing ovarian cancer, which includes:

Age: Ovarian cancer is more common in women over the age of 50.

Family history: Women with a family history of breast, colorectal, or ovarian cancer have an increased risk of the disease.

Endometriosis: Women with endometriosis (a disease in which tissue similar to the lining of the uterus grows outside the uterus) have a higher risk of certain types of ovarian cancer.

Obesity: Obesity is associated with an increased risk of developing ovarian cancer.

Never been pregnant: If you have never been pregnant, you may be at a higher risk of developing ovarian cancer.

Diagnosis of Ovarian Cancer:

Diagnosing ovarian cancer might be challenging due to unclear symptoms and limited screening methods. Healthcare providers may use a variety of diagnostic tools to assess suspicious symptoms, including:

Pelvic examination: A physical exam to look for abnormalities in the ovaries or pelvis.

Imaging tests: Ultrasound, CT scans, and MRI scans can help discover the ovaries and detect abnormalities.

Blood tests: The CA-125 blood test examines a protein that is frequently high in women with ovarian cancer, although it is not conclusive on its own.

Biopsy: A tissue sample can be taken through surgery or minimally invasive techniques and examined under a microscope.

Treatment of Ovarian Cancer:

The goal of cancer treatment is to remove as much of the cancer cells as possible from your body. The most common treatments for ovarian cancer are:

Surgery: This often includes the removal of your reproductive organs as well as any organs that have cancer. Your surgeon may perform laparoscopy (minimally invasive surgery) or laparotomy (open surgery with an abdominal incision).

Chemotherapy: Chemotherapy may be recommended either before or after surgery. Chemotherapy medications are intended to target and kill malignant cells.

Targeted Therapy: Targeted drugs are prescribed to specifically target cancer cells while minimizing damage to healthy tissues.

Hormonal Therapy: Some ovarian tumours use hormones to grow. This sort of therapy inhibits cancer growth by blocking hormones.

Radiation Therapy: In some cases, radiation therapy may be used to target and kill cancer cells.

The Ovarian Cancer Statistics:

• Among the world's population, India has the second largest estimated incidence of ovarian cancer, after China. India accounts for 76.5% of the incidence and 77.5% of the mortality of ovarian cancer patients among the south-central Asian countries.
• Among gynaecologic cancers, ovarian cancer has the worst prognosis, with roughly 3,14,000 new cases and 2,07,000 deaths each year.
• According to the WHO classification, 90% of ovarian tumours develop from the epithelium, 3% from germ cells, and 2% from sex-cord stromal.
• Cases are typically discovered in the late stages III and IV, when the tumour has spread beyond the abdomen. The diagnosis is mostly based on imaging techniques, CA-125 blood tests, and surgical specimens, and is associated with a poor prognosis. In India, Ovarian cancer patients had a 5-year survival rate of approximately 45%.

 
Ovarian cancer poses significant obstacles, but early identification and treatment improvements have led to improved prognosis for many patients. Let us continue to raise awareness by promoting routine screenings, genetic testing, and proactive healthcare practices.

Reference:

1. Frontiersin - Analysis of the Indian Ovarian Cancer Cohort

https://rb.gy/c683et

2. Cleveland Clinic - Ovarian Cancer: Symptoms, Diagnosis & Treatment

https://my.clevelandclinic.org/health/diseases/4447-ovarian-cancer

Over the recent times, it is heart-breaking to see so many individuals lose their precious lives to cancer. Cancer is one of the most dangerous life-threatening diseases in the world as it can impact any part of your body. We all know that cancer comes in different types, and it is crucial that we educate ourselves on the several types of cancers and the various symptoms that is associated with each cancer type. From cervical cancer to breast cancer, lung cancer to thyroid cancer, endometrial cancer to stomach cancer, the list goes on. But there are some rare types of cancer which we might not have even heard of. Let us get to learn about seven rare types of cancer, its symptoms, and its treatment.

Rare cancers, as defined by the National Cancer Institute, affect less than 15 per 100,000 people each year. Most types of cancer are rare, and they are often harder to prevent, diagnose, and treat than the more common cancers. Anal, stomach, and laryngeal malignancies are all examples of uncommon forms of the disease.

1. Anal Cancer

Anal carcinoma is a rare type of cancer that develops in the anal canal. The anal canal is a small tube at the end of your rectum through which faeces leave your body. It can cause signs and symptoms like:

• Rectal Bleeding
• Pain around the anus
• Itching in the anus
• Change in the bowel movements

To diagnose anal cancer, your doctor might need your medical history, your age, and your signs and symptoms. In addition to that, a few tests are also used to diagnose anal cancer. The tests include, Anoscopy, Biopsy, Ultrasound, X-ray, CT scan, Positron emission tomography (PET) scan, Magnetic resonance imaging (MRI) scan and Digital rectal examination (DRE).

The treatment for anal cancer includes, surgery, chemotherapy, radiation therapy, radiosensitizers, and immunotherapy.

2. Lymphoma Cancer

Lymphoma is a type of cancer that develops in lymphocytes, which are part of the immune system and help the body fight off infections. Lymphocytes can be found in the bone marrow, spleen, thymus, and lymph nodes. The signs and symptoms of this cancer include:

• Shortness of breath
• Fever
• Weight loss
• Cough
• Itchy skin

The diagnosis for Lymphoma cancer includes tests like, Blood tests, PET scan, MRI, Chest X-ray, Bone scan and Abdominal ultrasound. The treatment option varies from chemotherapy, radiation therapy, biological therapy, stem cell transplant and bone marrow transplant.

3. Chronic Myeloid Leukaemia

Chronic myeloid (myelogenous) leukaemia (CML) is a type of blood cancer that starts in your bone marrow in the blood-making myeloid cells or stem cells. It is a type of cancer that affects the white blood cells and is most common in people over 60 to 65 years old. Innovative treatments have turned CML from a life-threatening illness into a chronic illness. The signs and symptoms include:

• Bone pain
• Fatigue
• Fever
• Weight loss
• Night sweats

The diagnosis for Chronic myeloid leukaemia includes physical examination, Blood tests, and Bone marrow tests. CML is now mostly treated with a drug called imatinib. The treatment includes chemotherapy and stem cell transplant.

4. Heart Cancer

Heart cancer occurs when malignant cells develop uncontrollably on or around the heart. Most tumours that form in the heart are not cancer. However, some heart tumours are cancerous. Most cases of heart cancer are sarcomas, which develop in the body's softer tissues. The symptoms of heart cancer are:

• Chest pain
• Arrhythmia
• Chronic back pain
• Fainting

To people who are suffering with these symptoms, a doctor will need the following tests to diagnose: Chest X-ray, Electrocardiogram, Coronary angiography, Echocardiogram and CT scan. The treatment includes chemotherapy, radiation, and management of symptoms.

5. Wilms Tumours

Wilms tumour, also called nephroblastoma, is a type of childhood cancer that begins in the kidneys. It is the most common kind of cancer in children that affects the kidneys. It usually affects around children of ages from 3 to 4 years.

The most common symptoms are:

• Pain in the abdomen
• Swelling in the stomach
• Fever
• Hypertension

The diagnosis includes physical exam, tests like CT scan, X-rays, MRI scan, blood and urine tests and biopsy. The treatment includes chemotherapy and radiation therapy.

6. Male Breast Cancer

Male breast cancer is a rare cancer that develops in a man's breast tissue. Even though breast cancer is most often thought of as a disease that affects women, it does occur even in men. The most common symptoms are:

• Painless lump in breast tissue
• Discharge from nipple
• Redness in nipple

The diagnosis includes breast exam, mammogram, and biopsy. The treatments include chemotherapy, radiation therapy, surgery, and hormone therapy.

7. Esophageal Cancer

Esophageal cancer is cancer that starts in the esophagus, a long, thin tube that runs from your throat to your stomach. Your esophagus moves food from the back of your throat to your stomach so that it can be digested. The symptoms are:

• Chronic chest pain
• Weight loss
• Coughing
• Vomiting

Esophageal cancer can be diagnosed with tests like Biopsy, ultrasonography, Barium swallow, and PET scan. The treatment of this cancer includes radiation therapy, chemotherapy, and surgery.

It is not easy to come across these seven uncommon forms of cancer. An oncologist is someone you may consult if you have concerns or questions regarding cancers.

January is observed as the cervical cancer awareness month, with the aim of raising awareness about causes, diagnosis, prevention, and treatment. As per statistics, India alone is the contributor to almost one third of all cervical cancer fatalities, worldwide. This has been attributed to the lack of awareness, limited or restricted access to healthcare services etc. On the other hand, cervical cancer is also one of the most successfully treated and preventable cancer, if detected and diagnosed early and managed efficiently.  

Cancer is a disease, in which the cells inside the body grow out of control. Cervical cancer is when the cancer starts at cervix. Cervix connects vagina (also known as the birth canal) to the uterus (also known as womb or where a baby grows). This often occurs in people who are aged 30 and above. There exist three diverse types of cervical cancer, namely:  

• Mixed carcinoma  
• Adenocarcinoma: forms in the cells producing mucus  
• Squamous cell carcinoma: most common type and forms in the lining of cervix. 

What causes cervical cancer?

Cancer develops when healthy cells in the cervix starts to mutate (changes) in DNA. In normal situation, healthy cells multiply, grow and die at a set time. But in mutation the cells multiply, grow and do no die. This leads to the accumulation of the abnormal cells which then forms a mass, also known as tumour. These cancerous cells invade nearby tissues and can very well break and spread from cervix to any other part of the body (metastasize). 

Well, one of the most common causative factors in causing cervical cancer is strains of HPV (human papilloma virus) a sexually transmitted infection. Initially when the body is exposed to HPV, the immune system prevents it from causing harm. But in some cases, the virus survives inside the body for years and contributes to the transition of cervical cells to cancerous cells. The risk factors or  cervical cancer symptoms include:  

• Sexual activity and sexual partners: Risk of HPV is increased when a person involves in sexual activity at an early age. The higher the number of sexual partners, the higher number of partner’s sexual partners, greater will be the risk of acquiring HPV.  
• Sexually transmitted infections: Occurrence of other STIs - HIV/AIDS, chlamydia, gonorrhoea, syphilis also increases risk of HPV. 
• Smoking: raises odds of having cervical cancer and is associated with squamous cell cervical cancer. 
• Compromised immune system: incidence of HPV and a weak immune system is more likely to attract cervical cancer. 
• Exposure of fetus to the drug “diethylstilbestrol,” while carrying, has an increased risk in acquiring clear cell adenocarcinoma, a type of cervical cancer stages.
• Prolonged intake of birth control pills.

How does cervical cancer feel like? 

Usually, the body does not let out any signs during the initial stages of cancer. But a lot of changes can be observed when the cancer progresses to a more advanced stage, the signs and symptoms at this stage includes: 

• A heavy foul smelling watery and bloody vaginal discharge. 
• Pelvic pain 
• Pain during intercourse 
• Vaginal bleeding after intercourse and after menopause. 

So, when one experiences these symptoms or notices any sign, it is better to get diagnosed.  

Cervical Cancer Diagnosis: The most common and important cervical cancer screening is the broader use of Pap smear (also known as Papanicolaou test) and high-risk HPV test. Pap smear test is a part of women’s regular check-up test as well, where the cells from cervix surface is collected and viewed under microscope. Any abnormality in this will lead to the next step, which is biopsy, where a part of the cervical tissue is taken for testing and confirming.  

A pelvic exam, aka colposcopy, also carried out if there is any unusual findings in Pap smear.  

Conization is a removal process (a part of the cervix), using a LEEP (loop electrosurgical excision procedure), or a scalpel, or laser. A simple procedure, usually done for minimally invasive tissues, under anaesthesia, where the patient can leave home in the same day.   

Treatment: The course of treatment can be internal, external or both.  If cancer is present only on the surface, then process like conization will be carried out by doctors to destroy or remove the cancerous cell.   Surgery is recommended and needed of the cells have passed beyond the surface through a layer called the basement membrane, and if the disease has invaded into the deeper layers of the cervix.  

A hysterectomy is carried out if the tumor is found to be spread across the uterus. 

Radiation therapy, use of high energy rays is employed to damage cancer cells and to prevent them from growing further. This therapy, just like with surgery, affects the cancer cells only in the treated area. The course of treatment spans over a period of 5-6 weeks, wherein a beam of radiation is targeted over the pelvic area.  

Chemotherapy- use of powerful drugs to kill the cancerous cells. Used in cases where it is locally spread or advancing/spreading to other parts of the body. This treatment takes place in cycles of treatment with recovery period in between, as it is very intensive. 

Immunotherapy/Biological therapy: An advanced and recently emerging technique, which targets checkpoints in immune cells to alter the immune response, to block proteins on the cells which will cause shrinkage or slows down the growth of the cell.  “Prevention” plays a vital role!!! 

As said, earlier, cervical cancer prevention is vast and can be successfully treated if detected earlier. So, what must be done?? 

• Visit your medical expert and as a primary step, get yourself vaccinated with cervical cancer vaccines against HPV. The FDA approved HPV vaccine provides protection against two strains that causes 70% of cervical cancers and against 50% of precancerous lesions occurring in the vulva, vagina, and cervix.  
• Getting a Pap smear test at least once in a year, if 21 year or older.  
• Using a barrier while indulging in sexual activity.  
• Quitting smoking.

Cancer is one of the deadliest chronic diseases that human beings have been fighting for years. It is a universal plague that can affect any part of the body. Cancer is competent to rapidly create abnormal cells that can grow beyond their usual boundaries, invade adjoining body parts, and spread to other organs. 

Gastric Cancer, also known as stomach cancer, is a cellular abnormality that begins in the stomach (the stomach is located Just behind the ribs in the top middle of the belly  which helps with food digestion and breakdown) and it begins in any part of the stomach.

In 2020, stomach cancer accounted for approximately 1.1 million new cases worldwide and was the third leading cause of cancer mortality, accounting for nearly 800,000 deaths. Men are about twice as likely as women to have stomach cancer. About 90% to 95% of stomach malignancies are adenocarcinomas. The gland cells in the deepest layer of the stomach are where these tumours start to grow (the mucosa).

There are two main types of stomach adenocarcinomas. They are intestinal and diffuse types.

• The prognosis for intestinal types is marginally better (outlook). Certain gene modifications that might make it possible to treat cancer cells with targeted medication therapy are more likely to occur in cancer cells.
• The diffused form typically spreads more rapidly. It is less common than the intestinal type and is frequently more difficult to treat.

Gastrointestinal Stromal tumors (GISTs), neuroendocrine tumors, lymphomas, squamous cell carcinomas, small cell carcinomas, and leiomyosarcomas can also start in the stomach, but these cancers are rare. 

Symptoms of Stomach Cancer 

Stomach cancer can be hard to find, and there are no symptoms in the early stage.

• Indigestion or burning sensation (heart burning)
• Discomfort or pain in the abdomen
• Nausea and vomiting
• Diarrhea  or Constipation 
• Bloating of the stomach after meals
• Loss of appetite 
• Weakness and fatigue 
• Bleeding (vomiting blood or having blood in the stool)

Causes of Stomach Cancer

Stomach cancer is found most often in people over the age of fifty five, Scientists worldwide are trying to learn more about what causes this disease and prevention  but they could not find the exact reason for stomach cancer and the researchers speculate that genetic, environmental, infection and immunologic factors may contribute to the development of gastric cancer. They include:

• Family history of stomach cancer
• Helicobacter pylori (H. pylori) infection
• Gastroesophageal reflux disease (GERD)
• Gastritis
• Epstein-Barr virus infection
• History of stomach ulcers or stomach polyps
• A diet high in fatty, salty, smoked, or pickled foods
• A diet that does not include certain fruits and vegetables
• Frequent exposure to substances like coal, metal, and rubber
• Smoking, vaping, or chewing tobacco
• Drinking too much alcohol
• Obesity
• Autoimmune atrophic gastritis

There are considerable amounts of hereditary disorders linked to an increased risk of stomach cancer, including

• Lynch syndrome.
• Peutz-Jeghers syndrome.
• Li-Fraumeni syndrome.
• Familial adenomatous polyposis.
• Hereditary diffuse gastric cancer.
• Common variable immunodeficiency (CVID).

People with Type A blood have a higher risk of developing stomach cancer, though it is unclear why.

Diagnosis of Stomach Cancer

The diagnosis of stomach cancer is based on a thorough clinical examination, a detailed patient and family history, and a variety of specialized testing.

Imaging procedures, including CT scans, MRIs, and positron emission tomography, are just the amount of the tests that doctors can perform to identify stomach cancer (PET). When it comes to stomach problems, barium is frequently used. During a barium swallow test, you ingest the barium liquid, which travels down your food pipe and into your stomach. After that, X-rays are performed to check for any anomalies.

A tiny, flexible, and thin tube with a camera is inserted into the stomach by a doctor to perform an upper endoscopy. During the endoscopic operation of a gastric patient, the doctor can take a biopsy (sample), and malignant cells can be detected in the lab.

An endoscopic ultrasound test might be performed if a person is diagnosed with stomach cancer. The examination, which uses an ultrasound probe, aids in staging the tumors or determining how much of the stomach is impacted by the cancer.

Gastric Cancer Treatment

Treatment options for stomach cancer vary from person to person. According to the tumor's stage, different treatments are used. The principal treatment is surgery, chemotherapy, and radiation therapy.

Surgery is the typical treatment for stomach cancer. The operation is known as gastroplasty. During the surgery, the surgeon removes subtotal or total gastrectomy of the stomach and specific tissues around the abdomen.

Chemotherapy is the use of drugs to kill cancer cells. In this treatment, the drugs enter the bloodstream and travel through the body. Chemotherapy can be used before surgery for stomach cancer. (The dual form of chemotherapy and radiation therapy is referred to as "chemoradiation.”) Neoadjuvant treatment frequently results in tumour shrinkage and may facilitate surgery.

Additionally, it might prolong patients' lives and prevent cancer from returning. Neoadjuvant chemotherapy is one of the standard therapeutic options for specific stages of stomach cancer. Chemotherapy is regularly administered again after surgery.

After surgery, radiation therapy and chemotherapy can be used to try to eliminate any cancer cells that the surgery did not manage to remove. As a result, cancer may spread more.

Stomach Cancer Treatment in India 

According to a study from Karnataka, stomach cancer is one of the top five cancers among young Indian men and women (aged 15 to 44). In India, 50,000 cases of stomach cancer are estimated to occur annually.

Diagnosis of gastric cancer is made by taking various tests. They are blood tests, imaging tests (endoscopy, ultrasound, CT, PET-CT, biopsy, or diagnostic laparoscopy), and diagnostic laparoscopy, which are all available in India and are highly accurate in their diagnosis. India has improved healthcare facilities like surgery, laparoscopy, and robotic surgery, as well as the top oncologists specializing in treating complicated illnesses like stomach cancer are in India. They are adopting robotic or laparoscopic surgeries to ensure fast, safe alternatives to conservative open surgery. Using this technology, stomach cancer patients have decreased postoperative pain, shorter hospital stays and quicker recovery.

India is one of the most popular locations for stomach cancer treatment since it boasts modern facilities, innovative technology, sophisticated infrastructure, and access to highly qualified medical professionals at reasonable costs. So, people receive treatment in India each year for stomach cancer.