Cancer is an abnormal growth of a body cell or group of cells. If it is not destroyed or removed, cancer can spread very rapidly, and eventually lead to death.
There are billions of cells in the human body. Normally, they grow in a well – regulated pattern. When cancer sets in, a group of cells suddenly start multiplying haphazardly and form a lump or “Tumour”.
There are two kinds of tumors – Malignant & Benign. A benign tumor is more common, and is generally harmless; it doesn’t spread to other parts of body. A malignant tumor on the other hand, never stops growing unless & until treated and can spread to other parts of the body. Cancer is the name given to a malignant growth.
No. Since cancer is not caused by a germ, it is not “catching”, and cannot be transmitted from one person to another.
Cancer spreads in 3 ways
There is no definite rate of growth of cancer tissue. Some cancers grow fast and some are slow growing. For example it takes 2 to 5 years for breast cancer to develop to 1 cm. This is the window period of screening when cancer can be picked up early.
No. The term “cancer” includes all forms of malignant growths. Very many varieties are known. These have certain characteristics in common, such as uncontrolled growth, a tendency to spread widely in the body and fatal termination if not treated early and adequately. They differ in certain characteristics, such as location in the body, microscopic appearance, and response to treatment.
There are 7 early warning signals. But the real tragedy about cancer is that it produces very minor symptoms at first. So you could have cancer and not know it. The best way to detect cancer is to have a regular yearly check-up.
By performing a biopsy or FNAC i.e. examining a small portion of the tissue under a microscope. In advanced cases, physical examination alone may reveal the diagnosis. But the chances of cure at late stage are very poor.
No. Leprosy is caused by a germ. Both the symptoms and the treatment for the two diseases are entirely different.
As long ago as 3,000 BBC., Egyptian historians made references to “tumours and ulcers”. Mummies from the Gizeb Pyramids were found to have cancer involving the bones. But the incidence of cancer is increasing. It is related to our life styles and urbanization i.e. tobacco, alcohol use, pollution, preserved and junk food etc. it is becoming a disease of modernization.
Yes. Your life – style may make you more prone to some cancers e.g. cancers of the colon, lung and skin are common in Britain and U.S.A. Cancers involving the oral cavity are more common in India. In women, cancer of the breast, uterus and gall bladder are common.
One out of every 12 Indians develops cancer in their lifetime. There are about 10 lakh new cancer patients every year in India. Though cancer can occur at any age, the incidence is high after the age of 40 to 45 years.
Though, it is very difficult to pinpoint the definite cause. Certain substances, known as carcinogens, can definitely increase your chances of getting cancer. For instance, people who smoke or chew tobacco are more prone to mouth, throat and lung cancer. Contrary to popular opinion, beedi smoking is twice as dangerous as cigarettes.
Continued irritation of tissues can lead to cancer. Pollution, preserved food, smoked and junk food are also contributory. Even certain viruses can cause cancer (EBV, Hepatitis B, HPV). Amongst other known causes are asbestos, arsenic, tar, ultra-violet rays. Cancer is a life style disease.
There is no scientific evidence that cancer is directly caused by a germ. Although certain viruses are known to cause cancer but they form < 5% of the cancer burden.
No. A single injury to soft tissue or bone does not give rise to cancer. Injury may bring tumor into notice of patient.
High fat, low roughage, western diet predisposes to colon cancer. Diet rich in animal fats also contributes to breast cancer. Green leafy vegetables and fresh fruits contain certain antioxidants which prevent cancer. Recently, tomato, ginger and cabbage etc. have been found to have medicinal antioxidant property. Avoid junk food, smoked food and preserved food. Be vegetarian and prevent cancer!
There is little evidence that the temperature of food is an important factor in development of cancer. But recently, too hot food has been correlated with food pipe cancer. Too spicy food may be related to stomach cancer as is evident from its high incidence in Southern parts of India.
Alcohol is a predisposing factor for the development of cancer of oesophagus, laryngopharynx and liver.
There are probably inherited tendencies that may lead to cancers of different types. The presence of cancer in one or both parents should be a cause for greater alertness in looking for and recognizing suspicious symptoms in the individual. Cancer however is not inherited, except for one type of eye cancer known as Retinoblastoma. Only 5% of breast cancers are considered hereditary.
No. There is no record of cancer having been transmitted by kissing or by any contact, accidental or otherwise, between individuals or between person and animals.
Cancer may occur in any tissue to the body, but a corn does not as a rule, develop into cancer.
Simple freckles do not. However, flat moles containing pigment of a bluish-black colour and looking like dark freckles, may become cancerous and should be checked periodically.
No. Piles or hemorrhoids are merely enlarged veins in the rectal wall. Cancer is occasionally found in the tissue above the hemorrhoids. So “bleeding piles” should be examined carefully to determine whether cancer is also present. Rectal bleeding can occur due to cancer.
Cancer is a disease of body cells. One’s mental condition has no direct effect on the course of the disease since this malignant change is apparently due to physical process. But positive attitudes, fighting spirits and healthy thinking helps you to cope with cancer better. So, it has an indirect bearing on response to cancer treatment.
Indiscriminate use of X-rays frequently may increase your chances of getting cancer. Lately, there are certain reports quoting higher incidence of Leukemia and Brain Tumours in persons using Cell phone. But this needs further research.
Prevention is better than cure. More than half of the cancers are preventable! Avoid smoking and tobacco chewing in any form. Alcohol should only be taken in moderation. It is better avoided. Take low fat, vegetarian diet. Avoid ill fitting dentures. Report to doctor immediately, if you notice any of seven warning signals.
Any abnormal condition that, if permitted to continue, may develop into cancer with passage of time. Cancer does not form in day’s or week’s time. It takes many years to develop. It passes through many stages normal cell, abnormal cell, Precancerous lesion, Frank cancer, Metastasis. Detection of precancerous lesion and appropriate treatment can prevent frank cancer.
White spots on mucous (lining) membranes, especially of the mouth; non healing sores caused by jagged teeth and ill fitting dental plates; dark coloured moles which itch or bleed. These should all be investigated by a physician and adequately treated. Sub mucous fibrosis with inability to open mouth, polyps in large intestine Barret’s oesophagus associated with reflux oesophagitis are some of the conditions which should alarm the patient and physician. These require careful monitoring.
Cancer of mouth is a largely preventable disease. Avoid use of tobacco in any form (pan parag, pan masala, gutaka etc.) Any sore in mouth which does not heal in three weeks time should be examined by doctor and if required biopsied. Keep the mouth clean. Have jagged teeth filed or removed. Do not use an ill-fitting dental plate, which causes a sore on the gums or cheek. If white spots appear in the mouth or on the tongue, stop the use of tobacco and see a doctor.
Dark coloured moles and warts, which become itchy or bleed or ulcerate should be removed. Fair-skinned people should avoid overexposure to direct sun rays. Recurrent blisters on the lip should be carefully examined. Skin should always be kept clean.
No. A flat colourless mole is probably as harmless as a freckle. Bluish-black hairless moles, especially when subjected to irritation, should be removed. Any mole or wart showing changes in size or colour or bleeding should be promptly and completely removed and the tissue examined by a pathologist to determine if cancer is present.
Production of immunity is possible only in diseases caused by germs. As cancer is not caused by germs, immunity cannot be developed against it. But scientists are exploring possibilities of vaccines for cancer. Vaccines are available against viruses like human papilloma virus, E.B.V. and hepatitis B Virus which will decrease incidence of cancer.
Primarily because of fear. Ignorance of the signs of cancer and the vital importance of early treatment also play a role. Some people also think there is a social disgrace in having cancer and so hide the fact from their physicians and often from friends and relatives. This is not a justifiable attitude.
He can. The presence of tuberculosis or any other disease gives no assurance that cancer will not develop.
The chief function of white blood corpuscles is to protect the body against bacteria or germs. They kill germs and combat infection. Current research is being undertaken to promote such activity by certain kinds of while blood corpuscles. But cancer cells escape immune surveillance and defense mechanisms of body.
You can only suspect. A regular thorough physical check-up is your best guard against cancer, plus an examination when one of the seven danger signals or warnings appears. You are the first line of defense against cancer because, you alone, can recognize a danger signal.
There are seven common ones. They are often called the Seven Danger Signals of Cancer.
Nagging cough or hoarseness
No. Except in a cancer involving bone or nerve tissue. Pain usually is a late symptom and when it occurs, the growth is often far advanced.
The sooner it is found it is less likely to have spread to other parts of the body. Early cancer can be cured.
Any delay is dangerous. Go at once to a doctor and ask for a thorough examination.
The earlier a cancer is treated the greater are the chances of a cure. Thorough periodic examination may detect cancer in its early stages before the individual has noticed any sign or symptom in himself.
RGCI & RC has all screening facilities. Any individual with or without warning signals can come for check-up. Indian cancer society also runs several check-up clinics.
Thorough cancer check-up means examination of all accessible body parts like head and neck, oral cavity, chest, abdomen, breast, vaginal and rectal examination. Cancer screening at RGCI & RC also includes certain blood tests, X-ray chest, US whole abdomen, mammogram, pap’s smear, sputum exam and PSA (for prostate). Clinical examination and all investigations are done at nominal rates.
The check-up takes only an hour and is completely painless. You may phone and get an appointment. Please come empty stomach to preventive health check-up clinic in forenoon of any working day.
Mammography is a special X-Ray examination of the breast tissues. It is a quite sensitive test to pick up early lesions of the breast.
The Papanicolaou test, (or Pap smear) is in fact a microscopic examination of the cells exfoliated from the uterus and cervix. The doctor takes a swab from the tissue surface for examination. This test warns patients of the presence of early pre-cancerous lesion.
No. Bleeding should be promptly and carefully investigated, to determine if it is due to cancer. A small percentage of patients with blood stained discharge from nipple have cancer. Bleeding from other body openings, such as rectum or bladder, should be carefully investigated to rule out cancer. Unnatural vaginal bleeding, especially after the age of 50 can be suspicious of cancer.
Stool streaked with bright blood or the occurrence of black or “tarry” stools should lead to prompt and thorough investigation. The assumption that rectal bleeding is merely due to hemorrhoids, or piles, is most dangerous, since such bleeding may be due to multiple causes, including cancer.
It may. But it may also be caused by conditions other than cancer. A careful examination is essential to rule out cancer.
There is no known relation between the status of one’s health and the development of cancer. Poor genital hygiene and poor oral hygiene may be contributory factor in cancer causation.
Upper GI endoscopy is the best investigation for diagnosing stomach cancer. A flexible tube (Endoscope) is passed through mouth and introduced into food pipe and stomach for telescopic visualization. Biopsy can be taken if any lesion is found in stomach or food pipe.
Cancers in the head and neck region can be diagnosed by simple clinical examination which includes visualization of oral cavity and voice box with the help of head light and mirror. Any growth, ulcer or which patch is biopsied to confirm the clinical diagnosis. This is then reported by an experienced Histo-pathologist in the laboratory. In India more than 35% of male cancers arise in mouth and throat.
There is no substitute to good clinical examination. Ultrasound, X-Rays, CT, Scan, MRI & Mammography are some of the diagnostic imaging tools. Various blood tests (PSA, AFP) and endoscopic procedures are also available to clinch the diagnosis. Cytology (FNAC) or Biopsy of lesion is desirable to confirm the diagnosis before starting any treatment.
Yes. Latest diagnostic modalities like MRI and guided biopsy, PET – CT Scan, interventional radiology, immunohistochemistry, tumour markers, different types of nuclear scans are available at RGCI&RC. You don’t need to go anywhere outside the institute for any investigation. We have tele-link facility available with Samjhana Laboratories in Kathmandu where tele-pathology, tele-radiology and tele-consultation is readily available. Contact in Kathmandu for tele-consultation:
Mr. Urdeep Samjhana Laboratory – 9841346006
Dr. Sudip Shrestha – 9851041004
By surgery, chemotherapy, radiotherapy or a combination of all these. All these methods are available in India at various Hospitals. RGCI & RC provides all diagnostic and treatment facilities under one roof. The emphasis on cancer treatment should be on multimodal management.
No. Treatment depends on type and location of the growth. Some cancers will not respond to radiation treatment but must be treated by surgery or with hormones and chemotherapy.
Radiation destroys dividing cells including cancer cells. Normal cells are also damaged. But now sophisticated machines are available which spare normal tissues and destroy cancer tissue with precision.
Wires or tubes containing radioactive material are inserted into the cancer growth or in the tissue surrounding it, and removed after treatment is concluded. Radio-active material in suitable containers may also be placed in contact with the growth as in cancer cervix. Now a day’s endo-luminal RT is also available for cancer of tubular structures like bronchus.
Surgery is most effective in the early stages when cancer has not yet spread. Major advances in reconstructive surgery and anesthesiology have ensured a very high degree of success. Surgery is also done in most advanced solid tumours which are resectable. But it is combination of various treatment modalities which are used in advanced cases.
Chemotherapy implies treatment with anti-cancer drugs and injections. Today we have a large number of highly effective drugs for cancer control.
At times only. Certain types of cancerous growths, which cannot be expected to be curable, may be controlled temporarily by CT/Hormones/RT. Sooner or later, however, these growths fail to respond to further treatment.
Report at once for a thorough examination by the Cancer Specialist.
More than 80% of early cancers today are curable if treated early. At times, however, cures have been obtained after the cancers have been present for a long time. The type of cancer and stage of cancer have an important bearing on its curability.
After a cancer patient has been treated and has remained free of recurrence of disease for a period of five years, the chances for re-appearance of the tumor are small. Occasionally cancer recurs ten or twenty years later. So, a lifelong follow up is a must for cancer patients to detect recurrence of disease as well as to detect other cancers.
Yes. Regardless of a patient’s past medical history including the successful treatment of a previous cancer, he/she should be examined at regular intervals. Because of the tendency for cancer to re-appear at the place of a previously existing growth or nearby, a patient should have a regular follow up as advised by the Doctor. A new cancer may also appear at another part of the body.
No. Till today there is no vaccine cure for cancer. But vaccines against certain viruses like Hepatitis B Virus, HPV may reduce the chances of cancer occurrence.
Chemotherapy causes temporary side effects like nausea, vomiting, loss of hair and bone marrow suppression. Side effects of chemotherapy vary with drug schedule used. There are some long term side effects like infertility, hand foot syndrome etc. with few of the drugs.
There is evidence today to indicate that treatment with certain hormones may prolong life, and alleviate pain and suffering in certain breast and prostate cancers. Hormones are also useful as adjuvant after definitive treatment.
Immunotherapy is a new development based on the theory that the human body can be taught to defend itself against diseases, including cancer. Immunotherapy is being tried in cancers like melanoma, renal cell carcinoma etc.
There is no single modality of treatment, which can achieve cure. Emphasis is on multimodal treatment e.g. combination of surgery, radiotherapy, chemotherapy, targeted therapy and hormone treatment. Now gene therapy and immunotherapy are upcoming modes of treatment but they are in experimental stage.
There has been revolution in the treatment of cancer in last decade. Newer surgical techniques e.g. endoscopic surgery, reconstructive methods and robotic surgery are all available at RGCI & RC. High precision radiotherapy (IMRT, IGRT), brachytherapy are routinely used to minimize side effects of radiation, Chemotherapy and targeted therapy form part of personalized care. Interventional radiologists are also part of therapeutic team. Rehabilitation team, palliative care department, preventive oncology unit, trained nursing staff and quality team are part of therapeutic armamentarium.
A lot of progress has been made in cancer research. We have understood cancer behaviour better. Diagnostic facilities have improved. Operative methods and radiation techniques have also improved. Newer chemotherapy drugs have been launched. Future is not far off when we will have gene therapy and vaccines for cancer treatment. We are ushering into the era of “Personalized Care”.
More than 80% of the patient treated adequately in the early stages can be cured. Your chances of recovery are excellent, if you report for treatment very early after the cancer has developed.
The sooner you come for treatment, the better the quality of life after cancer. Most cancer patients can return to their normal lives, even during treatment.
There are no fundamental differences in cancers in men and women. Most important thing is that common male cancers (lung and oral) are preventable because they are caused by tobacco. Female cancers (Breast, Cervix) can be detected early and cured.
Cancer of the mouth, throat, gullet, stomach, rectum, larynx and lung are all more common in men than in women. Gall bladder and thyroid cancers are more frequent in women.
Smoking and tobacco chewing are known to cause cancer of the mouth, throat, lungs etc. Therefore, it is best to play safe. If you smoke or chew tobacco, make every effort to stop. Stop smoking and tobacco chewing and prevent cancer!
No. There is no known relationship between cancer and sexual activity on the part of the male or female. However women who have multiple sexual partners run a greater risk of getting cervix cancer.
Yes. Cancer of the prostate is one of the most common forms of cancer in older men in USA. Men should be on guard against this form of cancer especially as they approach 60. A thorough physical examination, including a rectal examination, blood test (PSA) and TRUS (Trans Rectal Ultrasound) are the only ways to discover this hidden cancer early enough for cure.
No, the misconception that cancer is primarily a woman’s disease is due to the frequency of cancer of the breast and cancer of the reproductive organs in women, in comparison with the more varied occurrence of cancer in men.
Reports from death certificates show that above the age of 40, the cancer death rate is higher among single women than among married women of the same ages. Single women have higher death rates from cancer of the breast and married women have more cancer of the cervix. Physicians believe that having the first child around the age of 20 is preventive against cancer of the breast. Multiple sexual partners increase the risk of cancer of the cervix.
Yes, a very grave danger. Time is the most important factor in the control of cancer and waiting to “see what happens” may permit a curable cancer to become incurable. This may allow it to spread to other parts of body and make the treatment more difficult.
No. only small percentages of lumps are cancerous. Careful physical examination and mammography can differentiate benign from malignant lump. Biopsy & FNAC of lump by a competent pathologist can clinch the diagnosis.
Every woman above the age of 40 should have her breasts examined annually by a physician. Every woman after the age of 25 years should be taught how to examine her own breasts (monthly after her periods). Screening Mammography should be encouraged at the age of 40 years onward and then every 2 yearly. We have genetic markers to detect high risk group of women who are likely to develop breast cancer or ovarian cancer.
Self examination of the breast should be done in the following ways after periods are over. Women should examine their breasts every month.
Have all unnatural vaginal discharges investigated. Up to the age of thirty-five have an annual examination by Gynaecologist. Bleeding after the age of 50 years (alter menopause) of life calls for a physician’s examination at once. Avoid multiple sex partners. Cervix cancer can be prevented by screening. Vaccines are available for HPV. These vaccines (between 10 yrs and 45 yrs age) can reduce the incidence of cervical cancer.
Fibroid tumours only very rarely undergo malignant change.
No age is free from cancer. Certain forms of cancer, especially of the eyes and blood are found in young children.
The answer is no. In many families where a parent had cancer, the disease does not appear in the children. Again, a person whose family has no record of cancer may develop it. A tendency to develop breast cancer however runs in families. Even colon cancers are known to be familial.
The rate of growth at any age depends upon the type of cancer though cancer does grow faster at younger ages.
The cure of cancer has relationship with age. Outcome depends upon the extent of growth at the time it is detected, the adequacy of the treatment given, as well as the type of cancer detected. Childhood cancer like ALL, Germ Cell tumours are highly curable.
Cancer deaths can be reduced by following means:
If often does. It depends upon the type of cancer you have and how much must be done to treat it.
For the following reasons, among others:
If a person advertise a cure, guarantees a cure, or employs a method of diagnosis or treatment not generally accepted or endorsed by the medical profession, may be classed as a quack. No reputed, ethical physician will do any of these things.
Only if you neglect it. Today more and more people are not only winning their fight against cancer, they are also able to lead normal, active lives.
Home Care Services are provided to those patients, who are terminally ill and in whom all treatment modalities have been exhausted. These facilities are provided free of cost. Doctor, Psychologist and Nursing Staff visit the home of patient and provide advice regarding nursing care, medicines etc. They also provide medicines free of charge to patients.
RGCI & RC practices evidence based multi modal treatment. We aim at cure with care based on ethical practices. We follow NCCN guidelines (National Comprehensive Cancer Network, USA) and many cases are discussed in Tumor Boards or multispecialty clinics with involvement of all diagnostic and therapeutic specialists. We provide all cancer related facilities (be it diagnostic, surgical, medical or radiation) under one roof. RGCI&RC has registered 2 lakh cases in last 20 years. Our vision is “quality care with human touch”.
MRI is a painless and harmless way of looking inside your body without using radiation. Instead it uses a large magnet, radio-waves and a computer to scan your body and produce detailed pictures. This provides information that is not available from conventional imaging modalities like x-ray.
Your body is made up of small particles called atoms. Hydrogen atoms, a major component of water, make up 95% of your body. Normally, the hydrogen atoms within your body spin around at random. However, when you are placed inside a strong magnetic field, the same hydrogen atoms naturally line up and spin in the same direction. When a radio-wave is passed through the body, this causes the hydrogen atoms to give off a signal. The scanner detects this signal and with the aid of a computer detailed images of the body are produced.
You will be asked to lie very still on a comfortable bed within the magnetic field. You will not feel anything while the scan is proceeding, but you will hear a rhythmical banging noise. This is quite normal. The radiographer will be in contact with you throughout the examination.
It is not possible to have an MRI examination if you have:
In case you are reporting us by the scheduled time you may have to wait typically 30 minutes to an hour. The waiting time may be increased in a case we need to take a little longer time for the patient before you undergoing the study, as most of the MRI we dealt are problem solving.
Typically it is approx 30 minute for a body part. In case you will be needing contrast then it may take another 10 minutes more.
Use of contrast becomes necessary in case of the evaluation of brain and for body part that was operated or radiated recently. In our department, this decision is usually taken by the radiologist during pre study planning or during the study to restrict the use of contrast in deserving cases. Contrast is to be avoided in cases of compromised renal function, previous history of allergy and during pregnancy.
A routine plain MRI of any body part is charged Rs.6000/ only. Cost of MR contrast (intravenous Gadolinium 10 ml per unit) will cost additional Rs.3000/ only. (Except for special cases, one unit is adequate). Special MRI tests like MRCP and packages involving multiple modalities like (PET – CT etc) the cost has been designed with price advantage to the patient.
The report is ready for dispatch to the central report collection counter by next day (24 hours) after a thorough analysis of your study. We try to provide an image appended print report for quick review, hard copy of relevant images on film for convenient appraisal of your referring doctor in his / her clinic and a CD containing all images of your study in standard DICOM format with self loading image evaluation software for your record, review and reference.