It's big, bad and considered to be the world's number one killer. Cancer is fast becoming a collective global fear and though the survival rate has gone up, its incidence continues in an upward spiral. Mandovi Menon  finds out more about the prevention, detection and treatment available for the five leading cancers of the world.

Breast cancer

What is it? It is a cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk.


* Worldwide, breast Cancer comprises 10.4% of all cancer incidence among women, making it the most common type in women.

* It is the fifth most common cause of cancer death, causing 5,19,000 deaths worldwide in 2004.

* Breast cancer has a comparatively lower chance of death (only 3%) as compared to other cancers.

Symptoms: The first noticeable symptom of breast cancer is typically a lump that feels different from the rest of the breast tissue and that's how more than 80% of such cancer cases are discovered. Other indications may include changes in breast size or shape, skin dimpling, nipple inversion etc.

Rarer symptoms include Paget's disease of the breast. This syndrome presents as skin changes such as redness and mild flaking of the nipple skin. As Paget's advances, symptoms may include tingling, itching, increased sensitivity, burning, pain and discharge from the nipple.

Prevention: Exercise may decrease breast cancer risk. Also avoid alcohol and obesity. Women can reduce their risk by maintaining a healthy weight, drinking less alcohol, being physically active and breastfeeding their children.

Diagnosis: While regular screening techniques are useful, a further testing is necessary to confirm if the lump is cancerous as opposed to benign. Most commonly used tests are mammography and clinical breast exams.

Treatment: Breast cancer is usually treated with surgery and then possibly with chemotherapy or radiation, or both. Hormone positive cancers are treated with long term hormone blocking therapy. Treatments are given with increasing aggressiveness according to the prognosis and risk of recurrence.

Stomach cancer

What is it? Gastric cancer, commonly referred to as stomach cancer, can develop in any part of the stomach and may spread throughout the stomach to other organs, particularly the esophagus, lungs, lymph nodes, and the liver.


* Causes about 8,00,000 deaths worldwide per year.

* It is the fourth most common cancer in the world with 9,20,000 cases diagnosed in 2002.

* It is more common in men and in developing countries.

Symptoms: The Stage One early symptoms include indigestion or a burning sensation, loss of appetite (especially for meat), abdominal discomfort or irritation. Stage 2 symptoms include weakness and fatigue, bloating of the stomach and Stage 3 symptoms include pain in the upper abdomen, nausea and occasional vomiting, diarrhea or constipation, weight loss, vomiting blood or having blood in the stool which will appear as black.

Diagnosis: The following exams are used to test for the same: Gastroscopic exam is the diagnostic method of choice. This involves insertion of a fiber optic camera into the stomach to visualise it. Other tests include the Upper GI series. The Computed tomography or CT scanning of the abdomen may reveal gastric cancer, but is more useful to determine invasion into adjacent tissues, or the spread to local lymph nodes. This particular type of cancer is difficult to cure unless it is found early, before it has begun to spread.

Treatment option: It varies from the usual surgery-chemotherapy-radiation and even multimodality therapy (combinations of the first three) but surgery is the most common as well as the most effective. The surgeon removes part or all of the stomach, as well as the surrounding lymph nodes, with the basic goal of removing all cancer and a margin of normal tissue.

Colon cancer

What is it? Colorectal cancer, also called colon cancer or large bowel cancer, includes cancerous growths in the colon, rectum and appendix.


* Responsible for 6,55,000 deaths worldwide per year, it is the third leading cause of cancer-related deaths in the western world.

* The risk of developing colorectal cancer increases with age. Most cases occur in the 60s and 70s, while cases before age 50 are uncommon unless a family history of early colon cancer is present.

Symptoms: The symptoms of colorectal cancer depend on the location of tumor in the bowel, and whether it has spread elsewhere in the body (metastasis). Most of the symptoms may occur in other diseases as well. Local symptoms include change in bowel habits, feeling of incomplete defecation, lower gastrointestinal bleeding including the passage of bright red blood in the stool or increased presence of mucus.

Prevention: Smoking, drinking heavily, an inactive lifestyle and unhealthy diets are the leading causes of this type of cancer and should be avoided to lower risk. Therefore, most colorectal cancers should be preventable.

Screening and Diagnosis:Colorectal

Cancer can take years to develop and early detection improves the chances of a cure. Tests for diagnosis include digital rectal exams, fecal occult blood tests and endoscopy. Other less used screening methods include double contrast barium enema and blood tests.

Treatment: Surgery can be categorised into curative, palliative and by-pass. This method of treatment is highly successful especially if the cancer is caught early. Chemotherapy is used to shrink tumor size, or slow tumor growth. Radiation therapy is not routinely used in colon cancer but is very useful in rectal cancer which is closely related to the same.


Lung cancer

What is it? It is a disease which consists of uncontrolled cell growth in the lung tissues. There are two types of lung cancer -0 Small Cell Lung Carcinoma (SCLC) and Non-Small Cell Lung Carcinoma (NSCLC).


* It is the most common cause of cancer-related deaths and is responsible for 1.3 million deaths worldwide

annually, as of 2004.

* NSCLC accounts for 80% of all lung cancers.

The high-risk category: People who smoke cigarettes, chew gutkha and tobacco are at a much higher risk. However if they quit completely it greatly reduces the risk.

Symptoms:"The most common symptoms include shortness of breath, coughing (including coughing up blood), and weight loss. It could also include pain in the chest, shoulders, or back. Watch out for a change in colour or volume of spit, changes in the voice, harsh sounds with each breath and recurrent lung problems, such as bronchitis or pneumonia," says Dr RK Deshpande, Consultant Onco-Surgeon at Breach Candy Hospital and Jaslok Hospital.

Diagnosis it:  Check whether you have been suffering from any of the symptoms for a long period of time. Though smokers are the main group at risk other factors like environmental pollutants could also be a cause.

Medical tests include physical examination, chest examination, chest X-ray, computed Tomography (CT) scan and bronchoscopy. Even with all the tests available, a biopsy is the only way to make a definite diagnosis of lung cancer.

Question to ask:

* Are you a smoker?

* Is there a history of cancer in your family, genetically predisposing you to it more?

If you answer yes to even one of the questions it would be wise to get yourself screened for lung cancer periodically.

Treatment option: If you have been diagnosed, possible treatments include surgery, chemotherapy, and radiotherapy. There are also a number of less invasive new therapies available like photodynamic therapy (the use of light to shine on cancer tissue), lung cancer vaccines, etc.

Liver cancer or hepatitic cancer

What is it It is considered to be a cancer which starts in the liver, as opposed to a cancer which originates in another organ and migrates to the liver (liver metastasis).


* Liver cancer, as a cause of death, is reported at less than 30 cases per 1,00,000 inhabitants in most of the world, with higher rates observed in parts of Africa and eastern Asia.

* Bile duct cancers account for 1 or 2 out of every 10 cases of liver cancer.

Symptoms: Symptoms, treatment and diagnosis all differ according to the type of liver cancer one is diagnosed with. But they range from jaundice, abdominal pain and weight loss to anemia, back pain, fever and itching.

Prevention: A 2009 study suggested that l-carnitine deficiency is a risk factor for liver cancer, and supplementation could reduce the risk.

Treatment: Some of the treatments available include surgery, chemotherapy, immunotherapy, photodynamic therapy, hyperthermia, radiation therapy and radiosurgery.


Coutesy: Mid Day