1-7 April Cancer Week

1-7 April Cancer Week

The Importance of Early Diagnosis in Cancer

Eastern Mediterranean University Faculty of Pharmacy Instructor Ahmet Sami Boşnak BPharm, Msc, PhD has prepared the following information to highlight some insights on cancer.

Cancer is the common name of over 100 types of disease that occurs by uncontrolled division of cells in various parts of the human body. Although it is known that there are many types of cancer, the common point of all is the onset of abnormal cells with uncontrolled proliferation. Cancer is a disease that can be started almost anywhere in the human body. As the cells of a healthy person get older or damaged, they are replaced by newly formed healthy cells. When cancer emerges, this usual pathway breaks down. Instead of healthy cells, the number of these abnormal cells increases and these cell divisions occur unintentionally. These abnormal cells can be divided continuously and form cell masses called tumors. Cancerous tumors are malignant. Malignant cancer cells can invade to nearby tissues and/or organs. While tumor growth continues, some cancer cells can travel to distant tissues and/or organs through the blood circulation or lymphovascular system and form new tumors away from the original tumor. 

 Cancer is a public health problem worldwide. Because of the important socioeconomic burden, cancer causes financial and emotional losses in society. Cancer is the second most important cause of death worldwide and caused the death of 8.8 million people in 2015. GLOBOCAN is a global research focused on the world's 20 geographical regions and estimating the incidence and mortality rates of cancer produced by the International Agency for Research on Cancer. GLOBOCAN predicts 18.1 million new cancer cases and 9.6 million cancer-related deaths in 2015. In both gender, lung cancer is the most common type of cancer with 11.6% of total cases. Nevertheless, 18.4% of cancer-related deaths in both gender are lung cancer. Lung cancer is followed by breast cancer in women with 11.6%, prostate cancer (7.1%), colorectal cancer (6.1%), gastric cancer (8.2%) and liver cancer (8.2%) in men. Lung cancer is the most common cancer in men and is the leading cause of cancer-related death. In women, breast cancer is the most common cancer, followed by colorectal, lung cancer and cervical cancer. If the incidence of cancer increases like today, in 2030, 22 million new cases are expected annually. This number means a 75% increase in new cases compared to 2008 data. In Cyprus, there were 3400 patients diagnosed with cancer in 2012, of whom 1500 died related to cancer.

Early detection of cancer increases the chance of successful treatment. Early diagnosis is possible in two ways: Performing health screening at the right time and public education to increase the awareness to these scans. Recognizing possible cancer warning signs and taking immediate action allows early diagnosis. Increasing awareness of possible cancer warning signs among the population may have a major impact on treatment success. Most common early signs of cancer are sensible tubers under the skin, non-healing wounds, abnormal bleeding, long-term gastrointestinal problems and hoarseness. Early diagnosis is possible especially in breast, cervix, mouth, larynx, colon, rectum and skin cancer.

Cancer screening refers to the tests performed in healthy individuals but who do not yet have symptoms to identify the disease. For example, mammography for breast cancer or cervical cancer screening performed by a method called Pap Smear are the most common methods of cancer screening. Screening can help physicians to detect many types of cancer early and treat them successfully before they cause symptoms. Early detected cancer treatment shall be much easier than late detection. When symptoms occur, cancer begins to spread and can be more difficult to treat.

The most common methods of cancer screening in the most common types of cancer are as follows;

Cervical Cancer:

• Cervical cancer screening tests should be started within the first 3 years or at the latest 21 years of age from the first sexual intercourse. Obstetrics and Pap tests should be performed every year.
• If the last 3 scans after the age of 30 are found to be normal, the screening intervals may be increased to 2-3 years.
• For women over the age of 30 and with normal results, another recommendation is the Pap test and the HPV-DNA test, which will be performed every 3 years.
• For women older than 70 years of age, if 3 or more of the last Pap tests or 10 of the consecutive tests are normal, screening for cervical cancer may be terminated.

Colorectal Cancer:

• The search for fecal occult blood: This test can detect bleeding in the stool, which can only be seen with a microscope. 3 stool samples taken on different days are tested. Repeats once a year.
• Colonoscopy: All small intestine is examined by entering a rectal tube with a light beam. If a suspected region like polyp, ulcer, etc. detects, it also allows for biopsy. Although it is reported that it should be done in people aged 50 and above, it is discussed how often. The last recommendation of the American Cancer Society is its repetition every 10 years. It is recommended to perform one of these screening tests in women and men from the age of 50 years.

Prostate cancer:

• Rectal examination and prostate specific antigen test (PSA test) are currently being investigated as screening tests in prostate cancer. These scans are recommended for men over 50 years of age. In high-risk individuals (one or more first-degree relatives of prostate cancer at an early age), these tests should be started at 45 years of age.
  

References:

1. Hejmadi M. Introduction to Cancer Biology. 2nd ed. Bookboon; 2010,p:7-16.
2. Pudata V, Subrahmanyam V, Jhanski K. A Short Note on Cancer. J Carcinogene Mutagene. 2011;2:4.
3. Cooper GM. The Cell: A Molecular Approach. 2nd ed. Sinauer Associates; 2000,p:65-71.
4. Tracey A, Martin A, Lin Y, Andrew J, Lane J, Wen G. Cancer Invasion and Metastasis: Molecular and Cellular Perspective. Landes Bioscience; 2013,p:243-254.
   
5. Haiguang L,Lin L,Kai Y. Chemotherapy targeting cancer stem cells. Am J Cancer Res. 2015;5(3):880–893.
6. Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.Ca Cancer J Clin. 2018;68:394–424.
7. http://www.cancerindex.org/Cyprus, Erişim tarihi: 15.06.2018.
8. https://kanser.org/saglik/toplum/pdf/Kanser_Tarama.pdf, Erişim tarihi: 15.03.2019