Introduction

Cancer is a group of diseases characterized by uncontrolled cell division leading to growth of

abnormal tissue. It is believed that cancers arise from both genetic and environmental factors that
lead to aberrant growth regulation of a stem cell population, or by the dedifferentiation of more
mature cell types. Cell multiplication (proliferation) is a normal physiologic process that occurs
in almost all tissues and under many circumstances, such as response to injury, immune
responses, or to replace cells those have died or have been shed as a part of their lifecycle (in
tissues such as skin or the mucous membranes of the digestive tract). Normally the balance
between proliferation and cell death is tightly regulated to ensure the integrity of organs and
tissues. Mutations in DNA that lead to cancer appear to disrupt these orderly processes.

The uncontrolled and often rapid proliferation of cells can lead to either a benign tumor or a
malignant tumor (cancer). Benign tumors do not spread to other parts of the body or invade other
tissues, and they are rarely a threat to life. Malignant tumors can invade other organs, spread to
distant locations (metastasize) and become life threatening.

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Cancer Symptoms Can Be Divided into Three Groups
Gc uocal symptoms: are restricted to the site of the primary cancer. They can include lumps
or swelling (tumor), hemorrhage (bleeding from the skin, mouth or anus), ulceration and
pain. Although local pain commonly occurs in advanced cancer, the initial swelling is
often painless.
Gc Metastatic symptoms: are due to the spread of cancer to other locations in the body. They
can include enlarged lymph nodes (which can be felt or sometimes seen under the skin),
hepatomegaly (enlarged liver) or splenomegaly (enlarged spleen) which can be felt in the
abdomen, pain or fracture of affected bones, and neurological symptoms.
Gc Systemic symptoms: occur due to distant effects of the cancer that are not related to
direct or metastatic spread. Some of these effects can include weight loss (poor appetite
and cachexia), fatigue, excessive sweating (especially night sweats), anemia (low red
blood cell count) and other specific conditions termed paraneoplastic phenomena. These
may be mediated by immunological or hormonal signals from the cancer cells.

None of these are diagnostic, as many of these symptoms commonly occur in patients who do
not have cancer.

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Causes of Cancer
Cancers are primarily an environmental disease with 90-95% of cases attributed to
environmental factors and 5-10% due to genetics. Environmental, as used by cancer researchers,
means any cause that is not genetic. Common environmental factors that contribute to cancer
death include: tobacco (25-30%), diet and obesity (30-35%), infections (15-20%), radiation (both
ionizing and no ionizing, up to 10%), stress, lack of physical activity, and environmental
pollutants.

Chemicals
The incidence of lung cancer is highly correlated with smoking. Cancer pathogenesis is traceable
back to DNA mutations that impact cell growth and metastasis. Substances that cause DNA
mutations are known as mutagens, and mutagens
that cause cancers are known as carcinogens.
Particular substances have been linked to specific
types of cancer. Tobacco smoking is created with
many forms of cancer, and causes 90% of lung
cancer. Many mutagens are also carcinogens, but
some carcinogens are not mutagens. Alcohol is an
example of a chemical carcinogen that is not a
mutagen. Such chemicals may promote cancers
through stimulating the rate of cell division. Faster rates of replication leaves less time for repair
enzymes to repair damaged DNA during DNA replication, increasing the likelihood of a
mutation. Decades of research has demonstrated the link between tobacco use and cancer in the
lung, larynx, head, neck, stomach, bladder, kidney, esophagus and pancreas. Tobacco smoke
contains over fifty known carcinogens, including
nitrosamines and polycyclic aromatic hydrocarbons.
Tobacco is responsible for about one in three of all
cancer deaths in the developed world, and about one
in five worldwide. uung cancer death rates in the
United States have mirrored smoking patterns, with
increases in smoking followed by dramatic increases
in lung cancer death rates and, more recently[when?,
decreases in smoking followed by decreases in lung cancer death rates in men. However, the
numbers of smokers worldwide is still rising, leading to what some organizations have described
as the tobacco epidemic.

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Diet and Exercise
Diet, physical inactivity, and obesity are related to approximately 30-35% of cancer cases. In the
United States excess body weight is associated with the development of many types of cancer
and is a factor in 14-20% of all cancer death. Physical inactivity is believed to contribute to
cancer risk not only through its effect on body weight but also through negative effects on
immune system and endocrine system. Diets that are low in vegetables, fruits and whole grains,
and high in processed or red meats are linked with a number of cancers. A high salt diet is linked
to gastric cancer, aflatoxin B1, a frequent food contaminate, with liver cancer, and Betel nut
chewing with oral cancer. This may partly explain differences in cancer incidence in different
countries for example gastric cancer is more common in Japan with its high salt diet and colon
cancer is more common in the United States. Immigrants develop the risk of their new country,
often within one generation, suggesting a substantial link between diet and cancer.

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*adiation
Up to 10% of cancers are related to radiation exposure either ionizing or no ionizing. Sources of
ionizing radiation include medical imaging, and radon gas. *adiation can cause cancer in most
parts of the body, in all animals, and at any age, although radiation-induced solid tumors usually
take 10±15 years, and up to 40 years, to become clinically manifest, and radiation-induced
leukemia¶s typically require 2±10 years to appear. Some people, such as those with nevoid basal
cell carcinoma syndrome or retinoblastoma, are more susceptible than average to developing
cancer from radiation exposure. Children and adolescents are twice as likely to develop
radiation-induced leukemia as adults; radiation exposure before birth has ten times the effect.
Ionizing radiation is not a particularly strong mutagen. *esidential exposure to radon gas, for
example, has similar cancer risks as passive smoking. uow dose exposures, such as living near a
nuclear power plant, are generally believed to have no or very little effect on cancer
development. *adiation is a more potent source of cancer when it is combined with other cancer-
causing agents, such as radon gas exposure plus smoking tobacco. Unlike chemical or physical
triggers for cancer, ionizing radiation hits molecules within cells randomly. If it happens to strike
a chromosome, it can break the chromosome,
result in an abnormal number of chromosomes,
inactivate one or more genes in the part of the
chromosome that it hit, delete parts of the DNA
sequence, cause chromosome translocations, or
cause other types of chromosome abnormalities.
Major damage normally results in the cell dying,
but smaller damage may leave a stable, partly
functional cell that may be capable of
proliferating and developing into cancer,
especially if tumor suppressor genes were
damaged by the radiation. Three independent
stages appear to be involved in the creation of
cancer with ionizing radiation: morphological changes to the cell, acquiring cellular immortality
(losing normal, life-limiting cell regulatory processes), and adaptations that favor formation of a
tumor. Even if the radiation particle does not strike the DNA directly, it triggers responses from
cells that indirectly increase the likelihood of mutations. Prolonged exposure to ultraviolet
radiation from the sun can lead to melanoma and other skin malignancies. Clear evidence
establishes ultraviolet radiation, especially the medium wave UVB, as the cause of most non-
melanoma skin cancers, which are the most common forms of cancer in the world. On-ionizing
radio frequency radiation from mobile phones, electric power transmission, and other similar
sources has also been proposed as a cause of cancer, but there is currently little established
evidence of such a link.

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Heredity
Hereditary nonpolyposis colorectal cancer (HNPCC, also known as uynch syndrome) can
include familial cases of colon cancer, uterine cancer, gastric cancer, and ovarian cancer, without
a preponderance of colon polyps.
*etinoblastoma, when occurring in young
children, is due to a hereditary mutation in the
retinoblastoma gene. Down syndrome patients,
who have an extra chromosome 21, are known
to develop malignancies such as leukemia and
testicular cancer, though the reasons for this
difference are not well understood.

Physical Agents
Some substances cause cancer primarily through their physical, rather than chemical, effects on
cells. A prominent example of this is prolonged exposure to asbestos, naturally occurring mineral
fibers which are a major cause of mesothelioma, a type of lung cancer. Other substances in this
category include both naturally occurring and synthetic asbestos-like fibers, such as wollastonite,
attapulgite, glass wool, and rock wool, are believed to have similar effects. Nonferrous
particulate materials that cause cancer include powdered metallic cobalt and nickel, and
crystalline silica (quartz, cristobalite, and tridymite).Usually, physical carcinogens must get
inside the body (such as through inhaling tiny pieces) and require years of exposure to develop
cancer.

Physical Trauma and Inflammation

Physical trauma resulting in cancer is relatively rare. Claims that breaking bone resulted in bone
cancer, for example, have never been proven. Similarly, physical trauma is not accepted as a
cause for cervical cancer, breast cancer, or brain cancer. One accepted source is frequent, long-
term application of hot objects to the body. It is possible that repeated burns on the same part of
the body, such as those produced by kanger and kairo heaters (charcoal hand warmers), may
produce skin cancer, especially if carcinogenic chemicals are also present. Frequently drinking
scalding hot tea may produce esophageal cancer. Generally, it is believed that the cancer arises,
or a pre-existing cancer is encouraged, during the process of repairing the trauma, rather than the
cancer being caused directly by the trauma. However, repeated injuries to the same tissues might
promote excessive cell proliferation, which could then increase the odds of a cancerous mutation.
There is no evidence that inflammation itself causes cancer.

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Hormones
Some hormones cause cancer, primarily by encouraging cell proliferation. Hormones are an
important cause of sex-related cancers such as cancer of the breast, endometrial, prostate, ovary,
and testis, and also of thyroid cancer and bone cancer. An individual's hormone levels are mostly
determined genetically, so this may at least partly explains the presence of some cancers that run
in families that do not seem to have any cancer-causing genes. For example, the daughters of
women who have breast cancer have significantly higher levels of estrogen and progesterone
than the daughters of women without breast cancer. However, non-genetic factors are also
relevant: Obese people have higher levels of some hormones associated with cancer, and a
higher rate of those cancers. Women who take hormone replacement therapy have a higher risk
of developing cancers associated with those hormones. On the other hand, people who exercise
far more than average have lower levels of these hormones, and lower risk of cancer. Sarcoma
may be caused by growth hormones some treatments and prevention approaches leverage this
cause by artificially reducing hormone levels, and thus discouraging hormone-sensitive cancers.

Others
Excepting the rare transmissions that occur with pregnancies and only a marginal few organ
donors, cancer is generally not a transmissible disease. The main reason for this is tissue graft
rejection caused by MHC incompatibility. In humans and other vertebrates, the immune system
uses MHC antigens to differentiate between "self" and "non-self" cells because these antigens are
different from person to person. When non-self antigens are encountered, the immune system
reacts against the appropriate cell. Such reactions may protect against tumor cell engraftment by
eliminating implanted cells. In the United States, approximately 3,500 pregnant women have a
malignancy annually, and transmission of acute leukemia, lymphoma, melanoma and carcinoma
from mother to fetus has been observed. The development of donor-derived tumors from organ
transplants is exceedingly rare. The main cause of organ transplant associated tumors seems to
be malignant melanoma, which was undetected at the time of organ harvest. Though other cases
existing fact, cancer from one organism will usually grow in another organism of that species, as
long as they share the same haste compatibility genes, proven using mice; however this would
never happen in a real-world setting except as described above.

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The role of diet in causing cancer
Our diet may increase cancer risk in several ways:

Gc Carcinogens (substances that cause cancer)

Gc High fat and excess calories from food salt
Gc uow fiber
Gc Alcohol
Gc Pesticides (No clear evidence in the humans)

Its role in the increased risk of cancer has been widely studied but the results may be different
depending on how the study was conducted. In general, there were some conclusions about the
risk and much study is ongoing in this area of influence of diet on cancer.

Dietary Carcinogens
Naturally present carcinogens: An example of this is' Aflatoxin, a mycotoxin produced by fungi.
Grains and nuts can be contaminated by fungi, which produce chemicals called aflatoxins. There
are known to cause liver cancer in Africa and the Far East, especially in people who are carriers
of hepatitis antigens. The formation of carcinogens during food preparation: Polycyclic aromatic
hydrocarbons such as benzopyrene, are formed during the barbecue meat on an open fire (eg
preparing chicken abruptly). These hydrocarbons are also major components in cigarette smoke
that cause lung cancer). The traditionally high consumption of fried and grilled food such as
meat may increase the risk of breast cancer in distal colon, prostate and pancreatic cancers.
Several studies showed that populations that eat fried or grilled meats have a relative risk greater
than 2 (deviation from the median) for colon cancer and breast cancer. More than 20 chemicals
have been identified. They are present in very small quantities, but their action is promoted, an
effect associated with n-6 polyunsaturated oils like corn or safflower oil in 30-40% of energy in
animal and human studies. A lower consumption of fat, 15-22% of energy, drastically reduce the
effects.

Preservatives and dyes added to food: (Need more evidence to establish this relationship). Food
coloring added to enhance the attractiveness of food, but not all are good for us. An example is
butter yellow and. artificial sweeteners (like saccharin and cyclamate) and preservatives which
produce nitrosamines are known to cause bladder cancer and stomach, respectively. Some
substances become Carcinogens: Nitrosamines are formed from sodium nitrite. Sodium nitrite is
present in drinking water and vegetables.

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Diet rich in fats and excess calories
People eat foods containing high levels of fat are more prone to colon, prostate, breast and
pancreatic cancer. uow incidence of cancer related to nutrition in Japan and around the
Mediterranean is due to the popularity of monounsaturated oil like olive oil and n-3
polyunsaturated oils such as fish oil.

Dietary fats ± especially omega-6-

polyunsaturated oils, are the promoters¶ powerful
breast, colon, prostate and pancreatic cancer in
humans and in animal studies. This effect was
observed with 40% of calories, but not with 15-
20% of calories. The typical dietary intake of the
American diet genesis of breast tumors
effectively increased when fed at 40% of
calories.

Saturated fats
Saturated fats like butter, cheese, red meat, egg yolk, etc. ± are more dangerous than
monounsaturated. (A type of oil from the fat found in fish oils called 'Omega-3 fatty acids are
good for health in the prevention of heart disease.) Fish contain 20-25% saturated fat and are a
rich source of n-3 fatty acids, vitamin D and E.
There is an inverse relationship between colorectal
cancer and intake of fish. We also found it salty
foods such as fish and pickled vegetables.
Esophagus stomach cancers are more common in
people who eat salty food. Salt damages the
protective coating on the stomach lining and
exposes the sensitive mucosa to carcinogens and
chemicals. In the U.S., glandular stomach cancer
and mortality from the disease were high before
1920 with the traditional use of salt and salt to preserve food. However, the incidence began to
decline in later years was made available as refrigerated storage.

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Alcohol
Alcohol increases the risk of mouth, larynx, esophagus, stomach and rectum. The incidence of
these cancers among alcoholics is ten times higher than in the general population. Chronic
alcoholism accelerates chemically induced rectal carcinogenesis and raises the possibility that
acetaldehyde, probably generated through bacterial ethanol oxidation, can participate in this
process. The secondary hyper regeneration mucosa, observed after drinking alcohol can, by
itself, for carcinogenesis. Not more than 2 drinks per day are recommended. Pesticides and
fungicides (There is no clear evidence in humans).These are used to keep vegetable crops free of
pests and diseases. They are present in low amounts in vegetables.

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Viruses Causes Cancer

Cervical Cancer and Oral Cancer Due to Cause of HPVs

There are other forms of HPV which are also sexually transmitted, and are a serious problem.
These are; HPV-16, HPV-18, HPV-31, and HPV-45. These cancer-associated types of HPVs
cause dysplastic tissue growths that usually appear flat and are nearly invisible. Dysplastic tissue
is the presence of abnormal cells on the surface of the skin. Dysplasia is not cancer, but it is a
tissue change seen prior to malignancy. A highly studied topic is HPV's ability to cause cervical
cancer. Dysplasia can be detected on the female cervix through a Pap smear test, or seen visually
using a magnifying glass called a colposcope. The most dangerous HPV's, 16 and 18, which are
transmitted through sexual contact, are known to cause up to 95% of cervical cancers. Now these
two HPV's are also being linked to oral cancer.

A recent study conducted by Dr. Maura Gillison at the Johns Hopkins Oncology Center furthered
the premise that HPV is linked with certain types of oral cancer. In 25% of 253 patients
diagnosed with head and neck cancers, the tissue taken from tumors was HPV positive and HPV
16 was present in 90% of these positive HPV tissues. This information helps to confirm that
there is a strong link between HPV 16 and oral cancer. 25% of those diagnosed with oral cancer
are non-smokers while the other 75% of those diagnosed have used tobacco in some form during
their lifetimes. The research into the relationship of HPV and oral malignancies may give us
clues as to the origin of cancer in those 25% of diagnosed individuals who did not smoke.
Further research is being conducted into the relationship of HPV with oral cancers.

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Hepatitis B and Hepatitis C Virus Causes Cancer of uiver
Hepatitis B and Hepatitis C virus (HCV) infection is also associated with the development of
liver cancer. In fact, in Japan, hepatitis B and C virus is present in up to 75% of cases of liver
cancer as with hepatitis B and C virus. In addition, the majority of hepatitis B and C virus
patients with liver cancer have associated cirrhosis (liver scarring). In several retrospective-
prospective studies (looking backward and forward in time) of the natural history of hepatitis B
and C, the average time to develop liver cancer after exposure to hepatitis B and C virus was
about 28 years. In hepatitis C virus patients, the risk factors for developing liver cancer include
the presence of cirrhosis, older age, male gender, elevated baseline alpha-fetoprotein level (a
blood tumor marker), alcohol use, and co-infection with hepatitis B virus. Some earlier studies
suggested that hepatitis C virus genotype 1b (a common genotype in the U.S.) may be a risk
factor, but more recent studies do not support this finding.

The way in which hepatitis C virus causes liver cancer is not well understood. Unlike hepatitis B
virus, the genetic material of hepatitis C virus is not inserted directly into the genetic material of
the liver cells. It is known, however, that cirrhosis from any cause is a risk factor for the
development of liver cancer. It has been argued, therefore, that hepatitis C virus, which causes
cirrhosis of the liver, is an indirect cause of liver cancer.

On the other hand, there are some chronic hepatitis C virus infected individuals who have liver
cancer without cirrhosis. So, it has been suggested that the core (central) protein of hepatitis C
virus is the culprit in the development of liver cancer. The core protein itself (a part of the
hepatitis C virus) is thought to impede
the natural process of cell death or
interfere with the function of a normal
tumor suppressor (inhibitor) gene (the
p53 gene). The result of these actions is
that the liver cells go on living and
reproducing without the normal
restraints, which is what happens in
cancer.

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HIV Virus Cause Cancer
In the past, people with HIV often got three types of cancer: Kaposi's sarcoma, non-Hodgkin's
lymphoma, and cervical cancer (in women). These are called AIDS-related cancers because they
occur more often in people whose immune systems have been weakened by HIV/AIDS. Here are
some facts about these cancers: Kaposi¶s sarcoma this cancer grows into reddish-purple patches
on your skin that cannot kill you. It can be deadly if it gets in your throat or lungs. A herpes virus
causes Kaposi's sarcoma. Non-Hodgkin's uymphoma This cancer usually starts in the lymph
glands, which are part of your immune system and help fight off disease. uymph glands are
mainly in the neck, under the arms, in the groin, and inside the belly. Epstein - Barr virus is a risk
factor for this cancer. Invasive cervical cancer this affects the cervix, the entrance from the
vagina to the uterus. Almost all women who get cervical cancer also have HPV. Having HIV and
HPV makes cervical cancer grow faster.

Helicobacter pylori Infection

This unusual name identifies a specific bacterium that can cause infection of the stomach. This
infection can contribute to the development of diseases, such as dyspepsia (heartburn, bloating
and nausea), gastritis (inflammation of the stomach), and ulcers in the stomach and duodenum. It
will be useful to know some things about the upper digestive tract to understand how and where
Helicobacter pylori infection can occur. These two types of cancer are now known to be related
to H. pylori bacteria. This does not mean that all people with H. pylori infection will develop
cancer; in fact, very few do. However, it is likely that if the infection is present for a long time,
perhaps from childhood, these cancers may then develop. This is another reason why it is
important to treat H. pylori infection.

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Different Types of Cancer

Bone Cancer
Bone cancer is the most hazardous form of cancer.
This type of cancer affects children more than the
adults. The most common type of bone cancer is
osteosarcoma, which develops in new tissue in
growing bones. Osteosarcoma, also called
osteogenic sarcoma, is a cancer of the bone that
usually affects the large bones of the arm or leg.
Bone cancer is rare and only accounts for 0.2% of
all cancers. Approximately 8,000 Americans will be diagnosed with soft tissue sarcoma this year
and about 3,500 will die as a result. The most common type of primary bone cancer is
osteosarcoma, which develops in new tissue in growing bones. How bone cancer is treated
depends on the type of bone cancer you have, how far it has spread, your age and your general
health. The treatment for these rare tumors is carried out in expert centers where cancer
specialists (oncologists) and surgeons are familiar with the special treatments required. The most
common symptom of bone cancer is pain, which is caused either by the spread of the tumor or by
the breaking of bone that is weakened by a tumor. Stiffness or tenderness in the bone may also
occur. While fluoride carries many health risks, bone cancer is perhaps the most invasive. Bone
cancer can be a long term and irreversible health complication that can result in death if
metastasis occurs. Definition of bone cancer: Primary bone cancer is cancer that forms in cells of
the bone. Some types of primary bone cancer are osteosarcoma, Ewing¶s sarcoma, malignant
fibrous histiocytoma, and chondrosarcoma. The cumulative radiation dose required to give
significant risk of bone cancer is found to be much less at lower dose rates than at higher rates,
but the time required for the tumors to be manifested is longer

Endometrial cancer
The most common gynecological cancer which is found among the women is endometrial
cancer. It is also known as uterine cancer. Here one would like to seek the answer to the question
that what is endometrial cancer? Endometrial cancer is the sub type of cancer that is attributed to
the development of abnormality in the women uterus in relatively older age. Many factors are
associated to its development in women uterus. The women who are fat often have high chances
of developing risks of this cancer than skinny women. Besides, the women who get menses at
very young age or have few chances of pregnancy and off springs build up a tendency of

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endometrial cancer. Sometimes, the women who face problems in the regular menses due to
physical and mental reasons also have the likelihood of getting endometrial cancer. The risk of
endometrial cancer is also attached to the glut of female hormones that are responsible for
pregnancy.

Brain Cancer
Brain cancer is a hideous affliction ² in many respects harder on the family than the one with
the cancer. I¶ve dealt with losing friends and family to brain cancer, so I know how the course of
such cancer often proceeds. The prognosis for those with primary brain cancer is not promising.
Out of the 17,000 people diagnosed with primary brain cancer in the United States each year,
about 13,000 perish from the disease. Gene therapy against brain cancer is receiving increased
research attention. In January, researchers in San Diego treated a 51-year-old woman with her
own cells, genetically altered to contain a gene for interleukin 2, a protein that bolsters the attack
cells in the immune system. So now that we know the basics of what is Brain Cancer, we need to
explain that Brain cancer is diagnosed in about 200,000 patients per year with approximately
40,000 being primary brain cancer, and the remainder the result of metastasis from other distant
primary cancers such as breast, lung and colon. Approximately 60% of brain cancers are
diagnosed as astrocytoma of which there are four forms, grade I through IV.

Instead brain cancer is usually suspected because of the symptoms it causes including headache,
nausea, vomiting, or blurred vision. If symptoms suggest a CNS tumor is present, imaging
studies including magnetic resonance imaging (M*I) or computer tomography (CT) scans are
used to confirm and locate the tumors. Secondary brain cancer is named for the organ or tissue in
which the cancer begins, such as lung cancer with secondary brain metastasis. Among the
malignant diseases, brain cancer is unique in that the organ affected is traditionally viewed as the
seat of an individual¶s literal sense of identity.

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Mouth Cancer
Cancer is of hundreds of types. Usually people are familiar with the frequently observed forms of
cancer. The people who excessively use tobacco and are addicted to smoking, often become a
prey of mouth cancer if remain indulged in the act of smoking in long run. Most of the people
who are engaged in smoking are unfamiliar with what is mouth cancer? Mostly the youth and
middle aged individuals including both men and women can be found as addicts of smoking. Not
only the long run smokers have the chances of becoming mouth cancer patients, but also the
alcohol users equally face such risks. As oral cancer is related to the cancers that are related to
the head and neck of human body, the mouth cancer being a form of oral cancer is related to the
same area. The mouth cancer can be in the form of a cavity. A few minutes trouble free
inspection of alcohol users and smokers by a qualified oral and ENT specialist or a dentist can
help identify the mouth cancer. The decreased used of alcohol and tobacco can help avoid and
protect one from the oral cancer. It is originated due to many factors. It can be caused by tobacco
and alcohol usage. It can also begin due to the continuous exposure to the sun light. The sun burn
can affect the lips which can be protected by using sun blocking products. The individuals who
cannot avoid remaining exposed to the sun light, due to the nature of their job or for unavoidable
other circumstances should use sun blocking products to avoid the risk of mouth cancer.

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Kidney cancer
Before answering what is kidney cancer, it is best to
define the function of the kidneys. The kidneys are
a pair of organs on both sides of the spine located in
the lower portion of the abdomen. Each is about the
size of the fist with an adrenal gland attached on top
of each. Fatty tissue with an outer layer of fibrous
tissue called Gerota¶s fascia enclose the kidneys and
adrenal glands. The kidneys are part of the urinary
tract. The product of the kidneys is the urine which is the liquid wastes and extra water from the
blood. Urine is collected in the renal pelvis in the middle of each kidney. When the kidneys are
full, the urine passes from the renal pelvis into the bladder through a tube known as the ureter.
Urine then goes through the urethra leaving the human body. Aside from the kidneys¶ urinary
function, it also produces substances that aid in the control of blood pressure and production of
red blood cells.

Any cancer determined to originate from the kidney

is kidney cancer. It is uncommon for cancer of the
kidney to arise from another primary part outside the
kidneys. Therefore, it is rather unlikely to have
metastatic cancer of the kidney. Types of kidney
cancer are divided into two reflecting their location
within the kidney. These are renal cell carcinoma
(*CC) and urothelial cell carcinoma (UCC) of the
renal pelvis. *enal cell carcinoma, also called renal
cell cancer, develops in the lining of the renal tubes ± tubes that filter blood and produce urine.
Urothelial cell carcinoma, also called transitional cell carcinoma, typically occurs in the urinary
system: kidney, urinary bladder, and accessory organs. This is the most common type of bladder
cancer and cancer of the ureter, urethra, and urachus. In simple terms, most cancers in the renal
tubule are renal cell carcinoma and clear cell adenocarcinoma; most cancers in the renal pelvis
are transitional cell carcinoma.The distinction between renal cell carcinoma and urothelial cell
carcinoma is relevant due to respective prognosis, staging, management, and treatment of the
cancer types.

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Skin Cancer
Basal cell carcinoma is the most common skin cancer. This form rarely metastasizes and almost
never leads to fatality. Nevertheless, it damages the surrounding tissue of the affected part of the
skin. Ultraviolet radiation from the sun is the main cause of skin cancer. This explains why the
greatest rates of skin cancer are found in Australia and Africa where relatively greater amount of
UV rays is received. Ultraviolet radiation in tanning booths, popular among adolescents, may
cause skin cancer. Therapeutic radiation from treatments of other health problems or cancers
increases the risks of having skin cancer. Usually, even though skin protection should start at an
early age, skin cancers appear after fifty years of age. People with lighter skin are more prone to
skin cancer. Exposure to the sun, exposure to ultraviolet radiation, therapeutic radiation, age, and
light skin color are risk factors involved in the development of basal cell carcinoma.

A basal cell carcinoma begins to appear

as a small bump covered by
telangiectases. The bump may be pearly
or dark (melanin pigmented). It is
difficult to tell the difference between a
basal cell carcinoma from benign growth
without a biopsy. Basal cell carcinomas
often on the chest or back and grow
slowly for a period of months or years.
If such growth develops near the eye, ear, or nose, such facial parts may be damaged or
disfigured.

Biopsies are performed to diagnose a skin condition displaying similar characteristics to what is
skin cancer. The method wherein a small piece of skin is scraped as a sample is called shave
biopsy. Presence of cancer cells can then be examined with the use of a microscope

Aden carcinoma lung cancer

Non-small cell lung cancers are grouped together because they display similar prognosis and
management options. These sub-types are Aden carcinoma lung cancer, squalors cell lung
cancer, and large cell lung cancer. Aden carcinoma is a cancer that arises in a glandular tissue.
The tissue is also part of a larger category, the epithelial. Aden carcinomas do not have to be part
of the gland. As long as they have secretary properties, they can be classified as Aden
carcinomas. Such form of carcinoma occurs in few higher mammals including man. Through
biopsy, a pathologist determines if the tumor is an Aden carcinoma or another type of cancer.
Aden carcinoma can originate in many tissues of the body. Each gland does not secrete the same
substance but for as long as there is an exocrine function to the cell, it is considered glandular. A

18
malignant form therein is named ³Aden carcinoma´. Abnormal tissue that is considered benign
(not malignant) is called ³adenoma´. Adenomas typically do not invade other tissues and rarely
spread or metastasize as opposed to Aden carcinomas that invade other tissues and metastasize.
Aden carcinoma lung cancer is the most common type of lung cancer in patients who have never
smoked all their lives. It accounts to about 10 percent of lung cancers. Unlike small cell and

squalors cell lung cancer, this cancer is

commonly seen peripherally in the lungs.
Smokers may also be diagnosed in smokers
but not as usual as it would be found in non-
smokers. In a biopsy, Aden carcinoma lung
cancer tends to stain musing positive as it is
derived from the lung glands that produce
mucus.

Prostate cancer
Prior to answering what is prostate cancer, it is best to define the prostate gland. The prostate
gland is found in the male reproductive system. It is located at the base of the urinary bladder
surrounding the urethra which is the passage through which urine is drained before exiting from
the penis. It helps control urination and produces several substances found in normal semen like
minerals and sugar. Semen is responsible for transporting sperm. However, man can survive
without his prostate gland. The size of a man¶s prostate gland usually enlarges with aging. Such
process is called benign prostatic hypertrophy which is a condition that does not have anything to
do with prostate cancer. Nevertheless, BPH and prostate cancer may cause similar problems in
older men.

Prostate cancer is a malignant growth of cells from

the prostate gland. The tumor usually develops
slowly and stays within the gland for years. In its
early years, the tumor produces little to none of the
symptoms. But the cancer cells may metastasize to
other parts of the body such as bones, lungs, liver,
and lymph nodes. Symptoms are therefore noticed
during the advanced stages of prostate cancer.
Prostate cancer is the most common cancer in men.
After lung cancer, it accounts to the second leading cancer deaths. It is then recommended that
upon reaching age 40, men must actively seek screening for prostate cancer on a yearly basis.

19
Causes of prostate cancer are still unknown. *isk factors associated with prostate cancer are: age,
genetics (heredity), race, diet, lifestyle, medications, hormonal influences, and environmental
factors including toxins, chemicals and industrial products. Age is the primary risk factor where
prostate cancer under age 40 is very rare and is common in men above 80.

Studies suggest that among men above 80, 50 to 80

percent may have prostate cancer. A family history
of cancers increases one¶s risk of having prostate
cancer. Black American men have a higher risk than
Japanese or white Americans. Diet, lifestyle, and
other environmental factors are considered risk
factors such that Japanese men who move to the
United States significantly increase their risk

Pancreatic cancer
The pancreas is a yellowish organ behind the stomach about six to seven inches long. It produces
digestive internal and external secretions. The
pancreatic juice contains enzymes that facilitate
digestion by breaking down large molecules into simple
sugars. The secreted hormones work together to
regulate sugar level in the blood.

Conventional pancreas cancer treatment options are

surgery, radiation, chemotherapy, and immunotherapy.
Surgery is a pancreas cancer treatment option. Surgical
oncologists can perform difficult and complex surgical procedures for pancreatic cancer. Some
surgical procedures include the whipped procedure, distal and total Pancreatectomies, and
surgical palliative procedures. Chemotherapy and radiation therapy may be applied in addition to
surgery. These other conventional treatment options may be performed before or after surgery.

When a tumor appear to be inoperable, innovative radiation therapies can be a pancreas cancer
treatment option. *adiation therapies may be offered alone or paired with a surgery and
chemotherapy, or both, to treat pancreatic cancer and relieve its symptoms. The position of the
pancreas (hidden behind other organs), radiation therapy requires a high level of accuracy and
precision. New techniques have been developed to offer the most targeted radiation treatment for
pancreas cancer. An advanced radiation therapy delivery system targets difficult-to-reach cancers
in the pancreas. It also allows higher radiation doses focused on pancreatic cancer cells with
reduced doses to normal pancreatic tissue. Chemotherapy is a common cancer treatment and is
one of the most chosen pancreas cancer treatment.

20
Treatment of Cancer

Surgery
Cancer surgery attempts to remove localized tumors completely or reduce the size of large
tumors so that follow-up treatment by radiation or chemotherapy will be more effective. The
surgery may be done as a diagnostic (staging) process as well as a treatment process, and these
two processes may take place simultaneously. For that reason, the surgeon may remove the
primary tumor, some normal tissue surrounding the tumor (to make sure that s/he gets it all, and
also to compare the cancer cells with the healthy cells to aid in diagnosis), the lymph nodes near
the primary tumor (to detect and guard against the spread of individual cancer cells that may
have already lodged in these lymph nodes), and any organs in the body that may already be
affected by the cancer.

Sometimes the surgeon will take out not only the lymph nodes adjacent to the tumor but all the
lymph nodes in the region. This may be done to check the spread of cancer or to determine
whether the cancer has spread further than the clinical diagnostic tests have shown. In addition to
curative surgery, surgery may also be performed as a preventive measure (to remove
precancerous conditions) and/or a palliative measure (to reduce pain and other symptoms). If
curative surgical procedures cause any disfigurement or deformity, reconstructive surgery may
be done to repair the damage.

Questions to Ask Prior to Surgery

c Exactly what will the operation involve, and what do they hope to achieve with the
operation?
c Is there a less radical procedure that can be done?
c Will the operation deform the patient in any way or cause psychological problems, and if
so, how will these problems be dealt with?
c What risks are involved?
c What will happen if surgery is postponed or not done at all?
c Are there any treatment alternatives that don't involve surgery?

21
The Principles of *adiotherapy for Cancer
*adiation therapy or also known as radiotherapy is a standard treatment method for cancer, along
with surgery and chemotherapy. Currently, it is utilized to cure localized solid tumors like breast
cancer, skin cancer and even cervical cancer. It may as well be utilized for lymphoma and
leukemia treatment

*adiotherapy causes cancerous cells the inability to develop and multiply by ruining the DNA
structure located in these cancerous cells. *adiation exposure is applied with the hope of
eradicating the cancer and curing the disease. The procedure of radiotherapy itself is intended to
target cancer cells; there is a possibility that healthy cells adjacent the tumor becoming affected
by the exposure thus causing damages to these healthy cells. The basic technique of radiotherapy
is to optimize tumor cell radiation exposure while minimizing the exposure to healthy cells.
When healthy cells are exposed to radiation, it may cause several adverse effects. The progress
and development radiotherapy is limited due to these negative side effects. Although, there are
other types of radiotherapy which results in minimal harm to the healthy tissue surrounding the
tumor since they are quite focused to the cancer. These types of sophisticated radiotherapy
include proton therapy and Cyber Knife therapy.

The success of radiotherapy increases with the use of radio sensitizers and radio protectors.
Several substances that are rediosensitizers include green tea, cur cumin, genistein and even
hyperthermia. On the other hand, substances that are considered to be radioprotectors include
glutathione, shark oil, whey protein, and ginseng. *adiotherapy is a very detailed and intricate
procedure which requires thorough preparation since the success of radiotherapy also depends on
specific drugs, technical approaches and nutritional supplements. These additional factors can
help improving and even curing side effects brought forth by radiotherapy exposure.

uearning about *adiotherapy and Brach therapy for Prostate Cancer

When dealing with the treatment of prostate cancer, several methods come to mind. Usually,
various different treatment methods are combined to achieve the most optimal results. One
treatment method for prostate cancer is Brach therapy. This is a form of treatment where several
radiation seeds are inserted into the cancerous tumor located in the prostate gland. Subsequently,
the inserted seeds produce a dose of radiation into the tumor over a certain time frame which can
be several months depending on the stage of the cancer.

Even though Brach therapy has the same principal as conventional radiotherapy, the way it is
administered is quite different. The basic mechanism of both methods is to apply radiation to

22
eradicate cancerous cells. With Brach therapy radiation seeds supply the dosage of radiation need
to eradicate the cancer. With this method, radiation exposure levels are not damaging to other
parts of the body, but it can still cause short term and long term side effects. A majority of Brach
therapy side effects are similar to conventional radiotherapy but there are slight differences.

Several short term side effects for prostate cancer radiotherapy include tiredness, pubic hair loss,
diarrhea and cystitis which can cause pain during urination. As for the long term side effects of
prostate cancer radiotherapy include urinary incontinence and difficulties or inability to have an
erection. On the other hand, Brach therapy is less likely to cause urinary incontinence compared
to conventional radiotherapy.

Understanding the Various Techniques of *adiotherapy

*adiation therapy or also known as radiotherapy is regularly used to treat cancer. Currently,
along with surgery and chemotherapy, radiotherapy is a standard treatment protocol for various
types of cancer. Though, compared to other types of treatment modalities such as surgery and
chemotherapy, radiotherapy has the least amount of knowledge and understanding by a majority
of the public. Basically, there are four variations or types of radiotherapy which are explained
below.

First of all is the conventional and conformal therapy, this procedure is usually administered to
simple and basic cancer cases. This technique uses single or double beam directions to irradiate a
specific target area without the use of intricate shielding areas of the body that has not been
affected by the cancer such as the spine or brain. The basic principal for this procedure is
applying multiple radiation beam directions to focus as close as possible towards the target are
subsequently delivering enough radiation dosage to the cancer area and simultaneously limit
radiation exposure to healthy tissues close by. Three dimension anatomic data of the patient is
essential for both conventional and conformal therapy techniques in order to obtain close
distributions of the cancer area.

The following radiotherapy technique is Intensity Modulated *adiation Therapy or IM*T for
short. Currently, it is the most sophisticated radiotherapy technology available. This technique
allows non uniform radiation beams to be irradiated onto the patient from any position of the
radiation source thus optimizes radiation distribution in a composite dosage. Basically, the result
of IM*T therapy is quite more significant compared to other radiotherapy techniques since it
limits the exposure of healthy organs and tissue to radiotherapy exposure. This technique allows
higher doses of radiations to be focused on the cancer cells without enhancing the side effects of
radiation exposure. Subsequently, this increases the survival rate post cancer therapy

23
Cancer Chemotherapy
Normally, your cells grow and die in a controlled way. Cancer cells keep forming without
control. Chemotherapy is drug therapy that can stop these cells from multiplying. However, it
can also harm healthy cells, which causes side effects. During chemotherapy you may have no
side effects or just a few. The kinds of side effects you have depend on the type and dose of
chemotherapy you get. Side effects vary, but common ones are nausea, vomiting, tiredness, pain
and hair loss. Healthy cells usually recover after chemotherapy, so most side effects gradually go
away. Your course of therapy will depend on the cancer type, the chemotherapy drugs used, the
treatment goal and how your body responds. You may get treatment every day, every week or
every month. You may have breaks between treatments so that your body has a chance to build
new healthy cells. You might take the drugs by mouth, in a shot or intravenously.

What does chemo do?

There are more than 100 chemo drugs used today. Doctors choose certain types of drugs based
on the kind of cancer you have and the stage of your cancer growth. Chemo can be used for
different reasons. Your doctor will discuss these with you before you start treatment.

c Chemo can be used to:

c Keep the cancer from spreading.
c Slow the cancer's growth.
c Kill cancer cells that may have spread to other parts of the body.
c *elieve symptoms caused by cancer.
c Cure your cancer.

How is Chemo Given?

Most chemo drugs are given in one of these ways:

c If your chemo is a pill or liquid, just swallow it as your doctor prescribes. You can take
some drugs at home, but you must be careful to follow the directions.
c Chemo can be given like a flu shot. The shots may be given in your doctor's office, a
hospital, a clinic, or at home.
c Most often, chemo drugs are put into your vein through a needle or tiny plastic tube
called a catheter. This is called an IV (intravenous) chemo.
c Other types of chemo can be put right into the spine, chest, or belly (abdomen), or rubbed
on the skin.

24
You may get chemo once a day, once a week, or even once a month. It depends on the type of
cancer you have and the drugs you are getting. Chemo is usually given with breaks between
treatment cycles. This break gives your body time to rebuild healthy new cells and helps you
regain your strength. How long you get chemo depends on the type of cancer, your treatment
goals, and how your body responds to the drugs.

Dietary
Dietary recommendations to reduce the risk of developing cancer, including: reducing intake of
foods and drinks that promote weight gain, namely energy-dense foods and sugary drinks, eating
mostly foods of plant origin, limiting intake of red meat and avoiding processed meat, limiting
consumption of alcoholic beverages, and reducing
intake of salt and avoiding moulds cereals (grains) or
pulses (legumes).Proposed dietary interventions for
cancer risk reduction generally gain support from
epidemiological association studies. Examples of
such studies include reports that reduced meat
consumption is associated with decreased risk of
colon cancer, and reports that consumption of coffee
is associated with a reduced risk of liver cancer.
Studies have linked consumption of grilled meat to an increased risk of stomach cancer, colon
cancer, breast cancer, and pancreatic cancer, phenomenon which could be due to the presence of
carcinogens in foods cooked at high temperatures. A 2005 secondary prevention study showed
that consumption of a plant-based diet and lifestyle changes resulted in a reduction in cancer
markers in a group of men with prostate cancer who were using no conventional treatments at the
time. These results were amplified by a 2006 study.

25
Cancer Patients in Bangladesh
There are about one million cancer patients in Bangladesh at present and every year about two
hundred thousand patients are affected by cancer and about 1, 50, 00 people die of cancer. In a
registry report, there should have many information of a patient under a specific collection
process, its preservation and analysis, which would found in a report format. This report would
help to find out reasons for disease and would give idea of the risk factor of the disease. This
registry system is two types. One is hospital-based registry and other is population-based registry
system, he added. Dr Habibullah further said that the government has started population- based
registry system, which would cost US$ 10,000 per year under the µBiennial Plan of Action
Project for 2005-2006 and 2006-2007 fiscal year. Prof SA* Choudhury, Medical Advisor of
*oche Bangladesh utd, said cancer causes 7 million deaths annually in the world and it is the
second most common cause of death in developed countries. In Europe, cancer claims almost 1.7
million lives each year. He also added that lung, colorectal and breast cancer each claim over one
million new cases per year worldwide. In developed countries, rate of breast cancer patients are
increasing day by day, while in western countries, cervical cancer patients are higher. In
developing countries, especially Bangladesh, India and other South Asian countries are in high-
risk condition in breast cancer. uack of awareness is the main reason for increasing breast
cancer.

There are proper educations on preventive action of breast cancer, religious factor and social
taboo make the situation difficult taking any action for the prevention of breast cancer. uow
budget, shortage of manpower, lack of cancer registry software is main problems in functioning
of the registry with high level of quality. For completeness of the information such as staging,
clinical extent, performance status, detailed treatment and follow-up, more active participation
from the clinical departments is required, he added. According to the draft annual report 2005 of
the National Institute of Cancer *esearch and Hospital, top five cancers in male are ± lungs 24.7
per cent, unknown primary site 8.1 per cent, larynx 7.3 per cent, lymphatic and lymph node 7.3
per cent and esophagus 5.1 per cent. To five cancers in females are cervix 24.6 per cent, breast
24Ǐ per cent, lungs 5.5 per cent, oral cavity 4.1 per cent and ovary 3.8 per cent

Children at Great *isk

Children are at particular risk to the harmful side effects of food adulteration, which may lead to
serious liver and kidney diseases including various forms of cancer and Hepatitis, experts warn.
The misuse of DDT powder, formalin, indolence and sulfuric acids, as well as toxic colors in
food is now well known because of media reports, drives by mobile courts and investigations by
Consumer Association of Bangladesh (CAB). Now experts are warning that the potential threat
of such adulteration is most acute among children. Junk food items like cold drinks, bottled fruit

26
juices, ice cream, pastries and biscuits prepared with sugar and chemicals create a light addiction
and dependency among children, says Dr Naila Khan, director of the Children Development
Centre (CDC) of Shishu Hospital. As a result, they do not feel like eating nutritious food, which
hinders their normal physical and psychological development, she said."The children become
more irritated and cannot concentrate on their studies due to a lack of nutrition, which directly
hinders the brain development," she said. No formal studies have so far been made on the impact
of junk food items, but in a number of cases it was found that the physical and mental condition
of children improved significantly after they stopped eating junk food, Dr Naila Khan
added.Other experts warn that chemicals used in adulteration directly attack the liver of
developing children. "Toxic chemicals in food and impure water, even the over mixture of
blissing powder in purifying water and adulterated oil are too dangerous for the children when
their livers are tender, ³said Dr *eaz Mobarak, epidemiologist of Dhaka Shishu Hospital. "These
chemical ingredients lead to longstanding and acute liver infection, liver cirrhosis, chronic
hepatitis and even liver cancer," added Dr Mobin Khan, Head of the Hepatology Department of
Bangabandhu Sheikh Mujib Medical University. Professor Dr UN Ahmed of the Government
Homeopathy Degree College said the rate of liver-related patients in his chamber is 15-20
percent. "The trend of children's indifference to food is a common phenomenon, mainly in the
cities," he explained. According to Shishu Hospital's Hepatology Unit, of the 36 liver-related
child patients between July 2004 and June 2005, 27 were diagnosed with viral hepatitis, 20 were
carriers of virus-A, 8 of virus-B, and 1 each of virus-C and virus-E. In a recent seminar, it was
revealed that around 40 lakh people in the country are believed to be carriers of Hepatitis-C,
which gradually leads to a malfunctioning of the liver and eventually death. Other chemicals
commonly mixed with food have harmful side effects. If formalin, which is widely used to
preserve fish, enters the human body, it breaks down the blood cells, causing lack of blood.

Blood Cancer Patients in Bangladesh

Chronic Myelogenous leukemia (CMu; also known as Blood cancer or chronic myeloid
leukemia or chronic Granulocytic leukemia) is a cancer of the blood system in which too many
white blood cells (WBCs) are made in the bone marrow. In the early stages of CMu (the chronic
phase). These excess WBCs mature normally. In contrast, excess WBCs in late CMu (the
accelerated and acute phases) do not mature. Do not mature. In Chronic phase CMu many
people have no symptoms. When symptoms are present, they are often nonspecific and can
include signs such as weakness, fatigue, weight loss and fever. These symptoms occur because
the leukemia WBCs is replacing normal bone marrow cells. In almost everyone with Blood
cancer, the genetic materials (chromosome) in the leukemia cells have an abnormal feature called
Philadelphia chromosome. The Philadelphia chromosome results from a mutation called a
translocation (two chromosomes breaks, then parts from each chromosomes switch places). In
CMu, the translocation occurs between chromosome 9 &22 (human DNA packaged in 23 pairs
of chromosome) and produces a new, abnormal gene called BC*- ABu. This abnormal gene
produces an abnormal protein that causes the excess WBCs typical of CMu.

27
The Philadelphia chromosome is an acquired mutation ± that is, a person is not born with it and it
is not passed on to their children. Exactly why the Philadelphia chromosome forms is unknown
in most cases, although exposure to ionizing radiations (such as during the atomic bomb
explosions in Japan) has been shown to cause CMu. Victoria *eiter, a 63 years old lady was
suffering from similar nature of blood cancer disease. Doctors had informed the dead line, she
was going to death few weeks. But who wants to die? She was treated with interferon-a highly
effective drug against blood cancer at that time.

Cervical Cancer in Bangladesh: Community Perceptions of Cervical

Cancer and Cervical Cancer Screening.
We investigated the awareness of, and the attitude towards screening for, cervical cancer in
Bangladesh. We performed a qualitative study using focus group discussions (FGD). The
framework approach to qualitative analysis was used. The study was performed in the catchment
areas of Addin Hospital, Jessore, Southern Bangladesh (peri-urban) and uAMB hospital,
Parbatipur, North West Bangladesh (rural). A total of 220 men, women and adolescents
participated in 28 FGDs. Awareness of cervical cancer was widespread. Knowledge about causes
was often inadequate. The perceived consequences of cervical cancer were numerous and
awareness of the need for cervical cancer treatment was present. Barriers to accessing care
include: low priority for seeking help for symptoms, limited availability of health services and
cost. Most women were unaware of the possibility of screening via speculum examination,
which was considered acceptable to women (and men), as long as the examination was done by a
female healthcare provider in an environment with sufficient privacy. In conclusion, adequate
gynecological services are not available or accessible for most women in rural and peri-urban
Bangladesh. However, awareness of cervical cancer is widespread. Screening for cervical cancer
in these communities is acceptable if done by a female healthcare provider under conditions with
sufficient privacy.

Wake Up Women Stand against Cervical Cancer

Cervical cancer which affects lower third of uterus (also called cervix) is the most common
cancer in women in Bangladesh. It constitutes about one fourth of the total number of female
cancers patient in Bangladesh. An estimated about 13,000 new cases and 6600 deaths occur
every year in Bangladesh. Most of these deaths are preventable if they would be detected early.
Ironically, 80 percent of the women with cervical cancer come for treatment at an advanced and
inoperable stage due to the ignorance about regular check-up and screening services, lack of
adequate and widespread screening facilities. Many women never attend hospitals and they
accept death for granted. Usually they do not know about the prevention and treatment options of
cervical cancer. Other important factors of high prevalence of cervical cancer in Bangladesh are
marriage at young age, polygamy, sexually transmitted diseases, low socio-economic condition,

28
and low educational level and so on. Cervical cancer can be detected by different screening tests
called Pap smear test and HPV test, Visual Inspection of Cervix with Acetic Acid (VIA). Among
the methods, VIA has been introduced by the Government of Bangladesh to screen mass
population due to its cost effectiveness and easy to use method.

In this way cervical cancer can be prevented. Another method of cervical cancer prevention is
vaccination against Human Papillomavirus (HPV), another common cause of cancer. VIA was
accepted as a feasible method
of cervical cancer screening in
Bangladesh as it is relatively
simple. It needs minimum
infrastructure support and the
result of the procedure is
available immediately. All the
government medical college
hospitals, district hospitals,
maternal and child welfare
centres and some of the urban
primary health care centres have facilities for VIA test free of cost for the last few years by the
support of UNFPA Bangladesh and Bangabandhu Sheikh Mujib Medical University (BSMMU)
who are helping GOB in expansion of these facilities. Please support women getting the
diagnostic facility and convey the message to your near and dear ones to help her prevent
cervical cancer.

Breast Cancer in Bangladesh

According to research, about 35,000 women in Bangladesh develop breast cancer every year, and
most do not seek treatment for this deadly disease. This is because about 79 percent of the
Bangladeshi population reside in rural areas, and due to ignorance, shyness, social taboos and
economic reasons, they suffer silently from this illness. Most of these women have heard of
cancer, but very few know what breast cancer is, so when they notice lumps or tumors they
simply ignore them if they are not painful. Women in Bangladesh are reluctant to show their
bodies to strangers and will therefore avoid visiting a doctor unless it is absolutely necessary, a
practice which is encouraged in most Muslim communities. If a woman does get diagnosed with
breast cancer, in most societies she is treated like an outcast and her disease is assumed to be
contagious. In a number of cases, marriages break up and her entire family is shunned by the
society. This is true for all classes of society in this country. Amongst the women who have
passed away from breast cancer; there have been doctors, professors, students, day laborers and

29
housewives. The treatment for breast cancer is very expensive and due to a lack of health
insurance, most members of the populace are unable to get the care they need to survive. Breast
cancer arises in breast tissue and is simply the abnormal growth patterns of a group of abnormal
cells. It is the most common type of cancer that occurs in women, but it can occur in men as
well. A high intake of alcohol is also a
risk factor for the development of
breast cancer, as shown in various
researches. Environmental causes
such as exposure to radiation can also
lead to the development of breast
cancer. In Bangladesh, women living
in rural areas are less prone to breast
cancer than those residing in large
metropolises. This is because of the
practice of early marriage, early
maternity, the consumption of a low fat diet and the habit of breast-feeding. City women are
usually more career oriented and tend to marry at a later age. Because of the availability of a
variety of baby foods in the cities, women also tend to avoid breast-feeding if possible. The diet
is also vastly different in cities as there are more fatty foods available.

Increasing Prevalence of liver cancer and the way out

The magnitude of liver cancer ranging from acute viral hepatitis, which is more familiar as
jaundice to liver cancer in Bangladesh is increasing progressively. Hepatitis A and E viruses
from drinking contaminated water remain a constant problem throughout the year. Hepatitis B
and C virus is the commonest culprit causing cirrhosis of liver and liver cancer in our country. It
has been observed that about one-third of people in Bangladesh are affected by Hepatitis B virus
infection sometimes in their lives. About 0.5 percent of the population was found to be infected
with Hepatitis C virus infection. Furthermore, consumption of adulterated foods, fruits, edible
oils etc. may be causative factor for long term inflammation of the liver leading to chronic liver
disease, cirrhosis and cancer. In comparison to the developed countries, liver diseases are more
common in Bangladesh due to the aforesaid factors, which could be avoided by strict supervision
of supplied consumable items regularly used in our kitchen. If people eat excess and fatty food
intake lead to fatty liver, this may progress to chronic liver cancer in the long run. The current
trend of first food culture in young generation is one of the reasons of fatty liver, which is
prevailing in our country.

30
Anti-Cancer Drugs Now Made in Bangladesh
Beacon Pharmaceuticals uimited yesterday launched a few anti-cancer drugs, first of its kind in
Bangladesh.Beacon Managing Director Mohammad Ebadul Karim said, "Beacon
Pharmaceuticals is the first to produce anti-cancer drugs in the country. The drugs with brand
names Fluroxan, Gemoxen, Platixen and Xelpac are already available in the market. Docexan,
Xurobin and Filgrast will be made available soon."The manufacturers said the prices of the
locally produced anti-cancer drugs would be 20 to 30 percent less than the imported ones. Prices
of the newly marketed products range from Tk 90 to Tk 12,000, they added."The Cisplatin drug
which is imported from the Netherlands with the brand name Platocin costs Tk 800 while the
same drug produced by Beacon with the brand name Platinex costs Tk 550 per vial," told
Monjurul Alam, manager, international marketing of the company to The Daily Star. One course
Pacloitaxel imported from Pfizer Company of the US with the brand name Taxol costs Tk 39,000
while locally manufactured Xelpac costs only Tk 12,000, he said. The manufacturers also
claimed that there are many anti-cancer drugs available in the market and most of them are
smuggled from India. Patients get each of the items at Tk 300 only. Around 12 lakh people
across the country are suffering from cancer currently and every year two lakh are newly
diagnosed with the disease. The anti-cancer drugs manufactured by Beacon will play an
important role in treating such a huge number of patients in the country, said health experts.

Cancer Care by Patient Assistance Programmed

Sanofi-aventis, one of the largest multinational pharmaceuticals in Bangladesh has decided to
provide its revolutionary anti-cancer drug ³Taxotere´ at an affordable price as a part of its patient
assistance programme, says a press release. Patient assistance programme was inaugurated
recently in a local hotel in the city. Iftekharul Islam, Managing Director of sanofi-aventis,
Bangladesh spoke about the patient assistance programme in presence of renowned oncologists
of the country. He said ³Sanofi-aventis has always been providing Taxotere at a reduced price of
5 to 25 per cent from 1998, the year when Taxotere was introduced´.³The patient assistance
programme has been introduced so that cancer patients can now get better access to treatment
with chemotherapy at the right time in a developing country like Bangladesh´ added Mr Islam.
Dr Md Salim *eza, Consultant Oncologist, Ahsania Mission Cancer and General Hospital
pointed out that the ordeal of cancer makes a patient mentally very stressed out. Prof.
Mohammad Abdul Hai, Head of Oncology, Khwaja Yunus Ali Medical College and Hospital
said that cancer patients usually go back home after they take the chemotherapy and stays home
until next chemotherapy.

31
Birth Control Pills May uower Colon Cancer in Bangladesh
Women who have used birth control pills seem to have a slightly decreased risk of colon cancer
as they age, a new study suggests. *esearchers found that among nearly 90,000 women ages 40
to 59, those who had ever used oral contraceptives were 17 percent less likely to develop colon
cancer over the next 16 years. The findings are in line with evidence suggesting that estrogen
plays a role in colon cancer risk. Some studies, for example, have found that older women on
hormone replacement therapy (H*T) have
a lower risk of the disease. In addition, lab
experiments have shown that estrogen may
inhibit tumor development in the colon by
affecting cell growth, or by lowering levels
of a cancer-linked hormone called IGF-1.
They may, for example, be more physically
active and weigh less ² two factors that
studies suggest may lower the risk of colon
cancer. During that time, women who had
ever used birth control pills were less likely
to develop colon cancer. However, this was
not true of women who had used H*T, in contrast to what several previous studies have found.
According to Kabat, there are still "many questions to sort out" regarding hormone use and colon
cancer, and the results of any single study have to be interpreted cautiously. More studies are
needed, he said, to figure out what factors are important in colon cancer development.

Tobacco and Cancer Situation in Bangladesh

Cancer has been appearing as an important public health problem in Bangladesh. Due to the lack
of reporting system and under-diagnosis of cancer, the real situation is unknown yet. Population-
based data on cancer are sparse. A recent WHO study estimated that there are 49,000 oral cancer,
71,000 laryngeal cancer and 196,000 lung cancer cases in Bangladesh among those aged 30
years or above in Bangladesh (as of 2004). The same study observed that 3.6% of the admissions
in medical college hospitals for the same age group are due to these three cancers. A WHO
supported hospital-based registry in the National Institute of Cancer *esearch and Hospital
indicates that lung cancer in men (30%), cervical (26%) and breast cancer (23%) in women are
the leading cancers in Bangladesh. These three cancers constitute 37% of all cancers irrespective
sexes. The GuOBOCAN study (1998) reported that rates of deaths from respiratory tract
(trachea, lung and bronchus) cancers are highest in Bangladesh compared to Sri uanka, India,
Afghanistan, Bhutan, Nepal, Pakistan. In response, the national cancer control plan has been
developed in collaboration with WHO Bangladesh. Population-based cancer registry has also
been established with technical assistance from WHO to facilitate evidence-based policies and
programmed to combat cancers.

32
Conclusion
Finally we can say that Cancer therapy according to the approach outlined here requires a great
deal of experience on the part of the physician. The most important objective must be to find the
best possible treatment strategy for each individual patient. We should strive for a synthesis
between scientific medicine and experience-based healing and should always check which of the
well-known treatment methods - conventional and unconventional - can be used meaningfully
for that particular patient in order to provide the greatest help.

Since cancer is a multi-factorial condition, treatment has to go beyond merely removing the
tumors. Instead, multi-component treatment must be employed in an attempt to restore order to
the disrupted regulatory cycles in the body because these disruptions appear to be a causal factor
in tumor formation. It should no longer be the case that patients are thrown into a state of
absolute despair simply because scientific medicine has nothing more to offer. We have a whole
range of patients whose conventionally incurable tumors have shown lasting and complete
regression on biological therapy alone. For sound theoretical reasons, we are more or less
obliged to regard this all-embracing therapy with biological treatment methods as an integral part
of optimum cancer therapy.

33
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