Cancer is Preventable Screenable Curable

hi

i am dr vp gangnam

medical oncologists working in

vps lakeshore hospital

kochi kerala india

i have been in this profession for the

last 30 years

so say something like starting from 19

89 1990

i think i say told you already i’m an

oncologist

that means i’m a cancer specialist

so my talk today will be on

my topic oncology

or cancer

i think uh the word itself is uh scary

to

many of you

why this care is a question to be

addressed

the answer is straightforward

there’s an increasing incidence

in cancer all over the world

our country too

almost 15 lakhs new cases of cancer

registered every year

and if you take the small state of

kerala

every day we see about 120

plus new cases it’s on the increase

but if the same token will immediately

say that

though the cancer is increasing the cure

rate is also going

up that means the number of people

who are getting cured of the disease is

also on the

hike so the question automatically asks

is cure

alone your aim of treatment

no when you speak about aims of cancer

treatment

it starts off like this prevention

early detection cure

pronation of survival and palliation

when you speak about prevention

the first question now to be addressed

is

can you prevent all cancers or

are all cancer is preventable

the answer is a double emphatic no

but thirty percent of the cancers are

preventable three zero thirty percent

almost one third

are preventable

and almost one third are screenable that

means

you can go for ln rejection

cure rate if you take on a broad

spectrum

all right on a broad base the number of

patients coming to hospital 45 to 50

of the cancers or cancer patients are

curable

and if you take the pediatric population

that means children

70 to 80 percent are curable

for about 30 percent of the patients

you can have prolongation of life that

means

they live with good quality of life

you take a diabetic patient with a

patient with a

hypertension you are not curing them

they live with the disease and lead a

normal life

like that one of the cancers you can go

for a

prolongation of life with good quality

of life

another one third they are neither

curable

nor can you prolong their life but

you can give them a good quality of life

for as long as they live that means

it’s purely palliative so there are all

these strong pillars in the treatment of

cancer

so the first question is prevention

i already told you one third of the

cancer preventable

and you are a plant of action is

no tobacco no alcohol

your dietary habits plus exercise

these are the three tools the prevention

of cancer

and out of this the most important is

tobacco so if somebody asks what is your

first step in the prevention of

cancer i think it’s uh against tobacco

in any form

because based on how you are going to

use the tobacco products

your site of cancer varies that’s all

alcohol is equally the problem and if

somebody is a smoker

and at the same time is a alcoholic too

then all the cancers are associated with

the use of tobacco

rise by 10 10-fold so the question is

what are the cancers related to the use

of tobacco

a lung cancer cardinal cancers

latino cancers they’re all connected

directly linked

and you look at a lot of cancers where

they

they contribute that means are not

directly linked

but they add to like certain cancers

bladder cancers kidney cancers and an

array like that

so if somebody asks back what is the

most

important stand against

or what is your most important plan in

prevention of cancer i think the

first 10 steps are going to be against

tobacco

against tobacco against tobacco like

that

so i told you tobacco plus alcohol

there are certain cancers which are very

close to the use of alcohol also

like esophageal cancers stomach cancers

liver cancers where alcohol plays a role

so no tobacco no alcohol

where is your dietary habits

i think the caption is very simple but

self explanatory like fast food

kills fast why the caption is because

high fat high calorie diet

lack of excess obesity

you have got a list of cancer telescopes

not only cancers

even others but if you take the cancers

as a whole

the breast cancer the uterine cancers

are colonic cancers i think the link

goes like that

and if you take a little bit more

high fat high quality diet

and lack of fiber diet you are prone to

go for a

colon cancers so the diet has to be

modified

has to be modified or changed that means

you should be able to prevent an obesity

developing

add access to your plan of action

and prudent obesity

water surrender green leafy vegetables

and fruits they got a protective effect

in cancer

that means it has to be included in your

diet

so the best healthy plate for you to

take food i

put it across this fifty percent of the

plate

should be filled with green leafy

vegetables and

fruits twenty-five percentage is grain

of your choice

and 25 percent is protein of your choice

that’s the best plate you can never

imagine

so i think preventing obesity

by that plus excess

forms your next step 30 percent cancers

are

screenable that means early detection is

possible

because the basic dictum is

early detection and proper treatment

that’s the tool for cure

so you should be able to detect them

early breast cancers

redneck cancers cervical cancers

colon cancers and prostate cancer they

are all screenable that means there’s a

definite plan of action to

detect them at an early phase yoga

are two vaccines that you can think of

at this point of time

they are not direct anti-cancer vaccines

but they have an effect on the cost

effect

and the two viruses implicated are one

is what is b

virus the costly factor for a liver

cancer

the human papilloma virus the costly

factor for a cervical cancer

and hp virus the ideal age group is

girls within 20 26 years

can go up to 40 years but ideally is 10

to 6 years

and three doses has to be taken this

month

second month and six months but be very

clear that it’s not anti-cancer vaccines

but

they are directed against the virus

implicated

against that cancer

so i covered two steps prevention

error detection the next step is

treatment or cure

how far we have reached and what are the

changes it has been

happening for the last 30 years the

four major arms of treatment are

surgery radiation

chemotherapy and immunotherapy

and the the three players in this game

are

surgical oncologists radiation

oncologists

and medical and pediatric oncologists

all areas we have changed a lot and the

basic concept of a change like

it’s a comprehensive cancer treatment

approach that means

surgeon radiation oncologist medical

they are sea turtle and plant treatment

not a single person

if you take the advancements in the

field of surgery

i think crude mutilating surgeries

have given way to

conservative surgeries without finally

touching upon the outcome that means

uh if possible you should be able to

preserve the organ

rather than fully removing the organ for

example breast cancer

there’s any chance you will try to

preserve the breast

and uh laparoscopic surgeries and

plastic

reconstruction techniques they all have

contributed on their own

when you come to radiation oncology the

precision has become the art of the day

that means

you are not interested in killing

cancers

you’re sorry it’s

you are interested in killing all the

cancers so you tried to focus

on the cancer cells and killed up that

area alone

preventing the normal cells getting

killed

so newer machines like linear

accelerators and lot of techniques like

imrt igrt they

all have contributed forces if somebody

asks me

which field of oncology has gone for the

maximum

we mean uh advancements i think cancer

is straightforward

medical oncology you’ve got newer drugs

with a

much less side effects because all of

will be scared about the side effect

called as a hair loss you have got drugs

without hair loss

you have got drugs called as targeted

chemotherapy that means you are

interested in only killing the

cancers not the normal cells so you can

target the cancer cells

i think these advances happened and if

you ask me

what about immunotherapy we have learned

that

we can equip our own

cells that means our own immune system

to fight against the cancer cells the t

cells

so the sleeping t cells they can get up

and they can wake up and uh they can

finish the cancer cells

so like that we have improved everything

to say that

cancer is a curable disease much more

research a second happen in the field of

uh oncology

like for every cancer there is a driver

mutation

that means one genetic mutation is a

driver or responsible for that cancer

and if you can identify that mutation

and you can target it best treatment

option is going to be there

and we just taught us a lesson that if

you take two breast cancers

they are not similar because the dryer

mutations are different whereas a breast

cancer lung cancer may be similar

because

the dry mutation is same that means

rather than the diseases going right is

you can say that

by identifying driver mutations you are

able to treat

and now so these are the advancement of

the question is

are we also doing the same thing yes we

are doing it but

we need a advancement in basic research

that should be part of our i mean uh

next plan because our country has to

come up with our own protocols

our own basic research methodology our

own basic research to say that

with this our data and we are going to

rely on this

code has taught us this lesson because

code has shown that our system is very

good

and we can be created or can be better

on par with any of the best systems in

the world

usa has collapsed we have got a shady

eyes on wh now but we sustained

we fought we are still fighting that

should be our

motto that should be our plan so why we

want to go for a change is

we should be able to see what we have

learned from this

like there should be a stop and a pause

and a restart and i think that is

something which uh which

is going to be there i think that the

sequence can be different but

the restart is one which has to be part

of it

and that restart you should be thinking

that we should improve

probably on our on our telemedicine

systems

we should be relying some of our

artificial injects

and the basic primary health system has

to

go forward still and if that’s to happen

i’m sure that will be a winner so

just like we are going to conquer covet

i think that day is not far off from

from

this day i’m going to come and say that

maybe

say three years four years or five years

from now we’ll be conquering this

disease

cancer with just like any other disease

preventable screenable and curable