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