Articles on head and neck cancer alliance

Head And Neck Cancer Is A Preventable Cancer

Dr. Suhail Sayed, Surgical Oncologist
What are cancers of Head and Neck?Cancers that are known collectively as head and neck cancers usually begin in the squamous cells that line the moist, mucosal surfaces inside the head and neck (for example, inside the mouth, the nose, and the throat). Head and Neck cancer is the sixth most common cancer in the world and India constitutes 30-40 per cent of all cancers seen among men mainly in their productive age group.What are the causes of Head and Neck Cancer?The most common causes are consumption of tobacco and alcohol. Smokeless tobacco, such as gutka or paan, is a major issue in India. These agents, when taken together,increase the person’s cancer risk by eight or 10 times, accounting for 90 percent of oral cancers and 80 percent of throat cancers in our population. We are the “mouth cancer capital of world” owing to this habit. Alcohol often taken together with cigarette increase the cancer risks by 38 times. Apart from these common causes other causes like poor oral and dental hygiene, loose dentures and some viruses (Ebstien-Barr andHuman Papilloma) are also known to cause this cancer.What are the symptoms of Head and Neck Cancers?The symptoms depend on the site where this cancer develops. This cancer usually presents with a non-healing mouth ulcer, white or red patch, reduced mouth opening, difficulty in swallowing or neck swelling. All these symptoms if persist for more than two weeks need to be evaluated.How are head and neck cancers diagnosed?A thorough physical examination combined with imaging studies (CT, MRI or PET CT scan) and biopsy is mandatory for diagnosing these cancers. Based on these findings the disease can be properly staged and treatment planned accordingly. Early diagnosis by biopsy can lead to better cure rates.How are head and neck cancers treated?The treatment plan for an individual patient depends on a number of factors, including the exact location of the tumor, the stage of the cancer, and the person’s age and general health. Treatment for head and neck cancer can include surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of treatments. Early stage (1 and 2)patients have a 60% to 95% chance of cure with local treatment alone (surgery or radiotherapy), but patients with more advanced (Stage 3 & 4) disease need a more aggressive treatment (Surgery with chemo radiation) and have a greater than 50% risk of recurrence or development of disease spread throughout the body. Therefore it is very important that the disease is picked up early and patients should avoid delay in treatment. Many patients fear of the change in appearance or speech and delay treatment by taking different indigenous drugs and present to us in an advanced stage. But in the present era with the availability of microvascular surgery and Image Guided Radio therapy (IMRT,IGRT), excellent cosmesis and functional rehabilitation of patients can be offered. Thus majority of head neck cancer patients today have a good quality of life after treatment.How can I reduce my risk of developing head and neck cancers?The most important point which needs to be understood by our population is that this cancer is “preventable”. There are several policy measures of tobacco control being implemented at the national and international level to fight the battle against tobacco. However, these efforts may not directly benefit the current tobacco user as nicotine in tobacco is very addictive, making quitting difficult. It’s the will power of the person himself which plays an important role in quitting tobacco. It’s basically the first three days that the person has a severe craving for smoking/chewing, if he is able to control his mind for this period the chances of quitting the habit increase by 80%.

Oral Cancer- a Menace to Your Mouth

Dr. Rashmi Maruti Hosalkar, Dentist
According to GLOBOCAN 2008, Oral Cancer ranks 11th among all cancers occurring around the world.  Approximately two-thirds of patients in the developing countries of  South and Southeast Asia, Eastern Europe and Latin America are affected by oral cancer. In India, oral cancer  ranks among top three cancers showing highest incidences (age-standardized rate of 9.8 per 10000) and accounting for about 30% of all new cases annually. The overall 5-year survival rate for all stages of oral cancer is 60% with localised tumour showing better rates than one with regional or distant metastasis (spread).ETIOLOGYSmoking Tobacco: Cigarette, Bidi, Cigars, Chutta, different smoking pipes such as chillum, etc.Smokeless Tobacco: Betel quid, Paan, Supari, Khaini, Mishri, Zarda, Mawa etc.Smoking increases the chance of developing oral cancer by 6 times, hookah and pipe by 16 times and bidi smoking by 36 times as compared to non- smokers. Similarly, chewing betel leaves, tobacco and lime increases the risk by six fold as compared to smokers and ten fold when its combination of both.AlcoholViruses such as Human Papilloma Virus (16 & 18), Epstein Barr Viruses, Herpes Simplex Viruses, Retroviruses.Recent studies have shown and increase in number of  HPV causing oral cancers. This usually seen in healthy non smokers segment of population in 25-50 years of age. Having multiple sex partners or engaging in oral sex with HPV infected partners is one of the reasons for contracting cancer. Weakened immune systems due to HIV/AIDS or Immune system suppressing drugs after organ transplants can also increase the risk.Diet and Deficiency StatesSunlight or UV radiation effectsPotentially Malignant Diseases such as leukoplakia. lichen planus, erythroplakia, oral submucous fibrosis etcPoor oral hygiene, faulty restorations, sharp teeth, ill fitting denturesSyphilis, Chronic CandidiasisGeneticsPrior history of cancerNot established causes FEATURESIn Indian population oral cancer occurs 50 years and above, however, due to changes in personal habits and lifestyle it is seen occurring in younger populationMales more frequently affected than females but the ratio is showing slow decline with increase in number of cases in females.Site at which oral cancer occurs has strong association placement of noxious irritants. Most commonly involved are lip, buccal mucosa, vestibule, alveolar ridge, hard palate, soft palate, tongue and floor of the mouth. The most common oropharyngeal site of involvement in Indian population is buccal mucosa followed by tongue.Classic features of oral malignancy include ulceration, nodularity, induration and fixation and cancer must be suspected especially when there is a single oral lesion persisting for more than 3 weeks.WARNING SIGNS OF ORAL CANCER (as given by Crispian Scully)Red lesion (erythroplasia)Mixed red/white lesion, irregular white lesion, lumpUlcer with fissuring or raised exophytic marginsPain or numbnessAbnormal blood vessels supplying a lumpLoose toothExtraction socket not healingInduration beneath a lesion, i.e., a firm infiltration beneath the mucosaFixation of lesion to deeper tissues or to overlying skin or mucosaLymph node enlargementDysphagiaWeight lossDIAGNOSISKey for prevention of oral cancer is early detection and treatment.Early diagnosis of potentially malignant lesions can reduce the chance of its transformation into malignancy.Thorough history (present, past medical/dental, habits, occupation, family) followed by physical examination is a must.Biopsy is a must  in cases of oral cancer. Histopathological diagnosis is the gold standard however many other histotechniques can also be applied.DNA ploidy Serum and salivary biomarkersOptical systemsRadiological imagingMANAGEMENTPrimary preventionSurgery with or without neck dissectionChemotherapyRadiotherapyDental rehabilitationIt is a duty of dentist to not only examine teeth but also the other oral structures and look for any abnormal signs prompting toward any oral disease including cancer. 

Prostrate Cancer: Early Detection Can Help Your Chances

Dr. Sandeep Nayak, Surgical Oncologist
In India, prostrate is the second leading site of cancer among males in large cities like Delhi, Kolkata, Pune and Thiruvananthapuram, third leading site of cancer in cities like Bangalore and Mumbai and it is among the top ten leading sites of cancers in the rest of the country. Usually, prostate cancer is a very slow growing cancer and most people do not have major symptoms until the cancer reaches an advanced stage. Most men with prostate cancer die of other unrelated causes, and many never know that they have the disease.Factors that can increase the risk of prostate cancer include:Age: Risk of prostate cancer increases with age. Out of every 10 prostate cancers, 6 are detected in men above 60 years of age.Diet: Consumption of excess calcium through food (especially dairy foods) or supplements has been linked with higher risk of developing prostate cancer.Family history: Prostate cancer seems to run in families which suggest a genetic or inherited factor involved in its causation. Hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome in which large bowel cancer is the most common feature, is caused by inherited gene changes that carry an increased risk for many cancers including prostate cancer.Screening and Early Detection    Early detection of cancer can often be done by testing the amount of prostate-specific antigen (PSA) in a man’s blood sample. Another way to find prostate cancer early is the digital rectal exam (DRE).If the results of either one of these tests are abnormal, further tests are performed to see if there is a cancer. The  prostate cancer found as a result of screening with the PSA test or DRE, will probably be at an earlier, more treatable stage than if no screening were done. However, neither the PSA test nor the DRE is 100% accurate.Treating Prostate CancerNowadays, robot-assisted radical prostatectomy has become the standard of care for prostate cancer throughout the world. In this approach, the laparoscopic surgery is done using a robotic interface (called the da Vinci system). The surgeon sits at a control panel in the operating room and moves robotic arms to operate through several small incisions in the patient’s abdomen.Robotic prostatectomy has advantages over the open approach in terms of less pain, blood loss, and recovery time. For the surgeon, the robotic system provides more maneuverability and more precision when moving the instruments than standard laparoscopic radical prostatectomy (LRP).

Lung Cancer: Survival Guide

Dr. Kaushal Yadav, Surgical Oncologist
LUNG CANCERSecond most common cancerLeading cause of cancer death. About 1 out of 4 cancer deaths are because of lung cancerDespite poor prognosis, lung cancer is curable in early stages.Two main types: -Non-small cell lung cancer: 85-90%-Small cell lung cancer: 10-15%Risk Factors:Tobacco smoking:- Smokers have 20 fold increase of lung cancer compared to non smokers- Tobacco smoke contain thousands of chemicals which include >70 chemicals are proven carcinogens- Quitting smoking is beneficial. Former smokers are at 9 fold increased risk while current smokers are at 20 fold increased risk of lung cancer  compared to non smokers.- Environmental tobacco smoke exposure to non smokers through passive smoking from smokers also increase the riskAsbestos and other chemical carcinogensRadiation exposureEnvironmental pollution Screening for Lung Cancer:Age group 55-80 yrs with a history of smokingUnited States Preventive Services Task Force (USPSTF) recommend annual screening for lung cancer with low dose computed tomography in adults aged 55-80 years who have a 30 pack year smoking history and currently smoke or have quit within past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.Alarming signs of carcinoma lung:Cough that is persistent or gets worseChest pain that is often worse with deep breathing, coughing, or laughingHoarseness of voiceCoughing out blood or rust-colored sputum (spit or phlegm)BreathlessnessInfections such as bronchitis and pneumonia that don’t go away or keep coming backNew onset of wheezingIf lung cancer spreads to distant organs, it may cause Bone pain, headache/ seizures, jaundiceTreatment for lung cancer:Multidisciplinary management involving surgical oncologist, medical oncologist and radiation oncologist improves treatment planning and better cure.Non small cell Lung Cancer:Surgery: Surgical resection play pivotal role in management of early stage cancer. Complete resection (Lobectomy/Pneumonetomy), systemic mediastinal lymph node dissection in suitable candidates is fundamental of surgical management. Videoassisted thoracic surgery is now done in many centres for early stage ling cancer because of associated low morbidity rate.Surgery for lung cancer is a major operation and can have serious side effects, which is why surgery isn’t a good idea for everyone. While all surgeries carry some risks, these depend to some degree on the extent of the surgery and the person’s health beforehand. Possible complications during and soon after surgery can include reactions to anesthesia, excess bleeding, blood clots in    the legs or lungs, wound infections, and pneumonia. While it is rare, some people may not survive the surgery.Chemotherapy: Depending on the stage, chemotherapy may be used as       - Before surgery (sometimes along with radiation therapy) known as neoadjuvant therapy.       - After surgery (sometimes along with radiation therapy) known as adjuvant therapy.       - Along with radiation therapy (concurrent therapy) for some cancers that can’t be removed by surgery because the cancer has grown into nearby important structures       - As the main treatment (sometimes along with radiation therapy) for more advanced cancers or for some people who              aren’t healthy enough for surgery.Radiation Therapy: Depending on the stage radiation therapy might be used as:- As the main treatment (sometimes along with chemotherapy), especially if the lung tumor can’t be removed because of its size or location or person isn’t healthy enough for surgery, or doesn’t want surgery.- After surgery (alone or along with chemotherapy)- Before surgery (usually along with chemotherapy) to try to shrink a lung tumor to make it easier to operate on.- To relieve (palliate) symptoms of advanced NSCLC such as pain, bleeding, trouble swallowing, cough, or problems caused by spread to other organs such as the brain.Targetted therapy:  eg Gefinib, erlotinib, crizotinibThey sometimes work when chemo drugs don’t, and they often have different (and less severe) side effects. At this time, they are most often used for advanced lung cancers, either along with chemo or by themselves.Small Cell Lung Cancer:Very aggressive cancer and spread very fast, so only rarely very early stage is detected for which sugery can be planned. Most patients are treated with chemotherapy or radiation therapy or both.Prognosis: for non small cell lung cancer                                                Stage                                                            5 year survival                                                    I                                                                        45-50%                                                    II                                                                       30-35%                                                    III                                                                      10-15%                                                    IV                                                                         1%

The Invisible Killer: Know More About Cancer Causing Infections

Dr. Sandeep Nayak, Surgical Oncologist
Many people are surprised to learn that cancer can be caused by an infection. Infections with certain viruses and bacteria have been recognized as risk factors for several types of cancer in humans.Worldwide, infections are linked to about 15% to 20% of cancers. This percentage is even higher in developing countries, but it is lower in the developed countries. This is partly because certain infections are more common in developing countries, and partly because some other risk factors for cancer, such as obesity, are more common in developed countries.Hepatitis Causing Liver CancerPeople who are infected with hepatitis B virus (HBV) or hepatitis C (HCV) virus may develop a chronic infection that can lead to cirrhosis. The damage that results increases the risk of liver cancer (hepatocellular carcinoma). The risk of liver cancer is greater for people who have chronic HBV or HCV infection than for the general population. These viruses are transmitted by unsafe sex or unsafe blood products. Presently HBV can be prevented by vaccination. There is no vaccine for HCV.HPV InfectionHuman papillomavirus (HPV) is the most common sexually transmitted infection with most sexually active men and women being exposed to the virus at some point during their lifetime. HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer). This infection can be prevented by taking a vaccine which is presently indicated for young women to prevent cervical cancer.Stomach CancerHelicobacter pylori (H pylori) bacteria which infects stomach causing gastritis can damage the inner layer of stomach. This damage can lead to cancer over years. H. pylori infection is common in developing countries and is spread by unhygienic food. There are tests to diagnose this and treatment to cure the infection. Prevention is by maintaining food hygiene and quality.Spread of These CancersMany of the infections that influence cancer risk can be passed from person to person, but cancer itself cannot. A healthy person can’t “catch” cancer from someone who has it.So to conclude, there is an unequal burden of infection-related cancers among the developing countries. This is particularly true for cervical cancer caused by certain genital papilloma viruses, liver cancer caused by the hepatitis B and C viruses, and stomach cancer caused by H. pylori.  Even though the infections described here can raise a person’s risk of certain types of cancer, most people with these infections never develop cancer. The risk of developing cancer is also influenced by other factors. For example, infection with Helicobacter pylori (H pylori) bacteria might increase your risk of stomach cancer, but what you eat, whether or not you smoke, and other factors also affect your risk. 

Integration of Acupuncture in Oncology

Dr. Sayali Arvind Kulkarni, General Physician
Integrative Oncology is the synthesis of mainstream care and non-pharmacologic, evidence-based complementary therapies for the control of cancer-related physical and emotional symptoms. Oncology acupuncture is a new and emerging field of research. Recent advances from published clinical trials have added evidence to support the use of acupuncture for symptom management in cancer patients.Acupuncture is defined as the insertion of one or several needles into the skin at particular sites (acupuncture points) for therapeutic purposes. Variations of this theme include the use of other means of stimulating acupuncture points: heat (moxisbution), pressure (acupressure),electrical currents (electroacupuncture), or laser light (laser acupuncture).Acupuncture's use in cancer patients has been recommended by the American Cancer Society (ACS) for the treatment of cancer and treatment-related symptoms. Pain, nausea, breathlessness, vasomotor symptoms and limb edema have all been found to respond to acupuncture.Acupuncture can also act against carcinogens (factors attributable to cancer development) through its ability to reduce stress and enhance immune function. Today several cancer centers have begun incorporating acupuncture for treating cancer-related symptoms such as pain and many patients have had significant results in the reduction of their symptoms. It may cause physical responses in nerve cells, the pituitary gland, and parts of the brain. These responses can cause the body to release proteins, hormones, and brain chemicals that control a number of body functions. It is proposed that in this way, acupuncture affects blood pressure and body temperature, boosts immune system activity, and causes the body's natural painkillers, such as endorphins to be released.For conditions where the cancer is detected early, acupuncture can maintain and promote the normal functioning of the body. Several studies have shown its ability to boost the immune system and encourage the growth of healthy functioning cells. This could be important forcounteracting the result of radiation and chemotherapy that tend to attack both normal and abnormal cells. An additional benefit of acupuncture is that it can induce a state of deep calm and relaxation and alleviate physical and emotional tensions.It is now routinely administered before, after and in between chemotherapy treatment sessions for control of nausea and emesis. Use of acupuncture helps in minimizing the use of standard, expensive multi-drug anti-nausea regimens with their attendant side effects for chemotherapy patients. Chronic disease process depletes the energy level in the organism. Acupuncture replenishes energy levels to the body and the diseased organs or part of the body. It also reestablishes homeostasis by re-balancing energy distribution and un-blocking energy flow. The acupuncture can provide a more durable, successful pain control and provide a sense of well being and increased energy to cancer sufferers, decreasing the malaise associated with any chronic diseases. Also useful in managing cancer-related pain. The use of acupuncture can reduce the need for narcotic drugs. This also means that acupuncture will minimize the side effects such as confusion, disturbed mentation, behavioral changes, nausea and severe constipation, the normal result of taking narcotics.The FDA approved acupuncture needles for use by licensed practitioners in 1996. The  US Food and Drug Administration (FDA) requires that sterile, nontoxic needles be used and that they be labeled for single use by qualified practitioners only.Acupuncture is often used as an adjunctive therapy in anesthesia, in post-operative pain control, and in aiding and hastening recovery from the side effects of the various therapies. Acupuncture is effective for control of pain, of local swelling post-operatively, for shortening the resolution of hematoma and tissue swelling and for minimizing use of medications and their attendant side effects.Recent new developments for which it is felt essential as a modality of treatment includes-Pain and dysfunction after neck dissectionRadiation-induced xerostomia in head and neck cancerAromatase inhibitor-associated arthralgia in breast cancerHot flashes in breast cancer and prostate cancerChemotherapy-induced neutropenia in ovarian cancer.Some acupuncture techniques include the following:ElectroacupunctureA procedure in which pulses of weak electrical current are sent through acupuncture needles into acupoints in the skin.Trigger pointacupuncture: The placing of acupuncture needles in a place on the skin that is away from the painful part of the body. Trigger pointshave to do with referred pain, pain that is not felt at the site of injury, but is sent along nerves and felt elsewhere in the body.Laser acupunctureThe use of a weak laser beam instead of an acupuncture needle to stimulate an acupoint.Acupuncture point The use of a syringe and needle to inject drugs, vitamins, herbal extracts, or other fluids into the body at an acupoint.MicrowaveThe use of a microwave device attached to an acupuncture needle to deliver microwave radiation to an acupoint.AcupressureA type of massage therapy in which the fingers are used to press on an acupoint. In cancer patients, acupressure has been used to control symptoms such as pain or nausea and vomiting.MoxibustionA type of heat therapy in which an herb is burned above the body to warm a meridian at an acupoint and increase the flow of blood and qi. The herb may be placed directly on the skin, held close to the skin for several minutes, or placed on the tip of an acupuncture needle.CuppingA procedure in which a rounded glass cup is warmed and placed upside down over an area of the body, making a vacuum that holds the cup to the skin. Cupping is used to increase the flow of blood and qi. It is believed to open up the skin’s pores and allow toxins to leave the body.There have been few complications reported. Problems are caused by using needles that are not sterile (free of germs) and from placing the needle in the wrong place, movement of the patient, or a defect in the needle.Problems include soreness and pain during treatment. Feeling tired, lightheaded, or sleepy; and infections. Because chemotherapy and radiation therapy weaken the body's immune system, a strict clean needle method must be used when acupuncture treatment is given to cancer patients. It is important to seek treatment from a qualified acupuncture practitioner who uses a new set of disposable (single-use) needles for each patient.

On World Cancer Day 2016: Let Us Understand Cancer Better!

Dr. Sahil Chheda, Dentist
World Cancer Day is celebrated annually on 4th of February to deepen our understanding of this killer disease. This year the campaign focuses on Target 5 of the World Cancer Declaration that is to reduce stigma and dispel myths about cancer with the tagline, "Debunk the myths".There has been enough research to validate that food acts as the most promising ammunition to fight the battle against cancer. Keeping in with this year's campaign we bring to you six common queries.1) What is the most common cause of cancer?Cancer is the abnormal growth of cells. There are around 100 types of cancer. The most common types of cancer are - Men: Lung, esophagus, stomach, oral and pharyngeal cancers. Women: Cervix and breast cancers.Cancer has many possible causes, the prominent ones being -Genetics: Certain cancers run in families. For example, certain mutations in the BRCA1 or BRCA2 genes greatly increase a person's risk of developing breast and ovarian cancer.Smoking: Cigarette smoking accounts for around 30% of all cancer deaths. It is linked with increased risk of these cancers - lungs, larynx, oral cavity, nose and sinuses, esophagus, stomach, pancreas, cervix, kidney, bladder, ovary, colon, rectum and acute myeloid leukemia. Chewing of tobacco, a carcinogen, is linked to dental caries, gingivitis, oral leukoplakia, and oral cancer.Diet and Lifestyle: Research shows that a poor diet and not having an active lifestyle are the key factors that can increase a person's risk of developing cancer.Three things to keep in mind in order to stay cancer free:- Get to and stay at a healthy weight throughout your life.- Be physically active on a regular basis.- Make healthy food choices with a focus on plant-based foods.2) What are the foods that up the risk of developing cancer?Some cancers like that of the stomach have a more direct relationship with food. Foods which should be consumed in moderation to avoid the incidence of cancer are -Processed meats such as bacon, sausages, lunch meats and hot dogs.Choose fish, poultry, or beans instead of red meat (beef, pork, and lamb).If you eat red meat, choose lean cuts and eat smaller portions.Prepare meat, poultry, and fish by baking, broiling, or poaching rather than by frying or charbroiling.3) What are the preventive foods that guard against cancer?In accordance with the most common types of cancers that our country suffers from, the following foods can help:Oral Cancer: A diet rich in green and yellow vegetables and proper oral hygiene has been shown to offer protection against oral cancer.Breast Cancer: Reduction of high calorie foods, increased intake of fruits and vegetables and regular physical activity is preventive.Lung Cancer: Avoid tobacco and stay free from environmental pollutants. Increase intake of vegetables, fruits and beta carotene.Stomach Cancer: Diets high in fruits and vegetables particularly raw vegetables, citrus fruits, and possibly allium vegetables (onions, leeks, garlic etc.), foods with high levels of carotenoid, high vitamin C intake and consumption of green tea helps prevent stomach cancers.4) What foods help in healing cancer and how?Good nutrition is a key to good health. Foods which are rich in Vitamin C, Beta-carotene and Lycopene are known to protect DNA from damages. Research proves that these foods help in healing cancer -Apple: Apple contains quercetin, epicatechin, anthocyanins and triterpenoids which have anti-inflammatory and antioxidant properties that help to lower the risk of cancer specifically Colorectal cancers. The apple peel is the most nutritious as the majority of Quercetin (80%) is found in it. Other cancers in which apples are known to heal are lungs, breast and stomach.Blueberries: Blueberries have great antioxidant power, due to the presence of many phytochemicals and flavonoids like Anthocyanins, Ellagic acid and Urolithin. These are known to decrease free radical damage to DNA that leads to cancer. They also decrease the growth and stimulate self-destruction of mouth, breast, colon and prostate cancer cells.Broccoli, Brussels sprouts, Green Cabbage, Cauliflower, White Turnip, Kale, Green Collard: The Glucosinolates present in them is converted into isothiocyanates and indoles on consumption, which decreases inflammation, one of the risk factors of cancer. Beta-carotene promotes cell communication that helps control abnormal cell growth.Cherries: Both sweet and tart cherries are a good source of fiber, vitamin C, and potassium. The dark red color comes from anthocyanins, which are antioxidants.Cranberries: They are high on dietary fiber and vitamin C. They're very high in antioxidant power, most of which comes from phytochemicals like anthocyanins, proanthocyanidins and flavonols, ursolic acid, benzoic acid and hydroxycinnamic acid. Proanthocyanidins and ursolic acid decrease growth and increase self-destruction of several types of cancer in cell studies.Grapefruit: An 18th century hybrid of the pummelo and sweet orange. It is grown mainly in the Americas. Its name derives from the fruit's appearance as it grows: grape-like clusters on trees. Grapefruit contains these naringenin and other flavonoids like limonin and other limonoids, beta-carotene and lycopene (pink and red varieties). Foods containing lycopene lower the risk of prostate cancer.Green Tea: Since ancient times, tea has been used as both beverage and medicine. Both black and green teas contain numerous active ingredients, including polyphenols and flavonoids, which are potent antioxidants. One class of flavonoids called catechins has recently become the focus of widespread study for their anti-cancer potential. Tea is the best source of catechins in the human diet, and green tea contains about three times the quantity of catechins found in black tea. In laboratory studies, green tea has been shown to slow or completely prevent cancer development in colon, liver, breast and prostate cells. Other studies involving green tea have shown similar protective effects in tissues of the lung, skin and digestive tract.Winter Squash/Pumpkins: They contain Alpha and Beta carotene which is converted to Vitamin A inside the body. The yellow pigmented lutein, zeaxanthin helps to filter high energy ultra violet rays that can damage our eye's lens and retina. Lab studies suggest that dietary intake decreases the chances of skin cancer related to exposure from sun. Walnuts: The major actives found in walnut are - Elligtannins, Gamma-tocopherol, Alpha-linolenic acid, phytosterols and Melatonin. Laboratory studies show that consuming walnuts helps in breast cancer, colon tumor and prostate cancer. The studies also show decreased damage to DNA by regular consumption of walnut.5) Do all chemicals, preservatives and additives in foods cause cancer?Additives serve a wide variety of uses. For example, preservatives protect foods against deterioration and prevent growth of fungi and bacteria. Other additives help improve the texture and consistency of foods, keep them flowing freely when poured, or prevent them from drying out. Flavourings restore taste losses or can enhance the flavour or aroma of food. Emulsifiers ensure that oil and water in foods do not separate. Some commonly used preservatives which are doubted to have a relation with cancer are - Monosodium Glutamate (MSG), Sodium Benzoate, Sodium Nitrate and Sodium Nitrite.Butylated hydroxyanisole (BHA) is a phenolic antioxidant which prevents rancidity of fats and oils in food by protecting against lipid oxidation. High levels of BHA is found to create stomach tumor in laboratory animals. Some other chemicals which are found in canned foods and are known to perpetrate cancer are -Bisphenol A(BPA) can be found in reusable plastic food containers and the lining of food and beverage cans. Research shows that BPA exposure is linked to breast cancer, and has been shown to interfere with chemotherapy treatment for the disease.Phthalates can be found in some plastic food containers and are considered as endocrine disruptors. Phthalate exposure has been linked to early puberty in girls, a risk factor for later-life breast cancer.Some pesticides and herbicides used on foods we eat have been labeled as human or animal carcinogens.Zeranol: Commonly found in the beef industry processing, it mimics an estrogen like action in the body and has been found carcinogenic in laboratory animals. This chemical is banned by the European Union.Polyvinyl chloride (PVC) is used to produce food packaging. It was one of the first chemicals designated as known human carcinogen and has been linked to increased mortality from breast cancer and liver cancer among workers involved in its manufacture.6) A lot is being talked about the Mediterranean diet and its anti-cancer properties. How helpful is the diet? The Mediterranean diet got popular in 1990's for its protective qualities against heart ailments. Later it was found to be effective for other lifestyle disorders and cancer. Instead of accepting all the dishes that are offered in the name of a Mediterranean diet we should look for some basic concepts for which this cuisine is revered. These are - good to control weight gain, bad cholesterol and blood sugar.A typical Mediterranean diet includes - abundant plant foods, fresh fruits, olive oil, cereals, wine, moderate consumption of fish, poultry and low amounts of red meat. The main benefit of this type of a diet is that it reduces inflammatory changes and oxidative stress in the body. By reducing inflammatory changes and delaying the age related changes in body it increases longevity and improves health. At least 7 types of cancers are related to obesity and in that context a Mediterranean diet helps to maintain a healthy glucose metabolism and insulin sensitivity. The biological mechanisms for cancer prevention associated with the Mediterranean diet have been related to the favourable effect of a balanced ratio of omega 6 and omega 3, essential fatty acids and high amounts of fibre, antioxidants and polyphenols found in fruits, vegetables, olive oil and wine.7) Five tips that one should follow for a healthy lifestyle.Include fibers in your diet for healthy bowel movements. Regular bowels are important for detoxification.Regular exercise is most important to boost immunity and avoid metabolic disorders like diabetes, hyper cholesterol, obesity, thyroid, hypertension etc. Yoga, pranayama are good for reducing stress, improving flexibility and correcting posture.Nuts provides a good source of energy and other nutrients which are helpful. They help in the reduction and maintenance of weight. Nuts are advisable for controlling bad cholesterol. Nuts like walnut, almonds and pistachios are good for diabetics, hypercholesterolemia.Intake of fruits and vegetables provides necessary antioxidants, vitamins, and minerals. These help to neutralize the oxidative stress in the body and avoid damages to DNA, ageing.Regular detox through green and herbal teas helps to maintain the balance in the body. Spa and Ayurveda therapies like body massages, shirodhara, chooran svedanam help to relax the body and mind. Lymphatic drainage therapy is also helpful to cleanse channels and get rid of toxins from the lymphatic system.

Understanding Cancer Better

Dr. Sandeep Nayak, Surgical Oncologist
What is cancer?Cancer is the name given to a group of diseases that behave similarly. There is a wide range of cancers which are characterised by an uncontrolled division of body's cells without halting and thereby, spread into surrounding tissues pushing normal cells.Cancer can begin at any place in the human body, which is comprised trillions of cells. Regularly, human cells divide and shape into new cells as the body needs them. At the point when cells get senile or get harmed, they bite the dust, and new cells assume their position. When the organised procedure of cell growth fails, cancer begins. Cells turn out to be increasingly irregular in shape and size, and continue to survive even when they ought to die, and new cells are formed even when they are not required. These cells can multiply without any reason and may form what is called tumours. Cancerous tumours are harmful, which implies that they can spread into, or attack, adjacent tissues. Moreover, as these tumours develop, some cancer cells can escape and go to far off spots in the body through the blood or the lymph framework and shape new tumours a long way from the first tumours.Why worry about cancer?Cancers figure among the main causes of morbidity and mortality around the world, with roughly 14 million new cases and 8.2 million cancer-related deaths every year. In the next two decades, it is estimated that the incidence of cancer will increase by 70% throughout the world. Among men, the five most common cancers in 2012 were lung, prostate, colorectal, stomach, and liver cancer.In women, the five most common cancers are breast, colorectal, lung, cervix, and stomach cancer.Around 33% of cancer deaths can be prevented by behavioural and dietary changes. The risks include high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, alcohol use.Read my blogs on early detection of cancer and cancer prevention to understand how to reduce your risk.

10 Symptoms of Cancer Which Nobody Should Ignore

Dr. Sandeep Nayak, Surgical Oncologist
Cancer is an unwanted growth of cells that destroys the healthy environment of the body. The fear associated with it is not because of the disease itself, but, because of the delayed diagnosis due to lack of clear symptoms. Here are a list of commonly ignored symptoms which could be warning signs of cancer. Cancers are PAINLESS when they start and so they get ignored by the patient and doctors alike. Anemia: Tiredness in cancer is usually due anemia (lack of blood) and deficiency of nutrition. The cancer eats up most of nutrients in its race to grow quickly. Also there bleeding from cancer tissue that makes one anemic.Blood while passing stool: very often this is due to piles or similar causes. However, cancer of colon and rectum also causes this. When anyone has blood in stool, it is advisable to do colonoscopy to look inside of colon. Cancer of colon can cause change in bowel habit (like alternating constipation and diarrhea)Blood in urine: This always require further tests.  Cancer of kidney or urinary bladder or prostate (among men) can cause blood in urine. The bad part is this bleeding can be infrequent. This infrequency makes patients ignore this symptom. Even one episode of blood in urine needs through examination.Bleeding in between periods (women): Any bleeding that does not follow the usual pattern of menstrual period is a warning sign. Cancer of uterus or cervix can present with this kind of symptoms. Patients with cervical cancer also have bleeding after having sexual intercourse. A patch or wound inside mouth: Oral or mouth cancers are common in India. These cancers start as a patch or wound and progress over months. If diagnosed early they can be treated effectively. Lump or swelling: Cancers of breast and limb begin as painless lumps or swellings and progress over months. Any newly appearing lumps or swellings should be completely investigated. Loss of weight without trying: A sudden weight loss when you are not dieting needs investigations. As cancer consumes most of the nutrition that you take, you tend to loose wt. Loss of appetite and bloating food: this could be because of obstruction to bowel or because of a cancer secreting its toxic substances. Thorough examination is needed to reach a diagnosis. Lymph node enlargement: Lymph nodes are present everywhere in the body and function as filters. Most of the times they enlarge due to infections. The cancer cells also get filtered in this nodes and are trapped. They grow in these nodes and the nodes enlarge as a result of this growth. Trouble swallowing or vomiting after taking food are both warning signs of a cancers in the digestive tract. These need to be evaluated with endoscopic tests to identify the cause. Some patients have only persistent heart-burns which is misdiagnosed as gastritis and treated only for months before correct diagnosis reveals itself. Pain is the last feature of cancer. Do not wait for it.