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Prevention and control of cancer by lifestyle awareness
Cancer is one of the important public health concerns of today. Since cancer is predominantly in older age groups, the problem of cancer is likely to increase manifold in future in India. This is due to the projected increase in life expectancy in India and changing life style of modern days.

This article is about cancer in adults, its relation with other diseases, its origin, its progress and finally its presentation as a disease, so that, you can find out ways of preventing it. Every person is the best judge of one’s needs. Do’s and don’ts imposed by others rarely last long in the minds. It is the self-motivation, based on the understanding of the problem and the ensuing sense of commitment that ensures the solution and also becomes the source of education for others.

Cancer may well be held at the same plane as that of any other chronic diseases like diabetes, hypertension, heart attack, stroke etc. This factor becomes clearer when we find that the difference is only in the affected/target cells of the respective diseases, based on the genetic profile of the individuals. All these diseases, in general, are caused by the way of life one leads and are hence aptly named as life-style diseases. Therefore, precautions taken against cancer ensure prevention of other chronic diseases as well and vice versa.

Irony of Life
First Half of the life we struggle to earn money at the expense of health and the next half of life we spend the same money to restore our health which we may never get back
What causes chronic diseases?
Every function of the body is controlled by a unit in our chromosomes known as genes. Basically, a disease is caused by weakness in a gene for a particular function in combination with other hostile factors (occurrence of abnormal genes causing genetic disorders is not considered here). The profile of the gene is not under our control. However, the encouraging factor is that only when the other hostile factors exist, despite the weakness in a gene, does a particular disease manifest. If the other hostile factors are taken care of even partly, despite the weakness of a particular gene, the disease either does not manifest or does so late in life or may be mild in nature and controllable. Also, it is just not enough if one does not have bad habits, but lack of good habits may cause a disease. This article deals with not only what should not be done, but more importantly on what one should do. It is based on the principle that - strengthen the good habits and the bad habits are automatically taken care of.

What is cancer?
Cell multiplication within the body is a normal process occurring day in and day out. For example, a skin wound heals with the multiplication of skin cells, and multiplication continues until the message from the body comes to stop the multiplication consequent to healing. Therefore, without the multiplication of cells within the body repair and survival is not possible. But in case of cancer this division of cells does not stop even when the purpose of division is over, in spite of the message from the body to halt the multiplication immediately. Cancer is nothing but the presence of “rebel cells” in the body. Thus, cancer cells are those which are out of control of normal body control mechanism.

Why this continuous abnormal multiplication of cells in some people?

Causes of cancer:
In order to understand the cause and to adopt practical measures to prevent, following are the three fundamental causative factors that should be considered along with the genetic profile.

  1. The first basic causative factor is constant and prolonged “irritation” of a cell due to an “Irritating agent” that could be anything under the sun, including the sun.
    • It could be a physical agent e.g. a sharp tooth, which is pressing the tongue or cheek constantly (Oral cavity area).
    • Or an infective agent e.g. a low level of infection, not showing any symptoms (anywhere in the body).
    • It could be excessive heat – for example consumption of food substances at very high temperature regularly or habitually (throat, oesophagus, stomach area)
    • It could be chemical substances (called carcinogens) – for example pesticide contamination, carbon in overcooked or smoked food, excessive use of spice, excessive use of dyes or deodorants or artificial substances, environmental pollutants etc (anywhere in the body).
    • It could be radiation – for example, repeated exposure to X-rays or excessive exposure to sunrays (skin area).
    • Negative emotions due to nagging situations. Irritation of mind can lead to series of reactions in the body with release of innumerable chemical substances (anywhere in the body). For example It is not only the face that gets red when one is angry, but also the entire cell lining of the stomach.
    • It could be combination of any of the above, which could be worse than the combined effect of single “irritating agent”

    In summary, “irritation” is of two types – a) mental / emotional “irritation”; b) physical / chemical / biological “irritation”. These two basic types of “irritants” act on the cells in a complex permutations and combinations. In this article the term “irritation” is used not only to understand, but also to feel the cause of cancer. Technically an “irritating agent” is known as a risk factor.

  2. The second basic factor is persistent and prolonged weakening of the normal cells. This can be due to;
    1. Lack of proper nutrient substances in the diet.
    2. Lack of proper activity of the cell due to insufficient exercise as a result of sedentary life style.
    3. Relentless emotional stress & emotional trauma. For example the emotion of fear, one that persists deep within, that affects the sub-conscious mind.

  3. The third basic factor is the balance between the earlier two factors mentioned. The two factors are like forces acting on a balance. If a cell becomes weak, even without any increase in the intensity of “irritation”, the balance may tilt towards the onset of the disease process. On the contrary if the cell is strong enough, even if the “irritation” of cell increases, the disease process does not set in. Therefore, it is better to continuously maintain our efforts to increase the strength of the cell to take care of the unknown “irritants” lurking in the body. This process of improving the power of cells to take care of the unknown and the unexpected, even in the absence of diseases, forms the basis of positive health concept.

Precancerous Developments
Induction Phase (this period lasts usually between 15 and 30 years):
Three basic factors that are mentioned earlier, happening off and on, occurring in short spurts, is part of the ups and downs in life. Any physical or emotional stress and grief lasting for reasonable period of time is well taken care of by the body. If any of these factors persist for a prolonged period, then there is increase the chance of getting disease. Now let us explore how these three fundamental causative factors lead to abnormal division of a cell.

If the “irritation” is severe it will probably kill the cell. This is what happens in acute infections. The infecting germ will kill the normal cell instantly and when a significant number of normal cells get killed, one immediately develops the symptoms of that particular disease Within a short period. On the other hand, when the “irritation” is of a lesser degree, the cell does not die, but is left with the job of overcoming the “irritation”. The genes in the cell start putting up defence against this “irritation”. When the “irritation” disappears, the defence subsides and all is normal. On the other hand, If the “irritation” continues the defence should also continue. To maintain this defence, the cell should either maintain the same strength or increase its strength. The situation now is something like a tug of war between damage and recovery and apparently the normalcy continues.

Alternatively, let us now understand what happens if the intensity of “irritation” increases or the irritated cell becomes weaker by changing life style due to;
  1. Aggravation or addition of bad habits. For example smoking, consumption of alcohol, eating junk food.
  2. Neglect of proper diet – due to under-nutrition or over-nutrition with lack of matching essential nutrients
  3. Increase in worries, for example financial or emotional problems.
  4. Indifference to physical exercise, with the misuse of motor vehicles and electronic gadgets.

In such a situation where the “irritation” increases the cell has to increase its defence further. For this, the cells are genetically programmed to divide and increase in number to overcome the damage. With the cumulative and increase in the intensity of “irritation”, this divisions of the cells continue, over the years. Simultaneously, as the number of cells increase, the available nutrition to the individual cell decreases, weakening the cells further. Usually after many years of tolerance, by and by, some cells are driven to the level of inability to cope up with the defence mechanism and may become indifferent to the messages from the body. They may also look different from the other cells (abnormal) under the microscope and this is the foundation for the development of cancer cells. This phase is technically called as stage of dysplasia. Many years would lapse before this happens and it may take few more years before the cancer cell develops.

Carcinoma Insitu Phase – Stage 0 (This period lasts usually between 5 and 10 years):
Still things can reverse, if only the “irritation” could be removed. If that is not the case, then many more cells act indifferent. At this stage, these cells “switch off” normal control mechanism to a lesser or greater extent and transform as cancer cells. These cells are not only indifferent to the messages from the body, but also start giving out their own messages. Now, under the microscope they have a distinct appearance which is describable as malignancy. The degree of malignancy could be proportional to the degree of “irritation” and number of “irritants”.

Invasive Phase - Stage I (this period usually lasts between 1 and 5 years):
Until this stage, spanning anywhere from 20 to 40 years, cancer may not be detectable at all. The whole process may be hidden and preventable.

Over the years, the cancer cells start damaging the surrounding cells, create their own world, and invade the surrounding tissues. Of course during this time, the rest of the body does not remain idle. It sends its law enforcement agencies i.e. immune system to take care of the errant cell or cells. There are many agencies of the immune system. One such agency is called Natural Killer cells, in short known as NK cells. These cells constantly and tirelessly hunt for the abnormal cells all over the body and remove them. Therefore, in every normal individual after a certain age, every now and then, abnormal cells form in the body and these are routinely taken care of by these NK cells. However, effectiveness of NK cell operation depends again on the strength of the body. If the body is weak the NK cells also weaken and end up like demoralized police force. Of all the factors that weaken the immune system cells, the first and the important one is the state of sub-conscious mind. For example, constant hidden fear can subdue these immune system cells and make them ineffective.

Over a period cancer cells may even invade lymph glands or the blood vessels. The period of progression depends on how far out-of-control they are. In the mean time, if the treatment is given, the malignant cells may be totally or almost totally killed and or removed (with surgery/radiotherapy/chemotherapy/combination of three. Malignant cells remaining after treatment will be killed by the “mop-up” operation of the revitalized immune forces of the body consequent to reduction in the number of cancer cells and cure is the outcome. Stronger is the possibility of cure, if the cancer cells are more towards the normal, or are the result of lesser “irritation” or if one is dealing with a stronger immune system.

But then the problem may not be over as yet, even with this cure. If the risk factor” persists or if the body/cell is not strengthened, there is a possibility of the disease recurring or another cancer developing after many years of yet another hidden battle. Also, the side effects caused by radiation and chemotherapy need the same measures that are mentioned below to increase the strength of the cells in order to recover.

Edited by Dr. Kumara Swamy (MBBS, DMRT, FCGP, MD, DNB (RT))

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