February 4 every year has been chosen as the World Cancer Day by the Charter of Paris of 2000. Since 2006, International Union Against Cancer (UICC) has been coordinating World Cancer Day activities, supported by the World Health Organisation.

A five-year programme was launched on World Cancer Day in 2007 that aims to raise awareness on the ways we can prevent cancer through the choices we make. The theme of 2010 is ” Cancer Can Be Prevented Too”, focusing on how the risks of developing cancer can significantly be reduced through simple measures:

- Stop tobacco use and avoid exposure to second-hand smoke.

- Limit alcohol consumption.

- Avoid excessive sun exposure.

- Maintain a healthy weight, through eating healthily and exercising regularly.

- Protect against cancer-causing infections.

Cancer… Either you have had it, will develop it at some time, or know someone who has had it or has it. Whether we like it or not, cancer affects each one of us directly or indirectly. So, what do we need to do? Can we do anything at all? Well, let’s share some common facts and ways that YOU can help to reduce the risk.

1. “Is it true that all tumours are cancerous?”

No. Tumour means swelling in Latin and sometimes a tumour stays contained in a small area and is unlikely to present a threat to other body tissues. This is called benign, ie not cancerous. Equally not all cancerous cells form tumours like cancer of the blood.

2. “Do we know what are the causes of cancer?”

Actually, nobody knows exactly what causes cancer. However, scientists have identified that cancer occurs because of changes of the genes responsible for cell growth and repair. These changes are the result of the interaction between genetic host factors, ie your body and external agents that can be categorised as:

1. Physical carcinogens such as ultraviolet (UV – SUN light) and ionising radiation.

2. Chemical carcinogens, such as asbestos and tobacco smoke.

3. Biological carcinogens such as:

a) Infections by virus (Hepatitis B Virus and liver cancer, Human Papilloma Virus (HPV) and cervical cancer).

b) Bacteria (Helicobacter pylori and gastric cancer).

c) Parasites (schistosomiasis and bladder cancer).

d) Contamination of food by mycotoxins such as aflatoxins (products of Aspergillus fungi) causing liver cancer.

Tobacco use is the single most important risk factor for cancer and causes a large variety of cancer types, such as lung, larynx, oesophagus, stomach, bladder, oral cavity and others. Although there are still some open questions, there is sufficient evidence that dietary factors also play an important role in causing cancer.

This applies to obesity as a compound risk factor per se as well as to the composition of the diet, such as lack of fruit and vegetables and high salt intake. Lack of physical activity has a distinct role as a risk factor for cancer.

There is solid evidence about alcohol causing several cancer types, such as oesophagus, pharynx, larynx, liver, breast and other cancer types.

3. “Can I get infected by being near to cancer patients?”

No, cancer is not contagious at all.

4. “Can I inherit cancer from my grandfather as he was diagnosed to have cancer in his 80s?”

Scientific facts have shown that a majority of cancer is not inherited, even though many people have relatives who were diagnosed with cancer.

However, a small number of people are born with a faulty gene inherited from their parents. For example, an early onset of colon, breast, renal or ovarian cancer in close relatives provides a clue of possible inherited tendency

5. “How are the statistics in Brunei and should we be worried?”

In Brunei, cancer has been the top killer since 2004 up to 2007 with a mortality rate of 55.1 per 100,000-population in 2007. From 2002 to 2006, Brunei Cancer registry has charted a total of 1,348 new cases of cancer, averaging 269 cases per year.

The most common type of cancer for men is lung cancer, whereas for women, it is breast cancer. Other types of cancer noted includes cervix, colon, endometrium and nasopharynx.

The trend is slowly increasing and there are some worrying features noted in Brunei Darussalam, such as the earlier age of onset for breast cancer, increasing trend of lung cancer in non-smokers and association of obesity and younger age in endometrial cancer.

6. “What are the signs and symptoms which suggest the possibility of cancer?”

If you have any of the following features, do not panic but do get to see your doctor as soon as possible for diagnosis (do not overlook the problem):

- A new or unusual lump or swelling anywhere on your body, for example breast lump.

- A sore that will not heal, anywhere on your body or in your mouth.

- A change in the shape, size or colour of a mole

- Blood in your urine or bowel motions.

- A cough, croaky voice or difficulty swallowing that lasts longer than four weeks.

- A change to looser or more frequent bowel motions lasting longer than four to six weeks.

- Difficulty in passing urine.

- Unexplained weight loss.

- Bleeding from the vagina after the menopause or between periods.

- Unexplained pain or ache that lasts longer than four weeks.

7. “How is cancer treated?”

The treatments include:

a) Surgery – remove a whole tumour or an affected organ.

b) Radiotherapy – using radiation to kill cancer cells and shrink a tumour.

c) Drugs – such as chemotherapy, hormones, etc. These are the anti-cancer drugs given to kill cancer cells throughout the body or to stop them from multiplying.

They may be used alone or in combination.

8. “Can cancer be cured?”

Some cancer can be cured for example, most cancer in children, leukaemia, and lymphoma. Most cancers respond well to treatment, particularly if they are diagnosed at an early stage and many cancer survivors are cured and go on to live long, healthy lives.

However, in some cases, a cancer that has been successfully treated may recur later and may need further treatment.

9. “What I can do to avoid or prevent cancer?”

There is no guaranteed way to avoid this complex disease, but there are many proven positive steps that can be taken to reduce one’s cancer risk. It has been estimated that 40 per cent of cancers are preventable

Avoid smoking, be it actual smoking or second-hand smoke.

Practice sun safety and recognise when skin changes occur.

Eat your fruits and veggies.

Fruits and vegetables are rich in antioxidants, which help repair our damaged cells. Green veggies and orange and yellow fruits and veggies are your best bet.

Watch the meats you eat, especially smoked or cured foods.

Research suggests that a diet high in animal fat can lead to the development of certain cancers. A diet high in smoked foods, salted fish and meat, and pickled vegetables increases your risk factor for cancer.

e) Limit your alcohol intake.

Drinking excessive amounts of alcohol regularly increases your risk factor for cancer. Studies suggest that men who consume two alcoholic drinks per day and women who have one alcoholic drink per day significantly increase their risk factors for certain types of cancer.

f) Exercise for cancer prevention.

Being overweight greatly increases your risk factor for developing cancer. So, exercising to maintain or reach your ideal weight is one of the best defences against cancer.

g) Know your personal and family history of cancer.

Research tells us that some types of cancers can be genetic. Knowing your family history of cancer can help you make more informed decisions about your healthcare. It can also aid in genetic testing and counselling, to assist you in finding out if you carry a mutated gene that increases your risk factor for cancer.

h) Know what chemicals you are being exposed to in your work environment.

If you are exposed to fumes, dust, chemicals, etc in the workplace, you have a right to know what you are being exposed to. Gasoline, diesel exhaust, arsenic, beryllium. vinyl chloride, nickel chromates, coal products, mustard gas, and chloromethyl ethers are all carcinogens and can be found in some work environments.

i) Practice safe sex.

Unsafe sex can result in the infection of the HPV virus, a known cause for cervical cancer and a risk factor for many other cancers. HPV is a virus transmitted through sexual intercourse.

j) Be sure to keep up on screening tests like the Pap and/or mammograms.

Make sure you have regular screening tests like the Pap smear if you are a woman and consider mammogram if you are over 40 years old. The Pap smear can detect cellular changes before they become cancerous, and the mammograms may be able to detect breast cancer early.

Cancer is not invincible and together we can beat this dreaded disease. Do something right, reduce your risk! – Ministry of Health, Public Awareness Programme

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