Cancer, food, cellphones and the environment - what we need to know

2017-01-29 12:20

Picture: Freepik

World Cancer Day

According to the Health Calendar for 2017, the 04th February is World Cancer Day. February is also an awareness month for healthy lifestyles, reproductive and environmental health. When people think cancer, most get scared. Either they have lost relatives or loved ones to cancer, or think they have a strong genetic risk of getting it. The ones who are not scared of cancer probably have a stronger faith in a higher power, won a battle against it or might just be ignorant. There are myths and beliefs about what causes cancer, how to prevent it and alternative cures. There are more than 200 types of cancer and this article cannot cover all the details surrounding cancer care and research.

Picture: Slideshare

What is cancer?

The Greek word “carcinos” was used by Hippocrates (the father of medicine) to describe a tumour. The word carcinoma is also used and includes both ulcerating and non-ulcerating cancers. The word tumour comes from the Latin word “tumor” or “tumere” meaning to swell. People often associate cancers with swelling visible to the naked eye. Cancer can start from almost any body organ or tissue. Cancers are therefore named according to the organs they originate from and we also get cancers of blood component origin (haematological). A human body is made up of building blocks called cells. Each cell is constantly undergoing changes, growing and dividing to form new cells. Different body cells also have different roles to play. Cells also have different lifespans and are programmed to die. There is a system meant to control faulty or defected cells. These cells will then be wiped out by the immune system. Cancer cells disobey the rules of growth and division. They become abnormal cells and do not grow in line with other cells.

Picture: CANSA

Picture: CANSA

Who gets cancer?

In the medical field, I find that people usually get shocked if cancer is diagnosed in younger people. Everyone seems to think cancer is the disease of the elderly. Others think that cancer only affects white people. In South Africa, the latest statistical figures are from the 2011 National Cancer Registry. They have a summary of cancer cases that were diagnosed and confirmed in the lab. According to the registry, in 2011, 300 black males between ages 0-19 years got cancer. In comparison, white, Asian and coloured males of the same age group were 93, 4 and 68 respectively. The cases of cancer increase with age, no doubt, but these figures are there to remind us that the young can also be affected. In black females across all ages, 13838 cases were reported in the year 2011 compared to 733 Asian, 3726 coloured and 13613 white females. There are more black people than other races in South Africa and some may argue about the incidence of cancer. However, the figures still show that black people get cancer as well.

Picture: CANSA

How bad is cancer compared to other diseases in SA?

South Africa is facing multiple health challenges as a developing country. In 2015, 7 million people were estimated to be living with HIV. We are also seeing an increased TB incidence worsened by HIV. Mothers, newborns and children under 5 years dying are estimated at 4.7 million yearly in Sub-Saharan Africa. There are national set targets for reducing new HIV infections and maternal and child deaths. Let us not forget an increase in lifestyle diseases (non-communicable) as described in my previous article. Interpersonal violence, accidents and trauma are also on the rise and some are linked to alcohol abuse. These conditions and diseases are burdens on the South African healthcare system. Cancer has increased the load by claiming additional deaths and adding disabilities to the quadruple burden of disease (HIV and TB, Maternal and Child mortality, Non-communicable Diseases and Violence, Injuries and Trauma).  There are also cancers linked to HIV and lifestyle diseases.

What causes cancer?

It is never easy for any doctor diagnosing a patient with cancer. The confusion on their faces, the questions about what caused it or how they got it. One never gets used to such. Worst part is having to explain to someone that has never tasted alcohol in their life or smoked. Others have been following a strict diet and exercising. Personally, the delay experienced by patients seeking health in state hospitals has to be the most devastating. There are limited referral hospitals, oncology and surgical specialists. There are long waiting lines and sometimes necessary equipment is unavailable or non-functioning. Just what can you tell patients about their odds in a situation like that? Provided you can figure out what caused their cancer.

Causes

Hereditary factors

Some of us carry genes that will increase our chances of getting cancer. Genes can be altered or mutated to predispose one to getting cancer compared to the general population. Other geness are just at risk of getting easily mutated by environmental and other factors. According to the American Cancer Society, these four cancers have a tendency to run in the family:

Breast cancer

Ovarian cancer

Prostate cancer

Colorectal cancer

In some institutions, genetic testing can be done to determine one’s risk of getting cancer by looking for mutated genes.

Tobacco use

Smoking has been linked to a number of cancers and is said to be a preventable cause. The Cancer Association of South Africa (CANSA) recognizes research that has been done on tobacco and cancer links. CANSA advises against smoking water pipes (hookah/hubbly bubbly) http://www.cansa.org.za/hubbly-bubbly-or-hookah-smoking-increases-cancer-risk/ . CANSA also helps those who would like to quit smoking through an online program: http://www.ekickbutt.org.za/ .

Alcohol use

According to CANSA, alcohol is known to cause cancers of the:

Mouth

Throat

Voice box

Oesophagus

Liver

Pancreas

Colon and rectum

Breast

Not all people who are regular alcohol drinkers get cancer. It is important to indicate that scientists have identified a link between certain cancer types and alcohol. They found that these cancer types were more common in the drinking than non-drinking group. It seems the quantity of alcohol taken may also increase the risk of cancer.

Infections

Viruses

HPV (Human Papillomavirus) is known to cause cancers of the female (including cervix) and male genital organs, anal cavity, oral cavity, throat and tonsils.

Hepatitis B and C viruses can cause hepatocellular carcinoma (a type of liver cancer).

HIV has been linked with Kaposi’s sarcoma, lymphomas, cervical and anal cancers.

Infection with the above mentioned viruses can be prevented to a certain extent. Vaccines are available for HPV and Hepatitis B in South Africa. HIV pre-exposure and post-exposure prophylaxis can be given to specific risk group individuals. There are other viruses linked with cancer (HTLV-1, HHV-8, EBV etc.).

Bacteria

Helicobacter Pylori (used to be called Campylobacter Pyloridis) is a known bacteria found in the stomach linked to development of gastritis, ulcers and since 1994 classified by the International Agency of Research on Cancer (IARC) as a cancer causing agent.

Parasites

A Bilharzia causing parasite (Schistosoma Haematobium) has been linked to development of a specific bladder cancer.

Lifestyle factors

The National Cancer Institute lists the following cancers as linked to obesity:

Oesophagus

Breast (after menopause)

Uterus

Prostate

Pancreas

Colon and rectum

Bowel

Uterus lining

Kidney

Thyroid

Gallbladder

Picture: Compoundchem

Environmental factors

International Agency of Research on Cancer (IARC) classifies cancer forming agents (carcinogens) as

Group 1 (carcinogenic to humans)

Group 2A (probably carcinogenic to humans)

Group 2B (possibly carcinogenic to humans)

About 118 agents have been described under group 1 (smoking and alcohol included here), 75 in group 2A, 288 in group 2B and there are 481 known substances in total. See pictures for examples.

Categories include (Taken from CANSA: Fact Sheet on Cancer)

Pesticides

Industrial chemicals and wastes

Chemicals in consumer products (building, furniture, food, packaging and cosmetics)

Pollution

Picture: Gmoanswers

Environmental toxins

A specific example relevant to our South African context is a fungus that may grow in maize if not stored well. The released toxin, aflatoxin, has been associated with development of oesophageal cancer.

Radiation

Repeated exposure to Ionising radiation (gamma rays, x-rays and high-energy UV rays) has been linked to cancer. Non-ionising radiation is generally not known to affect the risk of developing cancer, but new evidence may suggest otherwise. Cellphones, microwave ovens, power lines, cellphone towers and television screens give off non-ionising rays. Cellphone rays are still being studied as some researcher believe that lab studies are finding a link in radiofrequency waves released by cellphones and brain cancer. The IARC classified cellphones under group 2B carcinogens (see above).

CANSA advises all to be “safe than sorry until scientific clarity is achieved”. CANSA also looked at some recent studies that proposed that a 10 year or longer exposure to cellphones correlates with increased risk for certain brain cancers (gliomas and meningiomas) and multifocal breast cancer in young ladies who keep their phones in contact with their breasts for a longer time. CANSA has acknowledged such studies but will await the formal re-classification by the IARC. In the meantime, minimal use of cellphones is recommended by CANSA:

Limiting the number and duration of calls

Texting rather than making calls

Switching the sides of the head when a call is long – one should, however, avoid long conversations

Making use of hands-free kits or speaker phone mode to keep the phone a distance from the head

Instructing children and teenagers to limit calls to emergencies only as they are more vulnerable to electro-magnetic radiation because of the thickness of their skulls and their brains are still developing

Not sleeping with one’s cell phone close to one’s bed or under one’s pillow

Women not to keep their cell phones in their brassiere

Men not to carry their cell phones in the pockets of their pants (close to their testicles)

(Reference: CANSA Fact Sheet and Position Statement on Exposure to Radiofrequency and Electromagnetic Fields)

How will I know if I have cancer?

As mentioned earlier, there are many types of cancer affecting different body organs. Signs and symptoms will vary depending on the stage of cancer, location and other systemic factors. CANSA however has identified the following useful warning signs:

For Children: CHILD acronym includes weight loss (continued, unexplained), headaches (early night or morning with vomiting), bone, back, legs or joint pain or swelling, mass developing (abdomen, neck, chest, pelvis or armpits) or excessive bruising, rash or bleeding.

CANCER acronym includes constant infection, a whitish colour behind the black part of the eye, nausea or vomiting, always tired or pale, eye or vision changes and recurrent fever.

Picture: CANSA

For Adults: CANCER acronym includes change in wart or mole, any continued fever, nagging cough or continued hoarseness, chronic pain in bones or any other area of the body, enduring fatigue, nausea or vomiting and repeated infection or inflammation.

The CAUTION acronym includes change in bowel or bladder habits, a sore that does not heal, unusual discharge or abnormal bleeding, thickening or lump in the breast, testicles or elsewhere, indigestion or difficulty swallowing, obvious change in mole, wart or mouth sore (size, colour, shape or thickness) and noticeable weight loss or loss of appetite.

These symptoms can occur in other medical or surgical conditions. One should consult rather than self-diagnose if experiencing one or more of these symptoms.

Picture: CANSA

Cancer awareness

I will conclude with the following quotes from http://www.beseengetscreened.com/blog/25-inspirational-cancer-quotes-to-share-with-your-friends-and-family :

“Cancer is a word, not a sentence.” – John Diamon

“Time is shortening. But every day that I challenge this cancer and survive is a victory for me.” – Ingrid Bergman

“Some days there won’t be a song in your heart. Sing anyway.” – Emory Austin

“Courage is not the absence of fear, but rather the judgment that something else is more important than fear.” – Ambrose Redmoon

“Cancer affects all of us, whether you’re a daughter, mother, sister, friend, co-worker, doctor, or patient.” –Jennifer Aniston

“Cancer can take away all of my physical abilities. It cannot touch my mind, it cannot touch my heart, and it cannot touch my soul.” – Jim Valvano

“You can be a victim of cancer, or a survivor of cancer. It’s a mind-set.” – Dave Pelzer

“Feed your faith and your fears will starve to death.” – Anonymous

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