Preventive Oncology is a discipline that focuses on key measures that can prevent cancer development or catch the disease at an early stage or delay the progression of the malignant process.
Preventable cancers refer to the cancers that can be avoided by eliminating the risk factors or can detected at the pre cancer stage, when the changes are reversible or at an early stage when the treatment is simpler, less mutilative and less expensive. India has a rapidly growing population inflicted with cancer diagnosis. However, the cancer treatment facilities in India are limited. Thus, the only effective way to tackle the rising huge cancer burden is focusing on preventable cancer cases. Approximately, 70% of the Indian cancers (40% tobacco related, 20% infection related and 10% others) are caused by potentially modifiable and preventable risk factors. The top three cancers in India – breast cancer, cervical cancer, and oral cancer are all preventable and treatable. Creating awareness and screening the general population is the way forward to deal with this epidemic.
HOW CAN THESE CANCERS BE PREVENTED?
These cancers can be prevented by making the public aware of the causative factors and by ‘Screening’ for them in the population. Cancer screening is looking for cancer before a person has any symptoms. Screening tests can help find cancer at an early stage before symptoms appear.
CERVICAL CANCER SCREENING
Cervical cancer is the second leading cause of cancer deaths in women in low and low–middle income countries. Cervical cancer kills more than 68,000 women and statistics reveal one death every 8 minutes in India. Human Papillomavirus (HPV) is the cause of most cervical cancers. There are 14 types of high risk HPV that can cause this cancer.
Cervical cancer is largely preventable through vaccination and routine cervical screening. Screening for cervical cancer will help detect precancer lesions and early cervical cancer. This early detection can help treat precancer lesions thereby preventing cervical cancer. Timely detection of early cervical cancer can lead to higher chances of successful treatment of cancer.
Screening tests for cervical cancer
1. HPV test
2. Pap smear
3. VIA (visual inspection with acetic acid).
Screening is recommended for all women aged 25 to 65yrs.
All women who screen positive by any of these tests are further evaluated by colposcopy and treated according to the findings.
Breast Cancer Screening
Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. The different modes of screening for breast cancer include -
a) Self Breast Examination- Breast self-exams may be done by women to check their breasts for lumps or other changes. If they feel any lumps or notice any other changes in the breasts they are advised to see a doctor immediately. All the women coming to the preventive oncology OPD are taught self breast examination.
b) Clinical Breast Examination - A clinical breast exam is an exam of the breast by a doctor or other health professional. He or she will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.
c) Mammography- An X-ray imaging to detect for presence of tumor or lump in breast.
Oral cancer Screening
Oral Cancer screening involves self-oral examination or oral examination by trained health workers for identifying OPMLs. The exam will include checking all parts of the oral cavity and looking for lesions such as areas of leukoplakia (an abnormal white patch of cells), erythroplakia (an abnormal red patch of cells), an unhealing ulcer or a growth in the oral cavity or an inability to open the mouth (OSMF). These lesions on the mucous membranes may become cancerous.
Preventive oncology has three components which are as follows -
1. Hospital based OPD
Services offered
- • Cervical cancer screening
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- o Pap test
- o VIA/VILI test
- o Coploscopy
- • Breast cancer screening
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- o Teaching of Self Brast Examination
- o Clinical Breast Examination
- o Mammograpphy
- o USB Breast
- • Oral cancer screening by Oral Visual Examination of the oral cavity
2. Outreach activities
We regularly conduct cancer screening camps in different villages of Punjab. The outreach component deals with sensitizing and building awareness in the community regarding early signs of cancer and cancer screening. And holding meetings with different stakeholders and implementing cancer screening projects in the community for early diagnosis of the disease to ultimately bring down the incidence and mortality from it.
3. Research and training
Research is an integral part of the discipline. It is important to expand our knowledge base, studying for recent evidences and put new ideas to scientific testing. Apart from that the dept routinely receives request for capacity building and training in cancer screening from other institutes, which are met.
4. Cancer Control Programs in Punjab
Program to control cancer among women of North and North-Eastern India. ISHA (Indian Study of Healthy Ageing) Department of Atomic energy, Govt. of India sanctioned a project for screening of common cancers among women in various district of Punjab. This is a flagship program under the honorable prime minister of India, Shri Narendra Modi ji for the identified blocks in Sangrur, Mansa and SAS Nagar district of Punjab. The objective of this program is to raise the awareness and screening of 5 lakhs women for Oral cavity, breast and cervix cancer (1 lac women will be screened in Punjab).