Know it, to control it

Diagnosis of Cancer: Earlier the Better

Generally it is said, that if cancer is detected early it can be cured before it becomes invasive or metastasizes. So for cancer detection the golden rule is earlier the better. Some early signs and symptoms of cancer include sudden and unexplained weight loss, fever, fatigue, pain, skin changes, loss of appetite but having any of these does not surely mean that the individual has cancer. So early detection of cancer by clinical observation of symptoms is like finding needle in the haystack.

It has been suggested that symptom recognition accounts for at least 60% of the total delay in cancer treatment in women with breast and gynecological cancer. Vague or non-specific symptoms are more likely to be attributed to everyday explanations such as indigestion, old age or menopause. For example, most patients attribute their pharyngeal cancer to a common cold or infection and their oral cancer to an infection or dental problems.

Individuals who do not identify symptoms as cancer are more likely to delay seeking healthcare advice than those who do. Even, fear of cancer and fear of embarrassment are identified as key factors contributing to delay in patient presentation to a healthcare practitioner. Diagnosis of diseases like oral, cervical and breast cancers at earlier stages is also needed to save lives and reduce distress, especially when this can be linked to better and more accessible pain management.

There are some tests like pap test (cervical cancer), mammography (breast cancer), sigmoidoscopy and fecal occult blood test (colorectal cancer), prostate specific antigen tests (prostate cancer), or just visual observation of lesions in oral cavity for oral cancer. However, the usefulness of most of these tests is restricted due to factors like availability of hi-tech infrastructure, trained healthcare professionals; cost involved is high, negligence by patients. As a result, although these techniques have great impact on reduction of mortality due to cancer in developed countries, the impact of these techniques is in developing countries is limited.

Here are the problems associated with the early detection of some of the cancers.

Pancreatic cancer

The most effective treatment for pancreatic cancer is curative resection (surgical removal of cancerous cells). It is possible to resect and completely cure pancreatic cancer, only if it is diagnosed at a non-invasive stage. Moreover, surgical removal of cancerous cells is not completely curative and resection just helps to increase the quality of life of patients and survival time. Further, lack of curative adjunct chemotherapy is also a major problem responsible for high mortality in pancreatic cancer.

Colon cancer

Generally colon polyps and cancer have no symptoms in an early phase. Most commonly observed symptoms with colon cancer include change in bowel habits, diarrhea, constipation, blood in stool, stools narrower in size than normal, frequent gas, vomiting and indigestion, but anyone of these symptoms are not due to colon cancer, and may resemble symptoms of other diseases like inflammatory bowel disease, appendicitis etc.

Liver cancer

Liver cancer is often not associated with symptoms until its later stage. Small tumors in the liver are difficult to find by physical examination. Many patients who develop liver cancer may have had cirrhosis for a long time, often misdiagnosed as liver cancer. Cirrhosis may get worse for no reason, and then screening tests for liver cancer may be recommended. Screening tests like imaging and alpha feto protein are advised in patients considered on high risk for liver cancer i.e. patients with cirrhosis and Hepatitis B.

In conclusion, medical tests for early detection of some types of cancer are available; they have benefits but also costs involved. Till date early detection is riddle for several other cancers and there is long way to go to win the battle against this silent killer.