A Family Doctor's Tale - CANCER

DOC I HAVE CANCER
Cancer is the top killer in Singapore.
About one quarter of all deaths here are caused by cancer.

Normal healthy cells grow and multiply in an orderly, controlled manner. 
Cancer cells on the other hand multiply uncontrollably. They do not function normally and instead form a growth or tumour. These cancerous tumours can spread to nearby tissues and organs as well as to other parts of the body. 

Cancer kills by:
Destroying important organs
Disturbing normal body functions
Blocking important blood vessels or air passages.

Not all cancers are the same
Cancer is really a group of diseases. There are many types of cancer which can arise from the different types of cells in the body.

MOST COMMON TYPES OF CANCER IN SINGAPORE ARE:

Male
Lung
Colon & rectum
(large intestine)
Stomach
Liver
Nasopharynx
(back of the nose)

Female
Breast
Colon & rectum
Lung
Cervix
(neck of the womb)
Stomach

Cancer can be prevented
Cancer is not contagious like the flu or chickenpox. You cannot catch cancer from someone who has it.
Many cancers develop because of lifestyle habits such as smoking, excessive drinking of alcohol or eating too much fat (especially animal fat). Others are caused by factors in the environment such as sunlight, radiation and some industrial chemicals. By leading a healthy lifestyle and avoiding certain risk factors, about one-third of all cancers can be prevented from occurring.

Cancer can be cured
Many people are afraid of cancer because they think it is incurable. In fact, about one-third of all cancers can be cured if they are detected and treated early enough. Recognising the early warning signs and going for regular check-ups can save your life if cancer strikes.

Lower your risk of cancer by leading a healthy lifestyle
Stay away from cigarettes and cigarette smoke. Cigarette smoke contains about 40 different cancer-causing substances. Almost all of those who develop lung cancer are smokers. Smoking also causes cancers of the mouth, throat, larynx (voice box), oesophagus (gullet), stomach, pancreas, kidney and bladder. Even if you don't smoke, breathing in other people's smoke can increase your risk of developing lung cancer.

If you do not smoke, ask any smokers you live or work with to avoid smoking in your presence.

What you can do
Don't smoke. If you do, then stop.
Get your family and friends to support your efforts to quit.
Throw away all your cigarettes and lighters.
Join a programme or support group that helps smokers to quit.
Spend more time with non-smoking friends in smoke-free places.

Take more fresh fruits and vegetables. Fruits and vegetables contain fibre and vitamins which help to reduce your risk of developing colorectal (large intestine) and stomach cancer.

The chemicals used to process foods like ham, bacon, luncheon meat may form cancer-causing substances when they are digested. These substances have also been found in salted or preserved foods (such as salted fish or pickled vegetables) and may lead to cancer of the stomach and nasopharynx. But you don't have to give up these food items totally. Just eat them less often.
Peanuts, seeds and grains that are not stored properly often become mouldy. Some of these moulds produce substances that can cause liver cancer.

What you can do
Have some fresh fruits and vegetables at every meal.
Choose dark-green leafy vegetables and orange-yellow fruits as these contain greater amounts of vitamins and minerals.
Take more fibre by eating wholemeal bread or wholegrain cereals such as brown rice.
Eat salted, pickled, preserved and processed foods less often.
Store nuts in air-tight containers to prevent them from going mouldy.

Overweight? Exercise regularly and eat less fatty foods. People who are overweight are more likely to develop cancers of the colon, rectum, breast and prostate. To maintain a healthy weight, take up a regular exercise or sport. Eat less foods high in fat or sugar.
What you can do
Aim to stay in the healthy weight range.
Exercise for at least 20 minutes three times a week.
Choose a game or sport that you enjoy and can do with your friends or family.
Trim away fat from meat and skin from poultry before cooking.
Switch to foods low in fat like skimmed milk, reduced fat cheese or low-fat yoghurt.
Use low-fat cooking methods like stewing, baking, steaming or boiling instead of deep frying.
If you feel the urge to nibble, choose healthier snacks like fresh fruit or wholemeal crackers.

Prevent sunburn and avoid overexposure to the sun. People who have fair skin are more prone to skin cancer. The ultraviolet rays from the sun damage the skin. Frequent sunburn may lead to skin cancer.

What you can do
Avoid overexposure to the sun, especially if you are fair-skinned.
Stay in the shade whenever possible. Wear a hat or a cap.
Use a sunscreen or sunblock with a sun protection factor (SPF) of at least 15 on all exposed areas of skin.

Comply with safety regulations if you are exposed to cancer-causing substances at work. Always follow the safety regulations as they are meant to protect you.

What you can do
Take cover behind protective shields or stay in the "safe" area.
Remember to wear your personal protective equipment (like gloves, masks or goggles).
Learn how to handle the equipment or the chemicals properly. Pay attention to safety drills and know what to do in case of emergencies.

Avoid excessive alcohol if you drink
People who frequently drink large amounts of alcohol are likely to develop liver cancer. They are also at risk of developing cancer of the mouth, throat and oesophagus (gullet).

What you can do
If you drink, limit yourself to not more than two standard drinks a day. One standard drink is roughly equal to:

One can of beer
(285 mls) 
One glass of wine
(120 mls) 
One measure of spirits
(30 mls)

Alternate your drinks with non-alcoholic ones. Drink them slowly so they last longer.

Look out for these early warning signs and let your doctor know. Notice any unusual lumps, sores, moles or bleeding?


Be on the alert for: CAUTION
1.Changes in bowel or bladder
2.A sore or an ulcer anywhere on the body, including the mouth, which       does not heal properly.
3.Unusual bleeding from the nose or any other part of the body, and blood in the stools.
4.Thickening lump in breast or elsewhere
 5.Indigestion,
6.Obvious changes in the size, shape or colour of a mole on the skin.
7.Nagging cough, hoarseness,

 Pay attention to problems that won't go away or get better, like: a persistent cough (with or without phlegm), hoarseness of voice, indigestion or discomfort, loss of weight for no reason, a change in bowel habits (such as persistent diarrhoea or constipation).

What you can do
Tell your doctor about it right away. He can examine you and do some tests to find out if your problem is serious.

Ladies, early detection may save your life.

Examine your breasts once a month. Regular breast self examination (BSE) helps to detect breast cancer at a stage when it can still be treated and even cured. Many women have saved their lives through regular examination of their own breasts. A regular examination by your doctor is also recommended. Mammograms are special X-rays of the breasts to look for lumps. They are usually recommended for women over 50.

What you can do
Learn how to do BSE properly and then do it every month.
See your doctor for a breast examination once every two years. (Women over 40 should see their doctor once a year)
Recent changes in the size, shape or colour of a mole on the skin.
Ask your doctor about mammograms if you are over 50.

Regular Pap Smears. A Pap smear is a simple, quick and painless test that detects cervical cancer at an early stage when it has a good chance of cure. A woman should start having regular Pap smears once she becomes sexually active.

What you can do
Go for a Pap smear once a year for the first two years after becoming sexually active.
After that, get a smear done once every three years.

Speak to your doctor about your personal and family medical history. Certain medical conditions may increase your risk of developing some cancers. For example, people who are carriers of the Hepatitis B virus are more likely to develop liver cancer. Women infected with certain sexually transmitted diseases have a higher chance of getting cervical cancer.

Your doctor can advise you how to prevent such conditions. But if you already have them, he can tell you what steps you can take to reduce your risk of developing cancer.

Some cancers (like breast and colorectal cancers) tend to run in families. If your parents, brothers or sisters have had cancer, discuss it with your doctor. He may recommend some screening tests to help determine your risk for developing the same cancer.