THE FOUR STAGES
There are four stages of cancer. Stages 1 and 2 are the early stages, wherein the cancerous tumour is small and hasn't spread deeply into nearby tissues. Stage 3 is locally advanced, when the tumour is large and has potential to spread around. "Stage 4 is the advanced stage, in which the cancer has spread to other organs from the organ of origin. It's also called metastatic cancer," says Dr Pawan Gupta, additional director, surgical oncology, Jaypee Hospital, Noida.
Dr Sameer Kaul, senior consultant and head, Surgical Oncology, Indraprastha Apollo Hospitals, explains, "When cancer spreads to the second level lymph nodes and/ or organs in its vicinity it is called Clinical Stage 3. When it spreads to distant sites like liver, brain, bones, lungs via the bloodstream and lymphatic channels, it's Stage 4." Both these stages mean that the patient hasn't been able to detect the cancer on time.
DELAYED DETECTION
Cancers developing inside relatively voluminous organs like lungs, stomach, colon, muscle groups in thighs, kidneys and space around them called retroperitoneum, keep growing before they produce remarkable warning symptoms. Dr Sameer says, "Only when they've grown big do they start obstructing things or catching nerves and blood vessels in their vicinity, causing enough discomfort. Others organs like ovaries, stomach, etc, produce subtle symptoms which get ignored."
Heartburn or dyspepsia is mostly because of hyperacidity but can also be an intital symptom of Gastrointestinal cancer. Similarly, bloating or belching is dismissed as chronic indigestion and often self-medicated, though it could be a early pointer for Gallbladder and Ovarian cancer. Lung Cancer can also be misdiagnosed as chronic cough in routine chest X Rays.
Dr Anshuman Kumar, director, surgical oncology, Dharamshila Narayana Superspeciality Hospital, adds, "Anyone who has had a cough with blood-covered sputum a few times should get tested for Lung cancer."
GET TESTED REGULARLY
Late diagnosis can be avoided by keeping an eye out for any abnormal growth on the body, clinical examination. Liquid biopsy, pet scan, papsmear, biopsy, cancer SEEK, complete blood test count (CBC) and blood protein test should be done at regular intervals, once in six months if possible or in an year.
Dr Dinesh Agarwal, senior technical advisor, Health and Sanitation, Nutrition and Hygiene, IPE Global Limited, adds, "There are some blood tests like PSA for detection of prostate cancer and HPV test and PAP smear for Cervical cancer. Selfexamination for breast and oral cavity, along with mammography and USG, are some other check-ups one should get done annually, along with a colonoscopy, bronchoscopy and endoscopy.
TREATMENT OPTIONS
In the more advanced or late stages, chemotherapy, where anti-cancer drugs drawn from plant and metal sources or replicated synthetically in labs are used, has been the main treatment option. Dr Sameer says, "Intensive research has brought forth more selective and targeted drugs, most of which are proteins and may be consumed orally or are injectable for better responses and lesser side-effects, like Tyrosine Kinase Inhibitors and Monoclonal Antibodies."
Stimulating the body's innate defence mechanisms to kill Cancer cells is also becoming a popular option under Immunotherapy. Technological advances have to also led to the development of machines called Linear Accelerators which burn Cancer cells with precision via Radiotherapy.
Cancers in difficult areas use Proton Therapy, in which protons are harnessed to destroy cancer cells. Doctors say that late stage patients can now live longer than a decade ago.
Symptoms to watch out for
1. According to research overall, 93 per cent of cases of melanoma (Skin cancer) were diagnosed at stage one or two, as were 83 per cent of those found to have Breast cancer and 61 per cent of prostate cancers. Only 23 per cent of Lung cancer cases were found at an early stage, and 44 per cent of Ovarian cancers.