Early detection saves life

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By 2017-06-18

Text and pix by Priyangwada Perera Ceylon Today Features

When a friend tells you that her little son is diagnosed with Osteosarcoma Bone Cancer, you become dumb. Yet, you also recognize a trait you never knew the gutsy girl who played with you had. Motherhood has made a warrior out of her. Not willing to believe all those who said that her son did not stand a chance, she braves new seas. Her son is given new hope and she builds a bridge to give one ray of hope to many. Organized by Kapila Edirisinghe Foundation with the support of the Municipal Council of Gampaha, she invited her son's Cancer specialist and Oncologist, senior consultant and the Head of Clinical and Radiation Oncology at Health Care Global Enterprise in Chennai, Dr. G. Amarnath to Sri Lanka for an awareness programme.

Crucial decision making
"Once a person is diagnosed with cancer, it has a devastating effect on him and his family. The whole world crashes down on them. For some time the patient and family might be in denial. They might think the diagnosis is wrong and feel like going for a second opinion. Refusal and anger take time to accept and settle. Once they accept it, there are many things to think of. "Which stage am I in cancer? How long will I be alive? What will happen to my children? How can my family cope without me?" explained Dr. Amarnath.
Depending on one's financial strength, one selects the most suitable hospital. One should be aware of the facilities and the background of the hospital. He advised that patients do a search on these things. The best doctor in the country may not be facilitated at the hospital he practices to make the most out of his skills. "Resources, support of other Oncologists, both surgical and medical and best equipment are important. Next is to mobilize funds. Do you have enough money? Does the patient come under medical insurance? Desperation makes one choose the best hospital and doctors but can we continue the treatment at the same place? Changing hospitals or doctors half way is not good for the patient. Initially, a sound financial counselling is crucial. Ideally, there should be psychological counselling for the patients and family members. Once this is done, decisions can be made," he said.

First hit - the best hit
According to Dr. Amarnath, early management of cancer should be very aggressive. "In treatment, the first hit should be the best hit. Or else the game is lost. Hair fall, diarrhoea, vomiting and so on can be side effects and reactions. These are different from person to person. Today we have the medication and resources to tackle these complications. The patient is scared. Complexities make a patient feel she is getting worse. Daily psychological counselling throughout the treatment period is important. A doctor needs to be compassionate and loving. Patients and family are scared and they need reassurance."

Cancer is completely curable
Dr. Amarnath stressed, "There are myths about cancer; that it is incurable, a punishment from God and various things. Cancer is completely curable. The secret is to diagnose early. Cancer starts on a scale of 0-4. Staging is done with various investigations and reports and discussed in a multidisciplinary team. A Clinical Radiation Oncologist, Medical Oncologist and Surgical Oncologist all come into this."
Speaking of cancer in general he said, "The disease is contracted due to cell related factors. When the regulation of cells goes haphazard and when parental cells produce daughter cells but they don't die and even those daughter cells produce again without dying. Multiplication happens at a rapid rate not at a fixed rate. There are certain genes that cause this which are cancer related genes. Accumulation of such cells for a considerable bit of time results in the formation of a small lump that spreads to adjacent organs. There is a genetic predisposition to develop cancer. It is not hereditary. Hereditary means it is transmitted. Hereditary transmission has only a 5% chance in certain cancers like breast, colon and retinoblastoma. Smoking, drinking, tobacco chewing and consumption of fatty food excessively ignites it. Multiple factors contribute to the genesis of cancer."

Be mindful of symptoms
It takes time for a normal cell to become cancerous. From Stage 0 to stage 1, developing may take four to five years of time. Awareness of your body gives ample time for early detection. First, cells become slightly abnormal and through certain stages go on to become cancerous. From Micro invasive stage to Frank invasive stage they increase in size and spread to adjacent organs. The best is to be aware of possible symptoms. If one has a cancer in the food-pipe, swallowing is hard. The cancer does not occur over-night. If you have a lump in the breast, one should feel it from the very beginning. The aim is to detect cancer before it surfaces.

Go for the best treatment
Nirmal Patra, Regional Head - International Business for Health Care Global Enterprises Ltd. (HCG) emphasized that they are not here to compete with the local health sector. "Awareness and education can make a person consult doctors early and for cancer to be detected in the early stages. That gives maximum chance of recovery."
Patra spoke of the three types of treatment. These are surgical management, radiation which is instrumental and very scientific, plus medical management with chemotherapy and drugs. Drugs are for the cells. Chemotherapy is available in Sri Lanka but it is not the only mode of treatment. According to Patra, in radiation the ray comes into your body to destroy the affected cells. Unless the machine is accurate, up graded and up to mark it will destroy nearby unaffected cells. Patra insisted on pinpoint accuracy. Their patients are assured of it with Cyberknife gold standard of radiation. "Due to its accuracy other parts of the body are not affected." In India, genetic research is underway to prevent the possibility of the next generation getting affected by cancer. Patra called 'evaluation' the most critical of the process. To identify the cells and parts affected a PET CT scan is used. It would also tell the nature of the tumour and the required treatment. Here, the doctor decides on treatment. Generally when the tumour is spread, they opt for clinical management. The scope of radiation is effective when it is pin-pointed on a smaller targeted area. Chemo can also control spreading.

Only to spread awareness
Patra repeated that they were here with their senior consultant, Dr.Amarnath to educate people. Their target is to get people to make the right decision and right evaluation. They meet people coming to India from other countries being told by the respective doctors that they have cancer. But investigations show tumours are found to be non-cancerous. Early detection makes surgical intervention possible. Then radiation and chemotherapy can follow. Cancer is not fatal. The secret is timely diagnosis and best medication.

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