World Cancer Day, an international day marked on 4 February is led by the Union for International Cancer Control (UICC) to raise awareness on cancer as a public health issue and to strengthen actions towards improving access to quality care, screening, early detection, treatment and palliative care. This year’s theme marks the second year of the campaign “Close the Care Gap” which is about understanding the inequities in cancer care and taking actions to make the necessary progress to address them.
Key Facts:
- Cancer is the second-leading cause of death worldwide.
- 10 million people die from cancer every year.
- More than 40% of cancer-related death could be preventable as they are linked to modifiable risk factors such as smoking, alcohol use, poor diet and physical inactivity.
- Almost at least one third of all deaths related to cancer could be prevented through routine screening, and early detection and treatment.
- 70% of cancer deaths occur in low-to-middle income countries.
- Millions of lives could be saved each year by implementing resource appropriate strategies for prevention, early detection and treatment.
What is Cancer?
Cancer is a disease which occurs when changes in a group of normal cells within the body lead to uncontrolled, abnormal growth forming a lump called a tumour; this is true of all cancers except leukaemia (cancer of the blood). If left untreated, tumours can grow and spread into the surrounding normal tissue, or to other parts of the body via the bloodstream and lymphatic systems, and can affect the digestive, nervous and circulatory systems or release hormones that may affect body function.
Causes of Cancer:
Cancers can be caused by a number of different factors and, as with many other illnesses, most cancers are the result of exposure to a number of different causal factors. It is important to remember that, while some factors cannot be modified, around one third of cancer cases can be prevented by reducing behavioural and dietary risks.
- Modifiable risk factors include: Alcohol intake, being overweight or obese, diet and nutrition, physical activity, tobacco smoking and/or chewing, ionising radiation, workplace hazards, infection (Human papillomavirus (HPV) infections, while liver cancer and Non-Hodgkin Lymphoma can be caused by the Hepatitis B and C virus, and lymphomas are linked to the Epstein-Barr virus.
- Non-modifiable risk factors include: Age, cancer-causing substances (carcinogens), genetics and immune system.
Signs and Symptoms of Cancer:
With so many different types of cancers, the symptoms are varied and depend on where the disease is located. However, there are some key signs and symptoms to look out for, including:
- Unusual lumps or swelling – cancerous lumps are often painless and may increase in size as the cancer progresses
- Coughing, breathlessness or difficulty swallowing – be aware of persistent coughing episodes, breathlessness or difficulty swallowing
- Changes in bowel habit – such as constipation and diarrhoea and/or blood found in the stools
- Unexpected bleeding – includes bleeding from the vagina, anal passage, or blood found in stools, in urine or when coughing
- Unexplained weight loss – a large amount of unexplained and unintentional weight loss over a short period of time (a couple of months)
- Fatigue – which shows itself as extreme tiredness and a severe lack of energy. If fatigue is due to cancer, individuals normally also have other symptoms
- Pain or ache – includes unexplained or ongoing pain, or pain that comes and goes
- New mole or changes to a mole – look for changes in size, shape, or colour and if it becomes crusty or bleeds or oozes
- Complications with urinating – includes needing to urinate urgently, more frequently, or being unable to go when you need to or experiencing pain while urinating
- Unusual breast changes – look for changes in size, shape or feel, skin changes and pain
- Appetite loss – feeling less hungry than usual for a prolonged period of time
- A sore or ulcer that won’t heal – including a spot, sore wound or mouth ulcer
- Heartburn or indigestion – persistent or painful heartburn or indigestion
- Heavy night sweats – be aware of very heavy, drenching night sweats
Managing and Treating Cancer:
Treatment depends on the type of cancer, where the cancer is, how big it is, whether it has spread, and the general health of the patient. The general types of treatments include: surgery, chemotherapy, radiotherapy, hormone therapy, immunotherapy, and gene therapy.
Nutrition
Good nutrition is vital for people with cancer, as the condition and treatments can affect the way the body tolerates certain foods and uses nutrients.
A High Protein High Calorie Diet will aid in ensuring that people with cancer maintain their body weight and at the same time help cell regeneration. Protein is very important to keep the body functioning and is also needed for growth and repair and tissue regeneration. Protein is found in both animal and plant foods. Animal sources of protein include meat, poultry, fish, eggs and dairy products are called 1st Class proteins. Plant sources of protein include nuts, seeds, tofu and legumes (dried beans, peas and lentils), grains (cereals, breads and rice) and vegetables are called 2nd Class proteins. Fruits and fats do not have any protein.
Importance of food safety and hygiene: When a person receives chemotherapy, doctors monitor a type of white blood cell called a neutrophil, which is part of the immune system. Very low neutrophil levels are known as neutropenia. People with neutropenia have a higher risk for infection, so they must follow safe food handling and cooking practices to minimize this risk. There are several food and hygiene precautions people can follow, including:
- Store food at the correct temperature.
- Stew raw fruits and vegetables before eating.
- Consume sterile tetra pack juices instead of raw ones.
- Wash hands, knives, and countertops before and after preparing food.
- Wash hands after touching raw meat, fish, and poultry.
- Use different cutting boards for meat, and fruits and vegetables.
- Cook meat, poultry, and eggs thoroughly.
- Thaw meat, poultry, and fish in the refrigerator or defrost them in the microwave.
- Use a meat thermometer to ensure cooked meat is at a safe temperature.
- Make sure to consume pasteurized dairy and juice products.
- Eat nuts that are shelled and roasted.
- Consume only cooked chutneys like tomato or tamarind instead of the raw uncooked ones.
- Consume toasted bread only
- Avoid raw food as garnishes like coriander or coconut. Instead add them during the cooking time.
- Avoid uncovered and outside food.
How to Manage Eating Problems: Chemotherapy can cause a number of eating problems as common side effects of the treatment. These may include:
Loss of appetite:
Consume: Small frequent meals which are caloric dense, have a variety of foods for different taste and eat slowly, do not rush / hurry with meals
Avoid: low calorie foods like clear soups, juices.
Sore mouth / throat:
Consume: Soft foods that are easy to chew and swallow such as milkshakes, soft vegetables and fruits, mashed potatoes, paneer, cheese, custards, puddings, jellies, liquids or pureed vegetables and fruits.
Avoid: Foods that cause irritation such as citrus fruits or juices, spicy or salty foods, dry foods like toasts or raw vegetables.
Dry Mouth / Decreased Salivation:
Consume: Sip on water/liquids frequently along with meals, opt for high moisture foods with more gravies and sauces, soups, juices, fruit ice, beverages.
Avoid: Dry preparation of vegetables, pulses, snacks or bread products.
Nausea, Vomiting:
Consume: Clear liquids like soups, juices, kanji, dry toast, soft bland vegetables and fruits.
Avoid: Strong flavoured foods, fried foods, milk based beverages, desserts and sweets.
Nutrition before Cancer Treatment: People with cancer should eat a healthy diet and try to maintain a moderate weight. A healthy diet should include various fruits and vegetables, healthy fats, lean proteins, whole grains, and legumes. People should try to limit refined carbohydrates, added sugars, and ultra-processed foods in any healthy diet. Eating a healthy diet before treatment may help a patient lower their risk of infection, cope with side effects better, and have a greater chance of receiving treatment without unplanned breaks.
Nutrition during Cancer Treatment: Food and nutrition are critical parts of successful cancer treatment. Nutrients support the growth of healthy cells in your body; they also go a long way toward helping you maintain energy and strength. A personalized nutrition plan based on an individual’s likes, dislikes, lifestyle, symptoms and concerns is an integral part of cancer treatment.
Nutrition after Cancer Treatment: Once cancer treatment is complete, maintaining a nutritious eating routine can help the body heal and offer protection for the future. Focus on fruits, vegetables and whole grains. Studies have also found that people who limit added sugars, red meat and alcohol have lower risks of certain types of cancer. This type of eating routine also is good for heart health and can help reduce risk of other chronic diseases.
Summary
Getting the proper nutrients is vital during cancer therapy. Eating well can help with healing, prevent infection, and reduce the intensity of side effects. People undergoing chemotherapy can be more susceptible to infection, so food safety and hygiene are essential. People should store food at the correct temperature and practice good food hygiene. During treatment, people should try to include healthy fats, protein-rich foods, and high fibre foods in their diets. They should avoid foods that risk infection or illness, such as mouldy cheeses, raw fish, and foods. Before, during, and after treatment, a person should maintain a balanced diet and keep their protein and calories at a healthy level. A person can adjust their diet to deal with eating problems, such as nausea, a sore mouth, or weight loss.