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By Ian N. Olver MD Biographical note
Introduction
Cancer is the leading cause of premature death in Australia. The mortality rate from cancer in 2001 was 241 per 100,000 men and 148 per 100,000 women. The leading cause of cancer death in women is breast cancer; in men it is lung cancer.
The number of deaths from cancer is falling. One hundred years ago we could cure very few cancers; today, we can cure over half of all cancers. The improvement is due to better treatments and earlier diagnosis.
Unfortunately, many people still die from cancers that could be prevented through a healthy lifestyle, or cured if detected early enough. Cigarette smoking is estimated to have caused 10,592 new cancers and 7,820 cancer deaths in 2001.
Some simple lifestyle changes - healthy diet and more exercise - could help to reduce your risk of developing cancer.
Cancer incidence
Cancer occurs when genes that are damaged or faulty cause cells to multiply uncontrollably and form a mass (sometimes known as a tumour). Cancer cells can break away from the mass (or tumour) and travel via the bloodstream or lymphatic system to different parts of the body and form new masses there. Cancer can cause premature death because these masses of cells stop parts of the body from working properly.
Treatments
Some cancers can be cured if the tumour is detected and surgically removed before the cancer cells spread. Chemotherapy (anti-cancer drugs) and radiotherapy (radiation treatment) can also cure cancer, by killing cancer cells or stopping them from multiplying. Often these treatments are most effective when used together.
New ways of treating cancer are always being developed and tested. For example, tamoxifen is a highly effective form of endocrine therapy that has been the mainstay in reducing mortality from breast cancer for over two decades. Newer endocrine agents known as aromatase inhibitors are now proving even better. Trastuzumab, an antibody, is showing great promise in the management of breast cancer.
In the future, we will see increasing development of therapies that specifically target cancer. They will block cancer cells' signaling pathways, disrupt their blood supply, correct genetic defects which cause cancer and assist the body's immune system to fight cancer.
Prevention
More than half of all cancers are preventable. Almost another third of cancers are thought to be due to an unhealthy diet. Another third are due to cigarette smoking. Ten per cent of cancers are melanoma: a potentially fatal skin cancer but which is mostly preventable. If you follow these recommendations you will reduce your risk of cancer
- Eat plenty of plant foods: at least two servings of fruit and fives serves of vegetables per day and several serves of such foods as breads, cereals, grain products, pasta and rice
- Eat low-fat foods. Don t eat too much meat, especially high-fat meat
- Exercise for 30 minutes or more on most days of the week. A higher level of exercise, such as 60 minutes or 30 minutes high intensity, may have additional benefit
- Drink alcohol in moderation: no more than 1 standard glass per day for women and 2 standard glasses per day for men
- Don't smoke. Quit can help you: call 131 848.
- Protect yourself against ultraviolet radiation in sunlight by wearing a broad-brimmed hat, long-sleeved shirt, sunglasses and sunscreen, and by staying in the shade where possible. Avoid solarium tanning machines, which also transmit harmful UV radiation.
Early detection
Many cancers can be cured if they are treated early. Two federally-funded screening programs are in place in Australia, which help to detect cancers at a stage when they can be effectively treated.
The national breast screening program can detect cancerous lumps in the breast before they can be seen or felt. Women over the age of 50 are advised to have a mammogram every two years. Some women who have risk factors for breast cancer (for example, a personal or family history of breast cancer) should have mammograms more frequently.
The national Pap testing program can detect changes to cervical cells that could lead to cervical cancer. All women should have a Pap test every two years. Women who have a history of cervical cell abnormalities should have more frequent Pap tests.
A national bowel screening program will be implemented from mid-2006 following successful pilot studies. Australians turning 55 or 65 will be invited to participate in screening by completing a simple test in the privacy of their own homes and mailing it for analysis. An evaluation in 2008 will guide future development of the program.
Informal screening for skin cancers and prostate cancers is undertaken every day in every general practitioners surgery.
Advice
The Cancer Council Helpline is a free, confidential telephone information and support service run by Cancer Councils in each state and territory. Specially trained staff can answer questions about all aspects of cancer, including prevention, early detection and treatment. They can also assist with practical and emotional support and advise callers about specific services appropriate to their needs and location. Information about cancer can also be mailed to callers. Most states provide resources suitable for teachers, students or people seeking general information, as well as patients and their families. Health professionals may also use the service to access up-to-date information or to help patients. Call the Cancer Council Helpline: 13 11 20 (local call from anywhere in Australia) between 9am to 5pm, Monday to Friday. Some states have extended hours, some have health professionals on staff and some have multilingual services.
Links to and/or contact information for further information
Australian sources
The Cancer Council Australia also has a series of fact sheets on lifestyle, early detection and diagnosis of cancer.
International sources
Reviewed and updated February 2006
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