The Silent Killer

It was on her 26th birthday that Nicole accidentally noticed a lump in her left breast. She visited her gynaecologist who dismissed her concerns, considering Nicole’s age and the fact that nobody in her family had a history of cancer. Six months later, during a routine check-up, the doctor detected enlargement of her axillary lymph nodes. Investigations revealed Grade 3 cancer – an aggressive type of cancer that had already spread to her lymph nodes.

This case goes on to illustrate how cancers are often silent killers, for they are largely undetected in their early stages when they are more responsive to therapy. The symptoms associated with most cancers in the early stage are unfortunately vague, non-specific and not incapacitating enough to warrant attention. Most present as painless masses that cause significant symptoms only when they compress neighbouring tissues or spread to other tissues or cause functional impairment.

The mass may go largely unnoticed, especially if it is an internal mass. For instance, pancreatic cancer is one of the hardest to detect in its early stages because it may only present with vague abdominal symptoms such as bloating, abdominal discomfort, and nausea that may easily be mistaken for acidity or indigestion. Ovarian cancer can also present with vague abdominal symptoms and irregular menstrual cycles that may initially be ignored. Cancer of the prostate may present with urinary symptoms which can be mistaken for benign enlargement of the prostate which is a common age-related disease in men.

Consequently, most of these cancers are detected only when they have already progressed to stage 3 or 4. Delays on the part of the patient to seek medical help for symptoms or on the part of the doctor to establish diagnosis are also responsible for late detection. For aggressive cancers where the disease progression is rapid, small delays in establishing diagnosis can significantly alter the outcome.

Cancer-related deaths are on the rise, and the highest number of deaths is reported from the low and middle income countries. In these countries, public awareness pertaining to cancer and its presentation remains poor. Also, the gaps in healthcare access and affordability prevent patients from seeking early medical intervention. There are also challenges concerning effective diagnostic and screening tests – a crucial element in the early detection of cancer. Specialist referral systems for suspected cancers are also poor. There is thus a need to prioritize high impact, low cost screening and diagnostic tests in these countries.

Considering the above factors that contribute to poor early detection of cancer, there is a need to promote public awareness as well as strengthen screening tests. Screening criteria need to be clearly established for each type of cancer. For instance, women in the age group of 45 to 54 should get mammograms done every year. Pap smear should be done every 3 years for women in the age group of 21 to 29, in order to detect cervical cancer.

With the growing incidence of cancer and its poor response to therapy in the advanced stages, there is an urgent need to define measures to enable early detection and treatment of this global pandemic that poses significant financial burden to healthcare systems.

It is sad to know how so many people across the world poorly succumb to cancer. There are many such diseases that are causing thousands of deaths every year. While some ailments like cancer are not curable, there are others that are. And, there are many other new diseases coming up every day; those that don’t even have a medication because the ailment is not yet known! The field of medical science is a big one, and it is wise to dive into this ocean if you are willing to help such disease-stricken people. If you get the right kind of education and training, you can work towards research about new diseases and new medications to cure them. You can get such right kind of clinical research online training in Bangalore at Avigna Clinical Research Institute, where you needn’t attend a full-day physical class. You can learn online from the comfort of your home without compromising on your daily routine and responsibilities, and yet get a valid certification and Post Graduate Diploma in Clinical Research.

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