World Cancer Day is commemorated on February 4, the date chosen by the World Health Organization (WHO) to raise awareness among the population about the early diagnosis of this disease and the possibility of offering a better quality of life for the patients.
According to Globocan -Global Cancer Observatory-, in 2020 more than 113,000 new cases of cancer were registered in Colombia, the most common being breast (15,509), prostate (14,460), colon and rectum (10,783), stomach (8,214) and lung (6,876).
Faced with this scenario, the oncologists at Clínica del Country call for the importance of diagnosis and timely treatment.
Specialists agree that frequent check-ups and knowing the possible symptoms and/or risk factors that could lead to cancer are fundamental aspects to detect the disease early and reduce the probability of death by a high percentage.
In most cases, cancer does not present symptoms in its initial stage, hence the importance of regular check-ups.
According to the experts, good eating habits, regular physical exercise, smoking control, and in some cases vaccination (for example against the papilloma virus for the prevention of cervical cancer) are some of the measures most relevant to reduce the occurrence of cancer.
Along with this, knowledge of the family history makes it possible to establish populations at higher risk, since a percentage of cancer cases is related to hereditary conditions. In this scenario, more frequent check-ups are essential to rule out the presence of a malignant tumor.
Prostate cancer: Risk factors are mainly associated with first-line family history -father or sibling-, especially when the cancer has presented at an early age; likewise, black men have a higher incidence.
“Eating a healthy diet and maintaining an adequate weight are a protective factor against prostate cancer. From the age of 40 the risk increases, therefore, periodic controls with diagnostic tests such as antigen and/or rectal examination are advisable. If an abnormal condition is identified, an MRI or biopsy is performed,” says Dr. Juan Camilo Ospina, head of Urology at the Clínica del Country and Clínica la Colina.
Gastric cancer: one must be alert to symptoms such as easy fullness, loss of appetite, weight loss without apparent cause, nausea and/or vomiting, abdominal pain -especially in the upper part of the abdomen-, and bleeding stools.
It is recommended to perform a digestive endoscopy or biopsy from the age of 40, even when there are no symptoms.
“When it comes to gastric cancer, surgery is one of the pillars; However, the development of different drugs has allowed the treatment to be interdisciplinary, currently the treatment is not only based on surgery, chemotherapy and immunotherapy, there are also some drugs designed to “target” cancer cells”, explains the Dr. Andrés Muñoz, gastrointestinal surgeon and endoscopist at Clínica del Country.
The most common risk factors include Helicobacter pylori infection (common cause of stomach ulcers) and hereditary predisposition; Other less common ones are related to hypertrophic and/or atrophic gastritis, pernicious anemia (vitamin B12 deficiency) and intestinal metaplasia (inflammatory changes of the stomach).
Dr. Muñoz indicates that people who live at higher altitudes have a higher risk than those who live at sea level, since the type of water or components of the earth can influence the loss of stomach thickness, which makes them more vulnerable to contracting this cancer.
Lung cancer: mainly associated with high tobacco consumption (especially more than 10 cigarettes a day); It can develop over time, even after quitting smoking, with the highest incidence between the ages of 50-60. Exposure to contamination and/or pollution also increases the possibility of presenting it.
According to Dr. Kelman Ojeda, an oncologist at Clínica del Country, “there are currently innovative treatments with highly effective targeted therapies without the need for chemotherapy, such as immunotherapy, which activates the immune system and enables it to attack the cancer; even, the incorporation of both -chemotherapy and immunotherapy- is used with increasing success; and low-dose chest CT is an option to detect it with the possibility of low irradiation.”
Colon cancer: On many occasions it manifests late, but it can be suspected when changes in the intestinal environment are evident: unusual constipation, bleeding stools, recurrent abdominal pain, nausea, vomiting and even weight loss.
Dr. Juan Carlos Velásquez, head of oncology at Clínica del Country, affirms that “the treatment for this pathology has advanced enormously and for several years it has been possible to carry out a molecular analysis of the type of cancer in the patient in order to establish the use of additional drugs such as antibodies that block cancer cells -preventing the growth of the tumor-; and even immunotherapy.
Dr. Velásquez mentions that among the risk factors are a family history of colon cancer, obesity, smoking, diabetes, inflammatory bowel disease and some much less common hereditary syndromes such as familial adenomatous polyposis and lynch.
Physical activity, maintaining a proper weight and a balanced diet rich in fiber are protective elements against this cancer.
breast cancer: Dr. Carlos Lehman, breast cancer surgeon at Clínica del Country, mentions that “mammography has two important scenarios: screening -carried out on asymptomatic women-, which is recommended annually from the age of 50 in patients with low risk; and mammography, recommended for women over 40 who present symptoms such as a mass sensation, skin changes, and/or nipple discharge, generally accompanied by an ultrasound scan.
Ultrasound is a study aimed mainly at patients under 40 years of age; when there are symptoms that the mammography does not clarify; and in cases of prosthesis, because ultrasound allows greater visibility. However, Dr. Lehman emphasizes that there are aspects that ultrasound cannot see and vice versa, therefore it is important to take into account that they are complementary tests.
Not smoking, having a controlled weight, regular physical activity, low alcohol consumption, and a Mediterranean diet with fruits, vegetables, nuts, grains, and olive oil all work as protectors. In the case of women in the menopausal stage, the recommendation is to try not to include hormone replacement therapy as long as it is not necessary, as this minimally increases the risk of breast cancer.
Cervical cancer: Warning symptoms include breakthrough genital bleeding, irregular bleeding, foul-smelling or unusual discharges or discharges, chronic pelvic pain, and pain during sexual activity with bleeding.
“Surgical treatment has new less invasive techniques that do not generate major side effects, for example, there is a procedure that identifies, removes and examines the sentinel lymph node to determine if there are cancer cells, as well as fertility-preserving surgeries, which allow younger women to have children later, says Henry Rodríguez, a gynecologist oncologist at the Clínica del Country.
Risk factors include the presence of human papillomavirus infection, smoking, early initiation of sexual activity, and few periodic check-ups.