World Cancer Day is observed on 4 February. This international event is held under the auspices of the Union for International Cancer Control. This day was first observed in 2005. Since then, the aim of World Cancer Day has been to draw public attention to the problem of cancer in order to prevent the spread of such a terrible disease.
Unfortunately, the cancer situation is discouraging both in highly developed countries and in Ukraine. The incidence of malignant tumors keeps rising. In Ukraine, cancer is the second leading cause of death after cardiovascular disease. Every third man and every fifth woman in Ukraine is at risk of developing cancer, and up to 30% of patients are of working age. About a million patients are registered with cancer care institutions; about 160,000 new cancer cases are registered every year, and about 85,000 people die of the disease. More than 1,000 of those who fall ill are children.
In 2013, 4,725 malignant neoplasms were registered in Sumy Region; cancer incidence was 414.1 per 100,000 population (Ukraine: 357.6). Across the region’s administrative areas, cancer incidence ranged from 513.8 per 100,000 population in Buryn District and 472.9 in the city of Sumy to 333.3 in Okhtyrka District.
Malignant tumors are divided into 2 large groups: first, epithelial tumors, which develop from glandular or surface epithelium — cancer (Latin: cancer, carcinoma); second, connective tissue (mesenchymal) tumors — sarcoma (from the Greek sarcos, “flesh”). The group of mesenchymal tumors also includes hemoblastoses (mainly leukemias, non-Hodgkin lymphomas and lymphogranulomatosis, that is, Hodgkin lymphoma). It should be noted that in most other countries the term “cancer” is used for all malignant tumors, regardless of their tissue of origin. In our country, the word “rak” (cancer) is used only for epithelial tumors.
Malignant tumors have the following features: a) rapid tumor growth caused by uncontrolled cell multiplication; b) relative autonomy, that is, cells multiply independently; c) anaplasia (loss of differentiation, that is, of the properties typical of normal differentiated cells); d) invasive, or infiltrative, growth — the tumor grows into neighboring tissues and destroys them to varying depths in the form of infiltrates, offshoots and strands that resemble a crab’s claws, which led ancient physicians to call this disease “cancer” (crab). Because of this, it is almost impossible to determine the exact borders of the tumor. Clinically, malignant tumors are usually lumpy, dense, poorly mobile or immobile, fused with neighboring tissues and have no capsule.
Cancer is a disease that starts in our cells. Our body is made up of millions of cells that form organs and tissues such as the lungs or liver, muscle or bone. The genes inside each cell tell it to grow, work, reproduce and die. Usually these instructions are clear, and when our cells follow them, we stay healthy. But sometimes the instructions a cell receives get mixed up, and it starts to develop abnormally. Over time, groups of abnormal cells overgrow, multiply or form tumors. Sometimes abnormal cells invade the tissues around them and spread to other parts of the body. When this happens, the tumor becomes malignant. Tumor cells that spread to other parts of the body are called metastases. The first signs that a malignant tumor is spreading are often swollen lymph nodes nearby (the so-called regional lymph nodes). This is because malignant tumors most often spread through the lymphatic vessels.
The main causes of malignant neoplasms can be roughly divided into 3 groups of factors:
Physical factors (such as ionizing radiation and ultraviolet light)
Chemical factors (such as asbestos, components of tobacco smoke, food additives and drinking water pollutants)
Biological factors (infections, some viruses, for example, the papillomavirus).
Cancer incidence increases with age, probably because the risk of developing certain cancers accumulates and immunity weakens.
It is important to pay attention to the signs of precancerous conditions for the most common forms of cancer, such as skin cancer, breast cancer and rectal cancer. Symptoms of precancerous skin conditions include single dark red, smooth or slightly rough plaques; dark gray patches on the body with a rough, scaly surface; a cutaneous horn; seborrheic warts; papillomas; pigmented nevi; and chronic inflammatory skin processes such as trophic ulcers, scars and fistulous tracts.
As for the breasts, warning signs include a single lump, an increase in the size of one breast, nipple discharge of any kind, breast pain unrelated to the menstrual cycle, dense disc-shaped lumps without clear borders, and painful round lumps, the so-called cysts. This can also happen at a young age.
As for the rectum, warning signs include polyps, which can be found during preventive checkups; bloody mucous discharge from the anus; rectal bleeding; anal fissures that do not heal for a long time; and diarrhea with mucus, blood or pus.
People suffer from various illnesses and go to medical facilities, but some feel embarrassed and some neglect to have a checkup, which sometimes leads to unwanted consequences. I would like to stress to readers that regular checkups play a major role in detecting the clinical signs of disease early and in referring patients for treatment in time: these include fluorography, visits to a women’s health clinic, the men’s screening room and additional tests. Preventive medical checkups must not be neglected, because acting in time is the key to your health.
According to WHO estimates, about 40% of cancers can be prevented by avoiding tobacco, being physically active regularly and eating healthily. Tobacco use is the leading preventable cause of cancer in the world, claiming about 1.5 million lives every year. This harmful habit can lead to cancer of the lung, oral cavity, pancreas, bladder, stomach, liver, kidneys and cervix.
Because early diagnosis is difficult, timely cancer prevention is extremely important. By prevention, doctors mean eliminating the influence of harmful factors that can cause a malignant neoplasm. However, a clear system of actions and measures to prevent cancer has not yet been developed, so the only effective measure remains a set of simple rules known as a “healthy lifestyle”. For prevention, it is important to learn the measures that help prevent cancer, namely: avoiding tobacco; eating healthily and being physically active regularly; drinking alcohol only in moderation; and protecting yourself against infections that cause cancer. Taking care of your health means seeing a doctor regularly (once a year for preventive checkups, fluorography and laboratory tests).
In recent years, reform of the oncology sector toward European standards of care has begun, and significant results have been achieved: for the first time in Ukraine, cancer mortality has decreased while incidence keeps rising; mortality within the first year after diagnosis has decreased; more patients receive specialized treatment; and the rates of early-stage cancer detection and of survival among cancer patients have increased. National standards for the diagnosis and treatment of cancer patients have been introduced in healthcare facilities to unify the diagnostic and treatment process in Ukraine’s oncology service and to provide high-quality cancer care to all residents of the country, regardless of where they live.
For a long time, a cancer diagnosis was perceived as a death sentence, but today the level of cancer science allows us to say: cancer is not a death sentence, it is a curable disease. The positive trend toward lower cancer mortality in Ukraine that emerged in previous years continues. Mortality is falling by 1.5% every year. Modern medicine is constantly searching for new ways to treat cancer.
So, if you lead a healthy lifestyle and take sensible steps to prevent cancer, you can significantly reduce your risk of getting ill, and treatment started at an early stage of the disease will give good results and increase your chances of a long life.