Last week, a good friend passed away after battling with cancer for almost two years. The worst calamity, that can befall a person, is if he is diagnosed with cancer. It takes a real strength of character to face such an ailment. While cancer devours the patient from within, emotionally it devastates his family, and causes financial pain. Let alone the illness, its treatment is even more terrible, because of its side effects. Like my friend, millions of cancer patients worldwide, deserve our support and appreciation for their silent courage and patience, with which they fight this incurable affliction.

Today, cancer is a leading cause of death globally and according to International Agency for Research for Cancer, “In 2012, the worldwide burden of cancer rose to an estimated 14 million new cases per year, a figure expected to rise to 22 million annually within the next two decades. Over the same period, cancer deaths are predicted to rise from an estimated 8.2 million annually to 13 million per year.”

Among cancers plaguing mankind, lung cancer claims most victims and is most common in men. While among women, breast cancer proves to be most fatal. Lung, prostate and colorectal cancer together constitute around 42% of all types of cancers.

In per capita terms, the highest incidence of cancer in the world is in Denmark, where in every 100,000 people, 338 are diagnosed with cancer. France has second highest cases of cancer, followed by Australia, Belgium, Norway etc. Top ten countries with the highest incidence of cancer, all belong to Europe or North America.

In terms of total number of cancer cases, 60 percent comes from developing world, and owing to weak health care services, 70 percent deaths from cancer also take place in low and middle income part of the world.

In Pakistan, 1.4 million people are suffering from cancer, and this number is increasing at the rate of 8 -10% annually. Every year 80,000 people die of cancer, half of which are women dying from breast cancer. Pakistan has the highest incidence of breast cancer in Asia.

So what is cancer and what causes it? According to American Society for Cancer, “Cancer starts when cells in a part of the body start to grow out of control. Cancer cell growth is different from normal cell growth. Instead of dying, cancer cells continue to grow and form new, abnormal cells. Cancer cells can also invade (grow into) other tissues, something that normal cells cannot do. Growing out of control and invading other tissues are what makes a cell a cancer cell.” By getting into the bloodstream, these cells are spread to other parts of the body, and this spread is known as metastasis

The medical research shows that apart from genetics, certain lifestyle choices, either increases or decreases, the occurrence of cancer. According to WHO, “ About 30% of cancer deaths are due to the five leading behavioural and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, alcohol use. Tobacco use is the most important risk factor for cancer causing 22% of global cancer deaths and 71% of global lung cancer deaths.” In addition, presence of carcinogenic factors in environment, consumption of processed food, and exposure to UV or radiation enhances the risk factor.

Perhaps life style choices explains why the developed world has more cases of cancer. It is rich with more obese population, consuming more tobacco, alcohol, red meat and processed food; factors that directly or indirectly cause cancer. Whereas, information gaps and lack of treatment facilities explain higher mortality rate cancer in developing world.

In countries like Pakistan, poor health care facilities make cancer’s treatment a nightmare. Even in our biggest cities, most hospitals public or private, offer unsatisfactory treatment to cancer patients. In Lahore, apart from Anmol and Shaukat Khanum Cancer hospital, there is no proper facility for cancer treatment, and even these two suffer from bottle necks due to high influx of patients.

We cannot expect government, with its poor governance record to provide adequate health care to people. Private sector should take the lead and establish more treatment facilities across Pakistan, on the pattern of SKMCH, so that irrespective of financial status, every one gets an access to quality cancer treatment.

According to WHO per anum 1.16 trillion dollars are spent globally on cancer treatment, and this can be reduced to half with better prevention methods. World Cancer report 2014 states “ Global battle against cancer won’t be won with treatment alone. Effective prevention measures are urgently needed to prevent cancer crisis.”

These preventive measures also include legal restrictions against some products to discourage their use. Tobacco is already highly taxed and regulated, similarly alcohol, beverages, junk food and processed food should be taxed to discourage their high consumption. Better health care, improved life style choices and effective legislation and implementation, can go a long way in preventing a global cancer epidemic.

The writer is a freelance columnist and has worked as a broadcast journalist.

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