2009 > Cancer Prevention > Preventing cancer requires a plan

Preventing Cancer Requires a Plan

For all the progress that’s been made in the fight against cancer, the numbers are still alarming. By next year, ancer is expected to overtake heart disease and become the leading cause of death worldwide. And Thailand’s National Cancer Institute reported nearly 60,000 new cancer cases in just the past year.

While advances in medical research and new technologies have dramatically improved the way it is detected and treated,cancer still causes a great deal of worry and fear in Thailand and around the world.

As part of this issue’s special focus on cancer, Better Health examines the important aspects of an effective cancer evention plan, from awareness of cancer’s risk factors, causes, and symptoms,to the preventive steps everyone can take to lower their own cancer risk, to the importance of periodic cancer screenings and health check-ups that can spot cancerous and pre-cncerous conditions at their earliest – and most treatable – stages.


Cancer is caused by both internal and external factors. Internal factors are those related to family history, genetic or DNA abnormalities, as well as abnormalities of the immune system.

External factors include lifestyle behaviors that can eventually impact health and lead to cancer; these include poor diet, smoking, and lack of exercise. But other external risk factors such as hepatitis B, hepatitis C, HIV, fasciolosis, and excessive exposure to X-ray or ultraviolet radiation can also lead to cancer.

“External factors contribute to the vast majority of cancers,” says Dr. Harit Suwanrusme, an experienced oncologist and hematologist. “A typical modern lifestyle includes many risk factors such as unhealthy nutrition habits, lack of exercise, obesity, smoking, and heavy alcohol consumption. Each of these factors contributes to the growing number of cancer cases and cancer deaths every year.”


Among the nearly 100 known types of cancer, these are the six most prevalent in Thailand.

Liver cancer is the most common cancer in Thailand, with men having a higher rate than women. Liver cancer is difficult to treat and has a high mortality rate.

There are two types of liver cancer: hepatocellular carcinoma (HCC) and cholangiocarcinoma (bile duct cancer). The key risk factors for HCC liver cancer are hepatitis B, hepatitis C, and cirrhosis (scarring of the liver). For cholangiocarcinoma, key risk factors include fasciolosis contamination and consumption of food containing nitrites or nitrates. "The most deadly liver cancer in Thailand is cholangiocarcinoma," Dr. Harit says. "This type is usually found in the country's northeastern region where people consume more uncooked meats." Symptoms of liver cancer include loss of appetite and weight, low grade fever, constipation, and abdominal pain at the upper right part of the liver. Other symptoms are jaundice (yellowing of the eyes and skin), and swelling in the legs or abdomen.

There are a number of ways to reduce one's liver cancer risk. "Annual health check-ups should include hepatitis blood screening," notes Dr. Harit. "And in daily life, avoid sharing food utensils to guard against hepatitis B. People should also avoid smoking, limit alcohol consumption, and don't eat uncooked meats or food that contains nitrate and nitrite preservatives."

Lung cancer is the second most common cancer among Thais, and it's also one of the deadliest. Smoking is responsible for at least 80 percent of all lung cancer cases, which means that lung cancer is highly preventable. Other risk factors include exposure to secondhand smoke, asbestos and air pollution.

For those who worry that they may have lung cancer, Dr. Harit notes, "The symptoms to look out for include persistent coughing, wheezing, voice hoarseness, unexplained weight loss, fatigue and chest pain. You should see your doctor if you have any of these symptoms."

Besides avoiding smoking and exposure to toxic chemicals and pollution, healthier living can have a significant impact on lowering a person's lung cancer risk. This means exercising four to five times each week for at least 30 minutes, and eating a low-fat diet rich in fruits and vegetables (and other foods rich in vitamin C and E). Annual check-ups including a chest X-ray can also help detect lung cancer or pre-cancerous conditions at an earlier stage.

Only women have a cervix, so only women can get cervical cancer. In Thailand, cervical cancer affects more women than any other type of cancer, and women over the age of 35 have the highest rate of cervical cancer. "Cervical cancer is usually caused by the human papillomavirus, or HPV, which is sexually transmitted," Dr. Harit explains. "If you experience symptoms such as vaginal bleeding during intercourse, unusual menstrual cycles, or a vaginal discharge that may be heavy and have a foul odor, you should contact your doctor for evaluation."

Risk factors for cervical cancer include improper or unsafe sexual habits, becoming sexually active at an early age, a history of sexually-transmitted diseases, and a compromised immune system.
The good news is, cervical cancer is the first cancer for which a vaccine is available. The vaccine protects women and girls from the HPV strains that cause about 70 percent of all cases of cervical cancer. In addition to being vaccinated, women should get a Pap screening test every year, avoid smoking, and adopt safer sex practices such as the use of condoms.

Breast cancer is the second most prevalent cancer among Thai women. It's more common in women aged 40 or older, women who've never had children, and those using birth control pills continuously for many years.

Signs and symptoms of breast cancer include a change in breast size, a flattening or indentation of the nipple, a clear or bloody nipple discharge, breast pain, and the presence of a breast lump.

Like most other cancers, breast cancer is treatable and curable; in cases that are detected early, the five-year survival rate is 95 percent. "Every woman should learn to perform breast self-examination (BSE) and do it seven days after the end of every menstrual cycle," Dr. Harit advises. "And it's important to have annual mammograms starting at age 40. Healthier living and avoiding high-fat foods can also reduce a woman's breast cancer risk."

Colon cancer is a serious and growing problem in Thailand and around the world. "Men aged 50 and older have the highest rate of colon cancer in Thailand," says Dr. Harit. "It's often found in people whose diets are low in fiber and include a lot of red meat and high-fat foods."
Colon cancer symptoms include diarrhea, rectal bleeding or blood in your stool, persistent abdominal discomfort or pain, unexplained weight loss, fatigue, anemia, and the presence of an abdominal lump or intestinal obstruction.

A person's colon cancer risk can be reduced by healthier living, including eating more fruits and vegetables and exercising regularly. It's especially important for people with a family history of colon cancer to have periodic screening tests. "Beginning at the age of 50, you need to have a colonoscopy screening or CT scan at least every five years," Dr. Harit says. "These screening tests are usually able to detect pre-cancerous polyps and early stage tumors - when treatments are most effective."

Only men have a prostate gland, so only men can get prostate cancer. Prostate cancer grows slowly. In its early stages, it usually does not produce any significant physical symptoms. As prostate cancer progresses, symptoms may include urinary tract problems such as frequent urination, starting and stopping while urinating, blood in the urine, discomfort in the pelvic area, decreased force in the urine stream, fatigue, and weight loss.
The best way to reduce one's risk of prostate cancer is through a combination of healthy diet (especially reducing the amount of red meat and high-fat foods), sticking to a regular exercise regimen, and eating licopine-rich foods such as tomatoes, broccoli and watermelon. "For regular screenings, men should have a PSA test every year beginning at age 45," Dr. Harit recommends.


There's no denying that cancer is a serious and frightening disease. But even the most deadly types of cancer are often preventable. Taking action through healthy lifestyle changes and sticking to your doctor's recommended screening and check-up schedule are powerful tools to guard against getting cancer and to spot any potential problems at their earliest stages. For healthier living now and for years to come, that's a plan worth following.

Cancer by the numbers

  • By 2010, cancer will outnumber heart disease as the world's top killer.
  • There are more than 100 types of cancer; any part of the body can be affected.
  • One-fifth of all cancers worldwide are caused by a chronic infection, for example, human papillomavirus (HPV) causes cervical cancer and hepatitis B virus (HBV) causes liver cancer.
  • More than 70 percent of all cancer deaths occur in low and middle income countries.
  • A third of all cancers could be cured if detected early and treated properly.
  • More than 40 percent of cancer could be prevented, mainly by not using tobacco, having a healthy diet, being physically active and preventing infections that may cause cancer.
  • Cancer now accounts for about one in eight deaths globally.

Cancer’s key risk factors

  • Tobacco use - responsible for 1.8 million cancer deaths per year (60 percent of these deaths occur in low and middle-income countries);
  • Being overweight, obese or physically inactive - together responsible for 274,000 cancer deaths annually;
  • Harmful alcohol use - responsible for 351,000 cancer deaths each year;
  • Sexually-transmitted human papillomavirus (HPV) infection - responsible for 235,000 cancer deaths annually; and
  • Occupational carcinogens - responsible for at least 152,000 cancer deaths every year.

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