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Old 16-12-17, 11:43 PM
sriyanj sriyanj is offline
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Default Here, the unit's Medical Director Dr. Sarath Abeykoon elaborates on some of the types


The spectre of Cancer


In its first year of operation, Ceylinco Radiation Treatment Unit has helped hundreds of cancer patients in Sri Lanka to battle the disease with the latest equipment and techniques available.

The unit houses Sri Lanka's first Linear Accelerator, the international Gold Standard in the delivery of accurate intensity-modulated radiation therapy for the treatment of many forms of cancer. Here, the unit's Medical Director Dr. Sarath Abeykoon elaborates on some of the types of cancer and the treatment available.

Q: In layman's terms, what is cancer?

A: Cancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells. Cancer may affect people at all ages, but the risk for most varieties increases with age.

Q: What are some of the commonest cancers in Sri Lanka?

A: The commonest cancers among Sri Lankan males are head and neck cancers, of which the most predominant is oral cancer. Leukemaeias and lymphomas lie second and lung cancer follows a close third. Oesophageal cancer, colo-rectal cancer and prostate cancer constitute the other major cancers in males.

Breast cancer is the most common cancer amongst females while uterine cervix cancer lies second. Oesophageal cancer, ovarian cancer, leukemaeias and lymphomas, thyroid and head and neck cancer constitute the other major cancers in females.

Q: Lets start with breast cancer. In Sri Lanka, breast cancer accounts for about 22% of all cancers in women. How is this detected and cured?

A: Physical examinations and, past age 40, annual mammograms can detect up to 90% of cases in women. Well-funded research efforts have brought breast cancer therapies closest to personalized medicine. The first targeted cancer drug Herceptin was designed to seek and destroy breast cancers containing the HER2/ neu protein. The latest test, Oncotype Dx, a 21-gene screen can predict the likelihood that a woman's cancer will recur and even whether she will respond to chemotherapy.

No other cancer comes with so many treatment options which means more women than ever before can, and will continue to survive the disease. Ceylinco Healthcare Centre (CHC) is equipped with breast cancer screening facilities and offers mammography tests and more information on this disease as well.

Q: How is Lung cancer diagnosed and treated?

A: At present doctors are investigating whether X-rays or spiral CT scans are better at finding lung cancers early. When it comes to treatment, until targeted drug therapies emerged in the past decade, traditional cancer therapy could do little for lung cancer patients. But certain forms of the disease depend on blood vessel and growth factory agents, all of which can now be eliminated with anticancer drugs. Other compounds that block insulin growth factors are being studied.

Survival rates remain stubbornly low, but smarter treatments combined with better screening tests may soon raise those percentages. The best way to avoid the disease is by not smoking. However, there has been a reduction of lung cancer cases over the last two decades due to greater awareness of the repercussions of smoking.

Q:What is colo-rectal cancer? Is it curable?

A:Cancer of the colon or rectum is also called colorectal cancer. Caught early, it is often curable. Symptoms can include blood in the stool, narrower stools, a change in bowel habits and general stomach discomfort. However, a victim may not have symptoms at first, so screening is important. People over 40 years of age should be screened periodically for colorectal cancer. Colonoscopy screening should normally be done once in five years and in high-risk cases, frequent screening is essential. Treatment include surgery, chemotherapy, radiation, or a combination.

Q: What are the treatments on offer for oral cancer?

A: Oral cancer treatment may include surgery, radiation therapy or chemotherapy. Some patients have a combination of treatment.However, over the next decade the incidence of oral cancers amongst males and females may show a reduction. This could be attributed to the younger generation giving up the betel chewing habit as a result of an improvement in their educational and social standards.

Q: What can you tell us about Ovarian Cancer?

A: The majority of ovarian cancers are diagnosed late, after the cancers have spread. Only about 20% of women are diagnosed early, when the disease may be curable. There is no definitive screening test for early ovarian cancer. Regular pelvic examinations, sometimes supplemented by ultrasound examinations or blood tests for cancer-related markers have been routinely used for ovarian cancer screening, but none of these tests are specifically able to detect ovarian cancer. Traditionally, it was believed that ovarian cancer does not produce any characteristic symptoms until the tumor is widespread and that early symptoms of ovarian cancer were not recognizable.

Q: Isn't Thyroid cancer also common among Sri Lankan men and women?

A: Yes, generally, among women. Thyroid cancer is unique among cancers. In fact, thyroid cells are unique among all cells of the human body. They are the only cells which have the ability to absorb Iodine. Iodine is required for thyroid cells to produce thyroid hormone, so they absorb it out of the bloodstream and concentrate it inside the cell. Most thyroid cancer cells retain this ability to absorb and concentrate iodine. This provides a perfect treatment strategy. Radioactive Iodine is given to patients with thyroid cancer after their cancer has been removed.

Q: What about uterine cervix cancer?

A: Cancer of the uterine cervix is a condition when the cells of the cervix undergo abnormal growth. Early detection is the key to treatment and cure. Because of the slow progression of cancer of the cervix, it can be detected early and thereby prevented. Most often, treatment for uterine cancer involves surgery and radiation therapy. Sometimes radiation therapy is combined with chemotherapy. This is called Chemoirradiation. With these treatments death rate has been greatly lowered in recent years mainly because of early detection. However, it is hard to limit the effects of therapy so that only cancer cells are removed or destroyed, because treatment also damages healthy cells and tissues, it often causes unpleasant side effects.

Q:What is Oesophageal cancer and what is the treatment?

A:Oesophageal cancer is a serious form of cancer that starts in the inner layer of your esophagus, the 10-inch long tube that connects your throat and stomach. The most common symptom of esophageal cancer, usually occurring late in the disease, is difficulty swallowing and a sensation of food getting stuck in your throat or chest. Oesophageal cancer treatment depends on the type, location and stage of cancer as well as on your age, overall health and personal preferences. Decisions about therapy can be particularly complicated because various combinations of surgery, chemotherapy and radiation may be more effective than any single treatment.

Q: How about Prostate cancer?

A: A blood test for the prostate-specific antigen is the most common screen. A physical examination can also pick up changes in the gland's size or shape. Talking about treatment, doctors can cut out contained growths while radioactive seeds implanted in the tumor can destroy it from within. Newer beam devices can focus radiation on the prostate from outside the body. Hormone therapies can also shrink growth and stall the cancer. Prostate is one of the more curable cancers as long as it is detected early.

Q: What about brain cancer? How is it identified and what is the treatment?

A: This is somewhat rare in Sri Lanka. There is no screening test for brain cancer and symptoms such as headache, blurred vision and seizure are often the first signs. When it comes to treatment, surgery, radiation and chemotherapy are the standard anticancer measures. However, growths in the brain are difficult to reach with these methods and researchers are testing a number of potentially more effective ones, including harnessing immune cells via vaccination, heating up the tumors and cutting off the cancer's blood supply using targeted drug therapies.

These new treatment options have only recently started to emerge, but a better understanding of the molecular mechanisms behind brain cancer could push survival from months to years.

Q: What are the facilities that are offered by CHC and its radiation treatment unit?

A: CHC is equipped for oral, breast, colorectal, stomach and cervical cancer screening. Tests such as mammography, colonoscopy, endoscopy, laryngoscopy, ultrasound screening and x-ray are performed at the centre in comfortable and pleasant surroundings. Our state-of-the-art radiation treatment unit which began operations one year ago, houses the country's only operational Linear Accelerator for the delivery of Intensity Modulated Radiation Treatment. This unit also offers Brachytherapy, radioactive Iodine Treatment and Chemotherapy
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