Health Update

In the Philippines, cancer ranks third in the leading causes of morbidity and mortality after communicable diseases and cardiovascular diseases. This data, culled from the Department of Health – Health Intelligence Service or DOH-HIS (1992-1996), has also shown that over the period 1942-1956, communicable disease mortality has shown a gradually decreasing trend, in contrast to the increasing trends of non-communicable diseases, specifically heart disease and cancer.

The increasing menace of cancer may be due to several factors such as low cancer prevention consciousness and the majority of cancer patients seeking consultation only at advanced stages, making cancer survival rates relatively low.

In the same report, it was noted that lung cancer, the leading cancer in the Philippines and the rest of the world, had the lowest survival rate.

Why is lung cancer hard to treat?
The answer to this question was explained by medical oncologist Dr. Heinrik Martin Jude Strebel during a free patient lecture initiated by the C Network, an advocacy campaign to create awareness and foster education on cancer prevention and treatment.

“Lung cancer involves vital organ and symptoms can only appear at the more advanced stages. This is compounded by the problem that doctors in the Philippines face, and that is the lack of effective screening tools, said Dr. Strebel.

Unlike other cancers, there is no known predisposition to the disease. However, all evidence suggests that lung cancer is predominantly caused by cigarette smoking. Non-smokers who are continuously exposed to tobacco smoke in enclosed spaces also run the risk of getting lung cancer.

Quit smoking
“The number one risk factor for lung cancer is smoking, and it is related in 90 percent of lung cancer cases. Cigarettes contain 4,000 chemicals, 55 of which are known carcinogens.

I cannot stress this often enough, but that is what evidence shows and what could be the single factor that can stop lung cancer from being an increasing menace for both men and women,”"stressed Dr. Strebel.

Facts on smoking and cancer
During his lecture, Dr. Strebel also pointed out several fallacious perceptions on smoking that have misled people into thinking there is a way to beat lung cancer without totally giving up cigarettes.

* Myth #1 – Smokers who consume cigarettes with filters have lower chances of getting lung cancer.

* Fact: One kind of lung cancer is lowered; another kind went on the rise with introduction of filters. The chance in consumption from unfiltered high tar cigarettes parallels the chance in incidence from squamous cell carcinoma to adenocarcinoma.

* Myth #2 – Cigarettes with “low tar/”mild” decrease lung cancer incidence.

* Fact: Smokers adjust to these “mild” cigarettes by changing puff patterns, resulting in no change in lung cancer incidence.

* Myth #3 – Beta-carotene and other supplements will “help” prevent lung cancer among smokers.

* Fact: Taking beta-carotene increases the risk of lung cancer in smokers. In fact, continued smoking seems to remove any benefit from dietary supplements (vitamin A) and may worsen outcome for others.

* Fact: Saw palmento and PC_SPES (8-herb preparation), believed to help in some cancer types are not recommended to invalidate therapeutic claims, and the risk of causing adverse events.

* Fact: Selenium, vitamin E and lycopene are still undergoing evaluation for any benefits for preventing cancer.

* Myth #4 – After surgery or cancer treatment, a survivor is already risk free.

* Fact: If cancer is completely removed, continued smoking increases risk of second malignancy.

* Fact: If malignancy cannot be removed, treatment options are generally poorly tolerated by smokers.

Smoking controversies
The C Network lecture led by Dr. Strebel also discussed some smoking controversies that made the habit a difficult one to quit.

Product labeling doesn’t impact on smoking reduction, despite the drive to make these labels more prominent.

In some US areas, Dr. Strebel noted that political will through tax increases worked in some states.

These is also the controversy of targeting younger people who are more susceptible to satisfying a “psychological” criterion for the addiction, perceiving smoking as an “adult” and “cool” thing to do.

Although it was pointed out that of the 70 percent of smokers who think of quitting, only 10 percent are successful on their own, it is important to note that smokers aways have a choice.

“In other countries, smoking clinics have helped a lot of people quit. Here in the Philippines, the best option is to discuss smoking cessation with your doctor, because it is the only intervention that clearly shows preventive effect for lung cancer,” Dr. Strebel said.

Dr. Strebel specializes in Medical Oncology and Internal Medicine at the Philippine General Hospital.

Source: Manila Bulletin