What are the most common signs of cancer?

Answer: Unfortunately, cancer shows very few, and often no signs, in its early stages. In stage zero, when the disease is just beginning, patients usually do not experience any symptoms at all. Even at stage one when cancer is completely curable, most individuals remain symptom-free.

Taking breast cancer as an example, stage zero or stage one disease is entirely treatable. However, many women do not notice any abnormality at this stage. By the time a lump becomes noticeable, the tumour has often already grown beyond one centimetre in size. Like many other cancers, early-stage cancer does not cause pain or discomfort. Patients with stage zero or stage one disease generally feel completely normal.

Cancer is largely a painless disease in its initial stages and often remains painless until stage three. Pain usually appears only in advanced stages, commonly stage four, which is referred to as terminal disease. This creates confusion among patients. Many women visit doctors due to breast pain, assuming pain indicates cancer, but medical examination often reveals no abnormality.

On the other hand, when a woman notices a small, painless swelling in the breast, she may ignore it, assuming that something painless cannot be serious. During this delay of two to three months, the disease can continue to grow, spread to nearby areas such as the armpit (axilla), and even reach other parts of the body. By the time medical help is sought, the cancer may have progressed significantly.

At advanced stages, even if the tumour is surgically removed from the breast, the disease may no longer be curable at a systemic level, meaning it cannot be eliminated from the body. It is therefore crucial to understand that cancer in its early stages is painless, non-discomforting, and often silent, yet it is precisely at these stages that the disease is fully curable. Awareness and timely medical evaluation are essential to save lives.

Can cancer be prevented, and if yes, what are the most effective lifestyle changes?

Answer: Cancer cannot be viewed as a disease that can be completely prevented through lifestyle changes alone. As long as life exists on this planet, cancer will continue to exist. It is not a modern disease; cancer has been present since the beginning of human and animal life. Not only humans, but animals also develop cancer. Therefore, expecting complete prevention is unrealistic. Instead, the primary focus should be on early detection, which offers the best chance of cure.

While lifestyle changes do play a role, it is equally important to understand that many factors influencing our lifestyle are beyond individual control.

Scientifically, there are four primary causes of cancer. The first is exposure to toxins, which may enter the body through food, water, or the environment. The second major cause is radiation, particularly ionising radiation. Certain naturally occurring radioactive elements, such as thorium, are found in damp spaces, and some regions of the world have higher ambient radiation levels than others. Radiation is a well-established cause of cancer.

The third cause includes viral and bacterial infections, and the fourth involves harmful substances such as asbestos, which is known to cause a highly aggressive cancer called mesothelioma that often responds poorly to treatment. Other factors, such as genetics, diet, and lifestyle, are not direct causes but rather mechanisms through which cancer develops.

When discussing lifestyle changes, it is essential to also consider environmental toxins that enter our bodies daily. These toxins create oxidative stress within body tissues, increasing the risk of cancer. Environmental pollution is a major example. In cities with heavy traffic, including Srinagar and other metropolitan areas, vehicle emissions release hydrocarbons into the air. In regions like Kashmir, road dust poses an additional problem. The soil particles are extremely fine and easily become airborne, carrying these toxic hydrocarbons with them.

As these polluted particles settle on surrounding land, they contaminate agricultural soil. Vegetables, livestock, poultry, and dairy animals ingest these pollutants, which then enter the human food chain through milk, meat, eggs, and vegetables. This creates a continuous cycle of toxin exposure from traffic pollution to soil, from soil to food, and ultimately into the human body. As long as this vicious cycle continues, it contributes significantly to the rising incidence of cancer.

This scientific reality makes it clear that cancer risk is not limited to packaged or processed foods alone even home-cooked and agricultural foods may carry environmental toxins. Understanding this chain of exposure is crucial. Along with promoting healthier lifestyles, society must address environmental responsibility, public health awareness, and early medical screening. Only then can the growing burden of cancer be effectively reduced.

At what age should people begin routine cancer screening, and for which cancers?

Answer: Scientifically, cancer is considered a disease that is more common with increasing age. According to medical consensus, routine cancer screening should ideally begin after the age of 45. An exception to this is cervical cancer, for which screening can and should start earlier. For most other cancers, preventive or prophylactic check-ups are strongly recommended after midlife.

It is important to understand that screening is meant for healthy individuals who do not have symptoms. Many people believe that medical tests are necessary only when symptoms appear, but cancer screening is most effective before any signs develop.

There are several simple and effective screening methods available. For colorectal cancer, a basic stool test performed annually or every six months can help detect nearly 60 per cent of intestinal cancers. This is a significant achievement for such a non-invasive test. In addition, procedures such as sigmoidoscopy every three years or colonoscopy can further aid early detection. For patients who are uncomfortable with conventional colonoscopy, virtual colonoscopy is now a viable alternative.

Screening of the liver, biliary system, and gall bladder can also be done through advanced imaging techniques such as virtual cholangiography. These tests allow doctors to identify abnormalities at a very early stage.

For women, annual breast screening is essential. A mammogram is a simple and effective investigation that can detect breast cancer at stage zero or stage one, when the disease is completely treatable.

Today, there is a wide range of screening tests available that can detect cancer at an asymptomatic stage. The key challenge is not the availability of medical technology, but the willingness of healthy individuals to undergo regular screening. Early detection through routine screening remains one of the most powerful tools in reducing cancer-related mortality.

My mother is a cancer survivor. She was diagnosed with endometrial cancer, and her recent PET-CT report shows that she is cancer-free. What precautions should she take now?

Answer: The precautions a cancer survivor should follow depend largely on the type of cancer they were treated for. However, certain general guidelines apply to most survivors.

Maintaining a healthy and stable body weight is extremely important. Weight should ideally remain within the recommended range for the individual’s height and body type, as excess weight can increase the risk of recurrence.

Dietary management also plays a crucial role. Cancer survivors are advised to strictly regulate both the quality and quantity of carbohydrates in their diet, as carbohydrates act as a primary source of energy for cancer cells. While there is no need to impose severe restrictions on proteins and fats, carbohydrate intake should be carefully controlled.

Regular follow-up and surveillance are equally essential. Even after a patient has been declared disease-free, annual screening remains a priority. These routine evaluations help in early identification of any potential recurrence and ensure long-term health and reassurance for both the patient and their family.

These seemingly small but consistent measures, healthy weight maintenance, disciplined dietary habits, and regular medical screening form the foundation of care for cancer survivors and play a vital role in sustaining a cancer-free life.

Does cancer treatment always mean chemotherapy, or are there newer treatment options available, especially surgical options?

Answer: Surgical treatment has always been a cornerstone of cancer management. In cases of solid tumours, cancer cannot be effectively treated without surgery. Surgery remains the primary and most fundamental treatment option. However, surgical intervention is often followed by additional therapies such as chemotherapy and/or radiotherapy.

It is important to understand that not every patient requires both chemotherapy and radiotherapy. The choice of treatment depends largely on the stage at which the disease is diagnosed. When cancer is detected early, surgery alone may sometimes be sufficient, or it may need to be supported by only one additional therapy.

Unfortunately, many patients do not undergo screening or seek medical attention during the early stages of cancer. As a result, they often present at stage three, when the disease has already progressed significantly. At this advanced stage, treatment cannot rely on surgery alone, and chemotherapy and radiotherapy become essential components of care.

This highlights once again the critical importance of early detection and timely screening. When cancer is identified early, treatment options are simpler, outcomes are better, and the physical and emotional burden on patients is significantly reduced.

What is the one message you want every family to remember about cancer prevention?

Answer: The most important message every family must remember is that cancer cannot always be prevented, but it can very often be detected early and cured. Cancer in its initial stages is usually painless, silent, and does not cause discomfort. Waiting for symptoms before seeking medical attention is one of the biggest mistakes people make.

Families should understand that routine screening is meant for healthy individuals, not only for those who are unwell. Early detection through timely screening can save lives and significantly reduce the physical, emotional, and financial burden of treatment. Awareness, regular check-ups, and a proactive approach to health are far more effective than fear or delay.

Cancer is not just a medical issue, it is a family and societal responsibility. The moment families start prioritising early screening and informed decision-making, the outcome of this disease can change dramatically.

Arooj Bilal is a student at the Department of Media Studies, Amar Singh College, and is currently pursuing her academic assignment with the Centre for Interdisciplinary Studies on Ageing, Moul Mouj Foundation.

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