What are the leading cancers among males in Sri Lanka?
Oral cancer, Lung cancer, Oesophagel cancer, Colon and rectum cancer, Prostate cancer, Laryngeal cancer, Lymphoma, Leukaemia, Stomach.
What are the leading cancers among females in Sri Lanka?
Breast cancer, Cervical cancer, Thyroid cancer, Ovary cancer, Colon and rectum cancer, Oesophageal cancer, Oral cancer, Uterine cancer, Leukaemia.
Are cancers are increasing in Sri Lanka?
Yes, in Sri Lanka also cancer incidence is gradually increasing as most of the countries in the world over the years according to the cancer incidence data. Other than the actual increase due to unhealthy habits and unhealthy environment, population ageing, expansion of cancer early detection services, expansions of cancer care services, increasing coverage of cancer incidence data collection process, improving awareness of general public and health care workers, involvement private sector for cancer care services have contributed to the increasing incidence of cancers.
What are the commonest causes of cancer related deaths among males?
Oral cancer, lung cancer, Oesophageal Cancer, Liver cancer, Leukaemia.
What are the commonest causes of cancer related deaths among females?
Breast cancer, Oral cancer, Lung cancer, Oesophageal cancer, Liver cancer.
Are death rates due to cancer increasing?
According to the Cause of death data published by the Census and Statistics Department, cancer death rates are gradually increasing over the years. When we consider developed countries like United Kingdom & Australia even though similar to our country cancer incidence rates are increasing, their cancer death rates are decreasing due good early detection and organized treatment programmes.
If any person need cancer related epidemiological data for academic/ research purpose what are the data sources he/she needs to look for ?
What are the methods available in Sri Lanka for prevention and early detection of cervical cancer?
- HPV vaccination
- Screening by Pap smear test
- HPV DNA testing
At what age HPV vaccination is given in Sri Lanka?
At the age of 10-11 years, all girls are vaccinated with HPV vaccine with 2 doses, 6 months apart during School Medical Inspection (SMI) programme.
When do the women screened with Pap smear examination in the National programme of Sri Lanka?
At the age of 35 years and 45 years.
What are the places where Pap smear test is available?
- Well Women Clinics (WWCs) conducted by the MOH offices
- Gynaecology clinics in hospitals
- Cancer Early Detection Center, Narahenpita
What does a positive Pap smear result means?
You may have abnormal areas on your cervix that need treatment to prevent cervical cancers. You may sometimes need to undergo additional tests or advanced treatment.
Can breast cancer be prevented?
Breast cancer is not a preventable cancer. But early detection can save life. If breast cancer detect early, it can be managed with simple and successful treatment. Therefore, practicing Self Breast Examination (SBE) and Clinical Breast Examination (CBE) is important to detect changes in the breast at an early stage.
What do you do if you detect any change of your breasts?
Need to seek medical advice without any delay.
Are breast cancers inherited by genes?
Yes. But, out of 100 women with breast cancers, only 5 – 10% is due to genetic mutations. Most common genetic mutations causing breast cancers are mutated BRCA 1 and BRCA 2 genes, but there are some other gene mutations as well. However, more than 90% with breast cancers are multifactorial and probably the environmental and lifestyle related factors play a part.
What can I do when the doctor tells me that I have a cancer?
It is often difficult to take in the diagnosis immediately. It is normal to ask, 'why me?' or to feel sad, angry, helpless or worried about your future. Talk to your doctor about what your diagnosis means for you. Having cancer doesn't mean you need to lose hope. The outlook for many cancers is improving constantly.
How to look after yourself and maintain your life style after diagnosis of cancer?
Stay active and exercise regularly if you can. The amount and type of exercise you do will depend on what you are used to and how well you feel.
A balanced and nutritious diet will help you to keep as well as possible and better cope with the cancer and treatment side-effects.
Let your doctor know if you are having trouble sleeping.
If you are in pain, ask your doctor for help.
Seek practical and financial help if you need it.
Put your affairs in order. This doesn't mean you are giving up. Everyone needs to do these things.
Remember, if you have any concerns or questions, please contact your doctor.
How do you want to prepare before the consultation with your doctor?
To get the most out of your visit you might consider:
- prepare your questions beforehand
- take a friend or relative for support, or to write down answers to your questions if possible
- ask your doctor to explain again, if you don't understand the answers
- ask your doctor to give you a written summary of your treatment plan
What are the treatments available for cancer patients?
There are various approaches to treat cancer, many of which involve combinations of therapies to provide the most effective treatment.
Your doctor should discuss treatment options with you and explain the benefits and risks involved. Following is an overview of some cancer treatments.
Chemotherapy uses drugs to destroy or slow the growth of cancer cells. Treatment might use a single chemotherapy drug or combination of drugs. This will depend on the type of cancer being treated.
Chemotherapy may be the only treatment needed but can also be used in combination with surgery, radiation therapy or other drug therapies.
Radiotherapy (also called radiation therapy or x-ray therapy) uses high energy radiation to destroy cancer cells or impede their growth. It is commonly delivered externally, through the skin. However, it can be administered internally (brachytherapy) with the placement of small sources of radioactive material in or near the cancer. Radiotherapy is used:
- as a curative treatment, often in association with other approaches
- to relieve pain and discomfort associated with incurable disease
It will also relieve discomfort from tumours that are obstructing organs or causing bleeding. Surgery is often used in combination with radiotherapy and/or chemotherapy to make sure that any cancer cells remaining in the body are removed.
Immunotherapy is a cancer drug treatment focusing on using the body's immune system to attack cancer. Made up of a series of special cells, chemicals and organs, the immune system protects the body from infection. There are different types of immunotherapy that work in several ways. Immunotherapy may:
- Boost the immune system to help it fight cancer
- Slow the growth of cancer cells
- Remove barriers to the immune system attacking cancer
Hormone therapy can also involve the surgical removal of hormone producing glands to control cancer growth. These treatments are commonly used foruterine cancers.
Targeted therapy is a drug treatment that attacks specific features of cancer cells to stop the growth and spread of the cancer. These are known as molecular targets. Targeted therapy can also be known as biological therapy and molecular targeted therapy.
Is cancer contagious?
Cancer is not contagious. There is no reason to avoid people with cancer, and in fact they will need your support and understanding.
We now know that some cancer genes are hereditary and so several family members may have the same or related types of cancer.
This is due to an inherited genetic disorder, not spending time together. Human papilloma virus (HPV), a virus that causes 70% of cervical cancer,
is contagious and is transmitted via sexual activity. However, cervical cancer itself is not contagious.
Does cancer always cause pain?
Some cancers cause pain, others do not. Some people experience pain as the result of tumour growth or advanced cancer, or as a side effect of treatment.
Pain relief is always made available to cancer patients suffering pain. Your doctor can advise you on what to expect and how the pain can be managed.
Is cancer always fatal?
Absolutely not. Advances in our knowledge about prevention, early detection and treatment mean that majority of people diagnosed with cancer today can be effectively treated. Almost nine out of 10 children with cancer are effectively treated and go on to live normal lives.
As we further our knowledge about the disease, survival rates are likely to increase.
What are the treatment side effects?
Usually when you suffer a disease you feel symptoms such as pain and the treatment makes you feel better. Unfortunately, with some cancers, you may not have experienced any pain or discomfort until the treatment begins.
Cancer treatments designed to kill cancer cells can have unpleasant side-effects, such as nausea and vomiting, bowel problems, tiredness, hair loss and scalp problems and effects on nerves and muscles.
Before beginning treatment, it is best to be aware of the possible side-effects and changes that your body may go through, and ways of managing or reducing them.
What about alternative treatments?
There are many "alternative therapies" that are promoted as cancer cures. They are unproven because they have not been scientifically tested or were tested and found to be ineffective. If alternative therapies are used instead of evidence-based treatment, the patient may suffer, either from lack of helpful treatment or because the alternative treatment is actually harmful.
If you are thinking about using a treatment which is not an evidence-based medical treatment, make sure you carefully consider and investigate the claims being made. Look into the evidence for those claims, the credentials of the people or organisation promoting the treatment, the costs and the potential risks of delaying conventional treatments.
What is oral cancer?
Oral cancer is an unusual cell growth related to any part (tongue, floor of mouth, lip) of the oral cavity.
What are the warning signs of oral cancer?
- A red, white or white – red lesion that cannot be wiped away
- An unexplainable growth inside the mouth of recent occurrence.
- A non-healing wound / ulcer inside the mouth that persists for more than 2 weeks
- Burning sensation of mouth when taking spicy foods of recent occurrence
- Restricted mouth opening that cannot be explained by other factors such as trauma
- Unusual whitish appearance instead of pinkish colour in lips and oral mucosa of recent occurrence
What are the risk factors for oral cancer?
- Tobacco, areca nut and alcohol are the main risk factors for oral cancer in Sri Lanka. Carcinogens within them are ingested through habits such as betel chewing, smoking, consuming alcohol and consuming commercially prepared chewable areca nut products.
- As the number of habits or the frequency of habits increase, the risk of getting oral cancer increases.
- A reduction in immunity, Infections (Human Papilloma Virus, Candida and HIV) and being exposed to chronic irritation are minor risk factors.
- Being exposed to ultraviolet radiation is another risk factor which is not very applicable to the Sri Lankan scenario due to the natural solar protection offered by the skin of Sri Lankans.
- Increasing of age and poor nutrition increases the risk of any type of cancer.
Is oral cancer preventable?
Yes, since all main oral cancer risk factors are habit related, by quitting these habits a majority of oral cancers can be successfully prevented.
How do I prevent getting oral cancer?
- Do not get used to habits such as betel chewing, smoking, consuming commercially prepared chewable areca nut products and taking alcohol.
- STOP IT IMMEDIATELY! if you have already started these habits.
- It is all right for you to have difficulties stopping these habits on your own, because tobacco and areca nut products cause addiction. There are services to help you in getting rid of addiction. Please make it a point to visit your nearest Dental Surgeon/ Medical Officer. They will manage and further direct you to the required services. It may require more than 1 visit.
- Most oral cancers are preceded by oral potentially malignant disorders (manifesting as red, white or white red lesion that cannot be wiped away) which can be identified through routine self-mouth examination.
- It is important to note that these lesions are not oral cancers and once habits are stopped a majority will regress back to normal.
- If suspected lesions are identified through self-mouth examination do not hesitate to visit nearest government dental surgeons so that clinical oral examination can be done.
What will the Dental Surgeon do when I visit him?
- He will confirm your suspicion regarding the lesion
- Will provide basic counselling to help get rid of addiction to risk habits
- Will refer you to nearest Oro Maxillo Facial (OMF) Surgical unit / Oncologist for further treatment.
- Therefore, if in doubt do not hesitate to visit your nearest dental surgeon and get it clarified.
What should I do when I am referred to an OMF surgical unit / Oncologist?
- Your need to visit clinics at routine intervals as per the given instructions
- It is important to attend all review visits
- When you visit the clinic make it a point to bring all relevant documents regarding the disease
- As per the instructions given you might need to visit other treatment centers such as Radiotherapy units
What do you mean by palliative care?
Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual(WHO)
Who need palliative care?
Palliative care is for anyone with a serious/ progressive/ life threatening illness.
Examples; cancer, heart disease, chronic kidney disease, lung disease, HIV/AIDS, Dementia, Neurological conditions etc.imply it improves the quality of life for people of any age and at any stage of a serious illness.
How am I referred to Palliative care?
Any health care professional involving your care can make a referral. E.g.; Specialist care team in your tertiary care hospital / Family physician/or health care professionals in primary care setting
When should I referred to Palliative care?
When you and your family need additional support that can’t be dealt with your usual health care provider.
Ideally palliative care should be available from the time of your disease diagnosis and should last throughout the course of your illness.
You can ask for it, if you are not referred….
What is the aim of Palliative care?
Aim is to maximize the quality of life of the patient and their families by providing patients with relief from the symptoms, pain, loss of function and stress caused by serious illnesses
What are the services which I can get through palliative care?
- Advice on managing symptoms / relieve your symptoms and distress
- Support for emotional and psychological issues
- Help to understand the progression of illness and treatment options
- Information about other forms of support
- Advice on social and financial concerns
- Family and caregiver support
Who provides the palliative care?
Palliative care is provided by a specially trained team. This team includes doctors, nurses, Counselors, Nutritionists, social service officers, pharmacists, Physiotherapists, etc.
Where can I get Palliative care?
Palliative care can be received in any setting.
- Hospital – Many patients begin receiving palliative care during their hospital stay. Most tertiary care hospitals, including cancer treatment centres provide palliative care consult services in Sri Lanka
- Care home (Hospices)
- Home (Community setting)
What do you mean by Hospice care?
Hospice care is a specific type of palliative care for people who likely have 6 months or less to live. This care affirms life but does not try to hasten or postpone death. It treats the person and symptoms of the disease, rather than treating the disease itself. Aim of the care is to manage symptoms of the patient so that his last days may be spent with dignity and quality, surrounded by their loved ones.
Can I have curative treatment with palliative care?
Yes, of course you can receive palliative care while you are on curative treatment
Can I get palliative care if I am at home?
Yes, of course. Please discuss with your hospital care team before you get discharged from the hospital. They will make arrangements accordingly the resource available in your home area.
Most of the time you will be referred to your area Primary Medical Care Institution for the further arrangements. Then they will arrange your home care plan with participation of area Public Health Nursing Officer (PHNO), who will be visiting you at your home.
In addition to that in some places home care is provided by certain Non-Governmental Organizations. You can get the service from those organizations also.
What are those Non-Governmental Organizations which provide supportive care services for the patients on palliative care and how can I contact them?
Following are the voluntary organizations which provide supportive care services for the patients receiving palliative care.