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Early diagnosis is the most important prognostic factor for cancer outcomes as it maintains the quality of life of the patients and also reduces the financial burden as the treatment is certainly short and simple. In other words, early diagnosis has a huge impact because survival of cancer depends on the stage, so the ultimate goal is to catch cancer early as it reduces the difficulty in treating the patient and also improves survival significantly. It happens.
Are there any symptoms that are commonly ignored or misinterpreted which may delay diagnosis
In an interview with HT Lifestyle, Dr Venkat P, senior consultant surgical oncologist, breast, gynecology and GI cancer at Apollo Cancer Centre, shared, “Any change in the skin of the breast, small lump, change in the shape of the breast, Sometimes many people ignore. Patient. Sudden loss of appetite or weight loss, early satiety or feeling full after eating less, low hemoglobin are important symptoms of cancer that should not be ignored. Blood in the stool or dark black stool may be associated with gastrointestinal cancer and is often misdiagnosed as hemorrhoids.
He further added, “As a general rule any symptoms that do not subside in 6 weeks should be taken seriously and an oncologist should be consulted. Ovarian cancer many times manifests with gastrointestinal symptoms like bloating, gastritis, early satiety, abdominal distention. Most of these patients continue to take medications for gastritis and the correct diagnosis is delayed. Sometimes abdominal distension caused by ovarian carcinoma is mistakenly attributed to weight gain by women.”
According to Dr. Vineet Govinda Gupta, Senior Consultant and Unit Head Medical Oncology at Fortis Hospital, Shalimar Bagh, it is very important to know that cancer can have very subtle symptoms. He said, “Everyone knows the common symptoms of cancer, like someone feels a lump in their breast or someone feels a lump somewhere in the body. These are relatively common symptoms of cancer. People know these symptoms and people are more aware of these symptoms. But there are many symptoms that are more subtle. For example, weight loss. Therefore, many times patients do not think that weight loss is a symptom of cancer, but weight loss is actually a very common symptom of cancer. Usually what we say is that if a patient’s weight involuntarily decreases by more than 10% of their body weight, it is a high risk for cancer and they need to see their doctor. Is.
Another example of a subtle symptom is cough. Dr. Vineet Govinda Gupta said, “Lung cancer is a very common cancer and what happens is that people get a cough which lasts for a long time and they ignore it. So generally a persistent cough, which lasts for more than three weeks, is a very important sign of cancer. So many of these subtle symptoms can be cancer. Another example is persistent weakness. There can be many reasons for weakness but one important reason for weakness is lack of blood. Suppose someone is bleeding in his stool. What happens is that they develop anemia, they become pale and weak and actually the anemia may be due to cancer somewhere in the GI tract (gastrointestinal tract). So persistent fatigue that doesn’t go away also requires a thorough evaluation by a doctor, and is a relatively subtle sign of cancer.
He highlighted, “The main thing to note is that the patient has persistent symptoms. Even if it is a non-specific symptom. Generally when we think of cancer we think that a lump will develop somewhere in the patient’s body. The problem is that masses can also occur inside the body and they will give rise to very subtle symptoms that you need to be careful of. We generally advise patients that if they have any persistent symptoms, it may or may not be related to cancer, but if they have any persistent symptoms for more than three weeks, they should see a doctor. Must meet. Even if it’s a non-specific type of symptom, like fatigue or weight loss or weakness, still visit a doctor to get it checked out.
For people who have a family history of cancer, are there any preventive tests, such as genetic testing, that can help understand their risk?
Dr. Venkat P replied, “Science has advanced manifold and it is now possible to know genetic defects. Any patient suffering from cancer at a young age or having multiple family members with cancer is advised to undergo genetic testing after appropriate counselling.
Bringing forward his expertise, Dr. Vineet Govinda Gupta said, “Familial cancer is a very important cause of cancer. Data indicate that approximately 5% to 10% of cancers have some familial influence. Patients who have a strong family history should undergo a process called genetic counseling. In genetic counselling, the doctor sits down with the patient and family and creates a family tree that shows what type of cancer runs in the family and what genetic syndrome is likely. There are different genetic syndromes and the different types of cancer that are seen in the family, and genetic testing is ordered for the patient accordingly. “Genetic testing can confirm whether there is familial cancer.”
Nowadays it is very easy to do genetic counseling and testing and it is being done very commonly now but it is important to note that genetic testing should be done after genetic counseling. Dr Vineet Govinda Gupta said, “The reason is that there are so many different syndromes and you need to be very careful about the syndrome you are testing for. You can’t just order a large panel and hope for the best. That test should be done carefully. You only need to have a pre-test consultation to see what type of test needs to be done and prepare the patient for the test results, and a post-test consultation to discuss what the implications of that test are. have to give.
He elaborated, “If anyone is found tested positive, their surveillance should be increased and other members of their family should be tested. There are several things that need to be done after genetic testing. It’s not like we test and give up. If the test is positive, the patient’s lifestyle will change and they will have to do more to prevent cancer. There is something called genetic counseling, pre-test counseling, genetic testing, and post-test counseling. But you can improve the outcome of these familial cancers.”
What impact does early diagnosis have on cancer treatment and outcomes? Anything else you would like to add?
Dr. Venkat P assures, “The cure rate for breast cancer is up to 100 percent when it is diagnosed in its early stages. Early stage diagnosis and treatment has advantages such as higher cure rates, shorter duration of treatment, fewer side effects as the treatment is shorter and fewer treatment modalities are used.
According to Dr. Vineet Govinda Gupta, in case of breast cancer, if someone has stage one breast cancer, their chances of long-term survival are around 95 to 99%. He revealed, “For phase two, it drops to around 85 to 90%, for phase three it drops to around 70 to 80%. Similarly, let’s say someone has head and neck cancer, stage one. Again, the long-term cure rate is about 90%. But for patients who get to stage three or stage four, long-term survival is 30, 40%.
The expert said, “If you catch cancer early, there are many benefits. For one thing, survival rates are better. Number two, the treatment is easy. For example, suppose the patient has neck cancer and is stuck in stage 1, then he needs minor surgery. Patients may not have to undergo radiotherapy, patients may avoid chemotherapy and still survive very well. On the other hand, if the patient comes to us in stage three, the patient’s surgery will be major, radiation will be required, the patient may also require chemotherapy, and the relapse rate is higher.
Q. Where do they find genetic counselors? And in India, how can one get it?
Dr. Vineet Govinda Gupta shared, “Genetic counseling is a growing field. In metro cities, there are dedicated genetic counselors but in many smaller towns, there are no dedicated genetic counselors. Therefore, it is usually performed by medical oncologists. Genetic counselors will trace the family tree to see what type of genetic mutation is likely to occur. “They will provide pre-trial counselling, trial and post-trial counselling.”
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