Cancer Diagnosis: No longer a death verdict

On February 4, the international medical community marked the World Cancer Day. The topic is high on Ukraine’s health care agenda. The Ministry of Health’s statistics point to 165,000 freshly diagnosed cancer cases every year. Experts predict that before 2020 this disease will register 200,000 cases a year. Ukraine currently has over 800,000 cancer patients, out of whom 90,000 die every year. However, experts are convinced that every second case can be prevented. Many countries now focus on preventive measures, including Ukraine, where the Kravetsky Institute of Experimental Pathology, Oncology and Radiobiology at the National Academy of Sciences of Ukraine is the main actor. In collaboration with the charitable foundation Yednist proty raku (Unity vs. Cancer), this institute is launching a new educational project entitled “Science for Society.”

This project is aimed at spreading information about oncological diseases, and, above all, information about how such diseases can be prevented and about ways to lower the risk of developing malignant tumors. Experts say that people must revise their way of life and take better care of their health. Major causes of cancer include an improper diet, sedentary lifestyle, lack of outdoor activity, and smoking. Actually, this is nothing new for many Ukrainians: we know what we have to do, but more often than not we don’t do it. Vasyl CHEKHUN, director, Kravetsky Institute of Experimental Pathology, Oncology and Radiobiology, and his colleague Tetiana PIATCHANINA, Ph.D. (Biology), senior research fellow, told The Day about what the experts in the field are planning to do to lower cancer incidence.

Vasyl CHEKHUN: “In February 2000, more than 100 international leaders of government, patient advocacy leaders, cancer research organizations and corporations met in Paris at the first World Summit Against Cancer. The participants reaffirmed their commitment to the global eradication of cancer by signing The Charter of Paris Against Cancer.

“We are launching our project on the eve of the Charter’s 10th, and our institute’s 50th, anniversaries. We have accumulated a great deal of data on the causes, clinical course and further developments of cancerous diseases, yet the abyss between knowledge and action remains. The Charter of Paris is aimed at preventive treatment. Physicians in Ukraine are getting increasingly convinced that preventive measures are the groundwork on which to start combating and overcoming this disease. Despite numerous post hoc therapeutic and diagnostic methods, we entered the third millennium with hair-raising statistics. The International Agency for Research on Cancer predicts that malignant tumors will be the main cause of death across the world in 2010. World Health Organization’s statistics read that every 50th resident of Ukraine will develop cancer (compared to every 270th elsewhere in the world). Thus, Ukraine and the rest of the world have declared war on cancer, using all means and methods, with an emphasis on preventive measures. This can be accomplished only with knowledge. Every individual must know that a drop of nicotine can not only kill a horse, but also contains carcinogens.”

Tetiana PIATCHANINA: “Our Institute has developed special lectures for school children; our younger research fellows adjusted the texts, and these lectures are now suited for grade schools. For the time being the project is implemented in Kyiv, but it will shortly embrace other big Ukrainian cities. These lectures are delivered by young people who add life-experience examples when telling about the risks of smoking. The kids listen to them attentively, ask questions, and hopefully make the right kind of conclusions. This series of lesson-lectures embraces topics such as oncology (what it’s all about), environmental factors of cancerous diseases, healthy lifestyles, and cancer preventive measures. We’ve made a documentary entitled Instytut nadii (The Institute of Hope). It will be broadcast by national channels within the project’s framework.”

So what are the most important things to know about cancer-preventive measures?

.Ch.: Preventive measures are mostly not smoking and not eating this or that, but this is only part of the problem. Preventive treatment has a much larger scope; it includes diagnosis, and a vast array of knowledge and practices that increase the chance of avoiding this affliction. For example, our young people are eager to get suntans, especially visiting Ukraine’s southern regions and using all those special creams. But these creams/lotions contain lots of agents that are potential carcinogens. Excessive exposure to the sun is also a carcinogenic factor. Therefore, our project is aimed at spreading knowledge among young people and teaching them how to adopt a lifestyle that won’t damage their health.”

What about the leading trends in the struggle against cancer?

V.Ch.: “Today’s oncology focuses on early-warnings. The sooner you detect a malignant tumor, the better the recovery prospects. Computed tomography, diagnosing soft- and hardware are considered to be the groundwork for this early-warning strategy. There are also nanotechnologies which can help detect malignant tumors when they are still at the level of several hundreds of cells, rather than milimetres or centimetres. Nanotechnologies seem to be a promising treatment method. On the one hand, we have a marker of a malignant tumor. On the other hand, this marker can be used as the target of treatment, as a means of overcoming this disease.”

Suppose you have a healthy lifestyle and live in a healthy environment. How much does it reduce the risk of a cancerous disease? Are these the main factors that affect the proliferation of this lethal affliction?

T.P.: Almost all the factors are generally known. First, the environment. We’re all products of the current civilization. Most Ukrainians live in big cities where the living conditions leave much to be desired, especially in regards to heavy traffic, industry, the ocean of electromagnetic waves in which we keep floating, and so on. Not all of these factors are carcinogenic — in other words, their effect isn’t always known. We know that there are carcinogenic agents in industrial wastes, but there are others of which we know little if anything, like mobile phones or genetically modified foods. We are not sure which ones can cause changes on a cellular level and can cause malignant growth. It is generally known that apart from environmental factors, people shouldn’t consume over-fried foods, rancid vegetable oil, over-smoked foods because all of them contain carcinogens or agents that trigger their development in human organisms. There are also inner-factors, including genetic ones. There are families in which many people develop malignant tumors, but they pay little attention to this alarming fact. Working out family trees allows to assess the risk or trend for the next generation. Cancerous disease is not inherited, the trend is. In other words, the genetic apparatus undergoes certain changes, so that some can become carriers but not afflicted, and pass it on to the next generation. There are hereditary oncological diseases, like retinal cancer or colonic polyp. You mustn’t fearfully expect to develop such a disease simply because your relatives died of it. All you have to do is consult your physician and run some tests. There is only one recommendation for the entire society: healthy lifestyle. Think twice before you eat something, go for walks, work out a leisure schedule... We lack healthy lifestyles, something you develop since your birth. The main task of modern medicine is to keep the general public informed [about what is actually taking place] instead of scaring people stiff with hair-raising statistics about children dying from brain cancer or leukemia.”

Why children? Are they afflicted by genetic factors? Other reasons?

T.P.: There is a percentage of children afflicted on a hereditary basis. Look at all those expectant mothers who smoke and consume foods that aren’t meant for women in their condition. They drink gallons of chemicals advertised as energy- or stimulating-drinks instead of pure water. Also, one should take into consideration the environment, the kind of air these women breathe, whether they keep working, sitting at computers almost until the delivery date. There are factors whose effect is still to be studied. The problem of juvenile oncology is very important. Here the statistics are on an upward scale, like the adult ones. Ukraine currently has about 5,500 registered juvenile cancer cases — children afflicted with or who have survived the disease. Unfortunately, statistically every second child is cured, compared to two out of three in the United States.”

Our editorial office often receives letters asking to help collect money for the treatment of children afflicted with cancerous diseases. As a rule, the sum required goes into tens of thousands of euros.

T.P.: “It’s true that surgery — and the whole course of treatment — in such cases is very expensive. There are many factors that influence the effectiveness and results of such treatment. In oncology you won’t find treatment standards as in the case of pneumonia, for example, in which the patient is offered a set of medicines. Here it is necessary to adopt an individual approach. A cancerous patient undergoes molecular-biological tests, then markers are determined — in other words, ways to influence the malignant tumor and find the most effective methods of treatment. This is what determines the outcome of a treatment. All these methods are very carefully studied and chosen; they require a great many expensive reagents, which makes the therapy so expensive.”

When will Ukrainians and the rest of the world hear from the doctors that cancer diagnosis doesn’t mean a death verdict?

V.Ch.: This is precisely the goal of our project. It’s the path being followed by the global medical community. It is easier to prevent a disease than treat it. Physicians everywhere keep emphasizing that women, after reaching 40 years of age, must have regular medical checkups and keep track of their physical condition. A lot of women detect breast cancer when drying themselves with a towel after taking a shower. At one time stomach cancer ranked first among cancerous diseases in Japan. Scientists studied the phenomenon to reveal the agents that provoked this affliction. The applied an early diagnosing method. The entire population was informed that everyone had to undergo gastroscopy during the year. At present Japan has very low rates. Therefore, when the Ukrainian population learns about what has to be done and actually does it, the incidence will start going down.”