Cancers cause over 8 million deaths annually worldwide, second only to cardiovascular disease. The good fortune of living longer brings with it an increased risk ; in the UK 2/5 people may develop a cancer ; 2/5 cancers are thought to be avoidable ; around half survive 10 years or are cured.


• There are at least 200 different types ( each with subtypes ), so one " cure for cancer " is impossible ! We are told frequently that " immunotherapy " – strengthening our natural immune defences - is the " new weapon " in cancer treatment ; along with " targeted therapy " for the genetic abnormalities in each cancer type. Chemotherapy with drugs that kill rapidly dividing cells ; radiotherapy ; and surgery WILL continue to be important, and relatively cheaper, however.



• " Breakthroughs " and " ground-breaking discoveries " in cancer treatment may give hope to more cancer sufferers in the future, but it’s being realised that such treatments would come at enormous cost ; they don’t work for all patients ; and we know neither the side effects, nor the actual length of survival which may be possible.


• Prevention is better than cure ! Most of us are aware of the main risk factors ( smoking ; poor diet and obesity ; alcohol excess ; environmental pollution ; radiation ; infections ; occupations ; and " bad luck " chance mutations increasing with age ).



• Early detection and screening have advantages also - but it’s not so well known that screening especially has its disadvantages ( treating cancers which may never have caused illness during an individual’s lifetime ).



• What may not always be realized is that – while cancers are increasing worldwide – the frequency and outlook for cancer types VARIES in different countries. Part of this is explained by " Human Development Index " / HDI. This takes account of life expectancy, educational attainment, and income. In low HDI countries communicable diseases and nutritional disorders are still relatively more important. The outlook for cancers which occur in low HDI countries is worse than those in high HDI countries.



• Commonest cancers in the world are :-

1. Breast
2. Trachea, bronchus, lung
3. Large bowel
4. Prostate
5. Stomach
6. Liver
7. Cervix
8. Non-Hodgkin’s lymphoma ( lymph nodes )
9. Oesophagus ( gullet )
10. Leukaemia


• Cancers causing most deaths in the world are :-

1. Trachea, bronchus, lung
2. Stomach
3. Liver
4. Large bowel
5. Breast
6. Oesophagus ( gullet )
7. Pancreas
8. Prostate
9. Leukaemia
10. Cervix


• In UK, commonest cancers are :-

1. Prostate
2. Large bowel
3. Trachea, bronchus, lung
4. Breast
5. Bladder
6. Non-Hodgkin’s lymphoma ( lymph nodes )
7. Stomach
8. Malignant skin melanoma
9. Pancreas
10. Kidney


• Cancers causing most deaths in UK ( very high HDI country ; non-communicable diseases cause 9/10 deaths ) are :-

1. Trachea, bronchus, lung
2. Large bowel
3. Breast
4. Prostate
5. Pancreas
6. Oesophagus ( gullet )
7. Stomach
8. Non-Hodgkin’s lymphoma ( lymph nodes )
9. Ovary
10. Leukaemia


• In Philippines, commonest cancers are :-

1. Breast
2. Trachea, bronchus, lung
3. Prostate
4. Large bowel
5. Cervix
6. Leukaemia
7. Liver
8. Thyroid
9. Uterus
10. Lip and mouth


• Cancers causing most deaths in the Philippines ( medium HDI country ; non-communicable diseases cause 2/3 deaths ) are :-

1. Trachea, bronchus, lung
2. Liver
3. Breast
4. Large bowel
5. Leukaemia
6. Stomach
7. Cervix
8. Pancreas
9. Ovary
10. Non-Hodgkin’s lymphoma ( lymph nodes )


• Frequencies vary both in type and severity between the UK, Philippines, and elsewhere in the world. This is due, as well as HDI, to different causal factors ( infections such as hepatitis B, and smoking commoner in Philippines ; obesity and alcohol abuse commoner in the UK ) ; awareness ; screening ; early diagnosis ; and treatment.



• Most Filipinos still seek medical advice only when they have symptoms and are at more advanced stages than in UK. This is due, not just to lack of knowledge, but of course mainly full knowledge and fear that they can’t afford treatment.



• News of immunotherapy for advanced cancers such as melanoma ( relatively uncommon ) or lung ( common ) - which may cost £ 100,000 for each patient - needs to be put in perspective ! Most of these cancers can be prevented in the first place by sun screens and not smoking. There’s much that can be done – relatively cheaply – to reduce the numbers and improve the outlook of cancers. The best way to maintain natural immune defences is through a healthy lifestyle.



http://oncology.jamanetwork.com/arti...icleid=2294966