(All the articles published in past are available at www.shyamhemoncclinic.com/blog/)
Question: Last time we covered few more common symptoms in cancer patients that can be managed by family doctors, physicians. For cancer patients in any stage, from diagnosis to end of life. 1. Insomnia or Sedation. Role of identifying cause such as psychological, uncontrolled symptoms such as pain, various medicines, alcohol, caffeine etc. Importance of GOOD SLEEP HYGIENE. Use of medicines in difficult cases. 2. Delirium. Serious condition requiring specific diagnosis especially to rule out serious underlying condition such as sepsis, electrolyte disturbances, CNS disorder, medicines, etc. Restraining patient should rarely be done. Rather use sedation if required, especially in end of life stages. 3. ADVANCE Care planning where role of family doctor is extremely important. Patient or family should clarify if they do not want CPR, ventilator, dialysis etc. if they want to die at home. Preparing a “Will” to avoid suffering by family after death.
What are some of the other common issues that you face, especially where non oncologist doctors can play a role?
Ans: First of all I would like to wish a Very Happy New Year to you and all our readers. And wish a covid free year very soon! We have completed series on Palliative Care with last episode. What next? Let us start the new year on a very positive note. Cancer Can be Prevented.
Many patients, community members, and even doctors have these questions. How to prevent cancer? A very common question is even though Mr X or Ms Y did not have any addiction or bad habits, how did they get cancer? Why is the other person smoking for many years does not have cancer? Why is cancer incidence rising, including even young people? Why am I seeing so many cancer patients in my practice, much higher compared to when I started practice? Is cancer truly increasing fast? For many senior doctors, cancer was something they rarely saw during their MBBS education. What can I do to prevent cancer?
Que: Happy New Year to you as well. Excellent choice for topic. And very true questions. Not only patients, with ageing, we are ourselves interested in knowing more about this topic. Patients are reading a lot in “Whatsapp University” and asking all kinds of questions. One of my recently diagnosed cancer patient read somewhere that sugar leads to growth of cancer cells, and she stopped all sugar. Now she is feeling weak and has lost significant weight. She also stopped milk and all milk products because some friend read that online. Also many of them ask me about so many herbal products, and supplements – both cancer patients as well as those who would like to prevent cancer. What do I tell them?
Ans: So true. Every one wants a magical pill or herb to prevent all cancers. Or some magical diet formula. First of all, cancers are of so many types. Over 250 subtypes. There is no ONE answer. All doctors know about Tobacco as the biggest cause of cancer. And we have discussed this at length in lung cancer and head and neck cancer series. Hence we will not repeat that discussion here. In next few sessions, we will cover mainly new evidence related to what causes cancer and how to prevent cancer.
Main focus of research nowadays is Lifestyle, Bacteria in our intestine, Diet, Physical activity, Hygiene etc. Very surprising research findings have come out in last few years in the field of cancer prevention.
One size does not fit all. We are all different individuals. By birth place, how we were brought up, our genes, diet, physical activity, where we live today, what we do etc are some of the factors that affect our health. With so many different combinations possible for above mentioned factors, one can imagine that one formula does not apply to all. For example, diet for a patient from Gujarat, Kerala, Punjab cannot be same. Even within Gujarat, there are significant variations by region, culture, belief.
A number of healthy living concepts are same for cancer and for other diseases like heart problems, diabetes, obesity, bone issues. This is a good thing. Makes it easier to follow. First chapter in my book “Cancer Simplified For You” talks about cancer prevention for 14 pages.
One very important part of doctor’s role is to inculcate good habits in their patient families and communities from childhood. Your suggestions are taken much more seriously by children in the family too! And you would be surprised to know that for a number of cancers, risk is determined primarily by lifestyle during childhood. For example, risk of breast cancer is primarily determined by what the woman did in her life prior to age 30! But since we start screening for breast cancer only after age 40, we don’t advice anyone what they should do before age 30, to prevent breast cancer later in life. Imagine this. Telling a teenager or young woman about prevention of breast cancer. nearly impossible. Family would not allow that discussion. Good thing is, prevention is more of a comprehensive discussion. And fortunately, good lifestyle prevents most of the common diseases. Hence it is easier to recommend for any age, and it is very important to recommend for all ages. Vaccines are also part of cancer prevention. Do vitamin supplements have any role? We will see this too.
Means cancer prevention starts from childhood. Are you doing enough for children in your family???
January 11, 2022 Dr Chirag A. Shah; M.D. Oncology/Hematology (USA), 9998084001. Diplomate American Board of Oncology and Hematology. Ahmedabad. firstname.lastname@example.org