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CATCHING CANCER BEFORE IT’S CANCER.

A combination of patient awareness and modern diagnostics such as AI and blood tests can help detect cancer even at Stage 0.

Cancer is the second most common cause of death in India, and cases and deaths are expected to sharply increase by 2045. One of the reasons for this is that most people don’t make it to an oncologist till an advanced stage. But what if we could catch cancer when it’s still nascent, and root it out before it’s even called by that name? It seems we can. If we spot the signs and get early screenings done.

STOPPING AT STAGE 0:

But a vast majority tend to ignore such signs indicative of Stage 0 cancer – a precancerous stage also known as carcinoma in situ (CIS). “A condition in which abnormal cells that look like cancer cells under a microscope are found only in the place where they first formed and haven’t spread to nearby tissue. At some point, these cells may become cancerous and spread into nearby normal tissue.”

Stage 0 cancer is also called pre-cancer. “The cells may be malignant or benign. Since the cancerous ones have not spread to other parts of the body, it becomes easy to manage the tumor if one initiates prompt treatment.”

When detected at the right time, a local excision is enough. And since the tumor has not spread yet, the patient may even avoid chemotherapy or radiation which have their own adverse side effects.

 

SPOTTING THE SIGNS:

But how does one know if a particular symptom points to Stage O cancer? One should look at environmental factors and genetic predisposition first. “There are specific subgroups where someone in the family has some type of cancer, which is known to have some genetic predisposition. In such cases, if something abnormal is detected during a routine screening, we might take it out and find that it’s a Stage 0 cancer. This is applicable for the screening of cervical cancer and breast cancer. For colon cancer screening, we often perform an endoscopy or colonoscopy. If we see a polyp (abnormal tissue growth) during the procedure, we remove it. When that is tested, we often find that it’s CIS.”

One must also look for the recurrent symptoms which may cause cancer. For instance, a small hard lump in the breast or nipple discharge could indicate Stage 0 breast cancer. An abnormal pap smear might mean Stage 0 cervical cancer. Very mild and vague symptoms like slight indigestion, occasional stomach discomfort, or minor changes in bowel habits might be precursor to gastrointestinal cancer. Stage 0 skin cancer can show a subtle change in skin color or texture, like a flat, scaly, red patch, depending on the location. If these symptoms persist for longer than two weeks, then it could hint at CIS.

The problem is that most of these symptoms are non-specific nature, which means they are very similar to other diseases. They may be treated by a general physician and not even land up with an oncologist. If there is a suspicious patch in the mouth, an alert dental surgeon or ENT specialist may take out the tissue and send it to the lab, where it may turn out to be CIS. The most common type of Stage 0 breast cancer is ductal carcinoma in situ (DCIS) or intraductal carcinoma.

 

PREVENTION KEY TO SURVIVAL:

Doctors are urging patients to pay attention to the signs and symptoms that their bodies repeatedly give, especially when risk factors are involved, in a bid to prevent more cancer cases.  Most cancers studied (breast, prostate, colon, and rectal) survival was better than 90% when diagnosed at Stage 1; and survival for Stage 1 lung cancer was 62%.

 

SEA CHANGE IN DIAGNOSITCS:

With modern advancements such as artificial intelligence tools and liquid biopsies, early detection is very much possible. Their gender-specific liquid biopsy test was able to successfully detect Stage 1 cancers 93% of the time among men and 84% of the time among women. The analysis of 150 biomarkers also allowed researchers to pinpoint the origin of cancers to specific organs in more than 80% of cases.

India too has diagnostic and treatment options that can improve the prognosis of the disease. “AI can help check imaging scans with utmost accuracy. Non-invasive liquid biopsies (primarily of blood) can scan for circulating tumor DNA and help find out the risk of cancer before the symptoms appear. These are vital tools for cancer detection.

 

 

 

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