Pakistan has the highest Cancer rate in Asia

[halupridol]

The issue is their usefulness which needs studies which have been done. As doctors our job is not to think but follow tried and tested paths and improve where one needs to

they r useful.
if self examination reveals a lump,,,n it happens to be malignant,,,early diagnosis will improve prognosis.....even if it is benign,,I dont think any women will want a breast mouse permanently,,,she will get operated anyway.
let me add that with time,we can hope that more effective treatment regimes will come,,,hence early diagnosis shud be promoted

 

[Gufi]

if self examination reveals a lump,,,n it happens to be malignant,,,early diagnosis will improve prognosis.....even if it is benign,,I dont think any women will want a breast mouse permanently,,,she will get operated anyway.

A lump which can be felt has mostly spread by lymphatics already which is why breast cancer is so fatal. Please study the lymphatic system as well as prognosis with facts on usefulness of breast examinations. Remember that what you have learnt is always updating, at one time beta blockers were contraindicated where they are now used. If you stick to old thinking you would harm your patient or put them through unnecessary tests

 

[halupridol]

A lump which can be felt has mostly spread by lymphatics already which is why breast cancer is so fatal. Please study the lymphatic system as well as prognosis with facts on usefulness of breast examinations. Remember that what you have learnt is always updating, at one time beta blockers were contraindicated where they are now used. If you stick to old thinking you would harm your patient or put them through unnecessary tests

I think lymphatic metastasis has been known for some time
modified radical mastectmy includes lymph nodes too.
btw how do u expect to diagnose a patient of breast tumor without breast examination,,,or how do u expect the patient to be aware that somthng is wrong wid her,yes there r other things like discharges,,,but feeling an abnormal lump wud give enuff inspiration for a doctor visit,,,,,,, thn there r benign tumors too.

 

[Gufi]

btw how do u expect to diagnose a patient of breast tumor without breast examination,,,or how do u expect the patient to be aware that somthng is wrong wid her,n thn there r benign tumors too.

Routine mammograms are the answer, and there needs to be improvement on breast cancer tests which are more specific. It is age old technology which needs updating.

 

[halupridol]

Routine mammograms are the answer, and there needs to be improvement on breast cancer tests which are more specific. It is age old technology which needs updating.

ok,,,lets say,,a patient came to u with her mammogram,,,there is a lesion,,,, do u do next??
yes,a biopsy>>imvasive pro edure.
so either way u end up with biopsy...also I think I read that mammography isnt conclusive in young females due to dense tissues or somthng ,,,n the unneccessary radiation exposure..its ok in old women but doest breast examination sound better,,,non invasive,economic,easy.

 

[Donatello]

Hi,

My niece is a doctor at Shaukat Khanum hospital in Lahore----. She was telling me that there is a very high breast cancer in girls coming to the hospital-----that is a surprise.

Interesting, but that doesn't mean Pakistani girls in general have a higher risk or cause.....unless proven by environmental factors using a scientific data collection method.
It can simply mean, that since now you have the capability to diagnose, more and more are able to avail that 'moment'.......before that people would die or be sick and no one would know what was the cause...they would simply say 'Allah ki marzi thee'

This is the problem with Cancer, while it is the single most researched ailment in the health sciences today, the collection of data and correlating that is a very difficult task.

For example, i work at Jinnah Hospital Karachi, we admit and treat cancer patients. The most common type of person coming in for cancer treatment is from Interior Sindh and/or extremely poor and isolated regions, like villages etc where they have no knowledge of diet and living habits that inhibit cancer causes. The most common type of cancer we see in men is mouth cancer and ulcers. However, almost 90% of them were or are habitual tobacco smokers (hookah as you know) or Pan/Beedhi. So one can surely correlate the effects there. No cases of brain tumor that i have seen. Women sometimes are diagnosed with skin cancer, maybe because they work in the fields in sunlight all day long? But that is their lifestyle.

I am sure you know, back in the old days or even today in the villages, fits and seizures were considered to be a man possessed by 'jinns' and 'spirits'....today we know that is not true because that is a psychological condition due to chemical imbalance in your brain.

 

[Gufi]

ok,,,lets say,,a patient came to u with her mammogram,,,there is a lesion,,,, do u do next??
yes,a biopsy>>imvasive pro edure.
so either way u end up with biopsy...also I think I read that mammography isnt conclusive in young females due to dense tissues or somthng ,,,n the unneccessary radiation exposure..its ok in old women but doest breast examination sound better,,,non invasive,economic,easy.

Both are incorrect, which is why both have been proven to be inaccurate and new tests are needed. But comparatively it is mammograms which are more accurate

 

[syedali73]

@Gufi: You have not left much for me to add. To sum up things:

1. There us no clear association of any type of cancer with consumption of red meat or any meat:

a. Meat in the form of bacon is a staple in European breakfast, especially in USA but cancer incidence is not significantly higher compared to other countries.

b. Red meat (especially beef) is not widely eaten in South east Asia but fish and lots if it; However, incidence of breast CA in females and colorectal CA in men and women is very high. Fish does not seem to help Malaysians/Singaporeans/Indonesians for instance who eat it on daily basis.

2. There is no clear association of cousin marriages with any disease let alone cancer:

a. This is a myth that is presented feverishly to prove one religion superior over other. There are 1.7 billion Muslims and if cousin marriages were indeed the cause of all sorts of diseases, incidence of those diseases (or at-least any one disease) would be siginificantly higher in Muslim majority countries compared to the rest but we do not see anything like this.

b. Countless isolated tribes in Amazon basin, Papua New Guinea, Africa, Inouits of North pole etc. have been studies but despite the prevalence of rampant cousin marriages (no other choice), higher prevalence of any one diseases could not be established.

3. Mammography does not help much. It is not the size of the tumor but the invasiveness of the cancer that determines the prognosis. I have cases where 1cm tumor metastasized but 5 cm remained localized.

4. Cancers are multifactorial (more than one gene + environment + life style + age) and mere presence of certain mutations in certain genes do not necessarily predict that the person in question will eventually develop cancer.

5. There is also no clear association of cancers with lifestyle. Incidence of cancer in developed world, where people spend lots in healthy life style (diet + exercise) are no less than in 3rd world where only a small percentage of population enjoys 'healthy life style'.

 

[halupridol]

Both are incorrect, which is why both have been proven to be inaccurate and new tests are needed. But comparatively it is mammograms which are more accurate

n how does that accuracy help,,,, with mamogram.s u get false positives/negatives or concluding benign/malignant,,type>> biopsy.
when u appreciate a lump by examination>>biopsy
both r not accurate.in both u end up doing biopsy for diagnosis.
so in absence of a better option,,,,physical examination will be used much more thn mamography,,,cheap,easy,effective

 

[MastanKhan]

Interesting, but that doesn't mean Pakistani girls in general have a higher risk or cause.....unless proven by environmental factors using a scientific data collection method.
It can simply mean, that since now you have the capability to diagnose, more and more are able to avail that 'moment'.......before that people would die or be sick and no one would know what was the cause...they would simply say 'Allah ki marzi thee'

This is the problem with Cancer, while it is the single most researched ailment in the health sciences today, the collection of data and correlating that is a very difficult task.

For example, i work at Jinnah Hospital Karachi, we admit and treat cancer patients. The most common type of person coming in for cancer treatment is from Interior Sindh and/or extremely poor and isolated regions, like villages etc where they have no knowledge of diet and living habits that inhibit cancer causes. The most common type of cancer we see in men is mouth cancer and ulcers. However, almost 90% of them were or are habitual tobacco smokers (hookah as you know) or Pan/Beedhi. So one can surely correlate the effects there. No cases of brain tumor that i have seen. Women sometimes are diagnosed with skin cancer, maybe because they work in the fields in sunlight all day long? But that is their lifestyle.

I am sure you know, back in the old days or even today in the villages, fits and seizures were considered to be a man possessed by 'jinns' and 'spirits'....today we know that is not true because that is a psychological condition due to chemical imbalance in your brain.

Hi,

Me and my family's observations are a little different than your's and many others----. We are a family that had a few doctors in the household and then many a colleagues of their's and junior doctors to my father and uncles at nishtar medical college in the position of Professors, assistant Professors etc----so the discussions over a cup of tea were all about medicine and patients and diseases and surgeries but hardly about cancer.

--20-30-40 years ago cancer was a rarity----. My father being a divisional medical officer would travel 12 days a month to far out places in quetta division---sukkur division---multan division ( railway divisions ) -----I don't recall him ever discussing a case of cancer----maybe once or twice over the years---.

One of uncle was an MS / DHO in multan and also in D G Khan----. On his monthly travel to distant hospitals----in the early 80's he talked about high cancer rate in areas around D G Khan----possible extraction sites of radioactive material or radio active material being dumped in certain regions. But then hardly any cases in the multan area-----and then out of nowhere my aunt got breast cancer----.

Grain coming from the farm---milk and vegetables coming from the farm----fruit coming from the farm----. So---her breast cancer was shocking----where did that come from.

There is a major evil hiding behind the increase of cancer amongst younger women coming to Shaukat Khanum Hospital.

 

[Donatello]

Hi,

Me and my family's observations are a little different than your's and many others----. We are a family that had a few doctors in the household and then many a colleagues of their's and junior doctors to my father and uncles at nishtar medical college in the position of Professors, assistant Professors etc----so the discussions over a cup of tea were all about medicine and patients and diseases and surgeries but hardly about cancer.

--20-30-40 years ago cancer was a rarity----. My father being a divisional medical officer would travel 12 days a month to far out places in quetta division---sukkur division---multan division ( railway divisions ) -----I don't recall him ever discussing a case of cancer----maybe once or twice over the years---.

One of uncle was an MS / DHO in multan and also in D G Khan----. On his monthly travel to distant hospitals----in the early 80's he talked about high cancer rate in areas around D G Khan----possible extraction sites of radioactive material or radio active material being dumped in certain regions. But then hardly any cases in the multan area-----and then out of nowhere my aunt got breast cancer----.

Grain coming from the farm---milk and vegetables coming from the farm----fruit coming from the farm----. So---her breast cancer was shocking----where did that come from.

There is a major evil hiding behind the increase of cancer amongst younger women coming to Shaukat Khanum Hospital.

That is true, but we need enough evidence to corroborate that environmental factors to cancer rates. It is indeed shocking that Cancer diagnosis are on the rise the world over and many of them due to our changed lifestyles in the past 50 years or so. With rapid industrialization, GMO crops, Pesticides and what not, there is always a chance for increase in ill health affects that are not understood. But like you said, your aunt got cancer even though she had a healthy lifestyle. So what is it then? Something in the air? Or is it just that passive gene lurking from generations ago that have evolved to give this specific cancer? Breast cancer is indeed on rise in Pakistan.

Just a side example.......Madame Marie Curie, the famed the researcher on radioactivity didn't know the ill effects of radiation at the time......she would carry radioactive substances in her pocket.......only later did we learn the ill effects of radiation....today her lab notes are sealed because they are too radioactive.

There is a reason why the Cancer research is a multi-billion dollar effort and the cancer treatment and potential therapy is worth hundreds of billions...because it is affecting such a large population and hence money to be made.
I mean, we are not spending as much money on researching about Alzheimer's, Parkinson's or ALS etc

You know, during my undergrad final year as an Electrical and Electronic engineering student, i was working in the bio-medical field. I had access to the latest published research from the world over from leading experts. A lot of it contained the findings on various cancers, and there was this one article where the researchers hypothesized that certain kind of genes...that is people from different race(s) around the world were either having a higher probability or lower probability of having a certain kind of cancer.
For example, a Black Man, is naturally less prone to skin cancer than a white man....because his darker skin inhibits the UV rays from damaging the cells, but in a white person that is not the case.
However, findings like these will sound 'racism' to the ignorant.

Since our genetic makeup is 'Indian' or 'Indo-Aryan', we are land dwelling, farming people.......that is how our genes have evolved.
And genetics is a whole different ball game together.

 

[Butchcassidy]

ok,,,lets say,,a patient came to u with her mammogram,,,there is a lesion,,,, do u do next??
yes,a biopsy>>imvasive pro edure.
so either way u end up with biopsy...also I think I read that mammography isnt conclusive in young females due to dense tissues or somthng ,,,n the unneccessary radiation exposure..its ok in old women but doest breast examination sound better,,,non invasive,economic,easy.

Here is the protocol:
mammogram - biopsy- depending on the biopsy if DCIS- lumpectomy (depending on margins and cosmetic results, follow with rads otherwise mastectomy), if invasive- sentinel node mapping with modified radical mastectomy. In US it depends on the patients wishes, have seen some patient opting for nipple sparing mastectomy even with ADH (pt is not willing to take any chances).

 

[HAIDER]

Hi,

Me and my family's observations are a little different than your's and many others----. We are a family that had a few doctors in the household and then many a colleagues of their's and junior doctors to my father and uncles at nishtar medical college in the position of Professors, assistant Professors etc----so the discussions over a cup of tea were all about medicine and patients and diseases and surgeries but hardly about cancer.

--20-30-40 years ago cancer was a rarity----. My father being a divisional medical officer would travel 12 days a month to far out places in quetta division---sukkur division---multan division ( railway divisions ) -----I don't recall him ever discussing a case of cancer----maybe once or twice over the years---.

One of uncle was an MS / DHO in multan and also in D G Khan----. On his monthly travel to distant hospitals----in the early 80's he talked about high cancer rate in areas around D G Khan----possible extraction sites of radioactive material or radio active material being dumped in certain regions. But then hardly any cases in the multan area-----and then out of nowhere my aunt got breast cancer----.

Grain coming from the farm---milk and vegetables coming from the farm----fruit coming from the farm----. So---her breast cancer was shocking----where did that come from.

There is a major evil hiding behind the increase of cancer amongst younger women coming to Shaukat Khanum Hospital.

Assuming pesticides are greatest source of cancer...

 

[MastanKhan]

Assuming pesticides are greatest source of cancer...

Hi,

Right you are---pesticides---chemicals and harmful ingredients added to the food----steroids in chicken and beef---plastic water bottles---stress of daily living are a terrible recipe for a healthy life style.

 

[Skull and Bones]

Cancer is very unpredictable, and can happen to anyone. I can't think about any reason to prevent this other than bringing awareness to the general populace, making early detection possible by lowering medical examination cost, and promoting a healthy lifestyle, and less exposure to red meat, alcohol and tobacco.

Red Meat Increases Cancer Risk Through Immune Response