Dr. Vineeta Goel (Director & HoD – Radiation Oncology, Fortis Hospital, Shalimar Bagh) speaks about the frustration and the fear that surrounds a cancer diagnosis. Through the platform “A Voice of Hope”, Fortis Cancer Institute aims to challenge these feelings of hopelessness with stories of grit and courage from cancer survivors themselves. Stay tuned with us for real survival stories from real people.
World Cancer Day 2023- Smoking, chewing tobacco, and betel nuts are risk factors known to cause cancer. Expert explains various causes of Cancer.
Cancer is a dreaded disease, and its incidence is increasing. In a special series, on World Cancer Day, the OnlyMyHealth editorial team talked to Dr Vineeta Goel, Cancer Specialist, Fortis Hospital, Shalimar Bagh, Delhi. Dr Goel has been treating and helping cancer patients live a healthy life for the last 25 years. Dr Goel talks in great detail about what different causes of cancer and approaches to deal with them. It is important to remain vigilant of these causes of cancer and prevent them as much as possible.
According to Dr Goel, “The causes of cancer are not fully known, but we know some risk factors that are associated with cancer development. Consumption of tobacco, betel nut, and smoking are all associated with the increased risk of several cancers, including mouth, throat and lungs. Avoid these substances to prevent cancers.” Sometimes mouth/tongue cancer can also occur due to constant trauma or friction by sharp teeth or ill-fitting dentures. Be aware and see your dentist if you have any such teeth to avoid cancer development.
There are certain lifestyle factors like lack of physical exercise, sedentary life, obesity, and consumption of junk foods, which also increase the lifetime risk of developing cancer. There is a saying that “sitting is the new smoking”. This means lack of exercise or prolonged sitting is as harmful as smoking.
Few cancers run in families and are transferred through genes. According to Dr Goel, the extent of genetic cancer is only about 5%, while the rest 95% of cancers are not hereditary. It is important that people with a family history of cancer be more aware of this disease and do regular screening tests.
It is important that we change our perception towards cancer. Dr Goel suggests three ways one can deal with cancer.
Adding to the prevention of cancer, Dr Goel said, “Cervical cancer is common cancer in women but can be prevented by a vaccine. This vaccine is easily available in India. The vaccine is administered to girls after the age of 12 years, in two to three shots.” The risk of breast cancer reduces in women by breastfeeding and avoidance of prolonged use of oral contraceptive pills. Cancer of the liver is sometimes associated with Hepatitis B infection, and like cervical cancer, Hepatitis B vaccines are also available in the market.
Dr Goel recommended having a plant-based diet with more fresh fruits and vegetables instead of junk, processed foods, and meat. Additionally, one should not forget to indulge in regular physical exercise.
Many cancers cannot be prevented, but since they are common cancers, it becomes important to be aware of their symptoms and go for regular screening and health checkups. In today’s day and age, many people do regular checkups for heart disease, cholesterol, and blood sugar levels. One should include cancer screening tests in their health checkups as well.
If you have any symptoms like any ulcer, swelling, unexplained weight loss, reduced appetite, change in voice, difficulty in gulping food, difficulty in breathing, abnormal bleeding, or back pain persisting for more than three weeks, please consult your doctor to rule out the possibility of serious illness like cancer.
It is important that we change our perception towards cancer diagnosis and treatment. While concluding, Dr Goel said, “We need to change the pessimistic view that cancer cannot be cured. Modern medicine has made significant advancements that make cancer cure possible for the majority of patients. We should have an optimistic approach and think that cancer is just a comma in one’s life and not a full stop.”
Prevention, awareness, screening tests, early detection and optimism towards cancer diagnosis and treatment is the message that we should be spreading on this World Cancer Day.
Is Cancer Hereditary? What Is A Family Cancer Syndrome? Get expert advice on Family cancer syndrome, also known as hereditary cancer syndrome.
Cancer occurs when there is an uncontrolled growth of cells which also has the potential to spread to other organs. It can occur in any part of the body when genes that govern our cell’s behaviour are altered and get misregulated. In a special series on World Cancer Day 2023, we talked to Dr Vineeta Goel, Cancer Specialist, Fortis Hospital, Shalimar Bagh, Delhi, who explained us about cancer and if it is hereditary. For the past 25 years, she has treated cancer patients and assisted them in leading healthy lives.
If you have ever wondered if cancer is hereditary, the answer is mostly a “big no”. Although genetic alterations cause cancer, they are not always inherited. It is believed that only 5% to 10% of cancers are hereditary when someone inherits a genetic mutation. Some of the cancers that can be hereditary are breast cancer, prostate cancer, colon cancer, ovarian cancer and uterine cancer.
Family cancer syndrome, also known as hereditary cancer syndrome, is a type of inherited disorder where the risk of developing specific cancers is higher than average. Mutations in specific genes handed down from parents to offspring are the root cause of hereditary cancer disorders. However, it must be noted that not every cancer that appears to be inherited is caused by family cancer syndrome. In some cases, family members may develop the same type of cancer because of the same environment or habits, such as tobacco use or exposure to air pollution. There is also the possibility of cancer running in the family if members of the family possess a variety of genetic variations that are each associated with a very small cancer risk.
You may wonder if you need genetic testing to detect if you have inherited a genetic change. However, not everyone needs genetic testing if they have someone in their family who has or has had cancer. You should consult with a genetic counsellor to decide if you need to get tested for genetic testing. The doctor will ask you about your family history and medical records to determine if you need to get tested. The doctor will make you aware of the benefits, risks, and side effects of genetic testing. You should refrain from ordering the at-home genetic test, as it may have several drawbacks.
A sedentary lifestyle is basically a lifestyle where a person spends most of his/her time in one comfortable position
A sedentary lifestyle is basically a lifestyle where a person spends most of his/her time in one comfortable position and does not indulge in much physical activity. Medical experts claim that this kind of lifestyle has many sorts of health risks in general and increasing cancer cases are also reported which originate due to a sedentary lifestyle. In the past decade, the cases of obesity-related cancer have been on the rise and sitting, reclining, and lying down for hours at stretch is a new carcinogen, according to experts.
“World over incidence of cancer is increasing at an alarming rate. We all need to identify where in our lifestyles we are going wrong and correct it to prevent cancers in our present and future generations. An estimated 30-40% of cancers can be prevented through changes in modifiable lifestyle and environmental risk factors. We know for several years that consumption of tobacco either by chewing or smoking, alcohol and some viral infections are known risk factors for cancer. Recent studies have shown that physical inactivity, sedentary lifestyle and obesity are also emerging high risk lifestyle factors for cancers,” says Dr. Vineeta Goel – Director and HOD – Radiation Oncology, Fortis Hospital Shalimar Bagh.
According to many studies, risks of cancers like breast, colon (intestine), uterus, ovary, prostate, esophagus (food pipe), stomach and bladder can be reduced with higher level of physical activity.
“In the past 30–40 years, three main modifiable factors have emerged that are associated with an increased risk of cancer: physical inactivity, sedentary behaviour, and overweight or obesity. The incidence of obesity-related cancers is critically affected by dietary composition, physical activity, and sedentary practices. A key and effective measure in the prevention of cancer is to reduce the exposure to modifiable causes of cancer, such as physical inactivity,” says Dr. Sanjeev Kumar, Surgical Oncologist, HCMCT Manipal Hospitals, Dwarka.
It is very important to maintain optimum body mass index (BMI)/weight to reduce the risk of cancer and avoid the re-occurrence of cancer in survivors.
“Exercise has many positive biological effects on the body, some of which have been proposed to explain associations with specific cancers. These include lowering the levels of certain hormones (estrogen, growth factors, insulin ), reducing inflammation, improving immune system function, reducing transit time for food to travel through intestine and helping to keep a check on weight preventing obesity which has a direct link in development of many cancers,” says Dr Kumar.
Physical inactivity, sedentary behaviour, and overweight or obesity can raise our risk of cancer. Doctors on how to stay active and modify lifestyle.
Sedentary lifestyle is on rise due to increasing use of technology, decreasing physical activity and people moving or walking a lot less in general. This inactive lifestyle has far serious implications than it appears on surface and several studies suggest how it is linked to many kinds of cancer. Experts say that sitting, reclining, lying down for hours at stretch is a new carcinogen and can increase risk of cancer. The cases of obesity-related cancer are on rise in the past decades and to avoid this risk factor, making lifestyle changes that make you active can go a long way. (Also read: 5 exercises to improve heart health if you are leading a sedentary lifestyle)
“World over incidence of cancer is increasing at an alarming rate. We all need to identify where in our lifestyles we are going wrong and correct it to prevent cancers in our present and future generations. An estimated 30-40% of cancers can be prevented through changes in modifiable lifestyle and environmental risk factors. We know since several years that consumption of tobacco either by chewing or smoking, alcohol and some viral infections are known risk factors for cancer. Recent studies have shown that physical inactivity, sedentary lifestyle and obesity are also emerging high risk lifestyle factors for cancers,” says Dr. Vineeta Goel – Director and HOD – Radiation Oncology, Fortis Hospital Shalimar Bagh.
Strong evidence exists that higher level of physical activity reduce the risk of different cancers like breast, colon (intestine), uterus, ovary, prostate, esophagus (food pipe), stomach and bladder.
“In the past 30–40 years, three main modifiable factors have emerged that are associated with an increased risk of cancer: physical inactivity, sedentary behaviour, and overweight or obesity. The incidence of obesity-related cancers is critically affected by dietary composition, physical activity, and sedentary practices. A key and effective measure in the prevention of cancer is to reduce the exposure to modifiable causes of cancer, such as physical inactivity,” says Dr. Sanjeev Kumar, Surgical Oncologist, HCMCT Manipal Hospitals, Dwarka.
Sedentary lifestyle and physical inactivity has been linked with many cancers as per many studies.
“Sedentary behaviour means sitting, reclining, or lying down for extended periods of time. There is strong evidence that higher levels of physical activity are linked to lower risk of several types of cancer like breast cancer, uterine cancer, colon cancer, food pipe cancer, stomach cancer, bladder and kidney cancer. There is some evidence that physical activity is associated with a reduced risk of lung cancer,” says Dr Kumar.
Dr Vineeta Goel says physical Exercise and maintaining optimum body mass index (BMI)/ weight can reduce risk of cancer in general population and prevent cancer re-occurrence in cancer survivors.
“Exercise has many positive biological effects on the body, some of which have been proposed to explain associations with specific cancers. These include lowering the levels of certain hormones (estrogen, growth factors, insulin ), reducing inflammation, improving immune system function, reducing transit time for food to travel through intestine and helping to keep a check on weight preventing obesity which has a direct link in development of many cancers,” says Dr Kumar.
“WHO recommends that adults should do either moderate intensity exercises for 150-300 minutes per week or vigorous/high intensity exercises for 75-150 minutes/week,” says Dr Goel.
Every hardship in life makes one a much stronger person.
As an oncologist, when I meet some of my patients, I try to dig deeper to understand their perspectives on cancer, treatment, impact of close encounter with threat to life etc.
And every time I dig deeper, I learn something worth remembering and sharing.
Recalling one such meeting with a young 32 years old lady, college teacher by profession, treated for breast cancer. Upon her diagnosis of breast cancer, she took a sabbatical leave from college job to take care of her health and manage treatment. By the time she completed her breast cancer surgery, chemotherapy and radiation therapy, our lady had gained few extra kilos of body weight. Once she joined back her college job after many months of absent from work and while she had put on some weight-many of her colleagues asked if she was pregnant and was blessed with a baby. To this she wittily replied that –“I have been born again in last nine months-I have new hair, skin, nails and a new life”.
How true –I think almost all cancer patients especially breast cancer patients can relate to this.
Recently met another young lady who had completed her breast cancer surgery, chemotherapy and radiation therapy sometime back. I asked her how she was doing and how was life?
She said doctor this disease and its treatment has transformed me as a person. Cancer and its treatment shows you both life and death very closely. It has made me a much stronger and fearless person.
“C” (of cancer) has given me four new “G”s in my “new” life.
I have stopped keeping grudges and guilt.
I have more sense of gratitude and I am more giving by nature now.
Every day I try and live a better life then I was living before my diagnosis.
What a learning and journey from C to G !!
#Cancerfree #Guiltfree #Grudgefree #Gratitude #Giving #Newlife # Lifetransformation
As I became an oncologist/cancer specialist and started seeing both life and death more closely, my perspectives on life have changed and evolved.
I have learned over years that life is fragile. Life is unpredictable. Yet life is beautiful. Life is to be lived and cherished.
I realized fragility of human body when I first saw a patient in terrible pain caused by a 5 millimeter kidney stone (it was too tiny to cause that enormous pain). I realized fragility of life when I saw a patient having brain hemorrhage and paralysis after a trivial fall at home. Human body and life is really fragile as aptly said by Sant Kabir that human life is like water bubble.
Growing up as doctor, I also learned that diseases and ailments are part of life. What scares me as a health care professional are diseases for which definitive treatment is still not discovered. I am not so much scared of diseases for which treatments are available.
And all my above mentioned believes on life have been re – affirmed by the present corona virus pandemic.
This pandemic almost came like an avalanche for which nobody in the entire world was geared up or prepared. Practically there is no treatment for this infection and all we can do is – prevent it from spreading. If the infection still sets in, we can only give supportive care like oxygen, fluids, ventilation and hope for the best.
When I see cancer patients and I see a tag on them of being “cancer survivor” – I am pained. This tag almost means that these men and women with cancer were not expected to survive this disease and have been fortunate to have somehow survived.
I am sorry, but as an oncologist, I refuse to accept such pessimism towards cancer. And I urge everyone – no cancer, ex cancer, present cancer communities– to reject this pessimism and tag of cancer survivor especially now when all of us are facing fragility of life in the present circumstances of Covid -19 pandemic.
Fortunately for majority of cancers, treatment and hope is there while for viral infections like Corona, treatment is not available.
Adding on, I recently met a young lady who was almost completing her treatment for breast cancer. She shared with me that in the present times of lockdown, her father called her up enquiring how she was coping up with the diagnosis and treatment. She in turn assured her father that she is young and her body is fit to withstand this tough treatment and he need not worry. She even added that thankfully she has got a disease for which treatment and cure is possible. Now that’s what I call as winning and positive attitude.
So, my dear friends let’s live and cherish our fragile lives with gratitude towards one and all and live life without any tags.
DR VINEETA GOEL
Associate Director Radiation Oncology Max Super Speciality Hospital, New Delhi
Why is cancer detected in late or advanced stages? Why is there delay in diagnosing cancer? What can we do to catch it in early stages?
I recently saw one young man in his late 30s – he had persistent headache and pain in neck for almost a year- which he self-attributed to long working hours and desk job.
He would self-medicate himself with pain killers or analgesics. Incidentally his mom was admitted in hospital with typhoid fever. Since he was in the hospital, he thought of consulting a physician. Based on his history of long standing and severe pain – doctor ordered MRI brain and spine – which showed high grade advanced brain tumour going into spine/ neck. Fortunately, this tumour had not spread and was localized to brain, but had become very large in size. It was removed successfully with surgery and was then treated with radiation therapy.
Where did things go wrong? Why was there delay in diagnosis and what we could have done to pick it up early?
Cancer has no symptoms of itself which can be shared with the world to raise awareness of early cancer diagnosis. Some of the common symptoms of cancer are
Now let’s take example of back pain or cough – these are such common symptoms that almost everyone experiences them sometime.
But the key for early detection of cancer or any other serious health problem is that if any symptom is persisting beyond 3 -4 weeks then it needs to be adequately investigated- including investigations for cancer if suspected after basic investigations.
So the key to early diagnosis is -do not ignore any persistent symptom, consult your doctor and get yourself adequately investigated.
As I became an oncologist/cancer specialist and started seeing both life and death more closely, perspectives life have changed and evolved.
I have learned over years that life is fragile. Life is unpredictable. Yet life is beautiful. Life is to be lived and cherished.
I realized fragility of human body when I first saw a patient in terrible pain caused by a 5 millimeter kidney stone (it was too tiny to cause that enormous pain). I realized fragility of life when I saw a patient having brain hemorrhage and paralysis after a trivial fall at home. Human body and life is really fragile as aptly said by Sant Kabir that human life is like water bubble.
Growing up as doctor, I also learned that diseases and ailments are part of life. What scares me as a health care professional are diseases for which definitive treatment is still not discovered. I am not so much scared of diseases for which treatments are available.
And all my above mentioned believes on life have been re – affirmed by the present corona virus pandemic.
This pandemic almost came like an avalanche for which nobody in the entire world was geared up or prepared. Practically there is no treatment for this infection and all we can do is – prevent it from spreading. If the infection still sets in, we can only give supportive care like oxygen, fluids, ventilation and hope for the best.
When I see cancer patients and I see a tag on them of being “cancer survivor” – I am pained. This tag almost means that these men and women with cancer were not expected to survive this disease and have been fortunate to have somehow survived.
Fortunately for majority of cancers, treatment and hope is there while for viral infections like Corona, treatment is not available.
Adding on, I recently met a young lady who was almost completing her treatment for breast cancer. She shared with me that in the present times of lockdown, her father called her up enquiring how she was coping up with the diagnosis and treatment. She in turn assured her father that she is young and her body is fit to withstand this tough treatment and he need not worry. She even added that thankfully she has got a disease for which treatment and cure is possible. Now that’s what I call as winning and positive attitude.
So, my dear friends let’s live and cherish our fragile lives with gratitude towards one and all and live life without any tags.
MY PERSONAL VIEWS
DR VINEETA GOEL
Director and Head, Radiation Oncology Cancer Institute, Fortis Hospital, New Delhi
These are certainly difficult times – we have Corona Virus infection on one side and cancer treatment on the other.
I am speaking this out as a radiation oncologist to correct some wrong notions
There are two categories of cancer patients:-
1. Ex Patients- Patients who completed cancer treatment >6 months back- they are almost like a normal person. Their risk of acquiring Corona Virus infection or getting into some complications if they get Corona Virus infection is only a shade higher than an otherwise normal person who never had cancer.
Example Lady A is 70 years old with diabetes and heart ds; no history of cancer- say her risk of acquiring corona Virus infection or getting some complication is appox 5%
Lady B is 70 years old with diabetes and heart ds; with breast cancer treated 1 year back- say her risk of acquiring corona Virus infection or getting some complication is appox7-10%
Lady C is 70 years old with no health problems with breast cancer treated 1 year back- say her risk of acquiring corona Virus infection or getting some complication is appox5%
So, don’t have unnecessary fears in your mind.
Take universal precautions of hand hygiene, social distancing.
Please do not visit hospital for minor problems, routine tests or follow ups.
If needed do telephonic consultation with your doctors via phone. You may take appointment through max website.
2. Current Patients – Patients who are on active cancer treatment with either surgery, chemotherapy, immunotherapy or radiation therapy anytime since last 3-4 months or who are currently on treatment. This group of patients have their immunity little or sometimes very low as compared to a non- cancer age and health profile matched individual. These cancer patients are more susceptible to acquire Corona Virus or any other infection. So, follow all universal hygiene precautions like hand washing, face mask, social distancing etc. even more thoroughly.
Please discuss with your oncologist regarding urgency of following cancer treatment protocol.
Remember for a patient cancer is just one type, for us oncologists, cancer has multiple types and moreover every patient and his/her health profile is different.
For us as oncologist two women with similar breast cancer are still different, they are not same. When we look at breast cancer we think of multiple factors like stage, lymph nodal involvement, ER/PR/Her2 N status, age, other health issues and so many other things.
We go through all this before coming out with treatment recommendations based on all these multiple factors.
Based on your age, general health and overall cancer disease profile, your oncologist will guide you for cancer treatment in this time of Corona Virus Pandemic.
To give you an example – Glioma is a type of brain tumour and is commonly treated by surgery and post – operative radiation therapy. But Gliomas have several types. For a certain type of gliomas your oncologist might tell you that despite of Corona epidemic, we must immediately start radiation and chemotherapy. While the same oncologist might suggest that for another glioma patient its ok to start treatment anytime between 1-3 months from surgery. So do not panic and don’t overthink/overjudge. If you are seeking these answers on Dr Google, be careful least you fail to correctly comprehend it.
Another common case scenario that I come across is that majority women with breast cancer need radiation therapy after surgery or chemotherapy. Generally, we prefer to start Radiation therapy after minimum 3 weeks gap from surgery or chemotherapy. But the range of safe time frame to start radiation therapy anytime between 3-6 weeks from last chemotherapy or surgery. Again, these are standard guidelines, its best to discuss with your oncologist with regards to specifically your case.
Similarly as a radiation oncologist, I see some patients with cancers of head and neck regions who come to me for radiation therapy. Please discuss your specific case with us to help you take correct decision regarding optimum timing of starting radiation therapy.
Radiation therapy by itself does not cause much suppression of body immunity or lowering of blood counts. Cancer itself causes a state of low immunity and increases chances of acquiring viral infections. Additionally, patients are generally required to come to hospital for several days to weeks for radiation therapy. Travelling to and back from hospital by itself increase chances of catching Corona virus infection.
No two-cancer patients or their risk of catching corona virus infection is similar, hence speak to your cancer specialist for best professional advice.
Have trust in your doctor’s recommendations. We are available to you for tele and video consultations, you may book appointment via Max Health care website.
In these tough times use everything judiciously including your phone consultation timings. We also recommend that please keep your relevant reports ready before starting tele consultation (similar to the way you carry all your reports with you when going to hospital).
Dr Vineeta Goel
Associate Director Radiation Oncology
Max Super Speciality Hospital, Shalimar Bagh, Delhi
