Dr. Shama Fernando speaking at our Medical Crossword Draw:

Even men can get breast cancer

"Thirty per cent of cancer deaths due to poor diet"

Dr. Shama Fernando heading the Ceylinco Cancer Detection Centre in Colombo revealed that even men can get breast cancer but rarely and thirty per cent of cancer deaths in Sri Lanka are caused due to poor diets.

She was speaking at the 9th Novatis sponsored Health Watch Medical Crossword draw held at the Ceylinco Health Care Centre, Hyde Park, Colombo.

Delving into the subject further at this event where Prof. Rohan Jayasekera of the Colombo Medical Faculty is the Genetic Consultant of the Ceylinco HC Centre, she said:

More than 70 per cent preventable

"There is evidence to suggest that more than 70 per cent of cancer related deaths in Sri Lanka could be prevented by early detection (through education and screening) the apparently healthy who do not perceive to be cancer risky and thus detecting the concerned at the very early stage where a affected person shows no symptoms at all."

4000 cancer deaths annually

She said the annual cancer deaths in Sri Lanka is estimated at 4000 with an annual increase in cancer cases at 12,000. This shows how serious this problem is.

Now looking at the other side of it, meaning the causes leading to the problem we find that thirty per cent (30%) of the cancers are caused due to poor diet - a preventable cause. And another thirty per cent (30%) are due to tobacco use against preventable.

So the picture that we see before us is that sixty per cent of the cancers are preventable. What is needed is awareness and education mostly.

What is cancer?

Cancer is formed as a result of uncontrolled growth of abnormal cells in the body. They can grow in any part of the human body and spread all over.

WHO estimates that six million people die of cancer annually in the world. According to them by the year 2020, there will be 20 million cancer cases in the world and twenty per cent of them will be in the developing world.

She made the following points about the different cancers which the general public should be made aware of.

Oral cancer

A common cancer among the Sri Lankan adult population developing in the age group 50-80 risk factors include even ill fitting dentures; others being betel chewing, smoking, alcohol, poor dental hygienic. These cancers are not painful in the early stages with early detection they can be cured. Bowel cancer and Polyps affect both men and women.

The two main risk factors are - family history and life style (diet). Most colo-rectal cancers begin as polyps. Therefore if polyps are found they should be removed before they could develop into cancers. Early detection is the best for cure.

Prostate cancer

Very common in men. Again mostly occurring in the over 50s. High degree of animal fat and protein appear to be the risk factors with family history too contributing to some extent. Here too in the early stage there are no symptoms at all to indicate that one is having this condition. Again curable with early detection.

Breast cancer - even men can get it

Not only women, even men can get breast cancer but very rarely, can occur at any stage in life but generally in the over 50 age group. High riskers are those in the over 50 age group.

Risk factors include family history of even benign breast cancer, those who have had late pregnancies and those who have not given birth to children at all. Ninety per cent of breast cancers are curable with early detection.

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Some dont's to Counsellors working in tsunami hit areas

At a training workshop for would be counsellors in tsunami hit areas in Sri Lanka, held last weekend at the Colombo Apollo Hospital, Drs. M. Thirunavukarasu and Venkatesh Ramachandran of the Tamil Nadu State Branch of the Indian Association of private psychiatry gave out the following dont's for the counsellors.

The two doctors were part of a six member psychiatry medical team from the Indian Association.

Don't

* Don't encourage the affected person to bottle up their feelings. Ask them to discuss it with people they trust and Mental Health Professionals, because treatment is usually very successful.

* Don't tell the affected person that the symptoms they experience are a sign of weakness and to be strong. They are a normal reaction, of normal people, to terrifying experiences.

* Don't tell the person its ok to be angry with themselves. They are not to blame or feel guilty for what has happened.

* Don't tell the affected person that the memories will go away immediately. On the contrary it may be with them for quite some time.

* Don't tell the affected person to avoid talking about it. Encourage them to vent their feelings.

* Don't tell the affected persons that other people will worsen their symptoms. Encourage them not to stay away from other people.

* Other substances (alcohol, smoking, excess coffee drinking etc.) are not a way out or option out of their current problem. These may worsen their problems.

* Starvation or missing meals will not help them in any way, but on the long run cause health related problems.

* Persons should not overwork to get overtired as a coping mechanism for their problems.

* Don't tell them to take time off for holidays or short trips by themselves. It is very crucial time where desolation and resentment is very high which can lead to suicidal ideas and suicide.

* Don't tell the person it is ok that he lost a loved one (Child, spouse, parents etc.) It is to trivialize his loss and you show you are insensitive to his/her feelings.

* Don't tell the person that you know how he/she feels, because you don't

* Don't tell the person they are lucky to be alive - it may anger some.

* Do not suggest that they have to pull themselves together, if they could you will not be there.

The workshop had been organised by the CMI - TMC Disaster Relief Trust in association with Colombo Apollo Hospital

(Text by Anjalie Garnier)

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My experience of the tsunami

"Hygiene in camps was a problem. Pit latrines with shelters had been dug. However, many did not use them despite advice by the healthcare workers. This community had been using the bushes or the sea in response to their call of nature prior to the disaster. They were now contaminating the environment of the camps.

We suggested placing a plant or two in the latrine and taking off the roof in addition to making picture signs to remind people to avoid defecating in the school environment.

The PHI would have thought I was mad! Perhaps they were also afraid of falling into the pit! We attempted to educate inmates and especially community leaders in these camps on prevention of communicable disease.

Educational pamphlets were provided to health care workers to be distributed among the literate of the community. The lower literacy rate compared to the overall rate in Sri Lanka was a limitation to health education in this community."

- SLMA member

In months to come

In months to come will the enthusiasm and capacity to provide support gradually decline? We need to think about the tomorrow when television stations may no longer provide 24-hour coverage of the tsunami disaster.

Sooner or later the voluntary relief workers will have to face the reality of getting on with their own day-to-day struggles of life.

Still, there is a clear need for long term rehabilitation. The challenge is to maintain a viable and sustainable rehabilitation programme.

It is essential to identify priority needs for long term rehabilitation, in terms of both economy and health. It isn't just rebuilding homes or the survivors. Many must try to earn a living again, having lost their means of livelihood.

The services of the public transport should be resumed. The health care infrastructure facilities such as hospitals need to be reestablished.

The management of the psychological consequences of the survivors is of utmost importance. It is the responsibility of the medical profession to ensure that long-term health care support is continued. This is too huge a responsibility to be handled by a single institution, authority or ministry.

The resources of the government, the support from the international organisations, the expertise of professional colleges, medical schools, Ministry of Health and the SLMA, the organisational capabilities of the GMOA and medical students should all be directed towards a coordinated effort.

Collaboration, coordination and continuity are the key words.

- Dr. Indika Karunathilake

Heroics in the midst of tidal waves

The stories of heroic surgeries done by doctors, disregarding their own personal safety are not limited to wartime.

During the recent tsunami disaster, the doctors at the Mahamodara hospital managed to successfully complete a Caesarian section and even managed to evacuate the mother and the newborn to a safe area while the seawater was crashing into the hospital premises.

The power failure due to the damage caused by rampaging water meant that the only source of illumination under which they had to close the wound was the faint light of a laryngoscope. The medical team had to take the desperate measure of breaking one of the walls of the theatre to take the newborn and the mother to safety.

Doctors offer voluntary services to the North and the East

There were large number of doctors who volunteered to offer their services to the tsunami victims in the North and East. Some even willingly went to the areas where there was no direct transport and offered their service under limited infrastructure facilities.

Courtesy: SLMA January news bulletin

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School bag issue: parents meeting at Apollo

The Health Watch - Apollo School Bag Study Committee headed by Dr. Dennis J. Aloysius decided last week to call for views of parents on the issue, how they find their school going children coping with the heavily loaded school bags they have to carry daily to school today.

Apollo Hospitals senior consultant surgeon in orthopaedics Dr. Mandeep S. Dhillon (who is in this committee) feels that the heavy weight of the books, the children daily carry in their school bags in relation to their age has a health risk which will come up mostly later in their life.

He and the committee feels parents views and support is essential to push this issue further and recommend a solution for it.

The March 20th meeting will be at Colombo Apollo at 10.00 a.m.

Parents who wish to attend this meeting please give your name and address to Chammika de Silva at Apollo, Tel. 4539031, Mobile 0777 277934.