Cancer is the word used to define illnesses in which abnormal cells in the body are divided without control and can invade other tissues. Cancer cells can disseminate to other parts of the body through the blood system and lymph system.
Cancer is not just an illness but many illnesses. There are more than 100 different types of cancer. Most of them take the name of the organ or the cells where it starts; for example, a cancer starting in the colon is called colon cancer; a cancer starting in basal cells is called basal-cell carcinoma.
The principal categories of cancer are:
All cancers start in the cells, which are the basic life units in our body. To understand what cancer is, it helps to know what happens when normal cells become cancer cells.
The body is conformed by many types of cells. These cells grow and divide in a controlled way in order to produce more cells, according to what the body needs in order to be healthy. When the cells become older or damaged, they died and are replaced by new cells.
However, sometimes this organized process gets out of control. The genetic material (ADN) of one cell can get damaged or altered, and this produces mutations (changes) that affect the normal growth and division of cells. When this happens, cells don´t die when they have to die and new cells are formed before the body needs them. Additional cells form a tissue mass that is what we call a tumor.
Not all tumors are cancerous; they can be benign tumors or malign tumors.
Benign tumors are not cancerous. They can be surgically removed and, in most cases, do not appear again. Cells in benign tumors do not spread to other parts of the body.
Malign tumors are cancerous: The cells of these tumors can invade tissues that are close and they can disseminate to other parts of the body. When cancer spreads from one part of the body into another, this is called metastasis.
Some cancers do not form tumors. For example, leukemia is a bone marrow and blood cancer.
Each year in Mexico, 300 thousand people died from chronic diseases such as cancer, HIV, diabetes or cardiopathy.
A chain of deficiencies in the Mexican health system prevent most of these patients from getting access to palliative care services that can reduce physical and psychological pain during the last days of their lives.
Establishing palliative care not only reduces the pain in a patient, but also diminishes the cost of health systems, because it can prevent a great number of emergency hospitalizations.
Human Rights Watch (HRW) in its report “Care when there is no cure”, carried out in Mexico between 2011 and 2014, documents the lack of palliative care services and describe some cases of terminally ill patients that died in an attempt to move from the places they lived to the Cancer National Institute (INCAN), in order to receive any kind of health service that could improve the quality of their lives and diminish the strong pains and other symptoms caused by a terminal disease. However, the problem remains in the fact that there are few hospitals that offer palliative care services, a point that makes health services unavailable to many people in need.
HRW also affirms that “around 80% of cancer and AIDS patients and 67% of patients with cardiovascular disease or chronic obstructive neuropathy will suffer moderate or strong pain during the last days of their lives.
Diederik Lohman, associate director of the Health and Human Rights Division at HRW, specified that the population in Mexico is getting older due to the fact that life expectancy is extending. Therefore, chronic diseases will be considered more important each day in the mortality of Mexicans in the future.
Human Rights Watch. (2014) Care when there is no cure. Report, Human Rights Watch. Recover on April 29th, 2016 from: hrw.org
Late diagnosis and the desire to receive curative treatment, sometimes wrongly, avoid the use of appropriate palliative care, which would allow patients to prevent pain in terminal stages.
This is recognized in the agreement published on December 26th, 2014 in the Official Gazette where the General Health Council declares mandatory frameworks for Integrated Management Palliative Care, as well as the processes outlined in the Integrated Management of Palliative Care Guide.
This document, mandatory for all institutions in the Health System, is intended to improve the quality of life of patients and their families, when facing problems associated with life-threatening illnesses that impair the function and performance of patients; attending the oatient in their own environment and physical, emotional, social and spiritual aspects, promotion measures, prevention, rehabilitation and care for symptom control, ensuring continuity during the process of the disease.
In Mexico a significant percentage of patients with diseases in advanced stages such as heart disease, pulmonary, oncology, dementia, AIDS, amyotrophic lateral sclerosis, etc., can receive help to alleviate their suffering and improve their quality of life by incorporating palliative medicine to the continuum of medical care.
The goal is symptom management to provide maximum relief and improve as much as possible the quality of a patient´s life. “In every occasion it is precise to look for any measure that can at least, bring a partial relief. You can never consider that there is nothing left to do”, points the document. It emphasizes that first level attention should offer an attention to patients with a life limiting illness in an advanced state, patients that wish to stay in their homes with family members, who that are capable of giving this attention.
They should have a basic team (physician, nurse) or a complete team, if you have other health professionals (psychologists, dentists, nutritionists, physiotherapists, social workers or others) to call 24-hours a day.
For third level attention, there should be specialized attention units for high complexity palliative patients, with a physical structure that favors the privacy and comfort of patients, making the access for their families easier.
Among the pharmacological measures to manage these patients, medicines go from regular painkillers to opioids, establishing a direct relation of administration depending on the scale of the patient´s pain.
Alatorre A. (28, December, 2014). Obligation to offer palliative care services. Reforma Newspaper
Detecting and preventing the growth of cancer before cancer cells become invasive can save your life and avoid long, painful and costly treatments.
Cancer is one of the most dangerous diseases in our time. Although investigation and treatments are contributing to stopping it, we are a long way off eradicate it completely.
There are many ways to prevent different types of cancer, for example: detection tests in the uterine and colorectal wall, mammography and pap tests, which are free all over the country.
There are also vaccines that help in reducing the cancer risk such as the vaccine against the human papillomavirus (HPV) which is currently being applied in high school boys and girls in Mexico City. It’s purpose is to prevent cancers that occur in uterus, vagina and vulva. Additionally, the vaccine against hepatitis B can reduce the risk of getting a liver cancer.