Punjab Malwa region feeds the nation but farmers here fall prey to cancer far too often.

They take the cancer train to Bikaner for cheep treatment.

What Is Cancer ? Cancer, known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the body through the lymphatic system or bloodstream. Not all tumors are cancerous. Benign tumors do not grow uncontrollably, do not invade neighboring tissues, and do not spread throughout the body. Healthy cells control their own growth and will destroy themselves if they become unhealthy. Cell division is a complex process that is normally tightly regulated. Cancer occurs when problems in the genes of a cell prevent these controls from functioning properly. These problems may come from damage to the gene or may be inherited, and can be caused by various sources inside or outside of the cell. Faults in two types of genes are especially important: oncogenes, which drive the growth of cancer cells, and tumor suppressor genes, which prevent cancer from developing. Determining what causes cancer is complex, and it is often impossible to assign a specific cause for a specific cancer. Many things are known to increase the risk of cancer, including tobacco use, infection, radiation, lack of physical activity, poor diet and obesity, and environmental pollutants. These can directly damage genes or combine with existing genetic faults within cells to cause the disease. A small percentage of cancers, approximately five to ten percent, are entirely hereditary. Cancer can be detected in a number of ways, including the presence of certain signs and symptoms, screening tests, or medical imaging. Once a possible cancer is detected it is diagnosed by microscopic examination of a tissue sample. Cancer is usually treated with chemotherapy, radiation therapy and surgery. The chances of surviving the disease vary greatly by the type and location of the cancer and the extent of disease at the start of treatment. While cancer can affect people of all ages, and a few types of cancer are more common in children, the risk of developing cancer generally increases with age. In 2007, cancer caused about 13% of all human deaths worldwide (7.9 million). Rates are rising as more people live to an old age and as mass lifestyle changes occur in the developing world.

Causes It is almost always impossible to prove exactly what caused a cancer in any individual, because most cancers have multiple possible causes. For example, if a person who uses tobacco heavily develops lung cancer, then it was very probably caused by the tobacco use, but since everyone has a small chance of developing lung cancer as a result of air pollution or radiation, then there is a tiny chance that the smoker's lung cancer actually developed because of air pollution or radiation.

Cancers are primarily an environmental disease with 90-95% of cases attributed to environmental factors and 5-10% due to genetics. Environmental, as used by cancer researchers, means any cause that is not genetic, not merely pollution. Common environmental factors that contribute to cancer death include tobacco (25-30%), diet and obesity (30-35%), infections (1520%), radiation (both ionizing and non-ionizing, up to 10%), stress, lack of physical activity, and environmental pollutants. Carcinogens Carcinogens are a class of substances that are directly responsible for damaging DNA, promoting or aiding cancer. Tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and compounds in car exhaust fumes are all examples of carcinogens. When our bodies are exposed to carcinogens, free radicals are formed that try to steal electrons from other molecules in the body. Theses free radicals damage cells and affect their ability to function normally

Other medical factors As we age, there is an increase in the number of possible cancer-causing mutations in our DNA. This makes age an important risk factor for cancer. Several viruses have also been linked to cancer such as: human papillomavirus (a cause of cervical cancer), hepatitis B and C (causes of liver cancer), and Epstein-Barr virus (a cause of some childhood cancers). Human immunodeficiency virus (HIV) - and anything else that suppresses or weakens the immune system - inhibits the body's ability to fight infections and increases the chance of developing cancer.

How is cancer classified? There are five broad groups that are used to classify cancer. Carcinomas are characterized by cells that cover internal and external parts of the body such as lung, breast, and colon cancer. Sarcomas are characterized by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues. Lymphomas are cancers that begin in the lymph nodes and immune system tissues. Leukemias are cancers that begin in the bone marrow and often accumulate in the bloodstream. Adenomas are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues.

How is cancer diagnosed and staged? Early detection of cancer can greatly improve the odds of successful treatment and survival. Physicians use information from symptoms and several other procedures to diagnose cancer. Imaging techniques such as X-rays, CT scans, MRI scans, PET scans, and ultrasound scans are used regularly in order to detect where a tumor is located and what organs may be affected by it. Doctors may also conduct an endoscopy, which is a procedure that uses a thin tube with a camera and light at one end, to look for abnormalities inside the body. Extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose cancer. This procedure is called a biopsy. Other types of molecular diagnostic tests are frequently employed as well. Physicians will analyze your body's sugars, fats, proteins, and DNA at the molecular level. For example, cancerous prostate cells release a higher level of a chemical called PSA (prostate-specific antigen) into the bloodstream that can be detected by a blood test. Molecular diagnostics, biopsies, and imaging techniques are all used together to diagnose cancer. For the famers from the southern districts of Punjab, cancer can be traced back to the excessive use of pesticides which are known carcinogens. As stated in the article Punjab farmers' use of pesticides is 923 g/ha, way above the national average of 570 g/ha (grams per hectare). Malwa is also Punjab's cotton belt; cotton crops are prone to pests. Farmers here use at least 15 different pesticide sprays. Of the top 15 pesticides used, the US's Environmental Protection Agency considers seven used on cotton in the US as 'possible', 'likely', 'probable,' or 'known' human carcinogens (acephate, dichloropropene, diuron, fluometuron, pendimethalin, tribufos, and trifluralin).

The government's cancer registry programme for 2004-2005 found a cancer prevalence rate of 68 to 115 per 100,000 for males and 92 to 116.5 for females. So, in the whole Malwa region of a population of about 1.5 crore, there ought to be about 12,000 cancer patients. In Bathinda district itself, with a population of about 14 lakh, there should be about 1500 patients. These figures are staggeringly high. Farmers believe they may be paying a price for the success of the 1970s' Green Revolution. That was when farmers in Punjab switched from traditional farming methods to a combo formula of high yield seeds-fertilizer-pesticide-water. The small but wealthy state on an average now accounts for 19% of wheat and 13% of India's rice production. The Green Revolution, and Punjab's contribution, ensured that from begging for food and aid, India went on to export food grains. Despite repeated warnings from doctors and activists, governments are still dragging their feet. "Health is private business in Punjab and the rich farmers go to Delhi and Mumbai for treatment.

How can we reduce cancer occurrences? Cancer prevention is defined as active measures to decrease the risk of cancer. The vast majority of cancer risk factors are due to environmental (including lifestyle) factors, and many of these factors are controllable. Thus, cancer is largely considered a preventable disease. Greater than 30% of cancer is considered preventable by avoiding risk factors including: tobacco, overweight / obesity, an insufficient diet, physical inactivity, alcohol, sexually transmitted infections, and air pollution. Not all environmental causes can be prevented. For example, exposure to naturally occurring background radiation cannot be prevented.

Dietary Dietary recommendations to reduce the risk of developing cancer, including: (1) Reducing intake of foods and drinks that promote weight gain, namely energy-dense foods and sugary drinks, (2) Eating mostly foods of plant origin, (3) Limiting intake of red meat and avoiding processed meat, (4) Limiting consumption of alcoholic beverages, and (5) Reducing intake of salt and avoiding mouldy cereals (grains) or pulses (legumes). The farmers of the Punjab should stop using the empty pesticide cans to store water and food.

Vaccination Vaccines have been developed that prevent some infection by some viruses that are associated with cancer, and therapeutic vaccines are in development to stimulate an immune response against cancer-specific epitopes. Human papillomavirus vaccine (Gardasil and Cervarix) decreases the risk of developing cervical cancer. The hepatitis B vaccine prevents infection with hepatitis B virus and thus decreases the risk of liver cancer.

These vaccines should be made available to every single individual in this country of ours and especially to the ones who a more prone to cancer like the farmers from Punjab. It is our governments duty to protect its citizens in any and every way possible. And it is our duty to protect ourselves. Also for those who are affected should be exposed to cheep and affordable but also reliable treatment, with proper hygienic facilities and proper medication.

A Train Ride TO Cancer CARE

Roll No. 07