a) in men in India?

The most common type of cancers in men are:
• Lips and oral cavity cancer
• Lungs cancer
• Stomach cancer
• Colorectum cancer
• Pharynx cancer
• Prostate cancer
• Pancreas etc

b) in women in India ?
• Breast
• cervical
• lip & oral cavity
• stomach
• colon & rectum
• ovarian

Some of the most common symptoms of lips and oral cavity cancer are:

• • Abnormal Patches (Red/White) on the tongue, lips
  • Abnormal Swelling or lump
  • Pain over affected area
  • Mouth ulcer or sores that does not heal
  • Toothache
  • Difficulty or pain to swallow food
  • Jaw pain or stiffness
  • Hoarseness of voice
  • Bad Odour
  • Weight loss

Coating of tongue is usually a result of unhygienic practices during the disease, progress of the
disease can hinder routine hygiene practice. However, it can be improved by following steps:
• Brushing of teeth twice daily
• Cleaning the tongue
• Gargling twice or thrice a day (using a pinch of table salt & baking soda in warm water)
If the coating does not subside then consult a doctor to rule out candidiasis. The doctor can prescribe
antifungal medications accordingly.
In case of smoking and tobacco chewing, it is advisable to stop immediately.

Dryness of mouth, also known as Xerostomia, is a common outcome of treatment process like chemo radiotherapy. It can be improved by doing the following:

Maintain good oral hygiene

Increase the intake of oral fluids than usual

Avoid spicy, salty, and sour food

Avoid intake of oily or thirst inducing foods

Gargling twice or thrice a day (using a pinch of table salt & baking soda in warm water)

• Oral pain can be due to combined effect of localised lesion or unhygienic practices due to disease progression.
• Some measures which can help overcome pain are:
• Maintain good Oral hygiene practices like brushing teeth twice daily, tongue cleaning, gargling (using a pinch of table salt & baking soda in warm water) 2-3 times a day.
• Quitting smoking and tobacco chewing
• Consuming semi solid or liquid diet less (Avoid spicy, salty, and sour food)
• If symptoms of difficulty to swallow food/liquid is present, consult physician

Difficulty in swallowing occurs at some phase of oral cancer due to increase in tumour size and
superadded inflammation.The best possible thing to do is to have soft diet.In case of complete inability
to swallow, it’s important to consult a specialist as soon as possible.

Disturbed sleep could be due to:
• Pain (refer pain management)
• Inadequate food intake (refer difficulty in swallowing)
• Mental disturbance – need counselling to rule out depression, consult doctor for further evaluation
• Social Stigma – a good counselling is advised

Oral cancer patients can be given soft diet like ragi malt, rice malt, less spicy and less oily food rich in
proteins, vitamins and minerals.

Loss of weight is the outcome of the cancer. However,weight can be managed by maintaining an
adequate intake of proteins and carbohydrates and consuming food rich in vitamins and minerals.
However, it may take some time to completely overcome the problem.It is better to consult a dietician
for a food chart, because the diet chart varies for different type of cancer depending on the location of
cancer.

The common symptoms in lung cancer patients are:
• Cough – for prolonged period
• Pain – Localised or General pain
• Blood in sputum
• Difficulty in Breathing
• Frequent Lung Infection
• Loss of appetite
• Weight Loss
• Hoarseness of voice

Measures that can be followed for pain management in lung cancer are:
• Steam inhalation is the cheapest and easiest management, Steam dilate the airway and bronchioles of lung and improves air movement, it liquefies the thick mucus secretion and helps in expulsion of the sputum, also decrease cough reflex can offer some relief from the associated pain.
• Cough syrups and antibiotic drugs can help in reducing the infection that causes cough and pain but should be taken under Physician Supervision.
• Evaluations of the type of pain are most important (spiritual, emotional, social and physical) and should be managed accordingly.
For a lung cancer patient, the pain could be due to the tumour or it can also be due to complications of secondary causes like Pleurisy, pleural effusion, lung abscess. All this condition needs further evaluation and management by chest Physician.

Lung cancer patients can suffer from excessing coughing at night which can be primarily due to the
Abnormal mass which might cause obstruction to bronchioles and alveoli leading to excessive cough or shortness of breath. The cough can also be due to presence of infection.
In both the cases, the symptoms aggravate in lying down position. The common practices that can offer some relief are:
• Use of steam inhalation to dilate the airway and bronchioles of lung
• Use of cough syrups and antibiotic drugs to reduce infection with Physician opinion
• Patient can find a comfortable position like lying at the angle of 45 degree or sitting position to reduce coughing

Breathing difficulty could be primarily due to the increase in the size of the tumour causing obstruction of alveoli/bronchioles or due to infection.
Here are some common measures that can offer some relief:
• In case of mild difficulty, use of nebulisers and oxygen at home can help. Oxygen at home should be advised by the doctor.
• For Moderate – Severe difficulty, the patient should be taken to nearby hospital for further evaluation and management.

Soft diet like ragi malt, rice malt, less spicy and less oily food rich in proteins, vitamins and minerals is
advisable for lung cancer patients.

Bad odour is basically due to lung abscess which is secondary to cancer. It can also be due to bad oral
hygiene practises. This can be improved by the following steps:

• Oral hygiene practices like brushing teeth twice daily, tongue cleaning with cleaners, gargling 2-3 times a day(using a pinch of table salt & baking soda in warm water), can be adopted. If the bad odour still does not subside consult a doctor to rule out candidiasis.
• With doctor’s prescription, antifungal mouth paint can be used twice daily for local application.
• In case of smoking and tobacco chewing, it is best to be stopped.
• In case of lung abscess, draining of lung abscess under doctor’s guidance can be helpful.

Some of the most common symptoms of stomach cancer are:
• Nausea & Vomiting
• Bloating sensation
• Pain in Abdomen
• Loss of Appetite
• Loss of Weight
• Constipation/Diarrhoea
• Blood in Vomitus or Stool (Mostly Black coloured stools seen)
• Abdominal swelling

Stomach cancer patients could be experiencing pain due to Gastritis, Gastric Ulcers, Inflammation of
the Local Lesion, or due to secondary involvement. The following steps can be followed to combat the pain:
• Have adequate amount of fluids and antacids as required under doctor’s prescription
• Treat the primary & secondary focus of infection
• Analgesic can precipitate Gastritis or ulcer symptoms thus pain killers should be taken only after the advise of Physician.

Soft diet like ragi malt, rice malt, less spicy and less oily food rich in proteins, vitamins and minerals is
recommended for patients with stomach cancer.

It is important to consider all possible causes of nausea, including those which may require specific treatments rather than an antiemetic alone (e.g. hypercalcemia, oral candidiasis, gastritis.). Causes for nausea can be multi factorial. If there is a significant nausea/vomiting the oral antiemetics may be
temporarily ineffective and parenteral antiemetics may be required.
Nausea can also be one of the side effects of chemo radio therapy and also could be due to disease process. The best that one can do to manage it is:

• Use anti-emetics and antacids as prescribed by consultant
• Adopt good diet practise

The patient’s relatives and caregiver should be given the opportunity to discuss what is important to them at this time.Decision about the plan of care should be communicated to the patient and to the relatives or caregiver.The patient may be anxious for themselves or for others and addressing psychological and spiritual needs may contribute to alleviating the symptoms of agitation, so one has to deal with it in matured way.

Some of the common symptoms of patients with colorectal cancer are:

• Nausea & Vomiting
• Pain in Abdomen or lower abdomen
• Loss of Appetite
• Loss of Weight
• Constipation/Diarrhoea
• Bleeding per rectum
• Abdominal swelling

Constipation is very common in palliative/supportive care patients due to a combination of factors like immobility, decreased food and fluid intake, medication, bowel pathology, and sometimes hypercalcemia. Diagnosis is usually made on the basis of a history of decreased frequency of bowel moments, the passage of small hard faeces, and the need to strain to pass the stools. Constipation can present with overflow diarrhoea. Patient education and information about causes of constipation can help. The additional measures that can help to improve the symptoms are:

• • Adequate amount of fluid intake which can include juices and coconut water
  • Appropriate dietary changes that includes fibre rich food

In case constipation is on and off then regular intake of laxatives as advised by the doctor would help, in severe constipation the patient may require enema.

First thing is to rule out the cause for bloating, causes could be acidity, constipation, urinary retention, intestinal obstruction. Some of the common measures that can help relieve the symptoms of bloated stomach are:

• • • Adequate amount of fluid intake; like juices, coconut water (for constipation & acidity)
    • Consuming fibre rich food (for constipation)
    • In case of urinary retention and intestinal obstruction consult the treating doctor immediately.
    • In case acidity & constipation is severe then doctor consultation is necessary.

Patients may be experiencing pain due to gastritis, gastric ulcers, Inflammation of the local lesion or due to secondary involvement. Analgesics as advised by the doctor can be used to relieve the pain and treating the cause will help to relieve the pain.

Excessive bleeding is a major complication which cannot be treated at home. Best is to reach out to the nearby hospital for further evaluation and management. Sometimes local factors like Piles or Fissures can also cause Bleeding per rectum and thus local examination will be required to rule them out.

Loss of weight is the outcome of the cancer. It can be maintained by adequate intake of proteins and carbohydrates, food rich in vitamins and minerals. However, it may take time to completely overcome it. It is better to consult a dietician for food chart.

Some of the most common symptoms of cancer of pharynx
• Chronic Sore throat
• Lump in the neck or back of the tongue
• Pain (referred) to Ear or Jaw
• Hoarseness of voice
• Persistent Coughing
• Difficulty in swallowing food
• Unexplained Weight loss
• Swollen Lymph Nodes
Some of the most common symptoms of cancer of Oesophagus
• Difficulty in swallowing liquids or solids
• Chest Pain – Burning or pressure sensation
• Persistent Cough
• Excessive Secretions and other associated symptoms.
• Unexplained Weight loss
• Hoarseness of voice
• Hiccups
• Bleeding in oesophagus causing blood in vomitus or black coloured stool

Pain could be due to the primary tumour, due to secondary involvement, due to the inflammation of the surrounding tissue or due to obstruction, thus treating the underlying cause is important in the management.
In mild and moderate pain oral analgesics will be help as prescribed by the doctor. In case of severe pain, it is better to consult a doctor and to rule out the cause of pain and treat it accordingly, if pain is severe patient may need opioids class of drugs.

Soft diet like ragi malt, rice malt, less spicy and less oily food rich in proteins, vitamins and minerals is advisable.

They patient can be experiencing cough due to infection – a secondary involvement to cancer – or
due to increase in the tumour size causing difficulty in breathing and leading to responsive cough. The following steps can help in managing this cough better:

• • • Use of steam inhalation can help dilate the airway and bronchioles of lung
    • Cough syrups and antibiotic drugs can help in healing of infection causing the cough
    • They patient can find a comfortable position when lying down which relieves the cough

Coughing of blood could be because of irritation of the wall of pharynx and oesophagus or could be because of involvement of lower respiratory tract. Thus, detailed evaluation is necessary from a doctor and hence need to visit nearby hospital.

The common symptoms of patients with cervical cancer are:
• Abnormal Vaginal Bleeding – After Sexual intercourse, Irregular cycles, between menstrual periods or after menopause
• Pain during intercourse
• Foul smelling discharge from vagina
• Pelvic or back pain
• Unexplained Weight loss
• Difficulty to pass urine or pain when passing urine if cancer has spread to nearby tissue

Screening is an important part in these patients. It is also important to rule out any associated infections, mostly fungal infection of the cervix, or any other inflammatory process of the cervix or the uterine wall.
The treatment will depend on the diagnosis.The best thing is to practise hygiene and consult a
gynaecologist as early as possible.

Pain in cervical cancer could be due to primary tumour or infection and secondary involvement of the adjacent parts.Some measures to be taken in pain management include:

• • • To practice hygiene
    • Pain can be treated with pain killers. Dicyclomine and mefenamic acid tablets are commonly used but under doctor’s prescription.

It is also advisable to consult the doctor as and when required.

The cause for the irregular cycles should be evaluated first. Treatment would depend upon the
diagnosis. It is advisable to consult your gynaecologist.

Headache could be due to dehydration, anaemia, stress factor, and alteration in BP. Treatment will depend upon the cause:

• • • To take adequate amount of fluids
    • Adequate consumption of iron rich food.
    • Treatment of altered BP
    • Pain killers as prescribed by the doctor

The common symptoms of ovarian cancer are:
• Pain in the lower abdomen
• Abdominal Bloating
• Pressure effects on bladder or rectum causing increase urination or diarrhea/Constipation
• Irregular menstrual cycle
• Loss of weight and appetite

Pain in abdomen could be due to gastritis or irregular food habits. Sometimes pain can be drug
induced. It can also be caused by infection or the tumour itself. Gastritis can be overcome by taking
adequate quantity of water, antacid supplements, and by changing drugs or its dosage which are causing gastritis. The pain due to tumour should be treated accordingly.

Swelling of legs (pedal oedema: may be unilateral or bilateral) & abdomen swelling (due to organ involvement or due to accumulation of fluid) could be due to many reasons such as:

• • • Renal pathology (direct/indirect)
    • Cardiac involvement (direct/indirect)
    • Metastasis to different organs
    • Obstruction blood flow and lymphatic drainage
    • Anaemia and decreased albumin

Loss of weight is mainly due to inadequate food intake and due to poor prognosis of disease which
hinders the adequate intake of food. Adequate intake of food depending upon the patient comfort
would help but it’s very difficult to overcome weight loss completely.

The symptoms of pancreatic cancer are:
• Abdominal Pain (Mid epigastric region) or Back pain
• Yellow discoloration of the skin or eyes (due to obstruction of bile duct)
• Bloating sensation
• Nausea, Vomiting
• Significant weight loss and loss of appetite
• Generalized weakness
• New onset of Diabetes

It is advisable to take a diet that is rich in protein and calories.

Rule out the cause of pain and to be treated accordingly, usually the pain management is done by analgesics as prescribed by the consultant.

Nausea and vomiting are the common side effects of chemotherapy in some patients. The patient
need not panic because of this.The medication prescribed by the treating doctor will help (antiemetics are the drug of choice).

The common symptoms of bone tumours are:

• • • Swelling
    • Pain
    • Impaired mobility of the affected site
    • Loss of weight
    • Open wound and discharge from the affected site etc;

Pain in bone cancer patients is because of the tumour which interferes with the nerve course
(compression/damage), due to secondary involvement of surrounding tissue, or because of superadded
infection. Pain management will depend on what is causing it. For example, if the pain is because of
tumour per se the tumour has to be taken care. But if infection is causing the pain, then treat the
infection.
Pain killers (as prescribed by the doctor) can be used irrespective of the cause for temporary pain relief.

Impaired mobility could be due to increasing tumour size or the pain caused by nerve involvement or infection. Firstly, try to manage the pain which hinders the mobility by use of pain killers prescribed by the doctor. In other cases, it should be treated accordingly.Physiotherapy plays a very important role in improving mobility.

It is the best practice to follow the guidance of doctor and physiotherapist. To take care of mobility, pain and routine consultation with doctor and physiotherapist is must because they will guide you in the best possible way to prevent any further complications.

Exercise in case of complete immobility is advised to keep the joint functionally active and to prevent fibrosis of muscle which hinders the basic function. The exercise should be done under the guidance of physiotherapist.

In general, the food advisable for cancer patient includes the soft diet rich in proteins and calories likeclear vegetable soup, clear chicken soup, ragi malt, smashed fruit salad, etc. It is also important to consult a dietician and follow their food chart.

It usually depends on the doctor’s prescription and follow-up. It will also depend on drug interaction or a sudden occurrence of the symptoms.

The most important part is to make the patient aware of the current situation and to make them
understand the outcome and accept the condition. They would need mental support from the people
around them. Try to motivate them spiritually in a way that they can understand better and help them
to accept it.

It usually depends on the stages of the cancer. The most important part is the treatment aspect and how it is planned. Lastly but not the least, the patient’s attitude towards the disease process,the way they take it and fight back also matters a lot.

This question can be well answered by the regular follow up of patients. It depends on the progress of disease and treatment process.

Pain is common in advanced cancer and non-malignant conditions, and its management can be
difficult. Pain management requires a multi-disciplinary approach because pain is a completely personal experience with physical, psychological, social, and spiritual dimensions. Optimal pain management will be compromised if any of these aspects are neglected. Regular review of the pain, effects and side effects of pain killers, how the pain is affecting the patient/family is vital for good pain control. Not all pain experienced by a patient with cancer is caused by the cancer itself. Often several pains coexist and
an accurate diagnosis of the cause as well as the type of the pain is necessary for effective pain management. Analgesic (pain killer) option will be determined by the specific cause, type, and severity of pain. Previous exposure to analgesics will also determine the type and the strength of analgesics used.

Some of the most common symptoms of Prostate cancer are

– Complaints of difficulty (pain/frequency) during micturition.

– Complaints of altered bowel habits.

– Blood in urine or semen

– Erectile dysfunction/ Difficulty in ejaculation.

Having an inability to pass urine

Having a hard time starting or stopping urine flow

Needing to urinate often, especially at night

Having a weak urine flow

Having pain or burning while urinating

Frequent pain in the lower back, hips, or upper thighs

The common symptoms of breast cancer are:

lump or mass in the breast.

Swelling of part or all of the breast,

Skin irritation,

Breast or nipple pain and/ or appears red, scaly or thickened

Nipple retraction,

Discharge from nipples

Loss of weight

In general the food advisable for cancer patient includes the soft diet rich in proteins and calories ,E.g.; Clear Vegetable soup ,Clear chicken soup , Ragi malt ,Smashed fruit salad and more important to follow the dietician prescription

It usually depends on the doctor’s prescription and follow up and in case if there is any drug interaction or the sudden occurrence of the symptoms.

Pain is common in advanced cancer and non-malignant conditions and its management can be difficult. Management requires a multi-disciplinary approach because pain is a total personal experience with physical, psychological, social & spiritual dimensions. Optimal pain management will be compromised if any of these aspects are neglected. Regular review of the pain, effects & side effect of pain killers & how the pain is affecting the patient /family is vital for good pain control. Not all pain experienced by a patient with cancer is caused by the cancer itself. Often several pains coexist, and an accurate diagnosis of the cause as well as the type of the pain is necessary to enable effective pain management. Analgesic (pain killer) option will be determined by the specific cause, type and severity of pain. Previous exposure to analgesics will also determine the type and the strength of analgesics used.