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Taking up the fight against cancer

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Find out the functions of the Institute of Cytology and Preventive Oncology, Noida.

Cancer, one of the major killers in the world, is a generic term for a large group of diseases that can affect any part of the body.

The usual sites of cancer are oral cavity, lungs, oesophagus and stomach among men and cervix, breast, and oral cavity among women. Lung, stomach, liver, colon and breast cancer cause most cancer deaths.

There are various risk factors leading to cancer deaths. Use of tobacco and alcohol, lack of physical activity, a high body mass index, low fruit and vegetable intake, viral infections and ageing are some of these factors.

Tobacco use is the single most important risk factor for cancer causing 22 per cent of the global cancer deaths.

Heredity may play a role in certain types of cancer. They may run in families not only because of common risk factors such as smoking but also because abnormal genes may be passed from generation to generation.

Inherited cancer, however, occurs less than other varieties.

How is cancer developed?

It can start from a single cell. A normal cell is transformed into a tumour cell in progressive stages. A lesion may get changed as a malignant tumour.

This kind of transformation takes place consequent on interaction between a person’s genetic factors and external agents. The agents may be physical, chemical or biological carcinogens (cancer-causing substances or agents). Typical examples of these three categories of carcinogens are ionising radiation, tobacco smoke, and viruses.

The incidence of cancer deaths can be reduced through early detection and appropriate management of patients. Reduction in the risk factors listed above would help prevention to some extent. Vaccination against human papillomavirus (HPV) and Hepatitis B virus is another strategy. Awareness creation in society can help early detection and care.

Cancer treatment may involve chemotherapy, radiotherapy or surgery. In cases where total cure is not possible, there would be chances of substantially prolonging quality life. Palliative care and psychological support are vital elements in providing active life.

Cytological evaluation or analysis under a microscope of cells collected from a part of the body is part of cancer detection. Pap smear is a usual method of cytological evaluation for the detection of cervical cancer. Cytological evaluation is different from a biopsy test where a tissue is examined.

(Cytology refers to the study of the microscopic appearance of cells, especially for the diagnosis of abnormalities and malignancies. Oncology is the branch of science that deals with tumours and cancers and their treatment.)

ICPO

There is a centre of excellence that carries out studies and research in areas related to cancer.

The centre works under the control of the Indian Council of Medical Research (ICMR): the Institute of Cytology and Preventive Oncology (ICPO), I-7, Sector - 39, Noida – 201 301; Website: www.icpo.org.in.

It was established as the Cytology Research Centre by the ICMR in 1979. After 10 years, it assumed the present name. The basic objective was promoting research in the field of cancers that are most prevalent in India with a stress on early detection and prevention. Studies had a multidisciplinary approach covering epidemiological, behavioural, clinical, cytomorphological, cytogenetic, biochemical, virological, immunological, and molecular biological aspects.

Special emphasis has been laid on pre-cancer and cancer of the uterine cervix and breast in women. The institute has made substantial contributions in cervical cancer research. Sixteen per cent of the world’s total cases of cervical cancer occur in India; but only five per cent are reported in the early stages.

The method of clinical downstaging, a process of screening for cancer using clinical approaches for early detection, is employed.

This differs from the screening test.

In the absence of screening, downstaging helps in the detection of cancer at a less advanced stage.

Paramedical staff with minimum training will be able to identify any abnormality in cervix by this method.

This is significant, since cytological screening may not be possible in many cases.

Visual inspection of cervix with selective cytology screening and development of novel diagnostic approaches for screening HPV have been introduced.

Preparatory work on an HPV vaccine and analysis of breast cancer susceptibility genes are some of the other areas of research. Educating women on risk factors, symptoms of the disease and prevention are also being done.

ICPO promotes clinico-epidemiological cancer research to determine social, environmental, and genetic factors.

Further, it undertakes research for the development of preventive and therapeutic approaches for cost-effective management of cancer and their implementation in the hospital and community settings.

A noteworthy aspect of its working is its commitment to studying and analysing behavioural and psychosocial parameters in cancer patients, in order to ensure effective counselling to patients.

The ICPO aims at human resource development in various specialties of oncology through formal and informal training courses and related academic programmes. It has facilities for Ph.D. research and MD programmes.

It also provides in-service training. It functions as a national reference centre for HPV and cervical cancer, providing specialised diagnostic referral services.

The institute also works as a WHO-collaborating centre for research and training in cytology and HPV vaccine programme. It is a member of the International Union Against Cancer, Geneva.

It would be of interest to potential research students that the institute conducts research in the following areas:

Molecular oncology, clinical oncology, cytopathology, molecular genetics and biochemistry, immunology and virology, epidemiology and biostatistics, and early detection and referral services.

ICPO has adequate facilities and laboratory support for quality studies in all these subject areas.


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