This month has been a month of pink,  it is the month that as a man, you may wear pink and not get labeled as a metro sexual or get curious looks, this has been breast cancer awareness month.  While talking about breast cancer we will target the men, this time round but we won’t leave out the ladies either.

What is cancer? Cancer is the uncontrolled growth of abnormal cells anywhere in a body. The abnormal cells are termed cancer cells, malignant cells, or tumor cells. Many cancers and the abnormal cells that compose the cancer tissue are further identified by the name of the tissue that the abnormal cells originated from (for example, breast cancer, lung cancer, colon cancer). Cancer is not only confined to humans, your pets, and livestock also get cancer too.

In some cases the cancerous cells move from their original location, break away from this original mass of cells, travel through the blood and lymph systems, and lodge in other organs where they can again repeat the uncontrolled growth cycle. This process of cancer cells leaving an area and growing in another body area is termed metastatic spread or metastatic disease. This is the reason why it is important to get early diagnosis and treatment to prevent this from occurring.

There are over 200 types of cancer though we have some categories where most cancers fit:

• Sarcoma: Cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue
• Leukemia: Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood
• Lymphoma and myeloma: Cancers that begin in the cells of the immune system
• Central nervous system cancers: Cancers that begin in the tissues of the brain and spinal cord

What causes cancer? 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 happens when problems in the genes in a cell prevent these controls from working.

Anything that may cause a normal body cell to develop abnormally potentially can cause cancer. Many things can cause cell abnormalities and have been linked to cancer development. Some cancer causes remain unknown while other cancers may develop from more than one known cause. Some may be developmentally influenced by a person's genetic makeup. Many patients develop cancer due to a combination of these factors. Although it is often difficult or impossible to determine the initiating event(s) that cause a cancer to develop in a specific person, research has provided clinicians with a number of likely causes that alone or in concert with other causes, are the likely candidates for initiating cancer. The following is a listing of major causes and is not all-inclusive as specific causes are routinely added as research advances:

Chemical or toxic compound exposures: Benzene, asbestos, nickel, cadmium, vinyl chloride, benzidine, N-nitrosamines, tobacco or cigarette smoke (contains at least 66 known potential carcinogenic chemicals and toxins), and aflatoxin

Ionizing radiation: Uranium, radon, ultraviolet rays from sunlight, radiation from alpha, beta, gamma, and X-ray-emitting sources

Pathogens: Human papillomavirus (HPV), EBV or Epstein-Barr virus, hepatitis viruses B and C, Kaposi's sarcoma-associated herpesvirus (KSHV), Merkel cell polyomavirus, Schistosoma spp., and Helicobacter pylori; other bacteria are being researched as possible agents

Genetics: A number of specific cancers have been linked to human genes and are as follows: breast, ovarian, colorectal, prostate, skin and melanoma; the specific genes and other details are beyond the scope of this general article.

There has been a linked relation between certain dietary lifestyles and cancers, Experts think that about a quarter of all cancer deaths are caused by unhealthy diets and obesity.

Our diet influences our risk of many cancers, including cancers of the bowel, stomach, mouth, food pipe and breast.

You can reduce your cancer risk by eating a healthy, balanced diet that is: high in fibre, fruit and vegetables low in red and processed meat, saturated fat and salt. There several stories on certain specific foods that can prevent cancer, but they may never substitute for healthy and balanced diets.

Fruits are especially good as the chemicals that give fruits their color are good for your health. Meat can be substituted for the healthier beans and pulses, but knowing Kenyans they may opt for healthier cooking methods such as braising or boiling, instead of roasting as this can produce cancer causing chemicals. Processed foods don't help either as they may contain lots of sugar or salt which provides a enabling environ for cancerous cells.

Fatty foods are a can of worms, eat lean cuts of meat, semi-skimmed or skimmed milk, avoiding oil when cooking is advisable, or light grilling. Try eating more fish instead of red or processed meat. When poached, baked or steamed, it is especially good for you.

What are the signs and symptoms? Most cancers may present with common symptoms as follows, but it is especially important to go for regular screening and check ups.

• Fever (no clear infectious source, recurrent or constant)
• Fatigue (not relived by rest)
• Weight loss (without trying to lose weight)
• Pain (usually persistent)
• Skin changes (coloration, sores that do not heal, white spots in mouth or on tongue, wart changes)
• Change in bowel or bladder functions (including trouble swallowing or constipation)
• Unusual bleeding (mouth, vaginal, and bladder) or discharge
• Persistent cough or change in voice
• Lumps or tissue masses

Many cancers will present with some of the above general symptoms but often have one or more symptoms that are more specific for the cancer type. For example, lung cancer may present with common symptoms of pain, but usually the pain is located in the chest. The patient may have unusual bleeding, but the bleeding usually occurs when the patient coughs. Lung cancer patients often become short of breath, and then become very fatigued.

In the Mount Kenya region, one such hospital that may provide such services as screening and diagnosis is the Outspan hospital, the hospital is able to diagnose for cancers such as, breast cancer, prostrate cancer, cervical cancer, ovarian cancer, stomach cancer, liver cancer, pancreatic cancer and cancer of the uterus. Their rates for screening may range from as low as Kshs 1000 for a pap smear test, this is used to test for cervical cancer, Kshs 2400( between 15^th and 31^st October) for a mammography, this is used to detect for breast cancer.

During diagnosis a physical exam and medical history, especially the history of symptoms, are the first steps in diagnosing cancer. In many instances, the medical caregiver will order a number of tests, most of which will be determined by the type of cancer and where it is suspected to be located in or on the person's body. In addition, most caregivers will order a complete blood count, electrolyte levels and, in some cases, other blood studies that may give additional information (for example, a PSA or prostate specific antigen test may guide the caregiver to do additional tests, such as a prostate biopsy)

The biopsy can provide more than the definitive diagnosis of cancer; it can identify the cancer type (for example, a primary or metastatic type of brain cancer) and the "stage" of the cancerous cells.

How is cancer treated? The treatment for cancer is usually designed by a team of doctors or by the patient's oncologist (an oncologist is a cancer specialist) and is based on the type of cancer and the stage of the cancer. Most treatments are designed specifically for each individual. In some people, diagnosis and treatment may occur at the same time if the cancer is entirely surgically removed when the surgeon removes the tissue for biopsy.

Although patients may obtain a unique treatment protocol for their cancer, most treatments have one or more of the following components: surgery, chemotherapy, radiation therapy, or combination treatments (a combination of two or all three treatments).

Individuals obtain variations of these treatments for cancer. Patients with cancers that cannot be cured (completely removed) by surgery usually will get combination therapy, the composition determined by the cancer type and stage.

Palliative therapy (medical care or treatment used to reduce disease symptoms but unable to cure the patient) utilizes the same treatments described above. It is done with the intent to extend and improve the quality of life of the terminally ill cancer patient. There are many other palliative treatments to reduce symptoms such as pain medications and anti-nausea medications.

The prognosis (outcome) for cancer patients may range from excellent to poor. The prognosis is directly related to both the type and stage of the cancer. For example, many skin cancers can be completely cured by removing the skin cancer tissue; similarly, even a patient with a large tumor may be cured after surgery and other treatments like chemotherapy (note that a cure is often defined by many clinicians as a five-year period with no reoccurrence of the cancer). However, as the cancer type either is or becomes aggressive, with spread to lymph nodes or is metastatic to other organs, the prognosis decreases.

What is chemotherapy? Chemotherapy (also called chemo) is a type of cancer treatment that uses drugs to destroy cancer cells. Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly. But it can also harm healthy cells that divide quickly, such as those that line your mouth and intestines or cause your hair to grow. Damage to healthy cells may cause side effects. Often, side effects get better or go away after chemotherapy is over.

Depending on your type of cancer and how advanced it is chemotherapy can:

• Cure cancer - when chemotherapy destroys cancer cells to the point that your doctor can no longer detect them in your body and they will not grow back.
• Control cancer - when chemotherapy keeps cancer from spreading, slows its growth, or destroys cancer cells that have spread to other parts of your body.
• Ease cancer symptoms (also called palliative care) - when chemotherapy shrinks tumors that are causing pain or pressure.

Sometimes, chemotherapy is used as the only cancer treatment. But more often, you will get chemotherapy along with surgery, radiation therapy, or biological therapy. Chemotherapy can:

• Make a tumor smaller before surgery or radiation therapy. This is called neo-adjuvant chemotherapy.
• Destroy cancer cells that may remain after surgery or radiation therapy. This is called adjuvant chemotherapy.
• Help radiation therapy and biological therapy work well.
• Destroy cancer cells that have come back (recurrent cancer) or spread to other parts of your body (metastatic cancer).

What is radio-therapy? Radiation therapy (also called radiotherapy), high-energy rays are used to damage cancer cells and stop them from growing and dividing. A specialist in radiation therapy is called a radiation oncologist.

Like surgery, radiation therapy is a local treatment; it affects cancer cells only in the treated area. Radiation can come from a machine (external radiation). It can also come from an implant (a small container of radioactive material) placed directly into or near the tumor (internal radiation). Some patients receive both kinds of radiation therapy.

External radiation therapy is usually given on an outpatient basis in a hospital or clinic 5 days a week for a number of weeks. Patients are not radioactive during or after the treatment.

For internal radiation therapy, the patient stays in the hospital for a few days. The implant may be temporary or permanent. Because the level of radiation is highest during the hospital stay, patients may not be able to have visitors or may have visitors only for a short time. Once an implant is removed, there is no radioactivity in the body. The amount of radiation in a permanent implant goes down to a safe level before the patient leaves the hospital.

With radiation therapy, the side effects depend on the treatment dose and the part of the body that is treated. The most common side effects are tiredness, skin reactions (such as a rash or redness, permanent pigmentation, and scarring) in the treated area, and loss of appetite. Radiation therapy can cause inflammation of tissues and organs in and around the body site radiated. This can cause symptoms that depend on what organs are affected and to what degree. For example, radiation can inflame skin to cause a burn or permanent pigmentation. It can also irritate the colon and cause diarrhea. Radiation therapy can also cause a decrease in the number of white blood cells, cells that help protect the body against infection.

Although the side effects of radiation therapy can be unpleasant, they can usually be treated or controlled. It also helps to know that, in most cases, they are not permanent. To a great degree, the possible side effects of radiation therapy depend on the location and the amount of radiation.

Is cancer preventable? The medical field is convinced that many cancers can either be prevented or the risk of developing cancers can be markedly reduced. Some of the methods are simple; others are relatively extreme, depending on an individual's view.

Prevention of cancer, by avoiding its potential causes, is the simplest method. First on most clinicians and researchers list is to stop (or better, never start) smoking tobacco. Avoiding excess sunlight (by decreasing exposure or applying sunscreen) and many of the chemicals and toxins is an excellent way to avoid cancers. Avoiding contact with certain viruses and other pathogens also is likely to prevent some cancers. People who have to work close to cancer-causing agents (chemical workers, X-ray technicians, ionizing radiation researchers) should follow all safety precautions and minimize any exposure to such compounds.

Screening studies for cancer, while they do not prevent cancers, may detect them at an earlier stage when the cancer is more likely to be potentially cured with treatment. Such screening studies are breast exams, testicular exams, colon-rectal exams (colonoscopy), mammography, PSA levels, prostate exams, and others. People who have any suspicion that they may have cancer should discuss their concerns with their doctor as soon as possible. The earlier cancer is disproved or diagnosed and treated, the person will be better served.

People with a genetic predisposition to develop certain cancers and others with a history of cancers in their genetically linked relatives currently cannot change their genetic makeup. However, some individuals who have a high possibility of developing genetically linked cancer have taken actions to prevent cancer development. For example, some young women who have had many family members develop breast cancer have elected to have their breast tissue removed even if they have no symptoms or signs of cancer development to reduce or eliminate the possibility they will develop breast cancer. Some doctors consider this as an extreme measure to prevent cancer while others do not.

In conclusion cancer preventable, treatable and curable, we only have to make good and informed choices when dealing with our bodies.