Cancer, in simple terms, occurs when cells divide in an uncontrolled manner. The human body is made up of different tissues and each tissue has its individual cellular structure. The cells in the tissues are lost through wear and tear and are constantly replaced by a process called cell division. Normally, cells divide - and produce the exact number of cells required - only when the body needs more cells. In cancer, however, cells divide for no apparent reason. In time, they form a mass of extra tissue and become big enough to be noticed as a growth or tumour.

A tumour can be benign - harmless - or malignant - bad. Benign tissues are rarely a threat to life, unless in a major organ. These do not invade the surrounding tissue and do not spread. They can usually be removed and do not come back. But malignant tumours grow into the surrounding tissue in a process called invasion. Cancer cells also break away from a malignant tumour and enter the blood stream or lymphatic system. This is how cancer spreads from the original tumour to other tissues and organs. The spread of cancer is called metastasis.

A periodic health check is a woman's best bet against Cancer. Regular screening tests can detect cancer right in the beginning and intercepting the cancer early, means a more effective cure and a higher survival rate. While it is advisable that everyone go in for screening examinations regularly, this might not always be possible. But this is a must for people in high-risk groups.

Mammograms, breast examinations by a qualified medical professional and breast self-examinations (BSE) play an important role in detecting lumps and tumors early on. All lumps need not be cancerous - the doctor can diagnose cancer either through a biopsy or a cytological examination. A biopsy is done by removing part of the tumor, which is then examined by a pathologist to examine whether it is cancerous or not. In a cytological examination, body fluids are examined for cancer cells.

The Pap smear - also called Pap test - named after Dr. George N. Papanicolau, is the most effective advance warning in cases of cervical cancer. It not only detects cancers early but also spots precancerous conditions. The cells shed by the uterus are found in the vaginal fluid. These cells carry telltale signs of cancer or precancerous conditions. Examining a sample of the vaginal fluid helps identify abnormal cells, if any. In this procedure a few cells are scraped off the cervix, put on a microscope slide, dyed and examined.

Annual pelvic examinations - where the doctor feels the internal sex organs, bladder and rectum for abnormalities - can help spot endometrial cancer.

Once the cancer is detected, a whole lot of tests, like blood tests and X-rays, are done to check out the person's state of health and whether the cancer has spread to other parts of the body. Procedures like isotope scanning give a glimpse of inner organs and the stage of the cancer. Once the details of the cancer have been charted out, the doctor can decide on the right course of treatment.

• Don't smoke cigarettes. Avoid passive smoking, too. Cigarette smoking can cause lung cancer, besides heart disease, stomach ulcers, frequent colds and chronic bronchitis. Don't chew tobacco.

• Avoid alcohol. A woman who has two standard drinks a day (two glasses of wine or two nips of spirit) increases her risk of breast cancer by more than 50 per cent.

• Vary your diet to include foods low in fat and calories to keep you trim. Include fresh fruits, vegetables, sprouts, whole grains, whole grain breads and cereals in your daily diet.

• An apple a day, along with the doctor, could also keep cancer away. Scientists have found that extracts of apple with the skin left on slowed growth of cancer cells of colon and liver. They believe that the phytochemicals could be the cancer-inhibiting factors in the fruit.

• Exercise at least four hours a week. It need not be strenuous activity. Brisk walking is recommended. Being overweight is a risk factor for breast and uterine cancers.

• Excessive intake of fried foods, fat, preserved meat and burnt food could cause cancer.

• Avoid using heated oil over and over again for cooking. Also avoid artificial sweeteners and colouring agents in food. Clean vegetables and fruits thoroughly before use to remove pesticides.

• Personal hygiene is important. Especially oral hygiene, cleanliness of skin and genital hygiene.

• Early marriages and multiple pregnancies can lead to cancer of the uterus. Late first pregnancy may lead to cancer of the uterus or cervix.

• Avoid multiple sex partners.

• Avoid indiscriminate use of drugs. Always check with your doctor before taking medicines.

• Avoid too much sunlight, particularly if you are fairskinned. Wear protective clothing or use effective sunscreens.

• Avoid exposure to X-rays. Go for it only if your doctors recommend one.

• Take estrogens only as long as necessary. Discuss with your doctor about the duration of hormone replacement therapy.

• Onions and garlic have allium which has anticarcinogenic mechanisms.
• Cruiciferous vegetables like cabbage and cauliflower have dithiothiones which inhibits enzymes that activate carcinogens.

Stage II:- Promotion - At this stage, the prolific cells transform into a discernible group.
Role of food: The energy balance must be maintained as it will thwart the expansion of abnormal cells. Selenium and vitamin D have shown a protective effect against tumor promotion.

• Selenium (a mineral) is found in cereals, fish, liver and seafood. It has an antioxidant capacity and functions as a co-factor for glutathione peroxidase, an enzyme that prevents tissue damage.
• Vitamin D is present in milk, yogurt, curd, small fish (when eaten with their bones, like sardines) and egg yolk.

Stage III:- Progression - The local lesion transforms into an invasive tumor mass. There is widespread DNA damage. Ultimately there is metastasis, whereby tumor cells migrate to distant sites in the body.
Role of food: Folates in green, leafy vegetables and wholegrain cereals may help reduce damage to DNA. Fruits and vegetables have carotenoid (pigments) that have antioxidant properties.

• Beta-carotene is found in abundance in spinach, carrots, sweet potatoes and mangoes.

How different foods fight cancer

• Carrots - the antioxidants include alpha-carotene and beta-carotene
• Cauliflower - the indoles promote the production of enzymes that make the hormone estrogen less effective, reducing the risk of breast cancer.
• Tomatoes - the lycopene neutralizes cancer-causing substances. Ten servings a week may help reduce risk of prostate cancer by half.
• Cabbage, turnips - the phytochemical, phenethyl isothiocyanate, hampers the development of lung cancer.
• Ginger - suppresses the creation of adducts, formed by the reaction of chemical carcinogens with DNA.
• Garlic, onions - the allium vegetables contain organosulphides that lower the risk of gastrointestinal cancers.
• Apples - the caffeic acid increases the production of enzymes that make carcinogens more soluble in water and ultimately ejects them from the body.
• Grapes - the ellagic acid is a scavenger of carcinogens.
• Oranges - the terpenes may prevent lung cancer; while beta-cryptoxanthin is an anti-cancer carotenoid.

Food that is detrimental

• Consumption of red meat-beef, pork and lamb could increase the risk of cancer, especially colorectal, pancreatic, breast, colon and renal cancers.
• Fat is another suspect. Indian sweets contain loads of fat and sugar and digesting them produces bile acids which can transform into substances that promote colon canter. It also causes hormones levels to shoot up and increases the growth of breast and prostate cancers. 
• Excessive drinking causes cancer of mouth, throat, oesophagus and liver.

Tips to work fruits and vegetables into your busy schedule

• Put fruits that don't need refrigerating where you can see them. Make a habit of grabbing a few on the way out.
• Keep a bag of your favourite vegetables, cut into sticks, in the freezer. It will last months.
• Keep fruit canned in 100 per cent juice in your kitchen.
• Keep assorted dried fruits like raisins, apricots, peaches, pears, figs and dates, in your desk.
• Keep bottles of fruit juice in the refrigerator instead of aerated drinks.
• Whenever eating out, make it a point to order salads and fruit juice instead of junk food.

• What is my diagnosis?
• What is the stage of my disease?
• What are my options for treatment? Which one do you recommend for me? Why?
• What are chances that the treatment will be successful?
• Would a clinical trial be appropriate for me?
• What are the risks and possible side effects of each treatment?
• How long will treatment last?
• Will I have to change my normal activities?
• What is the treatment likely to cost?