Cancer is an abnormal growth of cells caused by multiple changes in gene expression leading to deregulated balance of cell proliferation and cell death and ultimately evolving into a population of cells that can invade tissues and metastasize to distant sites, causing significant morbidity and, if untreated, death of the host. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected. Cancers are caused by exogenous chemical, physical, or biological carcinogens.
Although cancer can occur at any age, it is usually considered as a disease of aging. The average age at the time of diagnosis for cancer of all sites is 67 years, and about 76% of all cancers are diagnosed at age 55 or older. Although cancer is relatively rare in children, it is the second leading cause of death in children ages 1–14. In this age group leukemia is the most common cause of death. Thus even though the overall death rates due to cancer have almost tripled since 1930 for men and gone up over 50% for women, the age-adjusted cancer death rates in men have only increased 54% in men and not at all for women. World Health Organization (WHO) estimates that some 84 million people will die of cancer between 2005 and 2015 around the world. In 2007, there were 7.9 million deaths from cancer, around 13 percent of all deaths.
Cancer Epidemiology in Bangladesh
Like many other countries in the world cancer in Bangladesh is one of the major killer diseases. The National Institute of Cancer Research and Hospital (NICRH), Dhaka, started a cancer registry in 2005 for the first time in Bangladesh with technical assistance from the World Health Organization (WHO). This report covers three years from 2005 to 2007. Data were collected from 24,847 cancer patients who attended the NICRH for the first time. Essential information (confirmed diagnosis) could be made available for 18,829 cases, and they are included in this analysis. Among them 10,847 (57.6%) were males. Lung cancer was the leading cancer (17.3%), followed by cancers of breast (12.3%), lymph nodes and lymphatics (8.4%) and cervix (8.4%) for sexes combined in all ages. In males lung (25.5%) and in females breast (25.6%) and cervical (21.5%) cancers were predominant. In children aged 14 years or younger (n=657) lymphoma, retinoblastoma, osteosarcoma, leukaemia and kidney cancers were most prevalent. Lung cancer in males, and cervical and breast cancer in females constitute 38% of all cancers in Bangladesh (Cancer registry report 2005-2007). According to the latest WHO data published in April 2011 Oral Cancer Deaths in Bangladesh reached 11,562 or 1.21% of total deaths. The age adjusted Death Rate is 12.52 per 100,000 of population ranks Bangladesh #4 in the world. At present, there are one million (10 lakh) cancer patients in Bangladesh while approximately 200,000 new patients, mostly women, are added every year creating a social burden on the country. The country’s women are now in danger of being affected by cervical cancer, one of the sexually transmitted diseases that claim the life of 18 women every day in the country for lack of awareness.
Alternative or Complimentary Medicine against Cancer
Various plants have been used against cancer in folk traditional medicine of Bangladesh. Traditional medicinal knowledge has been a means towards the discovery of many modern medicines (Cotton, C.M., 1996). Bangladesh has a rich history of several traditional medicinal systems, among whom the most notable ones are the Ayurvedic, Unani, and the folk medicinal systems. Folk medicine is practiced by Kavirajes who utilize simple formulations of medicinal plants in most of their preparations. Recently World Health Organization has shown great interest in documenting the use of medicinal plants used by tribes from different parts of the world. Many developing countries have intensified their efforts in documenting the ethno medical data and scientific research on medicinal plants. Natural products or natural product derivatives comprised 14 of the top 35 drugs in 2000 based on worldwide sales (Butlet, 2004). Two plant derived natural products, paclitaxel and camptothecin were estimated to account for nearly one-third of the global anticancer market or about $3 billion of $9 billion in total annually in 2002 (Oberlines and Kroll, 2004). Several anticancer agents including taxol, vinblastine, vincristine, the camptothecin derivatives, topotecan and irinotecan, and etoposide derived from epipodophyllotoxin (Epipodophyllotoxins are alkaloids naturally occurring in the root of American Mayapple plant (Podophyllum peltatum) and currently used in the treatment of cancer) are in clinical use all over the world. There are more than 270,000 higher plants existing on this planet. But only a small portion has been explored phytochemically. So, it is anticipated that plants can provide potential bioactive compounds for the development of new ‘leads’ to combat cancer diseases.
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