Understanding Cancer: What It Is, How It Starts, and What You Can Do About It

 

Cancer is one of the most feared diagnoses in Ghana and globally, and much of that fear comes from misunderstanding. Cancer is not a single disease — it is more than 100 different diseases with distinct causes, biological behaviours, treatment responses, and outcomes. Some cancers, when caught early, are almost universally curable. Others are aggressive regardless of stage. Understanding what cancer actually is at the biological level, what causes it, and what the most evidence-based prevention and early detection strategies are, is information that every Ghanaian deserves.

What Is Cancer?

Cancer arises from a failure of the normal controls on cell division. In a healthy body, cells divide in a regulated, purposeful manner — replacing worn-out cells, healing wounds, supporting growth. Cell division is governed by a complex set of genetic programmes: oncogenes (genes that promote cell division), tumour suppressor genes (genes that put the brakes on division), and DNA repair genes (genes that correct replication errors).

Cancer begins when mutations accumulate in these controlling genes within a single cell. A cell with an activated oncogene receives a persistent 'divide' signal. A cell with a damaged tumour suppressor gene loses its 'stop' signal. A cell with impaired DNA repair accumulates errors faster than they can be corrected. When enough mutations accumulate — typically 5–10 key mutations — the cell acquires the hallmarks of cancer: uncontrolled proliferation, resistance to cell death (apoptosis), ability to invade surrounding tissues, and eventually the capacity to spread to other organs (metastasis).

Common Cancers in Ghana

Breast Cancer

The most common cancer in Ghanaian women. As discussed in detail elsewhere — screening through breast self-examination, clinical examination, and mammography is the cornerstone of early detection. Triple-negative breast cancer, more common in women of African descent, requires aggressive chemotherapy and presents management challenges in Ghana due to limited access to targeted therapy.

Cervical Cancer

Caused by HPV. Entirely preventable through vaccination and screening. A persistently tragic statistic because the tools to prevent it exist and are accessible.

Liver Cancer (Hepatocellular Carcinoma)

Ghana has one of the world's highest incidences. The major risk factors — chronic Hepatitis B and aflatoxin exposure — are both preventable and manageable. HBV vaccination, antiviral therapy for chronic HBV, and reducing aflatoxin exposure in the food supply are the primary prevention strategies. Regular ultrasound and AFP monitoring in known HBV carriers is the early detection strategy.

Prostate Cancer

The most common cancer in Ghanaian men. As discussed in the PSA post — PSA screening from age 40–45 in men of African descent is strongly recommended.

Colorectal Cancer

Rising in Ghana with the nutrition transition. Colorectal cancer has a long pre-cancerous phase (polyps) that can be detected and removed by colonoscopy before cancer develops. Family history, obesity, low-fibre high-fat diet, and physical inactivity are the primary risk factors. Screening colonoscopy from age 50 (or 40–45 with family history) is recommended in high-income countries and should be increasingly available in Ghana's tertiary centres.

Non-Hodgkin Lymphoma

Lymphomas — cancers of the lymphatic system — are among the more common cancers in younger Ghanaians. Burkitt lymphoma, a highly aggressive but chemosensitive lymphoma strongly associated with Epstein-Barr virus and malaria exposure, occurs predominantly in children in sub-Saharan Africa. Early diagnosis and prompt initiation of chemotherapy can be curative.

The Role of Blood Tests in Cancer

Tumour Markers

Tumour markers are proteins produced by cancer cells (or by normal cells in response to cancer) that appear in blood. They include AFP (liver cancer, testicular cancer), PSA (prostate cancer), CEA (colorectal, lung cancer), CA-125 (ovarian cancer), CA 15-3 (breast cancer monitoring), and many others. An important caveat: most tumour markers are not suitable for population-level screening because they lack sufficient sensitivity and specificity. They are most useful for monitoring known cancer during and after treatment — a rising marker after treatment can indicate recurrence before it is clinically apparent. Their appropriate use requires clinical context.

Full Blood Count in Haematological Cancers

Leukaemia — cancer of the blood cells — is often first detected through a CBC. A very high white blood cell count, particularly with abnormal cell morphology on peripheral blood film, raises the immediate possibility of leukaemia. Lymphoma can cause anaemia, elevated LDH, and abnormal lymphocyte counts. Any CBC with significantly abnormal white cell count and morphology should be reviewed by a haematologist.

Cancer Prevention: What the Evidence Actually Supports

• Vaccination: HPV vaccine (cervical cancer), Hepatitis B vaccine (liver cancer) — these are among the most powerful and direct cancer-prevention interventions available

• Tobacco cessation: Smoking causes at least 15 different types of cancer. It remains the most preventable cause of cancer death globally.

• Alcohol reduction: Causally linked to cancers of the mouth, oesophagus, liver, colorectum, and breast

• Maintaining healthy weight: Obesity is a risk factor for at least 13 cancer types through inflammatory and hormonal mechanisms

• Regular physical activity: Independently reduces risk of breast, colorectal, and endometrial cancer

• Diet: High fibre, high fruit and vegetable intake with limited red and processed meat reduces colorectal cancer risk

• Sun protection: Though less of a concern in Ghana than in lighter-skinned populations, reducing excessive UV exposure prevents skin cancer

�� Cancer prevention is not passive. Vaccination, screening, and lifestyle modification are active choices that meaningfully reduce your personal cancer risk. Make them deliberately.

�� Get instant interpretation of your lab results — visit https://VincentAkwas.github.io/lablens — free, detailed clinical commentary for every value.