Why did I get cancer when I do not smoke or drink?

Most of my male patients have used tobacco and/or alcohol and it has been blamed for their cancer. But, there are few patients both male and female who did not use the above carcinogens and have had cancer at an early age. They always have this question why did they get it when their friends with all the habits have been spared so far!
Cancer is a complex disease. It results from various factors at interplay. Ageing is the biggest risk factor!

VIRUSES, my dear friends are responsible for many cancers. Different viruses have been implicated in different cancers. HPV virus in carcinoma cervix and head and neck cancers, EBV virus in nasopharyngeal carcinoma, Hepatitis B and C virus in Hepatocellular carcinoma, HSV and HIV in Kaposi's sarcoma. We have vaccine for HPV virus which today is recommended for preventing carcinoma cervix. Who should take it, when they should take it, how many doses are better answered in the following link, Who and When?

Will discuss HPV positive head and neck cancer in the next post.

Tamoxifen 5 years or 10 years?

There is a recent trial result published in Lancet

Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61963-1/fulltext?_eventId=login

If you were a patient diagnosed of early breast cancer and had oestrogen positivity, in all likelihood you were/are taking tamoxifen(some of you may be on letrozole or anastrozole!). Your doctor would have suggested that you need to take this for 5 years. With the results of the above mentioned trial, now you will be recommended to take it for 10 years. Because the results suggest that 10 years of tamoxifen treatment can approximately halve breast cancer mortality during the second decade after diagnosis.

Consistency!

Lot has happened from the time I last wrote here. Significant advancements have happened in few cancers and others promise to catch up. I have had the good fortune of treating patients who have had good, moderate and bad outcomes. They have taught me a lot and i know my learning will never end. It has been a very emotional journey also. Malignancy makes one ponder more about life and death. It can make one philosophical or practical!
The bad part is my inconsistent writing. I am writing as if i have a great audience! Honestly a part of me desires for an audience. For feedback, but first for that i need to consistently post what i assimilate. But most of the writing and compilation is for self! As i read the previous posts i realized their relevance in terms of time and my own understanding.
My proposed way to catch up with myself is to write on each therapy area periodically. All views expressed here are personal and do not constitute medical advice.