Social Services focuses on increased public awareness of the second biggest cyause of death in Bermuda.

Despite the sobering statistic, there is a great deal of unnecessary fear surrounding this disease. Far too many people believe cancer is synonymous with death whereas, of all the chronic diseases, cancer is the most curable.

Today, research shows that nearly half of all cancer patients are cured by modern treatment methods, thanks to the great advances medical science has made in preventing, detecting and treating the disease.

Just what is cancer anyway? Specifically, it is a group of diseases in which abnormal cells grow out of control and can spread throughout the body.

Normal body cells reproduce in an orderly fashion. With expanding and renewing cells, just enough new cells grow to replace the old ones.

Cancer cells most closely resemble renewing cells, but they don't stop dividing. Instead, the cells grow in an uncontrolled pattern. There are over 100 various types of cells in the body, each type designed for a certain function. All of these types of cells are subject to uncontrolled cell reproduction -- cancer.

Groups of cells which divide too much and form in masses within organs are called tumours, which can either be benign or malignant.

Benign tumours may interfere with body functions and require surgical removal but they do not spread to other parts of the body. Malignant tumours, on the other hand, invade and destroy normal tissue. Unlike the cells in benign tumours, cells from malignant tumours can break away from the original and travel to other parts of the body through the blood or lymph system. This process is known as metastasis.

The spread of cancer may be confined to one organ, or travel far from the original tumour. Distant spread is usually associated with lower survival rates, which is why early detection and proper treatment -- before the cancer has spread -- is essential.

Not all cancers are solid tumours. For example, cancer cells of the blood (leukemia) and the lymph system (lymphoma) are called generalised cancers, and do not form tumours.

While cancer may strike any part of the body, the Department of Health, Welfare and Social Services is particularly anxious to focus on five types: breast, lung, colon, prostate and skin.

No one knows for sure how a normal cell becomes a cancer cell, but scientists agree that people get cancer mainly through repeated or long-term contact with one or more cancer-causing agents, known as carcinogens. It is these which cause body cells to change their structures and grow out of control.

Scientists now believe that most cancers are caused in two steps by two kinds of agents: initiators and promoters. Initiators start the damage to a cell that can lead to cancer. Cigarette smoking is an initiator, certain chemicals are others.

Cancer risk factors are agents which have been linked to the cause of a particular kind of cancer. There are both "avoidable'' and "unavoidable'' risk factors, and "known'' and "suspected'' risk factors.

Not all risk factors are equal, however. Tobacco is the most important, and some risk factors, when combined, are greater -- such as smoking and heavy drinking.

It is avoidable and known risk factors which the Department wishes to bring to the public's attention in its June campaign.

"We want people to know what the risks are, and what steps they can take to reduce them,'' Government health co-ordinator, Mrs. Ivena Laurenceo, explained.

Here's what you can do to take control of a healthier life and reduce the risk of cancer: DIET Risk factors: A high intake of dietary fat, obesity.

Applicable body areas: Colon, mouth, throat, gullet, liver.

To reduce risk: Eat a well balanced diet containing a variety of foods every day. This will help keep weight at correct level. To lose weight increase physical activity, eat smaller portions, eat less sugar and sweets.

Include in your daily diet: fresh fruits and vegetables, especially those high in vitamins A and C, such as oranges, grapefruit, nectarines, peaches, strawberries, cantaloupe, honeydew melon. Choose leafy green and yellow-orange vegetables such as spinach, kale, sweet potatoes, carrots, cauliflower, broccoli, Brussels sprouts.

Keep intake of all fats low, both saturated and unsaturated. Choose lean red meats, fish, poultry. Trim fat from steaks, roasts and chops; skin poultry before cooking. Broil, roast or bake meats and fish or simmer them in their own juices, rather than frying.

Limit use of butter, margarine, cream, shortening, vegetable oils. Avoid hidden fats in salad dressings and snack foods like potato chips. Choose low fat skim milk, low fat cheeses and dairy desserts. Choose fruit instead of high fat desserts.

Eat foods with fibre (roughage), such as whole grain breads and cereals; a variety of raw fruits and vegetables, eaten with the skin on; beans, peas, seeds.

TOBACCO Applicable body areas: Mouth, throat, gullet, bladder, pancreas, lungs.

Risk factor: Tobacco smoke, primary or secondary, chewing tobacco, snuff.

To reduce risk: Stop smoking. Non-smokers should pressure employers, MPs, and all other appropriate authorities to protect them from the proven lethal risk of lung cancer through inhaling secondary smoke. Clean indoor air is a right.

ALCOHOL Applicable body areas: Mouth, throat, gullet, liver.

Risk factors: Heavy drinking. In addition, researchers have discovered that a combination of drinking and smoking does the most damage.

To reduce risk: Limit alcohol to one or two drinks per day.

THE SUN Applicable body area: Skin. Those most at risk are Caucasians who have had melanoma (skin cancer) or whose parent, child or sibling has had melanoma; those with very fair skin who sunburn easily or who have more than several dozen moles.

Risk factor: Ultra-violet rays.

What to look for: Flat lesions showing: asymmetry, in which one half of the mark does not match the other; border irregularity, with a scalloped or poorly defined edge; colour variance between areas of the mark, with shades of tan and brown, black and sometimes white, red or blue; diameter larger than a pencil eraser. Also, any mole which starts growing or changes in appearance should be checked by a doctor.

To reduce risk: Avoid excessive sun exposure, especially between 10 a.m. and 3 p.m. and slip, slop, slap: Slip on a top, slop on sunscreen lotion or cream, slap on a hat. Sunscreens block out the harmful ultra-violet rays. To be effective, they must be applied generously and re-applied every two hours, especially when doing outdoor exercise. Use sunscreen with minimum protection factor of 15.

Examine skin over entire body, including between toes, back of neck, soles of feet for evidence of melanoma (skin cancer).

In addition to adopting a healthier lifestyle, there are other measures which can be taken to reduce the risk of other cancers.

BREASTS Breast cancer is the most common form of cancer in women. Early detection offers the chance of a complete cure.

What to look for: Any change in the size of either breast or either nipple; bleeding or discharge from either nipple; unusual puckering or dimple on the breast or nipple; veins standing out more than is usual for you.

What to do: (a) Self-examination -- examine breasts regularly -- at least once a month, preferably just after a period. If you no longer have periods, choose same date each month for examination. Doctors and clinics will provide information on how to conduct a proper self-examination. Report anything unusual to your doctor immediately.

(b) Have a mammogram. Mammography (baseline breast x-ray) can detect a change in breast tissue long before a woman can feel or notice anything unusual, or before she feels unwell. Recommended frequency is: one mammogram for women between ages 30 to 39; one every two to three years, as recommended, for ages 40-49; one a year after age 50.

UTERUS AND CERVIX Uterus: Hae pelvic examination by doctor every three years.

Cervix: Have a Pap test (smear). Performed by a doctor, this involves inserting narrow wooden spatula through the vagina to obtain cell samples from the cervix. Smear is sent to laboratory for examination. Procedure is painless.

Sexually active women aged 18 and over should have Pap test annually for at least two years then, if tests are normal, doctor may suggest an interval of two to three years until age 35, after which it should be annual until doctor feels test is no longer necessary.

TESTICLES With early detection, testicular cancer is one of the most curable forms. It can affect males from infancy through old age, though it occurs mostly between ages 15 and 35, particularly the 20-34 age group.

Self-examination right after a hot bath or shower is best. Examinations should be done monthly.

What to look for: Any thickening or lump, however small (even pea size).

What to do: Place index and middle fingers on testicle underside, thumbs on top. Gently roll testicle between thumb and fingers. Normal testicle feels slightly soft with even consistency and smooth surface. Examine both testicles. Report any abnormality to your doctor promptly.

PROSTATE Prostate cancer is a common form of cancer in men. Cause unknown, but evidence suggests diet may play an important role in its development.

What to look for: Since cancer symptoms are similar to those of benign prostate hyperplasia (prostate enlargement) in men over 40, they can be confused, so examination by a doctor is important. Symptoms of both include: difficulty in urinating, frequent urination, incomplete emptying or obstruction of the bladder or dribbling of urine due to enlarged prostate putting pressure on the urethra (duct from which urine flows).

What to do: Apart from medical examinations, follow a healthy diet (see above).

COLON AND RECTUM What to do: Have annual digital rectal examination by doctor once a year; stool slide test every year after 50; procto examination as follows: after two negative tests, then tests one year apart. This examination can also detect prostate irregularity.

Remember, all of the above guidelines apply to people without symptoms. If you have any of the following cancer warning signals, see your doctor immediately: Change in bowel or bladder habits.

Sore throat that does not heal.

Unusual bleeding or discharge.

Thickening or lump in breast or elsewhere.

Indigestion or difficulty in swallowing.

Obvious change in wart or mole.

Nagging cough or hoarseness.

Free literature on cancer, prepared by the Ministry of Health, Social Services & Housing, is available at all libraries, the General Post Office, and the health centres on Victoria Street, St. George's and Somerset throughout this month.

BREAST CANCER -- It is the most common form of cancer in females. Mammograms, in which the breast is X-rayed with a special machine, can spot trouble long before a lump is felt. As these photographs of the same patient show, the mammograph on the right produces a much sharper image.