On Cancer patients:

From medical mis-diagnosed

to
DISASTER

dr. Noer Faisal Darmi, Sp.B(K)Onk

Who are we?

General practitioner
surgeons
Who are we?

people
The problem WHO 2015

Cancer is a leading cause of death worldwide, accounting for 8.8

million deaths in 2015. The most common causes of cancer death are
cancers of:
Lung (1.69 million deaths)
Liver (788 000 deaths)
Colorectal (774 000 deaths)
Stomach (754 000 deaths)
Breast (571 000 deaths)
65 % of cancer patients get a service on stage
3 dan 4.
This rate is persistent during multi decades.

(RS Dharmais 2017)

Mostly delayed treatment are due to multiple
limited:

Limited of knowledge of patients

Obstacle in culture and believe
Lack of facility
Limited of professional skill
Cell transformation:
Normal cell pre cancerous cancer
Interaction a person's genetic factors and
external agents, including:

What causes cancer?

physical carcinogens, such as ultraviolet and
ionizing radiation;
chemical carcinogens ; asbestos, tobacco
smoke, aflatoxin (a food contaminant), and
arsenic (a drinking water contaminant);
biological carcinogens; infections viruses,
bacteria, or parasites
Risk factors for cancers
Tobacco use, alcohol use, unhealthy diet, and
physical inactivity
chronic infections; Helicobacter pylori,
Human papillomavirus (HPV), Hepatitis B
virus, Hepatitis C virus, and Epstein-Barr
virus3.
Hepatitis B and C virus and s HPV increase
liver and cervical cancer, respectively.
Modify and avoid risk factors
tobacco use including cigarettes and
smokeless tobacco
being overweight or obese
unhealthy diet with low fruit and vegetable
intake
lack of physical activity
alcohol use
sexually transmitted HPV-infection
infection by hepatitis or other carcinogenic
infections
ionizing and ultraviolet radiation
urban air pollution
indoor smoke from household use of solid
fuels.
How to indentified
malignancy
Group of patients
History of disease
Physical examination
Diagnostic tool
Group of patients; age, sex, area of living
(address)
History of disease:
Current disease history: based on TNM
tumour doubling time
http://radclass.mudr.org/content/doubling-
time-calculation-growth-rate-lesion-or-mass
Familiy history
Major field in oncologic surgery
Breast
Thyroid
Soft tissue
Skin
Intra oral
Lymphatic
Breast
please pay attention to patient age and
growth time of tumor
Thyroid
stressing point is predictive score: AMES etc
Soft tissue tumor: TDT
Intra oral tumor : TDT
Lymphatic: age and distribution of mass