Cancers

Characteristic

: A group of diseases characterized by

Abnormal growth of cells Ability to invade adjacent tissues and even distant organs The eventual death of the patient if the tumour has progressed beyond that stage when it can be successfully removed.

Types
Carcinomas Sarcomas Lymphomas ,myeloma, leukamia
Primary tumor Secondary At least one third of the cancers are preventable.

Problem statement
Incidence lung 12.3 % Breast 10.4 % Colorectal 9.4 %

Mortality Lung 17.8% Stomach -10.4 % Liver 8.8%

India
57-79 /100,000 Mouth, oropharynx, oesophagus, stomach, LRT Female 56-91/100,000 Cervix, breast , Mouth, oropharynx, oesophagus, stomach, LRT Time trend second cause of death
Male

Causes

of cancer
factors- 80-90%

Environmental

Tobacco: 90 % Cancers of lung, larynx mouth, pharynx, esophagus, bladder, pancreas, and probably kidneys. Alcohol: 3 % Esophageal and liver Beer with rectal Occupational exposures 1-5 %to carcinogenic agents like benzene, arsenic, cadmium, chromium, etc.

Dietary factors: Smoked fish related to stomach cancer, high fat diet to breast. Dietary fibre intestinal Beef consumption bowel Additive and contaminants intestine

 Viruses: e.g. Hepatitis B and C viruses hepatocellular ca, HIV Kapposis sarcoma NHL, spleen Schistosomiasis bladder. CMV Kapposis sarcoma HPV cervix HTLV Adult T cel leu/ lymphoma
Schistosomiasis bladder

 Customs, habits and lifestyles: e.g. Betalnut chewing and oral cancer. Other : sunlight , radiation, air ,water pollution, medication, pesticides

Genetic factors: e.g. Mongols

Cancer control
Primary prevention a. Control of tobacco and alcohol consumption b. Personal hygine c. Reduce the amount of exposure to radiation d. Protection against occupational exposure e. Immunization f. Foods, drugs and cosmetics g. Control of air pollution h. Treatment of precancerous lesions i. Legislation j. Cancer education

Early warning signs or Danger signals of cancer

1. 2. 3.

4. 5.

6.
7. 8.

a lump or hard area in the breast a change in a wart or mole a persistent change digestive or bowel habits a persistant cough or horseness excessive loss of blood at monthly periods or loss of blood outside usual dates blood loss from any natural orifice a swelling or sore that does not get better unexplained loss of weight

Secondary prevention
Cancer registration 1. Hospital based registration 2. population based registration Early detection of cases by Cancer Screening Methods such as Mass screening by comprehensive cancer detection examination Mass screening at single sites Selective screening

Importance
preceded by premalignant lesion, removal prevent the subsequent devl Begin as localised lesion high cure 75 % of cancer on accessible body site

Screening Cervical Ca
smear Problems the disease ca in situ invasive ca abnormal smear invasive The test : response rate sensitivity 80%
Pap

Breast ca
BSE Palpation Thermography Mammography very sensitive and specific Exposure to 500 mr compared to 30 mr by Xray High std equipment and radiologist False positive 5-10 case for each ca

Lung ca
Not

recommended :Chest radiography Sputum cytology

Treatment: Multimodality approach. Right of cancer patient freedom from cancer pain