الرحيم الرحمن الله الرحيم بسم الرحمن الله بسم

CANCERCANCER

Cancer is a group of diseases! It can Cancer is a group of diseases! It can occur at any site or tissue of the occur at any site or tissue of the body, may involve any type of cells . body, may involve any type of cells .

Three main reasons are:Three main reasons are:

i Being a longer life expectancy,i Being a longer life expectancy,

ii More accurate diagnosis,ii More accurate diagnosis,

iii The rise in cigarette smoking, iii The rise in cigarette smoking,

especially among malesespecially among males

Characteristics of cancerCharacteristics of cancer

A cancer is characterised by an :A cancer is characterised by an :

(i) abnormal growth of cells (i) abnormal growth of cells

(ii) ability to invade adjacent tissues and(ii) ability to invade adjacent tissues and

even distant organs,even distant organs,

(iii) (iii) eventual death of the affected patient if eventual death of the affected patient if

that tumour has progressed beyond the that tumour has progressed beyond the

stage wherein it can be successfully removed.stage wherein it can be successfully removed.

Categories of cancerCategories of cancer

The major categories of cancer are :The major categories of cancer are : Carcinomas:Carcinomas: which arise from epitheial cells lining the internal which arise from epitheial cells lining the internal

surfaces of the various organs (e.g. mouth, surfaces of the various organs (e.g. mouth, oesophagus, intestines, uterus and from the skin oesophagus, intestines, uterus and from the skin epithelium;epithelium;

Sarcomas:Sarcomas: which arise from mesodermal cells constituting the which arise from mesodermal cells constituting the

various connective tissue;various connective tissue;(e.g. fibrous tissue, fat and bone); (e.g. fibrous tissue, fat and bone);

Lymphomas myeloma and leukaemias:Lymphomas myeloma and leukaemias: arising from the cells of bone marrow and arising from the cells of bone marrow and

immune systems.immune systems.

PREDOMINANT CANCERSPREDOMINANT CANCERS

In malesIn males predominant cancer is lung predominant cancer is lung cancer. Stomach, esophageal and cancer. Stomach, esophageal and bladder cancer are also much more bladder cancer are also much more common in males.common in males.

Among womenAmong women of underdeveloped of underdeveloped countries , the cancers of cervix and countries , the cancers of cervix and breast account for nearly 60 percent breast account for nearly 60 percent of all cancers.of all cancers.

IncidenceIncidence

Approximately, 10 million people are Approximately, 10 million people are diagnosed with cancer and more than 6 diagnosed with cancer and more than 6 million die every year. million die every year.

The most common cancers worldwide are:The most common cancers worldwide are: LLung cancer; 11. 23 % of all cancers.ung cancer; 11. 23 % of all cancers.

Breast cancer 10.4 %.Breast cancer 10.4 %.

Colorectal cancer 9.4 %.Colorectal cancer 9.4 %.

Mostly involved OrgansMostly involved Organs

The two organ sites are most commonly The two organ sites are most commonly involved; involved;

(i) the uterine cervix in women (i) the uterine cervix in women

(ii) the oropharynx in both sexes(ii) the oropharynx in both sexes

ENVIRONMENTAL FACTORSENVIRONMENTAL FACTORS

TOBACCO:TOBACCO: ca. lung, larynx, mouth, pharynx, oesghagus, bladder, ca. lung, larynx, mouth, pharynx, oesghagus, bladder,

pancreas.pancreas. ALCOHOL: ca ALCOHOL: ca esophageal, liver, beer associated with ca rectal. 3% esophageal, liver, beer associated with ca rectal. 3%

of all cancer deaths. of all cancer deaths. DIETARY FACTORS:DIETARY FACTORS: Smoked fish related to ca. stomach, dietary fibers –intestinal, beef - Smoked fish related to ca. stomach, dietary fibers –intestinal, beef -

bowel ca, fat- breast ca.bowel ca, fat- breast ca. OCCUPATIONAL EXPOSURES:OCCUPATIONAL EXPOSURES: Exposure to benzene, arsenic, cadmium, Exposure to benzene, arsenic, cadmium,

chromium, vinyl chloride, polycyclic hydrocarbon and asbestos. 1-5 chromium, vinyl chloride, polycyclic hydrocarbon and asbestos. 1-5 % %

VIRUSES: VIRUSES: Hepatitis B & C -- hepatocellular carcinoma, Kaposi ‘s Hepatitis B & C -- hepatocellular carcinoma, Kaposi ‘s sarcoma -- HIV. HPV -- ca cervix, sarcoma -- HIV. HPV -- ca cervix,

PARASITES. PARASITES. Schistosomiasis -- ca bladder. Schistosomiasis -- ca bladder. Others: sunlight, radiation, air & water pollution, medication – Others: sunlight, radiation, air & water pollution, medication –

estrogen and pesticides.estrogen and pesticides.

ASSOCIATED FACTORS:ASSOCIATED FACTORS:

CUSTOMS, CUSTOMS, HABITS HABITS LIFE –STYLES,LIFE –STYLES,

increase risk of cancer i e smoking increase risk of cancer i e smoking associated with lung cancer and tobacco & associated with lung cancer and tobacco & betel chewing with oral cancer. betel chewing with oral cancer.

GENETIC FACTORSGENETIC FACTORS

There is probably a complex There is probably a complex interrelationship between hereditary interrelationship between hereditary susceptibility and environmental susceptibility and environmental carcinogenic stimuli in the causation of a carcinogenic stimuli in the causation of a number of cancers.number of cancers.

Retinoblastoma occur in children of same Retinoblastoma occur in children of same parent. parent.

Control of cancerControl of cancer

Consist series of measures based on :Consist series of measures based on :Present medical knowledge in the field Present medical knowledge in the field

of prevention, detection, diagnosis, of prevention, detection, diagnosis, treatment, aftercare and treatment, aftercare and rehabilitation.rehabilitation.

The basic aim is to reduce significantly The basic aim is to reduce significantly the number of new cases and reduce the number of new cases and reduce the invalidism due to cancer.the invalidism due to cancer.

It is estimated that at least 1/3 of all It is estimated that at least 1/3 of all cancers are preventable. cancers are preventable.

PRIMARY PREVENTIONPRIMARY PREVENTION

It is concerned with early diagnosis of disease in pre It is concerned with early diagnosis of disease in pre cancerous stage. cancerous stage.

CANCER EDUCATION:CANCER EDUCATION: (a) CONTROL OF TOBACCO AND ALCOHOL CONSUMPTION;(a) CONTROL OF TOBACCO AND ALCOHOL CONSUMPTION;

(b) PERSONAL HYGIENE(b) PERSONAL HYGIENE © Protection from RADIATION:© Protection from RADIATION: (d) OCCUPATIONAL EXPOSURES :(d) OCCUPATIONAL EXPOSURES : (e) IMMUNIZATION :(e) IMMUNIZATION : (f) FOODS, DRUGS AND COSMETICS:(f) FOODS, DRUGS AND COSMETICS: (g) AIR POLLUTION(g) AIR POLLUTION (h) TREATMENT OF PRECANCEROUS LESIONS(h) TREATMENT OF PRECANCEROUS LESIONS (i) LEGISLATION(i) LEGISLATION

PRIMARY PREVENTIONPRIMARY PREVENTION

Danger signals of cancer:Danger signals of cancer: a. a. lump are hard areas in breast.lump are hard areas in breast.

b. Change in wart or mole.b. Change in wart or mole. c. c. persist change in digestive and bowel habits.persist change in digestive and bowel habits.

d. persistence cough or hoarseness.d. persistence cough or hoarseness. e. e. Excessive loss of blood during menstruation / Excessive loss of blood during menstruation /

otherwise.otherwise.

f. Blood loss from any natural orifice.f. Blood loss from any natural orifice.

g. Swelling or sore that does not get better.g. Swelling or sore that does not get better.

h. Unexplained loss of weight. h. Unexplained loss of weight.

SECONDARY PREVENTIONSECONDARY PREVENTION

i) CANCER REGISTRATION:i) CANCER REGISTRATION: (a) HOSPITAL -BASED REGISTRIES:(a) HOSPITAL -BASED REGISTRIES: (b) POPULATION-BASED REGISTRIES(b) POPULATION-BASED REGISTRIES

ii) EARLY DETECTION OF CASES:ii) EARLY DETECTION OF CASES:

Iii) Treatment of cases.Iii) Treatment of cases.

TREATMENTTREATMENT

Treatment facilities should be available to Treatment facilities should be available to all cancer patients.all cancer patients.

Certain forms of cancer are amenable to Certain forms of cancer are amenable to surgical removal, while some others surgical removal, while some others respond favorably to radiation or respond favorably to radiation or chemotherapy or both.chemotherapy or both.

Since most of the known methods of Since most of the known methods of treatment have complementary effect on treatment have complementary effect on the ultimate outcome of the patient, multi-the ultimate outcome of the patient, multi-modality approach to cancer control has modality approach to cancer control has become a standard practice in cancer become a standard practice in cancer centers all over the wordlists.centers all over the wordlists.