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بسم هللا الرحمن الرحيم CANCER Cancer is a group of diseases! It can occur at any site or tissue of the body, may involve any type of cells . Three main reasons are: i Being a longer life expectancy, ii More accurate diagnosis, iii The rise in cigarette smoking, especially among males Characteristics of cancer A cancer is characterised by an : (i) abnormal growth of cells (ii) ability to invade adjacent tissues and even distant organs, (iii) eventual death of the affected patient if that tumour has progressed beyond the stage wherein it can be successfully removed. Categories of cancer The major categories of cancer are : Carcinomas: which arise from epitheial cells lining the internal surfaces of the various organs (e.g. mouth, oesophagus, intestines, uterus and from the skin epithelium; Sarcomas: which arise from mesodermal cells constituting the various connective tissue; (e.g. fibrous tissue, fat and bone); Lymphomas myeloma and leukaemias: arising from the cells of bone marrow and immune systems. PREDOMINANT CANCERS In males predominant cancer is lung cancer. Stomach, esophageal and bladder cancer are also much more common in males. Among women of underdeveloped countries , the cancers of cervix and breast account for nearly 60 percent of all cancers. Incidence Approximately, 10 million people are diagnosed with cancer and more than 6 million die every year. The most common cancers worldwide are: Lung cancer; 11. 23 % of all cancers. Breast cancer 10.4 %. Colorectal cancer 9.4 %. Mostly involved Organs The two organ sites are most commonly involved; (i) the uterine cervix in women (ii) the oropharynx in both sexes ENVIRONMENTAL FACTORS TOBACCO: ca. lung, larynx, mouth, pharynx, oesghagus, bladder, pancreas. ALCOHOL: ca esophageal, liver, beer associated with ca rectal. 3% of all cancer deaths. DIETARY FACTORS: Smoked fish related to ca. stomach, dietary fibers – intestinal, beef - bowel ca, fat- breast ca. OCCUPATIONAL EXPOSURES: Exposure to benzene, arsenic, cadmium, chromium, vinyl chloride, polycyclic hydrocarbon and asbestos. 1-5 % VIRUSES: Hepatitis B & C -- hepatocellular carcinoma, Kaposi ‘s sarcoma -- HIV. HPV -- ca cervix, PARASITES. Schistosomiasis -- ca bladder. ASSOCIATED FACTORS: CUSTOMS, HABITS LIFE –STYLES, increase risk of cancer i e smoking associated with lung cancer and tobacco & betel chewing with oral cancer. GENETIC FACTORS There is probably a complex interrelationship between hereditary susceptibility and environmental carcinogenic stimuli in the causation of a number of cancers. Retinoblastoma occur in children of same parent. Control of cancer Consist series of measures based on : Present medical knowledge in the field of prevention, detection, diagnosis, treatment, aftercare and rehabilitation. The basic aim is to reduce significantly the number of new cases and reduce the invalidism due to cancer. It is estimated that at least 1/3 of all cancers are preventable. PRIMARY PREVENTION It is concerned with early diagnosis of disease in pre cancerous stage. CANCER EDUCATION: (a) CONTROL OF TOBACCO AND ALCOHOL CONSUMPTION; (b) © (d) (e) (f) (g) (h) (i) PERSONAL HYGIENE Protection from RADIATION: OCCUPATIONAL EXPOSURES : IMMUNIZATION : FOODS, DRUGS AND COSMETICS: AIR POLLUTION TREATMENT OF PRECANCEROUS LESIONS LEGISLATION PRIMARY PREVENTION Danger signals of cancer: a. lump are hard areas in breast. b. Change in wart or mole. c. persist change in digestive and bowel habits. d. persistence cough or hoarseness. e. Excessive loss of blood during menstruation / otherwise. f. Blood loss from any natural orifice. g. Swelling or sore that does not get better. h. Unexplained loss of weight. SECONDARY PREVENTION i) CANCER REGISTRATION: (a) HOSPITAL -BASED REGISTRIES: (b) POPULATION-BASED REGISTRIES ii) EARLY DETECTION OF CASES: Iii) Treatment of cases. TREATMENT Treatment facilities should be available to all cancer patients. Certain forms of cancer are amenable to surgical removal, while some others respond favorably to radiation or chemotherapy or both. Since most of the known methods of treatment have complementary effect on the ultimate outcome of the patient, multi-modality approach to cancer control has become a standard practice in cancer centers all over the wordlists.