NON COMMUNICABLE DISEASES( NCDs)

1. NON COMMUNICABLE DISEASES( NCDs) By NSABIMANA Olivier Philemon, B.Pharm. ASEPA / UNR From 19/4-3/5 /2014

2. UnderstandingCANCER

3. What Is Cancer? • Cancer is a large group of diseases (over 200) characterized by uncontrolled growth and spread of abnormal cells.* *American Cancer Society, Cancer Facts and Figures 2005

4. Cancer • The division of normal cells is precisely controlled. New cells are only formed for growth or to replace dead ones. • Cancerous cells divide repeatedly out of control even though they are not needed, they crowd out other normal cells and function abnormally. They can also destroy the correct functioning of major organs. • Cell ;Tissue; organ; system; Body

5. What causes cancer? • Cancer arises from the mutation of a normal gene. • Mutated genes that cause cancer are called oncogenes. • It is thought that several mutations need to occur to give rise to cancer • Cells that are old or not functioning properly normally self destruct and are replaced by new cells. • However, cancerous cells do not self destruct and continue to divide rapidly producing millions of new cancerous cells.

6. What Causes Cancer? Family History Lifestyle Environment

7. Etiology • The etiology of cancer is multifactorial, with genetic, environmental, medical, and lifestylefactors interacting to produce a given malignancy. • Most cancer is caused by genetic mutationsoften, by a series of mutations.

8. Example Carcinogens) • Ionising radiation – X Rays, UV light • Chemicals – tar from cigarettes • Virus infection – papilloma virus can be responsible for cervical cancer. • Hereditary predisposition – Some families are more susceptible to getting certain cancers. Remember you can’t inherit cancer its just that you maybe more susceptible to getting it.

9. Types of Cancers • Carcinomas (cells that cover internal and external body surfaces) Leukemia (Blood Cells) Lung Lymphomas (Lymph nodes &tissues) Breast Colon Bladder Sarcomas Cells in supportive tissues – bones & muscles Prostate (Men)

10. Signs and Symptoms of Cancer • Sores that do not heal • Unusual bleeding or discharge • Lumps or thickening of breast or other parts of the body • Indigestion or difficulty swallowing • Recent change in wart or mole • Persistent coughing or hoarseness • Change in bowel habits or bladder functions

11. Risk Factors • Oldage • Unhealthylifestyle(Western lifestyle),Poor diet, lack of physical activity, or being overweight. • Environmentalfactors, defined broadly to include tobacco use, diet, sunlight and infectious diseases. • Occupational carcinogens • Radiation • Family historyof cancer (Genetic susceptibility) • Alcohol • Chemicalsand other substance

12. CAUSES – BARBEQUED FOOD • HIGH FAT AND HIGH PROTEIN FOOD WHEN GRILLED AT HIGH TEMPARATURE PRODUCES A CHEMICAL KNOWN TO BE HAVING CARCINOGENIC EFFECT • HIGHLY BROWN AND CHARRED FOOD HAS CANCER CAUSING COMPOUNDS

13. CAUSES - POLLUTION • AIR POLLUTION – MAY ALSO CAUSE CANCER (ASBESTOS) • INDUSTRIAL WORKERS ARE EXPOSED TO VARIOUS CHEMICALS WHICH ARE KNOWN TO BE CARCINOGEN

14. CAUSES – WATER POLLUTION • WATER MAY CONTAIN A NUMBER OF CANCER CAUSING SUBSTANCE AS THE INDUSTRIES DUMP CHEMICAL DIRECTLY INTO WATER OR BURRY THEM IN THE GROUND

15. CAUSES – X-RAY • X-RAYS MAY STIMULATE THE DEVELOPMENT OF CANCER • REPEATED X-RAYS SHOULD BE AVOIDED • X-RAY DONE ON PREGNANT WOMEN MAY INCREASE THE FREQUENCY OF CHILDHOOD CANCER

16. CAUSES - ALCOHOL • ALCOHOL CONSUMPTION LEADS TO CANCER OF ORAL CAVITY, PHARYNX, LARYNX, ESOPHAGUS, STOMACH, LIVER • PEOPLE WHO DRINK ALSO SMOKES FURTHER INCREASING THE RISK OF DEVELOPING CANCER

17. Lifestyle Risks • Smoking • Diet high fat and low in fruits and vegetables • Lack of exercise • Unprotected exposure to the sun, (UV) rays • Obesity

18. Environmental Risks • Second hand smoke • Air pollution • Industrial pollution • Chemical exposures

19. Avoidable Cancer Risk • Having a healthy diet, being physically active, and maintaining a healthy weight may help reduce cancer risk. • Eat well:A healthy diet includes plenty of foods that are high in fiber, vitamins, and minerals. This includes whole-grain breads and cereals and 5 to 9 servings of fruits and vegetables every day. Also, a healthy diet means limiting foods high in fat (such as butter, whole milk, fried foods, and red meat.

20. Prevention • Primary prevention:avoidance of exposure to cancer-causing agents (e.g. tobacco, industrial carcinogens, etc….). • Early detection of cancer: education to promote early diagnosis and screening (Imaging diagnosis and laboratory tests,…) • Genetic testing: these tests can check for certain inherited gene changes that increase the chance of developing cancer.

21. Fruits and Vegetables Decrease Cancer Risks • Cancer rates could decline by up to 20% if everyone consumed 5 fruits and vegetables a day!* • Cancer fighting substances: • Antioxidants • Dietary fiber • Carotenoids • Flavenoids *American Institute for Cancer Research, 1998.

22. Limit Alcohol to No More Than • Men – 2 drinks per day • Women - 1 drink per day

23. Reduce Your Skin Exposure to the Sun • Limit time outside, between 10 a.m. & 4 p.m. • Wear protective clothing. Use wide-brimmed hats and sunglasses. • Prevent sunburns, especially for children under 18. Use waterproof sunscreen of SPF 15 or higher. Reapply as directed. • Avoid tanning beds.

24. Be Active…Often • Exercise for 30 minutes or more at least 4 days a week.