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Understanding Cancer: Types, Causes, Prevention, and Control Methods

This presentation covers important aspects of cancer, focusing on types, causes, prevention strategies, and control methods. It delves into the global burden of cancer, time trends, risk factors, and screening methods for common cancers like cervical, breast, and oral cancer.

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Understanding Cancer: Types, Causes, Prevention, and Control Methods

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  1. Basic information • PowerPoints in Yengage: Community Medicine : III Year MBBS- 2013 Regular • Assignments • Chapters to be covered: • Non-Communicable Diseases (Lecture+Tutorials) • Demography, Family Planning • Preventive medicine in obstetrics, paediatrics, geriatrics • Mental Health • Genetics • Disaster

  2. Cancer Dr. Pracheth R, Department of Community Medicine

  3. Outline • What is cancer ? • Important types • Causes • Prevention • Screening

  4. Definition • Abnormal growth of cells • Invade adjacent tissues, distant organs • Carcinomas: arise-epithelial cells : internal surfaces of organs • Sarcomas: mesodermal cells-connective tissues • Lymphomas, myelomas, leukaemias

  5. Problem Statement: World • 12.7 million people., 7.6 million deaths • Large variation: different regions • Lung cancer: most deaths • Highest : affluent societies

  6. India • 9.4 lakh new cases • Men: lung, oral cavity, pharynx, oesophagus, stomach • Women: cervical, breast • Screening, management: limited

  7. Time trends • Earlier: sixth leading cause death • Second leading cause now • Longer life expectancy • Rise in cigarette smoking

  8. Causes • Environmental: tobacco

  9. Continued…. • Alcohol • Dietary factors • Occupational: benzene, arsenic, cadmium, asbestos • Viruses: Hepatitis B, C, HPV, EBV • Parasites: schistosomiasis-bladder • Lifestyle • Radiation

  10. Continued….. • Genetic: • Retinoblastoma • Leukaemia: Mongols • Difficult to identify

  11. Cancer Control • Primary prevention: • Control of tobacco, alcohol • Personal hygiene • Radiation • Occupational • Immunization • Treat Pre-cancerous lesions • Legislations

  12. Continued…… • Cancer education: motivate-early diagnosis, treatment * • Lump/hard area • Change: wart/mole • Persistent change: bowel, bladder • Persistent cough/hoarseness • Excessive/unexplained bleeding • Sore: does not heal • Unexplained weight loss

  13. Continued…… • Secondary prevention: • Cancer registration:* • Assess magnitude, plan services • Incidence • Time trend • Hospital based • Population based: area

  14. Continued….. • Early detection • Treatment

  15. Cancer screening • Search: unrecognized malignancy-rapidly applied tests • Best possible protection • Pre-malignant lesions • Begin: localized lesions • 75%: accessible body parts

  16. Methods of cancer screening • Mass screening: comprehensive cancer detection examination • Mass screening of single sites • Selective screening

  17. Screening for Cancer Cervix • CA-in-situ: Pap Smear: beginning, every 3 years • Periodic pelvic examination • Visual Inspection: 5% Acetic Acid • With Magnification • Well-defined opaque aceto-white lesions near squamo-columnar junction • Hospital: investigation, management • Colposcopy: same visit • Pap- smear, biopsy: back up

  18. Breast cancer screening • Breast self examination: • Start: 40 years • One fixed day every month

  19. How to perform ?

  20. When to consult a doctor Painless Lump Inverted nipple Skin dimpling Skin changes Nipple discharge Armpit swelling

  21. Continued….. • Palpation by physician • Mammography: yearly starting at 50 years • Most sensitive • Exposure to radiation • Equipment, skills • Biopsy: false positive

  22. Oral Cancer • One of the ten most common cancers • India: 9.8/1 lakh • Males> Females • Epidemiology: • Tobacco: 90%, side of the mouth • Alcohol • Pre-cancerous stage • High-risk group

  23. Continued…. • Cultural: bidi, hookah, snuff • Most common: betel quid: betel leaf, arecanut, lime, tobacco • Mixture (khaini): mouth-small amounts • AP: epidermoid carcinoma of hard palate- reverse smoking cigar (chutta)

  24. Prevention • Primary: education, legislation • Secondary: early detection, surgery, radiotherapy • Primary health workers : link

  25. Cancer cervix • Second most: women • Developing countries: most common: 88% • India: number one killer-women • Disease: Normal epithelium-dysplasia-CA in situ-Invasive cancer • HPV: 90%, multiple partners, personal hygiene, necessary but not sufficient

  26. Risk factors

  27. Continued…. • Age: increases from 25 to 45, falls off • Genital warts: • Prevention and control: • Primary: personal hygiene, education • Secondary: Radical surgery, chemotherapy • Prognosis: depends on stage

  28. Breast cancer • Most frequent cancer: women • Developed, developing • India: 1 lakh new cases; 12%: malignant

  29. Risk factors • Age: 35 and above, bimodal • Suppose under 40: second- three times • Indian: decade earlier • Family history: mother/sister-premenopausal • Parity: Delayed late thirties-high risk • Unmarried

  30. Continued….. • Early menarche, late menopause • Elevated oestrogen, progesterone • Diet: high fat, obesity • High socio-economic status

  31. Prevention • Primary: • Age at menarche increased: reduce obesity, increase physical activity • Diet, weight control • Secondary: • Early diagnosis, treatment • Follow-up: recurrence

  32. Lung cancer • Most common: men • High fatality • India: 58,000 new cases (90% men): 51,000 died

  33. Risk factors • Age and sex: 1/3 deaths below 65 years • Smoking: • Number, age of starting, nicotine, tar content, length of cigarettes • Passive smoking • Tar, carbon monoxide, nicotine • Interfere: myocardial oxygen delivery-CVD • Bidi: more carcinogens

  34. Continued… • Air pollution • Occupational: asbestos, arsenic

  35. Prevention • Primary: • Education • Legislation: COTPA • Smoking cessation • Secondary: • Early detection: chest X-ray, sputum cytology • Less attractive , most expensive

  36. NPCDCS- Cancer component • Launched: 1976 • Integrated: 2010 • Objectives: • Primary: education • Secondary • Tertiary: strengthen institutions

  37. Schemes • Regional Cancer Centre Schemes • Oncology Wing Development Scheme • NGO involvement • IEC activities • Research, training

  38. Services • Diagnostic, surgery, chemotherapy, palliative care • Each district: Rs.1 crore: • Chemotherapy drugs • Facilities: investigation, treatment

  39. Questions • Short essays (3 marks): • Warning signs of cancer • Primordial prevention of cancer • Cancer registries and uses • Early detection of cancer • Screening for cancer cervix • Screening for cancer breast • Passive smoking • Measures to prevent smoking

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