cancer awareness

1. Cancer prevalence and prevention in
India – challenges and opportunities
Dr Rupesh kumar Singh
MCh surgical oncology(TMH, Mumbai)
Consultant oncosurgeon @ SCPMH, Gonda.

2. WHAT IS THE
CANCER ?

3. • Cancer is disease characterized by cells
that
grow and divide without respect to
normol control
invade and destroy adjacent tissues
can spread other part of the body

4. FACTS ABOUT CANCER
1. 70-80% Cancer are detected at late
stage
2. 50% ignorant at early stage
3. Early detection helps in complete
cure of some cancer

5. Burden of thedisease- WORLD
 Cancer isone of theleading causes of morbidityand mortality worldwide,with
approximately14 million new cases in 2020.
 The number of new cases isexpected to riseby about 7 0 % over the next 2
decades .
 Cancer isthesecond leading causeof deathglobally,and was responsible for8.8 million
deaths in 2021 .Globally,nearly 1 in 6 deaths is due to cancer.
 Approximately7 0 % of deaths from canceroccur in low- and middle-income
countries.
 The overall age standardized cancer incidencerateisalmost 2 5 % higher in men than
in women, with ratesof 205 and 165 per100,000, respectively.

6. Burden of thedisease-INDIA
 Caner has become one of the ten leading causes of death in India.
 It is estimated that there are nearly 20 million cancer cases at any given point of
time. 8-9 lakh new cases and 4 lakh deaths occur annually due to cancer.
 Cancer of oral cavity and lungs in males and cervix and breast in females account
for 50% of all cancer deaths in India.
 According to the Global Cancer Observatory (GLOBOCAN) estimates, there were
19.3 million incident cancer cases worldwide for the year 2020 and India ranked third
after China and the United States of America.

7. Estimated age standardized
incidence and mortality
rates, (GLOBOCAN)- INDIA
M ales
Females

8. Estimated projected incidence and mortality
burden of all cancers in Indian men and women to
2035

10. What causes cancer?

11. WHAT CAUSES CANCER?
•
•
Chemical Carcinogens
Substances that cause
DNA mutaions are known
as mutagens
Tobacco smoking is
associated with lung
cancer
Alcohol is associated with
stomach, liver, mouth
cancer
•
•

12. What cuases cancer?
Tobacco(25-30)
Diet and
Obesity(30-35%)
Infections(15-20) Radiation
Stress
Lack of phisical
activity
Environmental
pollution

13. C A N C E R I T C A U S E S A B O U T 13% O F
A L L H U M O N D E A T H S

14. C A N C E R S A R E P R I M A R I L Y A N E N V I R O N M E N T A L
D I S E A S E W I T H 9 0 -9 5 % C A S E S D U E T O L I F E S T Y L E
A N D E N V I R O N M E N T A L F A C T O R S A N D 5 -10 % D U E
T O G E N E T I C S

15. SYMPTOMS
Local Symptoms:
 Unusual lumps or tumor
 Hemorrhage (bleeding)
 Pain and ulceration
 Chronic cough
 Compression of surrounding
 Difficulty in swallowing
 Changes in bowel habits
 Unexplained weight loss

16. Symptoms of metastasis:
Enlarged lymph nodes
Cough, especially blood in cough
Bone pain, fracture of affected bones
Systematic Symptoms:
Weight loss
Poor appetite and severe weight loss
Excessive sweating especially at night
Anemia

17. COMMON CANCER TYPES
1. Head and neck cancer
•Tobacco and betel nut
•Chronic denture irritatation
•HPV and EBV infection
2. Breast cancer
• Age, family history
• Nulliparous
• Estrogen, High fat
3. Ovarian Cancer
•Family history/genetics BRCA 1/2
•Diet heavy in fat, estrogen
• Nulliparous
•Post menopausal

18. 4.Colorectal Cancer
•family history
•low fiber diet
•history of rectal polyps
5.Skin Cancer
•Excessive exposure
•Fair complexion
•Work with coal, tar
6.Stomach Cancer
•Family history
•Diet heavy in smoked, picked or
salted foods
• Smoking
•H. pylori infection

19. 4.Esophageal Cancer
•heavy alcohol comsumption
•smoking
5.Prostate Cancer
•increasing of age
•family history
•diet high in animal fat
6.Lung Cancer
•cigarette smoking
•asbestos, arsenic and radon exposure
•Second hand smoke

20. Challenges
Cancer in India is emerging as a major cause of morbidity and mortality. Some of the
key features include young age (generally one decade younger compared to the
western population), advanced disease, poor performance status and possibly more
aggressive phenotype.
While many tertiary cancer centres have state of the art diagnostic workup and
treatment protocols, this is yet to reach to a standard level in many other regional
cancer centres and hospital in smaller towns.

21. Challenges
After cardiac diseases, cancer has emerged as an important cause of morbidity and
mortality in India.
Geographical variations - Higher incidence of gallbladder cancer in north India and NE
region compared to other parts, higher incidence of stomach cancer in south india,
oesophagus cancer in Kashmir and NE region (environmental, diet, lifestyle and
genetic factors).
Tobacco associated with Nearly 50 per cent of cancers in males and 15 per cent in
females. E. g. head and neck, lung and esophagus), pancreas and renal and urinary
bladder.

22. Challenges
Almost 75-80 per cent of patients have advanced disease (Stage 3-4) at the time of diagnosis
due to 
1. Low level of awareness in population and community physician
2. Lack of screening programmes, lack of diagnostic facilities locally
3. Vast distances to travel to reach a major tertiary cancer centre
4. Financial constraints and stigma associated with the diagnosis
The situation is even worse in rural areas (69% of total population) where patients and
families have to travel a long distance to reach a tertiary care oncology centre. Lack of
place to stay, long time taken for investigations, limited finances, language and
cultural differences are also some of the limitation

23. Challenges

24. PREVENTION AND DEFECTION
MEASURES
There are four principal
approaches to cancer control:
1. Prevention
2. Early Detection
3. Diagnosis and Treatment
4. Palliative Care

25. PREVENTION AND DEFECTION
MEASURES
1.Promotion Cancer
Awareness
Change in bowel habit
Any ulcer that does not heals
Unusual bleeding or discgarge
Thickening or lump in breast
Indigestion
Obvious change in wart mole
Nagging cough or hoarseness

26. 1. Promoting risk factors awareness
2. Promoting healty life style
3. Limitig alcohol consumption
4. Hepa B virus infant
vaccination
5
. Changing risk behaviors
6. Teaching skills for early detection programs

27. • Treatment of cases detected in these screening
camps
1
• Screening for precursors/early stages of cervix,
breast and oral cancer among women, and oral
cancer among men; and
2
• Creating health awareness about all cancers in
general and specifically about oral, breast and
cervical cancers;
3

28. Surgery
Chemotherapy
Radiation Therapy
Biologic andTargeted Therapy

29. Conclussion
1. Cancer in India is emerging as a major cause of
morbidity and mortality. Some of the key
features include young age (generally one
decade younger compared to the western
population), advanced disease, poor
performance status and possibly more
aggressive phenotype.
2. A planned and teamwork approach at the
community level and collaboration with
different organization will help in early diagnosis
and management of this deadly disease.

30. At SCPM HOSPITAL
1. Dedicated oncology ward
2. Separate State of Art operation theatre
3. Day care chemotherapy facility
4. Trained and dedicated nurses and support staff
5. Palliative treatment for terminally ill patients
6. Financial support for poor patients through CM fund.
7. Separate window for Ayushman Card holder

31. Thank you !!!