Cancer refers to diseases characterized by abnormal cell growth and the ability to spread. It is caused by changes to DNA that cause cells to stop normal functions and become cancerous. There are many known carcinogens or cancer-causing substances including chemicals, viruses, radiation, alcohol, asbestos and tobacco. Some common cancers in South Africa are urological, gynecological, breast, lung and blood cancers. Screening tests can find cancer early before symptoms when it may be easier to treat. Risk factors include age, family history, habits like smoking and diet, while protecting health through a healthy lifestyle can help reduce cancer risks.

1. CANCER AWARENESS
Dr Phillip Gama
Occupational Medical Practitioner
Foskor Phalaborwa

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What is cancer?
• Cancer refers to any one of a large number of diseases
characterized by the development of abnormal cells that divide
uncontrollably and have the ability to infiltrate and destroy
normal body tissue. Cancer often has the ability to spread
throughout your body.
• Cancer is the second-leading cause of death in the world
• There are different type of malignancies ( cancerous tumours)
and these differ in aggressiveness and severity.

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Causes
• Cancer is caused by changes (mutations) to the DNA within
cells. The DNA inside a cell is packaged into many individual
genes, each of which contains a set of instructions telling the
cell what functions to perform, as well as how to grow and
divide. Errors in the instructions can cause the cell to stop its
normal function and may allow a cell to become cancerous.

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Carcinogens
A carcinogen is any substance or agent capable of causing
cancer.
Types of carcinogens
Researchers divide carcinogens into three main categories. These
include:
• Chemical carcinogens: These are carcinogens that people release
into the environment through pollution, such as car exhaust fumes,
industrial by-products, and cigarette smoke.
• Physical or environmental carcinogens: These carcinogens come
from the environment. UV rays from sunlight and radiation from X-
rays or other radioactive materials are examples of physical
carcinogens.
• Oncogenic viruses: These are viruses that can cause
cancer. Examples include human papillomavirus (HPV), Epstein-
Barr, and hepatitis B.

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Common Carcinogens
Alcohol
• Alcoholic beverages can cause multiple cancers, including oral
cancer, colon cancer, liver cancer, and more.
Asbestos
• Asbestos is known to cause mesothelioma, a type of aggressive
cancer, and stomach, colon, lung, and ovarian cancers.
Engine exhaust
• Diesel exhaust particulates are known carcinogens. Engine exhaust
fumes may cause bladder cancer, but there is inconclusive evidence
for this in humans.
Formaldehyde
• Formaldehyde can cause multiple different types of leukemia.

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Common Carcinogens cont.
Processed meat
• Consuming processed meat is known to increase the risk of cancers of the rectum and colon. It may
also cause stomach cancer.
Radon
• Radon is a radioactive gas that occurs naturally in the environment.
Tobacco
• All tobacco products are carcinogenic. Tobacco smoke and tobacco products can cause many types
of cancer, including:
oral cancer,throat cancer,colon cancer,liver cancer,bile duct cancer,pancreatic cancer,nasal cancer
UV rays
• UV rays from tanning devices and welding can cause skin cancer and eye cancer. Solar radiation
from the sun can also cause melanomas

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The study of carcinogens is ongoing and there are multiple other
substances that have been associated with causing cancer.
New carcinogens are being discovered on a more regular basis
due to extensive cancer research.

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Your age
• Cancer can take decades to develop. This makes cancer more common in people above 65 years. While it's more common in older adults, cancer isn't exclusively
an adult disease — cancer can be diagnosed at any age. Cancers are becoming more common in younger people due to lifestyle changes and viral infections.
Your habits
• Certain lifestyle choices are known to increase your risk of cancer. Smoking, drinking more than one drink a day for women and up to two drinks a day for men,
excessive exposure to the sun or frequent blistering sunburns, being obese, and having unsafe sex can contribute to cancer.
• You can change these habits to lower your risk of cancer — though some habits are easier to change than others.
Your family history
• Only a small portion of cancers are due to an inherited condition. If cancer is common in your family, it's possible that mutations are being passed from one
generation to the next. You might be a candidate for genetic testing to see whether you have inherited mutations that might increase your risk of certain cancers.
Keep in mind that having an inherited genetic mutation doesn't necessarily mean you'll get cancer.
Your health conditions
• Some chronic health conditions, such as ulcerative colitis, can markedly increase your risk of developing certain cancers. Talk to your doctor about your risk.
Your environment
• The environment around you may contain harmful chemicals that can increase your risk of cancer. Even if you don't smoke, you might inhale secondhand smoke if
you go where people are smoking or if you live with someone who smokes. Chemicals in your home or workplace, such as asbestos and benzene, also are
associated with an increased risk of cancer.
Risk Factors
While doctors have an idea of what may increase your risk of cancer, the majority of cancers occur in people who don't have
any known risk factors. Factors known to increase your risk of cancer include:

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Symptoms
Signs and symptoms caused by cancer will vary depending on what part of the body is affected and the type of cancer.
Some general signs and symptoms associated with, but not specific to, cancer, include:
• Fatigue
• Lump or area of thickening that can be felt under the skin
• Weight changes, including unintended loss or gain
• Skin changes, such as yellowing, darkening or redness of the skin, sores that won't heal, or changes to existing moles
• Changes in bowel or bladder habits
• Persistent cough or trouble breathing
• Difficulty swallowing
• Hoarseness of the voice
• Persistent indigestion or discomfort after eating
• Persistent, unexplained muscle or joint pain
• Persistent, unexplained fevers or night sweats
• Unexplained bleeding or bruising

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What are the most common cancers in South Africa?
The five most common cancers in South Africa are
• urological (bladder, kidney, prostate and testis),
• gynaecological (cervix uteri, corpus uteri and ovary),
• breast, ( Note that, although not as common, can also occur in
males)
• lung and
• haematological malignancies (Hodgkin lymphoma, non-Hodgkin
lymphoma, multiple myeloma and leukaemia)

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Cancer screening
Cancer screening is looking for cancer before a person has any symptoms.
• Screening tests can help find cancer at an early stage, before symptoms appear. When abnormal tissue or cancer is
found early, it may be easier to treat or cure. By the time symptoms appear, the cancer may have grown and spread.
This can make the cancer harder to treat or cure.
• It is important to remember that when your doctor suggests a screening test, it does not always mean he or she thinks
you have cancer. Screening tests are done when you have no cancer symptoms.
There are different kinds of screening tests.
Screening tests include the following:
• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of
disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses
and treatments will also be taken. Prostate exam in males for prostate abnormalities.
• Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body.
Examples include PAP Smear in females, PSA in Males
• Imaging procedures: Procedures that take images of areas inside the body. Examples include Ultrasound,
Mammogram, CT Scan, MRI
• Genetic tests: A laboratory test in which cells or tissue are analyzed to look for changes in genes or chromosomes.
These changes may be a sign that a person has or is at risk of having a specific disease or condition. These tests are
usually performed in High risk individuals with a strong family history.

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Reducing Risk of Cancer
1. Stop Smoking !!!
2. Eat a healthy diet
•Eat plenty of fruits and vegetables. Base your diet on fruits, vegetables and other foods from plant sources — such as whole grains and beans.
Eat lighter and leaner by choosing fewer high-calorie foods. Limit refined sugars and fat from animal sources.
•Drink alcohol only in moderation, if at all. Alcohol increases the risk of various types of cancer, including cancer of the breast, colon, lung, kidney and liver. Drinking more increases the risk.
•Limit processed meats. Eating processed meat often can slightly increase the risk of certain types of cancer
3. Maintain a healthy weight and be physically active
4. Protect yourself from the sun
5. Get vaccinated
Protecting against certain viral infections can help protect against cancer. Talk to a health care provider about getting vaccinated against:
•Hepatitis B. Hepatitis B can increase the risk of developing liver cancer. workers who might have contact with infected blood or body fluids.
•Human papillomavirus (HPV). HPV is a sexually transmitted virus that can lead to cervical cancer and other genital cancers as well as squamous cell
cancers of the head and neck. The HPV vaccine is recommended for girls and boys ages 11 and 12
6. Avoid risky behaviors
Another effective cancer prevention tactic is to avoid risky behaviors that can lead to infections that, in turn, might increase the risk of cancer. For example:
•Practice safe sex. Limit the number of sexual partners and use a condom. Unsafe sexual practices increase the risk of cancer of the anus, penis, throat, vulva and vagina.
•Don't share needles. Injecting drugs with shared needles can lead to HIV, as well as hepatitis B and hepatitis C — which can increase the risk of liver cancer. If you're concerned about drug misuse or
addiction, seek professional help.
7. Get regular medical care and check ups
Doing regular self-exams and having screenings for cancers, such as cancer of the skin, colon, cervix and breast can raise the chances of finding cancer early. That's when treatment is most likely to
succeed.

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The occupational health clinic is always available should
employees feel they have an increased risk of developing cancer,
and we will test and screen employees accordingly.
Every medical examination performed at the clinic, either as part
of the annual medical or any other medical encounter with the
employee presents an ideal opportunity to screen employees and
enquire about any signs and symptoms which might raise
suspicion of underlying disease.
The changes in our lifestyles, diets and our daily exposures puts
every one of us at a risk of developing malignancies which can
be managed if diagnosed early.

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Thank you