Due to the rising number of women affected by cancer, there is a great need for awareness and prevention of risk factors .

1. COMMON CANCERS IN
WOMEN
Presented by-
Dr Garima Gupta
MBBS, MD (Post Graduate Resident)
University College of Medical Sciences and GTB Hospital
Delhi
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2. Contents
 Cancer – Introduction
-- Pathology
-- Incidence and Mortality of cancers worldwide
-- Prevention aspect for cancer
-- Treatment layout
 Breast Cancer
- Incidence and Mortality
- Summary Statistics
- Signs & Symptoms
 Cervix uteri Cancer - Risk Factors
- Prevention & Management
 NPCDCS - Introduction
-History
- Objectives
- Services available
- Cancer prevention under NPCDCS
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3. What is Cancer?
• Cancer is a group of diseases characterized by:
– Uncontrolled growth and spread of abnormal cells
– Ability to invade adjacent tissues and distant organs
– If the spread is not controlled, it can result in death
Causative factors:
 Tobacco
 Infectious organisms
 Unhealthy diet
 Internal factors such as inherited genetic mutations,
hormones and immune conditions.
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4. Types Of Cancer
• Epithelial cells
• Example: Mouth,
oesophagus,
intestine, uterus
and skin epithelium
Carcinomas
• Mesodermal cells
• Example: fibrous
tissues, fat & bones
Sarcomas
• Myeloma &
Leukemia
Lymphomas
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5. 5

6. Estimated New Cases-World
6Source: American Cancer Society(2012)

7. Estimated Deaths-World
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Source: American Cancer Society(2012)

8. Estimated New cases-Females
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Source: American Cancer Society(2012)

9. Estimated Deaths-Females
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Source: American Cancer Society(2012)

10. Most Common Cancer Sites Worldwide
Source: American Cancer Society(2012)
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11. Most Common Cancer Sites Worldwide
Source: American Cancer Society(2012)
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12. Cancer Incidences in India
Source: World Health Organization - Cancer Country Profiles, 2014.
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13. Cancer Mortality in India
Others-Larynx, prostate, liver, leukaemia (males)
Others-lung, stomach, oesophagus, corpus uteri, leukaemia (females)
Source: World Health Organization - Cancer Country Profiles, 2014. 13

14. Can Cancer Be Prevented?
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15. Treatment Layout for cancer
Cancer
Treatment
Surgical
ChemotherapyRadiotherapy
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16. BREAST CANCER
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17. 17

18. 18

19. Summary Statistics-Breast Cancer
REGION INCIDENCE MORTALITY
World (2012) 25.2 % (out of the total
cancers in world)
14.7 % (out of the total
mortality due to cancers in
world)
SEARO (2012) 14.4 % (out of the total
newly diagnosed breast
cancer cases)
21.1 % (out of the total
mortality due to breast
cancer)
India (2012) 27 % (out of the total
cancers in India)
21.5 % (out of the total
mortality due to cancers in
India)
Delhi (2008-09) 26.78 % (out of the total
cancers in Delhi)
-
GLOBOCAN 2012 (IARC)
National centre for disease informatics and research
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20. 20

21. • hx-history
• bx-biopsy
• LCIS- Lobular carcinoma in situ
• DCIS- Ductal carcinoma in situ
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22. Prevention and Management
• Primary Prevention
1.Average age at menarche – can be increased through a
reduction in childhood obesity and an increase in strenuous
physical activity.
2.Decrease the frequency of ovulation – by increasing the
strenuous physical activity
3.Reduce fat intake in diet.
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23. • Secondary Prevention
1.Breast cancer screening
2.Follow up:
 to detect recurrence as early as possible.
 to detect cancer in opposite breast at an early stage.
 to generate research data which might be useful.
No major improvement in survival rate has yet been shown by
current treatment modalities, however, in general the
removal of tumor early is more likely to be curative than
removal at a later stage.
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24. CERVICAL AND UTERINE
CANCER
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25. Cancer of The Cervix
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26. GLOBOCAN 2012 (IARC)
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27. GLOBOCAN 2012 (IARC)
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28. Summary Statistics-Cervix uteri Cancer
REGION INCIDENCE MORTALITY
World (2012) 7.9 % (out of the total
cancers in world)
7.5 % (out of the total
mortality due to cancers in
world)
SEARO (2012) 33.1 % (out of the total
newly diagnosed breast
cancer cases)
35.3 % (out of the total
mortality due to breast
cancer)
India (2012) 22.9 % (out of the total
cancers in India)
20.7 % (out of the total
mortality due to cancers in
India)
Delhi (2008-09) 12.6 % (out of the total
cancers in Delhi)
-
GLOBOCAN 2012 (IARC)
National centre for disease informatics and research
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29. Risk
factors
Age
Genital
Warts
Early
Marriage
OCP
Socio-
economic
class
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30. • Primary Prevention
Promoting legal age of marriage
Personal hygiene and birth control
• Secondary Prevention
Early detection of cases through screening
Treatment by radical surgery and radiotherapy
Prevention
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31. Endometrial Cancer
• Cancer of the uterine endometrial lining
• Most of these malignancies are adenocarcinoma
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32. Risk
factors
Age
Obesity
Family
history
Diet high in
animal Fat
Prior
radiation
therapy
Infertility/
Nulliparous
Tamoxifen/
HRT
Early
menarche /
late
menopause
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33. Endometrial Carcinoma
Etiology
• Unopposed estrogen
hypothesis: exposure to
unopposed estrogens
Pathology
• Spreads through uterus,
fallopian tubes, ovaries
and out into peritoneal
cavity
– Metastasizes via blood and
lymphatic system
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34. Symptoms of
Endometrial cancer
Non-menstrual bleeding or discharge (mainly
post-menopausal bleeding)
Heavy bleeding
Dysuria
Pain during intercourse
Pain and/or mass in pelvic area
Weight loss
Back pain
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35. Endometrial cancer
• Diagnosis
– Pelvic examination
– Pap smear (detect cancer spread
to cervix)
– Endometrial biopsy
– Dilation and curettage
– Transvaginal ultrasound
• Treatment
– Surgery
• Hysterectomy
• Salpingo-oophorectomy
• Pelvic lymph node
dissection
• Laparoscopic lymph node
sampling
– Radiation therapy
– Chemotherapy
– Hormone therapy
• Progesterone
• Tamoxifen
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36. Reduced Risk
• Oral Contraceptives
– Combined OC => 50% reduced rate
– Actual reduction number small because uncommon in
women of child bearing age
– Long term offers protection
– Reduced risk presumably => progesterone
• Tobacco Smoking
– Some evidence that it reduces the rate
– Smokers have lower levels of estrogen and lower rate of
obesity
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37. Prevention and Survival
• Early detection is best prevention
• Treating precancerous hyperplasia
– Hormones (progestin)
– D&C
– Hysterectomy
– 10 ~ 30% untreated develop into cancer
• Average 5 year survival
– Stage I => 72 ~ 90%
– Stage II=> 56 ~ 60%
– Stage III => 32 ~ 40%
– Stage IV => 5 ~ 11%
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38. NATIONAL PROGRAMME FOR CONTROL AND
PREVENTION CANCER, DIABETES,
CARDIOVASCULAR DISEASES AND STROKE
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39. Introduction
NPCDCS aims at integration of non communicable diseases
with NRHM.
The following diseases have been incorporated :
• Cancer
• Diabetes
• Cardiovascular Diseases
• Stroke
These diseases are also called lifestyle associated diseases.
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40. History of programme
1975-76
• National cancer control programme was launched
1984-85
• Programme was revised.
2004
• Programme further revised.
2010
• National cancer control programme was integrated with national
programme for prevention and control of diabetes, cardiovascular diseases
and stroke
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41. NPCDCS
Prevention
through
behaviour
change
Early
diagnosis
Medical
Treatment
Capacity
building
Supervision,
monitoring
& evaluation
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42. Objectives of NPCDCS
1) Prevent and control common NCDs through behavior and
life style changes,
2) Provide early diagnosis and management of common NCDs
through opportunistic screening
3) Build capacity at various levels of health care for
prevention, diagnosis and treatment of common NCDs
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43. 4) Train human resource within the public health setup via
doctors, paramedics and nursing staff to cope with the
increasing burden of NCDs
5) Establish and develop capacity for palliative &
rehabilitative care
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45. PrimaryPrevention
•Modification of
risk factor by
providing health
education and
screening
programs.
•Educating about
safe sexual
practice ,
practicing genital
hygiene. This is
carried out by
ASHA , AWW ,
SHG, YOUTH CLUB
SecondaryPrevention
• Early detection
and diagnosis
of common
cancer by
screening and
self diagnosed
method. Eg of
screening
programs
• Cervical
cytology
screening
programs
• Mammographic
screening
programs
TertiaryPrevention
• Strengthening
of the existing
institutions of
comprehensive
therapy
including
palliative care.
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46. Control of cancer under NPCDCS
• Facilities at 100 Districts-
 Common diagnostic services, basic surgery, chemotherapy
and palliative care for cancer cases
 Support for Chemotherapy drugs
 Day care Chemotherapy facilities.
 Facility for laboratory investigations including Mammography
 Home based palliative care for chronic, debilitating and
progressive cancer patients.
 Support for contractual manpower and equipment for
management of cancer cases.
 Strengthening of 65 centre Tertiary Cancer Centres (TCCs)
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48. SCHEME UNDER REVISED PROGRAMME
• Regional cancer centre scheme
• Oncology wing development scheme
• Decentralize NGO scheme
• IEC activities at central level
• Research and training
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49. THANKYOU
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