Introduction of cancer and process of cancer stages of cancer or treatment of them.

1. CANCER
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2. Contents…..
 Introduction
 Background information (related to Nepal)
 Body content related to public health
 Sign and symptoms, treatment, medication
 Community education, Awareness generation
 Prevention methods
 Recommendation
 Conclusion
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3. Introduction
 Cancer is a disease in which some of the body’s cells grow
uncontrollably and spread to other parts of the body.
 Cancer can start almost anywhere in the human body, which is
made up of trillions of cells. Normally, human cells grow and
multiply (through a process called cell division) to form new cells
as the body needs them. When cells grow old or become
damaged, they die, and new cells take their place.
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4. Contd..
 Tumors can be cancerous or not cancerous (benign).
 Cancerous tumors spread into, or invade, nearby tissues and can
travel to distant places in the body to form new tumors (a
process called metastasis). Cancerous tumors may also be
called malignant tumors. Many cancers form solid tumors, but
cancers of the blood, such as leukemias, generally do not.
 Benign tumors do not spread into, or invade, nearby tissues.
When removed, benign tumors usually don’t grow back, whereas
cancerous tumors sometimes do. Benign tumors can sometimes
be quite large, however. Some can cause serious symptoms or be
life threatening, such as benign tumors in the brain.
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5. Cancer cells Normal cells
 These cells divide in an
unregulated/ uncontrolled
manner.
 Their life span is not
definited.
 They undergo differentiation
after attaining a specific
growth.
 They tend to form tumours.
 These cells divide in a
regulated manner.
 They have a definite
lifespan.
 They donot undergo
differentiation.
 Tumours arenot formed.
Difference between normal cells and cancer cells
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6. Cancer cells Normal cells
 They donot show contact
inhibition.
 No apoptosis.
 Invisible to immune cells.
 Cancer cells are able to
metastasis.
 The cell show contact
inhibition.
 Undergo apoptosis.
 Visible to immune cells.
 Normal cells are unable to
metastasis.
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7. Types of cancer
1) Carcinomas:
It begins in the skin or the tissue that covers the surface of
internal organs and glands. It usually form solid tumors. Example
prostate cancer, breast cancer, lung cancer.
2) Sarcomas:
It begins in the tissues that support and connect the body. It can
develop in fat, muscles, nerves, tendons, joints, blood vessels
bone etc.
3) Leukemias:
It is the cancer of blood. It begins when healthy blood cells
change and grow uncontrollably.
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8. Types of leukemias
a) Acute lymphocytic leukemia
b) Chronic lymphocytic leukemia
c) Acute myeloid leukemia
d) Chronic myeloid leukemia
4) Lymphomas:
It begins in the lymphatic system. The lymphatic system is a
network of vessels and glands that help fight infection. Its types
are:-
a) Hodgkin lymphoma
b) Non-Hodgkin lymphoma
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9. Pathogenesis of cancer
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10. Background information (related to Nepal)
 Cancer is an major public health problem in the world. This study
aims to present a three-year trend of cancer incidence in Nepal.
This study used the three-year data of National Cancer Registry
Program (NCRP) from January 2013 to December 2015. NCRP
currently includes 12 major hospitals where diagnostic
treatment facilities are available and represent the majority of
the cases in Nepal. Descriptive analysis was used to present the
demographic profile of the participants and the incidence of
different topography of cancer. Age-specific and age-adjusted
cancer incidence per 100,000 population were presented.
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11. Contd..
 A total of 27,483 new cancer cases were included in the study.
The age-adjusted incidence rates were 39.1, 39.8 and 41.8 per
100,000 population in the year 2013, 2014 and 2015
respectively. The most common cancer in Nepal was lung
followed by cervical, breast, stomach and colorectal cancer.
Among males, lung cancer was the most common followed by lip
and oral cavity, stomach, colorectal cancer and leukemia and
among females, cervical cancer followed by breast, lung, ovary
and stomach.
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12. Body content related to public health
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 Cancer is the second leading cause of death in the United States and
therefore a focus of public health efforts. One defining feature of the
public health approach to cancer control is its reliance on population
data for planning and evaluating efforts aimed at preventing the health
consequences of cancer. The public health cancer prevention
continuum includes primary prevention such as tobacco control,
human papiloma virus (HPV) vaccination, and removal of precancerous
polyps during screening colonoscopies to prevent progression to
colorectal cancer; secondary prevention (early detection) such as
screening mammography and low-dose computed tomography among
current or former heavy smokers to identify early-stage lung cancer;
and tertiary prevention, which involves cancer survivorship care to
reduce disability, other health outcomes associated with a cancer
diagnosis or its treatment, and cancer recurrence and progression.

13. Contd…
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 The World Health Organization defines public health surveillance
as the continuous, systematic collection, analysis, and
interpretation of health-related data needed for the planning,
implementation, and evaluation of public health practice. This
comprehensive definition of surveillance along with the
heterogeneity of the disease and its complex public health
prevention continuum means cancer surveillance is an
exceptionally broad concept. It includes measurement of risk
factors; assessment of use of health services such as vaccination
rates and screening; and cancer prevalence, incidence, mortality,
and survival rates and various outcomes affecting cancer
survivors.

14. Risk factors
 It is usually not possible to know exactly why one person
develops cancer and another doesn’t. some of the risk factors
are:-
a) age
b) Alcohol
c) cancer- causing substances
d) Chronic inflammation
e) Radiation
f) Immunosuppression
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15. Sign and symptoms
 Fatigue or extreme tiredness.
 Change in bowel or bladder habits.
 Unsual bleeding or discharge.
 Thickening or lump in a breast or elsewhere.
 Indigestion or difficulty swallowing.
 Nagging cough or hoarseness.
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16. Treatment
 Surgery
 Chemotherapy
 Radiation therapy
 Immunotherapy
 Gene therapy (CAR T- cell therapy)
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17. Medication
 Drugs in this group include 5-fluorouracil, 6-mercaptopurine,
cytarabine, gemcitabine, and methotrexate Cisplatin, lomustine,
busulfan, etc
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18. Community education , Awareness program
 Create cancer awareness and remove the stigma and fear
attached.
 Help people recognize the early signs and symptoms of cancer,
thus enabling them to seek treatment at an early stage.
 Educate people about the key risk factors, since more than 30%
of cancer cases could be prevented by modifying lifestyle or
avoiding the risk factors.
 Inform people about the importance of regular screening and
check-ups.
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19. Contd….
 Inform women about mammograms, clinical breast exam and
breast self-exam.
 Inform women about Pap smear tests to check for signs of
cervical cancer.
 The primary goal of ICS is to promote and develop awareness in
the public and emphasize the importance of early detection, all
of which play a major role in the treatment of cancer. Cancer
awareness can also lead to people making healthier lifestyle
choices.
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20. Prevention methods
 Ways to avoid or control things known to cause cancer.
 Changes in diet and lifestyle.
 Finding precancerous conditions early. Precancerous conditions
are conditions that may become cancer.
 Chemoprevention (medicines to treat a precancerous condition
or to keep cancer from starting).
 Risk-reducing surgery.
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21. Recommendation
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22. Role of pharmacist
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 Develop pamphlets, fact sheets and posters on cancer.
 Offer counseling about risk factors for cancer.
 Describe cancer screening methods and what is known about
their effectiveness.
 Adverse drug reaction prevention and monitoring.
 Medication administration support, premedication , hydration.
 Assuring medication adherence.

23. Conclusion
 A plan for the diagnosis and treatment of cancer is a key
component of any overall cancer control plan. Its main goal is to
cure cancer patients or prolong their life considerably, ensuring a
good quality of life. In order for a diagnosis and treatment
programme to be effective, it must never be developed in
isolation.
 Programmes should include a awareness-raising component, to
educate patients, family and community members about the
cancer risk factors and the need for taking preventive measures
to avoid developing cancer.
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24. Thank you
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