Cancer is characterized by abnormal cell growth that can invade other tissues and spread to distant organs. Globally, cancer accounts for 13% of deaths, with lung cancer being the leading cause. In Southeast Asia, 3.4-5.5% of deaths in various countries are due to cancer. Common cancers in the region include oral and cervical cancers. Cancers can be caused by environmental factors like tobacco and alcohol use, dietary factors like smoked fish or red meat consumption, occupational exposures, and viruses or parasites. Prevention strategies include cancer screening programs, public education, and limiting risk factors.

1. CANCER Dr. Gopalrao Jogdand, M.D. Ph.D. Professor & Head, Community Medicine

2. Definition A group of diseases characterized by: a. abnormal growth of the cells. b. ability of these cells to invade the adjacent cells and tissues. c. involving distant organs through metastasis. d. Death of the patient in the event of growth of the tumor beyond the stage, when it could be removed.

3. Magnitude of the problem Global:- Accounts for 13% of all deaths. 7.9 million deaths due to cancer. Approximately 30.4 million people living with cancer. Statistics indicates 19% increase in incidence of the disease. 18% increase in the mortality in the last decade (2005).

4. South East Asia Region 3.4% of all deaths are due to cancer in India. 6.6% from Indonesia. 5.5% from Thailand. 4.2% from Sri Lanka. 2.9% from Myanmar. 0.8% from Nepal. Statistics for 2002.

5. Cancer deaths S.E.A.R. Statistical reports of W.H.O. 2005 show following mortality statistics for SEAR. India- 8 lakh 66 thousand deaths. Indonesia- 2 lakh 6 thousand deaths. Thailand- 66000 deaths. Myanmar- 39000 deaths. Sri Lanka- 21000 deaths.

6. Five leading cancers & their mortality in the world, 2005. Lung cancer- 1.4 million deaths. Stomach cancer- 8 lakh 66 thousand deaths. Colon cancer- 6 lakh 77 thousand deaths. Liver cancer- 6 lakh 53 thousand deaths. Breast cancer- 5 lakh 48 thousand.

7. Global pattern of cancers Globally lung cancer is very common. Stomach cancer is very common in Japan. Breast and colorectal cancer is very common in European countries. S.E.A.R. great majority of cancers are the oral and Ca. uterine cervix.

8. Origin of major categories of cancers Carcinomas- arising from epithelial lining of the internal surface of the organs, mouth, esophagus, intestine, uterus and skin. Sarcomas- arising from mesodermal cells of various connective tissues, fibrous tissues, fat and bone. Lymphomas, mylomas and leukemia's- arising from the cells of bone marrow and immune system.

9. Causes of cancer Environmental factors: Use of tobacco: for smoking or chewing purpose causes cancer after long term use. Alcohol: Excessive use of alcoholic drinks can cause cancer, a causal relationship is shown between beer consumption and rectal cancer.

10. Causes…… Dietary factors: Consumption of smoked fish is related to stomach cancer. Beef consumption is related to bowel cancer. High dietary fat consumption to breast cancer.

11. Causes…. Occupational exposure: Exposure to benzene, arsenic, cadmium, chromium, asbestos, vinyl chloride, poly cyclic hydrocarbons and aniline dyes cause various types of cancers. Viruses: Hepatitis b, c and d virus, Epstein-Barr virus, cytomegalovirus, human papilloma virus. Parasites: Schistosomiasis causing ca. bladder in Egypt.

12. Causes…. Habits and life style factors: Smoking, tobacco chewing, betel chewing, smoking and alcohol intake. Genetic factors: Retinoblastoma amongst siblings, leukemia in Mongols is suggestive of a genetic linkage.

13. Prevention and control of cancer Cancer screening: In affluent countries community based or clinic based screening for cancer is done. Breast cancer: 1. Breast Self Examination. 2. Mammography. 3. Thermo-mammography. Lung cancer: Mass radiography and sputum cytology. Ca. Cervix: Pap smear screening of women over 35 years of age.

14. Prevention and control Strategy for cancer control: 1. Public information and education. 2. Legislative and restrictive measures. 3. Community based cessation programs. 4. National and international coordination. 5. Better diagnostic and treatment facilities.

15. Warning signs of cancer Any change in the bowel and bladder habits. Persistent cough or hoarseness of voice. Bleeding form natural orifices. Any change in the size of a mole or wart. Hard and palpable lump in any part of the body. Chronic non healing ulcer. Excessive bleeding during menses. Sudden and unexplained loss of body weight.

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