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Cancer awareness
- 1. CANCER IN WOMEN Dr. Sowjanya Kurakula MBBS, MD Obstetrician & Gynecologist
- 2. CANCER IS A NON-COMMUNICABLE DISEASE Major risk factors -
- 3. GLOBAL PROBLEM OF CANCER 45% 55% INCIDENCE TOTAL 12 MILLION DEVELOPED COUNTRIES DEVELOPING COUNTRIES 38% 62% MORTALITY TOTAL 7.6 MILLION DEVELOPED COUNTRIES DEVELOPING COUNTRIES
- 4. More than 1 million new cases of cancer are diagnosed every year in a population of 1.2 billion this represents a combined male and female incidence of about a quarter of that recorded in western Europe
- 5. An estimated 600,000-700,000 deaths in India were caused by cancer in 2012
- 6. Many cancer cases in India are associated with tobacco use, infections, and other avoidable causes. Social factors, especially inequalities, are major determinants of India's cancer burden, with poorer people more likely to die from cancer before the age of 70 years than those who are more affluent
- 7. TOP FIVE CANCERS AMONGST WOMEN BREAST 42% COLORECTUM 8% OVARY 8% CERVIX 35% ORAL CAVITY 7% CANCER BREAST COLORECTUM OVARY CERVIX ORAL CAVITY
- 8. CANCER- WORLDWIDE 55% 23% 22% INCIDENCE BREAST LUNG COLON/RECTUM 56% 44% MORTALITY LUNG BREAST
- 10. WHAT IS CERVICAL CANCER? • IT IS A CANCER OF THE FEMALE REPRODUCTIVE TRACT • PEAK AGE – BIMODAL, 35 & 50 YRS • HUMAN PAPILLOMAVIRUS (HPV) INFECTION IS THE CAUSAL AGENT OF CERVICAL CANCER. • IT IS THE MOST COMMON CAUSE OF CANCER DEATH IN THE WORLD WHERE PAP TESTS ARE NOT AVAILABLE • IT IS THE EASIEST GYNECOLOGIC CANCER TO PREVENT THROUGH SCREENING AND EARLY VACCINATION
- 12. CANCER OF CERVIX, VAGINAAND VULVA RISK FACTORS • YOUNG AGE AT FIRST INTERCOURSE (<16 YEARS) • MULTIPLE SEXUAL PARTNERS • CIGARETTE SMOKING • RACE • HIGH PARITY • LOWER SOCIOECONOMIC STATUS
- 13. SYMPTOMS OF CERVIX AND VAGINA CANCER • ABNORMAL VAGINAL BLEEDING (POST COITAL BLEEDING/ POST MENOPAUSAL BLEEDING) • FOUL SMELL VAGINAL DISCHARGE • WEIGHT LOSS • DIFFICULTY IN PASSING URINE
- 15. WHAT IS A PAP TEST? • A TEST WHICH COLLECTS CELLS FROM THE SURFACE OF THE CERVIX AND LOOKS FOR ANY ABNORMAL CELLS • ABNORMAL CELLS CAN BE TREATED BEFORE CERVICAL CANCER DEVELOPS • WHEN CANCER IS DETECTED EARLY, IT IS EASIER TO TREAT
- 16. WHAT IS A COLPOSCOPY? COLPOSCOPY: • USE OF A MAGNIFYING INSTRUMENT • APPLICATION OF A VINEGAR-LIKE SOLUTION ONTO THE CERVIX • SHOWS ABNORMALITIES THAT CAN’T BE SEEN WITH THE NAKED EYE • FEELS LIKE GETTING A PAP TEST, BUT TAKES A LONGER TIME Source: This is a copyrighted image of the California Family Health Council, Inc. and may not be reproduced in any way without the expressed written permission of the California Family Health Council. California Department of Health Services "What You Should Know if your Pap Test is Abnormal"- Your Colposcopy Exam, Donna Bell Sanders (Education Programs Associates 1995; Campbell, CA).
- 17. WHAT IS A CERVICAL BIOPSY? BIOPSY: • REMOVAL OF A SMALL PIECE OF TISSUE FROM THE CERVIX • MAY FEEL LIKE GETTING A PAP TEST OR LIKE A MENSTRUAL CRAMP THAT LASTS A FEW SECONDS Source: TAP Pharmaceuticals, “Female Reproductive Systems.” Source: A. DeCherney and M. Pernoll, Current Obstetric and Gynecologic Diagnosis and Treatment (The McGraw-Hill Companies, Inc.) 586.
- 19. WHAT IS THE CERVICAL CANCER VACCINE? • THE CERVICAL CANCER VACCINE (ALSO KNOWN AS THE HUMAN PAPILLOMAVIRUS OR HPV VACCINE) WILL HELP PREVENT CERVICAL CANCER BY PROVIDING PROTECTION FROM THE ‘HIGH-RISK’ HPV VIRUS TYPES THAT CAUSE 70% OF CERVICAL CANCER • YOU CAN SIGNIFICANTLY DECREASE YOUR CHANCES OF GETTING CERVICAL CANCER IF YOU GET THE VACCINE BEFORE INITIAL SEXUAL CONTACT • THE BENEFIT OF THE VACCINE DECLINES WITH INCREASED HPV EXPOSURE
- 20. RECOMMENDED AGE GROUPS OF THE CERVICAL CANCER VACCINE? Girls 9-10 Eligible for the vaccine Girls 11-12 Recommended age group to receive the cervical cancer vaccine Girls 13-18 Eligible to receive the vaccine, if not previously vaccinated for cervical cancer Women 19-26* Eligible for the vaccine, if not previously vaccinated for cervical cancer Women 27-older Not FDA approved Men Not FDA approved *The effectiveness of vaccine may be reduced in this age group. The vaccine is less effective with more prior HPV exposure.
- 21. IS THE CERVICAL CANCER VACCINE RIGHT FOR ME? • IF YOU ARE A FEMALE BETWEEN THE AGES OF 11 AND 12 THE VACCINE HAS PROVEN BENEFIT FOR YOU • IF YOU STARTED HAVING SEX, YOU CAN STILL GET THE VACCINE, BUT THE BENEFIT FROM THE VACCINE MAY BE LOWER BECAUSE YOU MAY HAVE ALREADY BEEN EXPOSED TO HPV • THE VACCINE DOES NOT WORK TO ELIMINATE CURRENT HPV INFECTIONS • THE VACCINE ONLY PREVENTS CERTAIN TYPES OF HPV INFECTION • EARLY VACCINATION, REGULAR PAP TESTS AND HPV TESTS WHEN RECOMMENDED BY A HEALTHCARE PROVIDER WILL PROVIDE YOU WITH YOUR BEST PROTECTION AGAINST CERVICAL CANCER
- 22. WHAT SHOULD I EXPECT AT MY VACCINE APPOINTMENT? • YOU WILL NEED A SERIES OF THREE APPOINTMENTS OVER 6 MONTHS • YOU WILL RECEIVE A SHOT, USUALLY IN THE UPPER ARM, AT EACH OF THE THREE APPOINTMENTS • COMMON SIDE EFFECTS INCLUDE: • A SORE ARM FOR A DAY OR TWO AFTER THE VACCINE SHOT • A HEADACHE AND/OR A LOW GRADE FEVER • YOU CAN USE OVER THE COUNTER PAIN AND FEVER MEDICATIONS IF NEEDED • YOU SHOULD NOT GET THE VACCINE IF YOU ARE PREGNANT OR TRYING TO GET PREGNANT
- 23. HEPATITIS-B VACCINE PREVENTS LIVER CANCER
- 24. BREAST CANCER BREAST CANCER ACCOUNTS FOR ONE THIRD OF CANCERS IN WOMEN • THE RISK INCREASES WITH A POSITIVE FAMILY HISTORY AND THE USE OF HORMONE THERAPY • CONSTITUTES THE MOST COMMON CAUSE OF CANCER DEATH IN INDIA
- 25. RISK FACTORS OF BREAST CANCER • AGE • FAMILY HISTORY • HIGH FAT INTAKE IN DIET • OBESITY • ALCOHOL (WINE) • EARLY MENARCHE • EARLY MENOPAUSE IS PROTECTIVE • NULLIPARITY • HIGHER AGE AT 1ST CHILD BIRTH • H/O OVARIAN AND COLON CANCER • RADIATION THERAPY
- 29. BREAST CANCER • DIAGNOSIS • BIL MAMMOGRAPHY • CXR • BLOOD INV • CT/MRI • TREATMENT • SURGERY • RADIOTHERAPY • CHEMOTHERAPY
- 30. You can reduce your risk for breast cancer by adopting a balanced lifestyle and avoiding environmental carcinogens (cancer causing substances) Although very rare, men can also develop breast cancer Most women who have many risk factors never develop breast cancer Women who breastfeed for at least 18 months can further reduce their (and their baby’s) risk Be physically active, don’t be overweight and limit your alcohol intake
- 32. OVARIAN AND FALLOPIAN TUBE CANCER • POST MENOPAUSAL AGE • STRONG FAMILY HISTORY • H/O BREAST / COLON CANCER • OFTEN DIAGNOSED LATE
- 33. RISK FACTORS FOR OVARIAN CANCER • LOW PARITY • INFERTILITY
- 34. PREVENTION OF OVARIAN CANCER • HAVING AT LEAST ONE CHILD IS PROTECTIVE • ORAL CONTRACEPTIVE USAGE
- 35. SCREENING OF OVARIAN CANCER PERIODIC GYNECOLOGIC EXAMINATION HIGH RISK INDIVIDUALS ARE OFFERED • GENETIC COUNSELING • GENETIC TESTING FOR BRCA1AND BRCA2. • TRANSVAGINAL ULTRASONOGRAPHY EVERY 6 MONTHS • ORAL CONTRACEPTIVES SHOULD BE RECOMMENDED TO WOMEN SEEKING CONTRACEPTION • PROPHYLACTIC BILATERAL SALPINGO-OOPHORECTOMY • WOMEN WITH STRONG FAMILY HISTORY OF BREAST OR OVARIAN CANCER, ANNUAL MAMMOGRAPHIC SCREENING • WOMEN WITH A DOCUMENTED HNPCC SYNDROME PERIODIC SCREENING MAMMOGRAPHY, COLONOSCOPY, AND ENDOMETRIAL BIOPSY
- 36. SYMPTOMS OF OVARIAN CANCER MAJORITY- VAGUE AND NON-SPECIFIC SYMPTOMS • ABNORMAL VAGINAL BLEEDING IN POST MENOPAUSAL GROUP • CONSTIPATION • FREQUENT URINATION • LOWER ABDOMINAL PAIN AND DISTENSION • PAIN DURING SEX
- 37. OVARIAN CANCER • DIAGNOSIS • USG • CT • LOWER GI SERIES • IVP • CA125 • BIOPSY • TREATMENT • SURGERY • CHEMOTHERAPY • RADIOTHERAPY
- 38. UTERINE CANCER
- 39. RISK FACTORS FOR UTERINE CANCER • NULLIPARITY • LATE MENOPAUSE • OBESITY • DIABETES • UNOPPOSED ESTROGENS • TAMOXIFEN THERAPY • ATYPICAL ENDOMETRIAL HYPERPLASIA • HEREDITARY NONPOLYPOSIS COLORECTAL CANCER
- 40. SCREENING OF UTERINE CANCER • LIMITED TO HIGH RISK INDIVIDUALS • ENDOMETRIAL BIOPSY DONE IN SUSPECTED CASES
- 41. SYMPTOMS OF UTERINE CANCER • ABNORMAL VAGINAL BLEEDING OR FOUL SMELL DISCHARGE (PERI/POST MENOPAUSAL AGE GROUP) • LOWER ABDOMINAL PAIN • ASYMPTOMATIC OVERALL 5-YEAR SURVIVAL RATE IN ENDOMETRIAL CANCER IS APPROXIMATELY 75%
- 42. UTERINE CANCER • DIAGNOSIS • PELVIC EXAMINATION • PAP SMEAR • EM BIOPSY • TVS • TREATMENT • SURGERY • RADIATION THERAPY • CHEMOTHERAPY • HORMONE THERAPY
- 43. VULVA CANCER • VULVAR LESIONS REQUIRE BIOPSY TO AVOID DELAY IN DIAGNOSIS
- 44. RISK FACTORS FOR VULVA CANCER • YOUNG AGE AT FIRST INTERCOURSE (<16 YEARS) • MULTIPLE SEXUAL PARTNERS • CIGARETTE SMOKING • RACE • HIGH PARITY • LOWER SOCIOECONOMIC STATUS. • H/O MULTIPLE GENITAL TRACT MALIGNANCIES • IMMUNOSUPPRESSION
- 45. SYMPTOMS OF VULVA CANCER POST MENOPAUSAL LADY • LONG STANDING WHITE PATCH • NON- HEALING ULCER • VULVA ITCHING • FOUL SMELL DISCHARGE • PAIN OVER VULVA • DIFFICULTY IN URINATION • SWELLING IN GROIN
- 46. VULVA CANCER • DIAGNOSIS • PELVIC EXAMINATION • COLPOSCOPY • PAP SMEAR • BIOPSY • TREATMENT • SURGERY • CHEMOTHERAPY • RADIOTHERAPY
- 47. GESTATIONAL TROPHOBLASTIC TUMORS MOLAR PREGNANCY • AGE > 35 WITH PERSISTENT BLEEDING AFTER D&C IN MOLAR PREGNANCY CAN PREDISPOSE TO UTERINE CANCER
- 48. COLORECTAL CANCER • ANY ADULT CAN HAVE COLORECTAL CANCERS (CANCERS OF THE COLON AND RECTUM) BUT MOST OF THESE CANCERS ARE FOUND IN PEOPLE AGE 50 OR OLDER. • PEOPLE WITH A • PERSONAL OR FAMILY HISTORY OF THIS CANCER, • OR WHO HAVE POLYPS IN THEIR COLON OR RECTUM, • OR THOSE WITH INFLAMMATORY BOWEL DISEASE ARE MORE LIKELY TO HAVE COLORECTAL CANCER. • ALSO, EATING A DIET MOSTLY OF HIGH-FAT FOODS (ESPECIALLY FROM ANIMAL SOURCES), • BEING OVERWEIGHT, • SMOKING, • PHYSICAL INACTIVITY
- 50. LUNG CANCER • SMOKING IS THE CAUSE OF MORE THAN 80% OF ALL LUNG CANCERS, BUT PEOPLE WHO DON’T SMOKE CAN ALSO HAVE LUNG CANCER. WHAT YOU CAN DO • LUNG CANCER IS ONE OF THE FEW CANCERS THAT CAN OFTEN BE PREVENTED SIMPLY BY NOT SMOKING. • IF YOU ARE A SMOKER, ASK YOUR DOCTOR OR NURSE TO HELP YOU QUIT. • IF YOU DON’T SMOKE, DON’T START, AND AVOID BREATHING IN OTHER PEOPLE’S SMOKE. • IF YOUR FRIENDS AND LOVED ONES ARE SMOKERS, HELP THEM QUIT.
- 51. SKIN CANCER • ANYONE WHO SPENDS TIME IN THE SUN CAN GET SKIN CANCER. • PEOPLE WITH FAIR SKIN, ARE MORE LIKELY TO GET IT THAN PEOPLE WITH DARKER COLORING. • PEOPLE WHO HAVE HAD A CLOSE FAMILY MEMBER WITH MELANOMAAND THOSE WHO HAD BAD SUNBURNS BEFORE AGE 18 ARE MORE LIKELY TO GET SKIN CANCER. WHAT YOU CAN DO • MOST SKIN CANCERS CAN BE PREVENTED BY STAYING OUT OF THE MIDDAY SUN. • WHEN IN THE SUN, WEAR HATS WITH BRIMS, LONG-SLEEVE SHIRTS, SUNGLASSES, AND USE SUNSCREEN WITH AN SPF OF 30 OR HIGHER ON ALL EXPOSED SKIN. • IF YOU HAVE CHILDREN, PROTECT THEM FROM THE SUN AND DON’T LET THEM GET SUNBURNED. • BE AWARE OF ALL MOLES AND SPOTS ON YOUR SKIN, AND REPORT ANY CHANGES TO A DOCTOR RIGHT AWAY. • HAVE A SKIN EXAM DURING YOUR REGULAR HEALTH CHECK-UPS.
- 68. THE BEST DEFENSE AGAINST CANCER Early detection – finding a cancer early, before it has spread – gives you the best chance to do something about it. Knowing about these cancers and what you can do to help reduce your cancer risk can save your life.
- 70. COMMONEST CANCER IN WOMEN WORLWIDE
- 71. MOST COMMON CANCER IN WOMEN IN INDIA
- 72. SECOND COMMONEST CANCER AMONGST WOMEN IN INDIA
- 73. GENITAL CANCER WITH GOOD OUTCOME
- 74. GENITAL CANCER WITH WORST OUTCOME
- 75. MOST COMMON CAUSE OF CANCER DEATH IN INDIA