- The document discusses reproductive cancers that affect men, including statistics on testicular cancer, penile cancer, and prostate cancer globally and in Africa. It provides background on incidence rates, risk factors, methods for diagnosis and common treatment approaches.
- Policies and guidelines for cancer at both the global and local Malawi level are outlined. These address topics like national cancer control programs, early detection, diagnosis and treatment, and palliative care.
- Reproductive cancers present a significant burden in Malawi and other African countries. Improved prevention, screening, and treatment services are still needed given limited resources and rising incidence rates.
Epidemiology of oral cancer, cancer registry in India,Global Initiatives,Tobacco,Tobacco cessation centre,WHO framework,National Tobacco Control Programme,Squamous cell carcinoma,Leukoplakia, Benign,Malignant,Epidemiology,World
Epidemiology of oral cancer, cancer registry in India,Global Initiatives,Tobacco,Tobacco cessation centre,WHO framework,National Tobacco Control Programme,Squamous cell carcinoma,Leukoplakia, Benign,Malignant,Epidemiology,World
Cancer is a group of diseases involving
abnormal cell growth with the potential to
invade or spread to other parts of the body. Cancer is a group of diseases involving
abnormal cell growth with the potential to
invade or spread to other parts of the body.
Cancer is one of the leading causes of morbidity and
mortality worldwide, with approximately 14 million new
cases in 2012.
Cervical cancer global burden and where do we stand todayNiranjan Chavan
Cervical cancer is the 4th most common cancer in women worldwide but most common cause of cancer related death in India.
All over the world, including India, there is decreasing trend of cervical cancer.
Demonstrate the essential risk factors for developing cancer, and the predisposing factors for cancer.
Demonstrate a map of the prevalence of cancer throughout the world
Demonstrate how can we prevent the occurrence of cancer, by avoiding the predisposing risk factors.
Demonstrate the practical recommendation to avoid cancer
Ca cervix epidemiology,screening and preventionDrAnkitaPatel
CA CERVIX IS PREVENTABLE AND CURABLE IF DETECTED AT EARLY STAGE .VACCINATION, PAP SMEAR AND HPV VACCINATION ARE KEY COMPONENTS FOR PREVENTION AND EARLY DETECTION.
Background: The incidence of cancers is increasing worldwide, particularly in the developing countries as shown by recent cancer stastics from the WHO. It is even anticipated that with the increase in life expentancy, consequent upon inproved standard of living and globalization, the burden of cancers will increase within this millenium. With respective to cancer of the prostate, it is the most common type of cancer in urology. In developing countries, diagnostic is done at a late stage of evolution. In Cameroon, data on prostate cancer are scanty whereas the incidence of this disease is increasing. Objective: This article is designed to describe the epidemiological features of prostate cancer at the General Hospital of Yaoundé. Patients and methods: A 4-year retrospective study of patients seen with the diagnosis of cancer at the Medical Oncology unit of the Yaoundé General Hospital between January 2012 and December 2015. The demographic pattern (age of patients, socio professional activity, marital status), clinical features (cancer diagnosis), treatment modalities and outcome were studied. Main results: Of the 7 775 patients enrolled in the Medical Oncology Service over the study period, 1.4% (n = 108) cases of prostate cancer were seen. The prevalence over the study period was 1.38% and a relatively large annual growth of cases with an annual average of 27 cases was noted. The average age of patients was 67.82 years with a range of 34-83 years. The commonest presenting symptoms were the urinary frequency (54.63%) whereas the least common were fatigue (05.5%) and straining (03.70%). PSA was obtained in 49 patients, representing about 45.4% of all patients. Only 14 (01.26%) had biopsy reports. Conclusion: Prostate cancer is a major problem facing the aging male, and inadequate facilities make early detection difficult. Therefore, treatment is mainly palliative because of late diagnosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Cancer is a group of diseases involving
abnormal cell growth with the potential to
invade or spread to other parts of the body. Cancer is a group of diseases involving
abnormal cell growth with the potential to
invade or spread to other parts of the body.
Cancer is one of the leading causes of morbidity and
mortality worldwide, with approximately 14 million new
cases in 2012.
Cervical cancer global burden and where do we stand todayNiranjan Chavan
Cervical cancer is the 4th most common cancer in women worldwide but most common cause of cancer related death in India.
All over the world, including India, there is decreasing trend of cervical cancer.
Demonstrate the essential risk factors for developing cancer, and the predisposing factors for cancer.
Demonstrate a map of the prevalence of cancer throughout the world
Demonstrate how can we prevent the occurrence of cancer, by avoiding the predisposing risk factors.
Demonstrate the practical recommendation to avoid cancer
Ca cervix epidemiology,screening and preventionDrAnkitaPatel
CA CERVIX IS PREVENTABLE AND CURABLE IF DETECTED AT EARLY STAGE .VACCINATION, PAP SMEAR AND HPV VACCINATION ARE KEY COMPONENTS FOR PREVENTION AND EARLY DETECTION.
Background: The incidence of cancers is increasing worldwide, particularly in the developing countries as shown by recent cancer stastics from the WHO. It is even anticipated that with the increase in life expentancy, consequent upon inproved standard of living and globalization, the burden of cancers will increase within this millenium. With respective to cancer of the prostate, it is the most common type of cancer in urology. In developing countries, diagnostic is done at a late stage of evolution. In Cameroon, data on prostate cancer are scanty whereas the incidence of this disease is increasing. Objective: This article is designed to describe the epidemiological features of prostate cancer at the General Hospital of Yaoundé. Patients and methods: A 4-year retrospective study of patients seen with the diagnosis of cancer at the Medical Oncology unit of the Yaoundé General Hospital between January 2012 and December 2015. The demographic pattern (age of patients, socio professional activity, marital status), clinical features (cancer diagnosis), treatment modalities and outcome were studied. Main results: Of the 7 775 patients enrolled in the Medical Oncology Service over the study period, 1.4% (n = 108) cases of prostate cancer were seen. The prevalence over the study period was 1.38% and a relatively large annual growth of cases with an annual average of 27 cases was noted. The average age of patients was 67.82 years with a range of 34-83 years. The commonest presenting symptoms were the urinary frequency (54.63%) whereas the least common were fatigue (05.5%) and straining (03.70%). PSA was obtained in 49 patients, representing about 45.4% of all patients. Only 14 (01.26%) had biopsy reports. Conclusion: Prostate cancer is a major problem facing the aging male, and inadequate facilities make early detection difficult. Therefore, treatment is mainly palliative because of late diagnosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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1. REPRODUCTIVE CANCER FOR MEN
WAKHONDERACHI LIKHA
LINUS SAKANDA
MERCY NANDOLO KALANJE
June 1 st 2023
2. OUTLINE
• Introduction and background
• Statistics
• Current global and local policies
• Programmes
• Evaluation of programmes; opportunities, challenges, areas of research, leadership
roles
• Recommendations
3. BACKGROUND
• Cancer is a major cause of morbidity and mortality worldwide, with approximately 14
million new cases in 2012 and 8.8 million deaths in 2015 and it is the second leading
cause of death globally.
• Nearly two thirds of cancer cases and deaths occur in low- and middle-income
countries (LMICs) where resources available for prevention, diagnosis, treatment and
palliation are limited.
4. BACKGROUND
• Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly
one in six deaths.
• The most common cancers are breast, lung, colon and rectum and prostate cancers.
• Around one-third of deaths from cancer are due to tobacco use, high body mass index, alcohol
consumption, low fruit and vegetable intake, and lack of physical activity.
• Cancer-causing infections, such as human papillomavirus (HPV) and hepatitis, are responsible for
approximately 30% of cancer cases in low- and lower-middle-income countries.
• Many cancers can be cured if detected early and treated effectively. (WHO 2022).
5. BACKGROUND
• In sub saharan Africa, cancer is a major public health problem, affecting many of
the region’s 1 billion inhabitants.
• The disease is among the three leading causes of premature death (i.e. at ages 30–
69 years) in almost all constituent countries.
• It is responsible for 1 in 7 premature deaths overall and 1 in 4 deaths from
noncommunicable diseases.
(Lyon et al., 2022 )
6. BACKGROUND
• Estimated cancer incidence has doubled in sub-Saharan Africa over the past 30 years,
leading to more than 520 000 deaths in 2020.
• Unless steps are taken to reverse the trends, annual cancer deaths in sub-Saharan
Africa will likely reach 1 million by 2030 and incidence will likely double again by
2040, according to a comprehensive report by The Lancet Oncology commission.
Larkin et al., (2022)
7. BACKGROUND
• In Malawi cancer is of growing concern, causing significant morbidity and mortality
due to lack of comprehensive cancer prevention, early detection, treatment and
palliative care services.
• The IARC GLOBOCAN estimates for Malawi indicate total annual new cancer cases
at 15,349, with 5966 cases among men and 9383 in women around 2012.
8. BACKGROUND
• Cancer registration activity in Malawi dates back to 1980, when pathologists at
Queen Elizabeth Central Hospital (QECH) began reporting on surgical specimens
received at the hospital from districts across the country.
• Later in 1985, a formal pathology-based cancer registry was established within the
histopathology department at QECH.
• In 1993, the registry was expanded to become population-based (PBCR) with the aim
of complete registration of all incident cancer cases occurring within the population
of the city of Blantyre and its surroundings, to enable calculation of incidence rates
9. BACKGROUND
• During the period 2008–2010, a total of 3711 cases were recorded among residents of
Blantyre (both urban and rural), 1,643 males corresponding to an ASR of 169.8 per
100,000.
• (Chasimpha et al.2018).
10. MALE REPRODUCTIVE CANCERS
There are a few different types of reproductive cancers that occur in men. The most
common ones are:
● Testicular cancer – begins in the testes, the two egg-shaped glands that make sperm in
the scrotum (ball sac) near the base of the penis
● Penile cancer – begins in the penis, part of the external genitals.
● Prostate cancer – begins in the prostate, a gland inside the pelvis (the area in the
lower belly between the hip bones) that surrounds the urethra (the tube that empties
the bladder)
11. TESTICULAR CANCER
● Testicular cancer is a disease in which malignant (cancer) cells form in the tissues of
one or both testicles.
● Health history can affect the risk of testicular cancer.
● Signs and symptoms of testicular cancer include swelling or discomfort in the
scrotum.
● Tests that examine the testicles and blood are used to diagnose testicular cancer.
● Certain factors affect prognosis (chance of recovery) and treatment options.
● Treatment for testicular cancer can cause infertility.
12. TESTICULAR CANCER STATISTICS; GLOBAL
• Testicular cancer is relatively uncommon and accounts for <1% of all male tumors.
• However, it is the most common solid tumor in men between the ages of 20 and 34
years, and the global incidence has been steadily rising over the past several decades.
• White men are four times more likely than Black men to have testicular cancer.
13. TESTICULAR CANCER STATISTICS; GLOBAL
• In 2020, the International Agency for Research of Cancer (IARC) recorded 74,458
new cases worldwide.
• Incidences vary greatly across the globe, ranging from 3 to 12 new cases per 100,000
males/per year in Western societies.
• In contrast, figures are very low in Asian and African countries. European White men
seems to be more affected overall, independently of the country of residence and
migration compared to other ethnicities.
14. TESTICULAR CANCER STATISTICS; GLOBAL
• Incidence is increasing worldwide, and some countries, such as Slovenia and the
Netherlands, registered a doubling of testicular cancer cases in the last two decades.
Reasons are still unclear.
• An estimated 9,560 new cases of testicular cancer will be diagnosed in the United
States in 2019, resulting in approximately 410 deaths, which reflects the excellent 5-
year survival rate for this disease (∼95%).
15. TESTICULAR CANCER STATISTICS; AFRICA
• The incidence of testicular cancer in Africa is among the lowest worldwide; however,
it is highly likely to be underreported.
• It ranges between 0.3 and 0.6 cases per 100,000 .
• According to IARC, the African continent accounted for 3302 cases which
represented the 4.4% of the total in 2020.
• Data from GLOBOCAN 2008 show relatively high mortality rates in Sub-Saharan
countries like Mali, Ethiopia, Niger, and Malawi.
• Mortality rate has shown a reverse trend to its incidence with higher rates in low- and
middle-income countries (0.5 per 100 000) than in high-income countries.
16. World map of estimated number of new testicular cancer cases in
2020
17. The most common risk factors contributing to testicular cancer
development (Int. J. Mol. Sci. 2015,)
Int. J. Mol. Sci. 2015,
18. DIAGNOSING PENILE CANCER
• Medical history and physical exam.
• Biopsy; Incisional biopsy, Excisional biopsy, Lymph node biopsy.
• Imaging tests; Computed tomography (CT), Magnetic resonance imaging (MRI),
Ultrasound, Chest x-ray.
,
19. TREATMENT FOR TESTICULAR CANCER
Treatment of recurrent testicular cancer may include the following:
• Combination chemotherapy.
• High-dose chemotherapy and stem cell transplant.
• Surgery to remove cancer that has either: come back more than 2 years after
complete remission.
• Clinical trials of a new therapy are underway.
20. PENILE CANCER
• Penile cancer is a disease in which malignant (cancer) cells form in the tissues of the
penis.
• Human papillomavirus infection may increase the risk of developing penile cancer.
• Signs of penile cancer include sores, discharge, and bleeding.
• Tests that examine the penis are used to diagnose penile cancer.
• Certain factors affect prognosis (chance of recovery) and treatment options.
21. PENILE CANCER
• Penile cancer is rare in North America and Europe.
• It's diagnosed in fewer than 1 man in 100,000 each year and accounts for fewer than
1% of cancers in men in the United States.
• Penile cancer is much more common in some parts of Asia, Africa, and South
America.
22. PENILE CANCER STATISTICS
• The estimated age-standardized incidence of penile cancer worldwide was 0.80 per
100,000 person-years in 2018, and the incidence is predicted to increase by more than
56% by 2040, according to the Global Cancer Registries (GLOBOCAN) Cancer
Tomorrow prediction tool.
• In certain Asian, African, and South American countries, the incidence of penile
cancer constitutes up to 10% of malignancies in men.
• The 5-year survival rate of penile cancer is about 65% but greater in countries with
greater access to treatment .
23. PENILE CANCER STATISTICS
• The incidence of penile cancer has been increasing in many areas in the past
few decades.
• There was a 21% increase, from 1.1 to 1.3 per 100,000, in penile cancer
incidence in England between 1979.
• and 2009 ; in Norway, the incidence of penile cancer increased from 0.6 to
0.9 per 100,000 between 1956 and 2015;
• the incidence of penile cancer in Germany increased from 1.2 per 100,000 in
1961 to 1.8 per 100,000 in 2012.
24. PENILE CANCER STATISTICS
Prediction of Incidence and Mortality Patterns in 2020
• The global estimated ASIR of penile cancer was 0.8 (per 100,000) in 2020, with estimates
indicating 36,068 newly diagnosed cases.
• The ASIR of penile cancer varied among 5 continents, with higher ASIRs being observed
in Southern Africa, South Asia, and South America. In 2020, the largest number of
incident cases was estimated to have occurred in India (n=16,677), China (n=4628), and
Brazil (n=1658).
• The highest ASIRs were found in Eswatini (7.0 per 100,000), Uganda (4.6 per 100,000),
and Botswana (4.4 per 100,000), while the lowest were mostly concentrated in countries in
Northern Africa, such as Nigeria and Libya (less than 0.01 per 100,000).
25. PENILE CANCER STATISTICS
• Estimates suggest that 13,211 men with penile cancer died in 2020 globally,
corresponding to an ASMR of 0.29 cases per 100,000 .
• Geographical patterns of ASMR were similar to those of ASIR, and the highest penile
cancer ASMRs were noted in Eswatini (3.5 per 100,000) and Uganda (2.4 per
100,000).
• The largest number of deaths occurred in India (n=4760), China (n=1565), and Brazil
(n=539) in 2020.
27. RISK FACTORS FOR PENILE CANCER
• Infection with human papillomavirus (HPV)
• Smegma and uncircumcised penis
• Age more than 70 years
• Smoking
28. DIAGNOSING PENILE CANCER
• Medical history and physical exam.
• Biopsy; Incisional biopsy, Excisional biopsy, Lymph node biopsy.
• Imaging tests; Computed tomography (CT), Magnetic resonance imaging (MRI),
Ultrasound, Chest x-ray.
,
29. TREATMENT OF PENILE CANCER
• Surgery is the main treatment for most men with penile cancers
• radiation therapy may be used, either instead of or in addition to surgery.
• Other local treatments (circumcision) might also be used for early-stage tumors.
• Chemotherapy may be given for some larger tumors or if the cancer has spread.
30. PROSTATE CANCER
• Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of
the prostate.
• Signs of prostate cancer include a weak flow of urine or frequent urination.
• Tests that examine the prostate and blood are used to diagnose prostate cancer.
• A biopsy is done to diagnose prostate cancer and find out the grade of the cancer
(Gleason score).
• Certain factors affect prognosis (chance of recovery) and treatment options.
31. PROSTATE CANCER STATISTICS
•Prostate cancer is the second most commonly diagnosed cancer and the fifth leading cause of cancer death
among men worldwide, with an estimated 1.41 new cancer cases and 375,304 deaths in 2020 (WHO 2022) .
•Prostate cancer is the most frequently diagnosed cancer in 112 countries, and the leading cause of cancer
death in 48 countries .
• It is worth noting that the burden of prostate cancer is supposed to increase owing to the population aging
and economic growth.
(wang et al.,2022).
32. PROSTATE CANCER STATISTICS
• The incidence rate of prostate cancer varies across the regions and
populations .
• Prostate cancer incidence rates are highly variable worldwide. The age-
standardized rate (ASR) was highest in Oceania (79.1 per 100,000 people)
and North America (73.7), followed by Europe (62.1).
• Conversely, Africa and Asia have incidence rates that are lower than those
from developed countries (26.6 and 11.5, respectively) .
(Globocan 2018).
33. PROSTATE CANCER STATISTICS
• International mortality rates for prostate cancer vary considerably worldwide. In 2018, the
highest mortality rates were recorded in Central America (10.7 per 100,000 people), followed
by Australia and New Zealand (10.2) and Western Europe (10.1).
• The lowest rate was reported in the countries of Asia (South-Central, 3.3; Eastern, 4.7 and
South-Eastern, 5.4) and Northern Africa (5.8).
• One-third of the deaths for prostate cancer occurred in Asia (33.0%, 118,427 of deaths),
followed by Europe (29.9%, 107,315 of deaths).
• The mortality rate of prostate cancer rises with age, and almost 55% of all deaths occur after 65
years of age . (Globocan 2018).
34. PROSTATE CANCER STATISTICS
• Interestingly, a trend towards an increase of prostate cancer incidence worldwide with
1,017,712 new cases (+79.7% overall change) up to 2040 is estimated.
• The highest incidence of prostate cancer will be registered in Africa (+120.6%),
followed by Latin America and the Caribbean (+101.1%) and Asia (100.9%).
• On the contrary, the lowest incidence will be registered in Europe (+30.1%).
(RawlaP.2019)
35. Malawi Prostate cancer
• Number of new cases of prostate cancer in 2020 were 934 (13.8%) of all male
cancers. (Globocan 2020)
• The incidence of prostate cancer in malawi is at 2.7% with a mortality of 2.6%
(Cancer Country Profile 2020)
• According to the latest WHO data published in 2020 Prostate Cancer Deaths in
Malawi reached 271 or 0.28% of total deaths.
36. Fig. 1: World map showing age standardised world incidence rate of prostate
cancer (WHO,2018)
37. Fig. 2: World map showing age standardised world
mortality rate of prostate cancer (WHO,2018)
38. The most common causes contributing to prostate cancer development (Int. J. Mol. Sci.
2015,)
39. DIAGNOSIS OF PROSTATE CANCER
• Medical history and physical exam.
• Digital rectal examination.
• Biopsy; Incisional biopsy, Excisional biopsy, Lymph node biopsy.
• Imaging tests; Computed tomography (CT), Magnetic resonance
imaging (MRI), Ultrasound, Chest x-ray.
,
40. TREATMENT PROSTATE CANCER
• Cryotherapy. Placing a special probe inside or near the prostate cancer to freeze and
kill the cancer cells.
• Chemotherapy. Using special drugs to shrink or kill the cancer.
• Biological therapy.
• High-intensity focused ultrasound.
• Hormone therapy.
41. POLICIES AND GUIDELINES
GLOBAL
• National cancer control programmes; policies and managerial guidelines, second
edition, WHO, 2002.
• Cancer control; knowledge into action; WHO Guide for effective programmes; early
detection, 2007.
• Cancer control; knowledge into action; WHO Guide for effective programmes;
diagnosis and treatment., 2008
42. POLICIES AND GUIDELINES
• Cancer control; knowledge into action; WHO Guide for effective programmes;
palliative care, 2007.
• Guide to cancer early diagnosi, WHO 2017.
• WHO list of priority medical devices for cancer management; WHO Medical device
technical series, 2017
• Road map towards a national cancer control programme, WHO 2019.
43. POLICIES AND GUIDELINES
LOCAL
• Malawi National Reproductive Health Service Delivery Guidelines, 2014-2019.
• National cancer control strategic plan; Malawi, 2019-2029.
44. National cancer control strategic plan; Malawi, 2019-2029.
Has 6 themes
1. Cancer prevention
2. Screening and early diagnosis
3. Palliative care and survivorship.
4. Governance and financing of cancer control.
5. Cancer control research, monitoring and evaluation.
45. National cancer control strategic plan; Guiding principles
1. Equity and universal coverage
2. National ownership and leadership.
3. Primary health care.
4. Human rights based approach.
5. Gender sensitivity.
6. Ethical considerations.
7. Efficiency and effectiveness.
8. Coordination and collaboration.
9. Community participation.
10. Evidence based decision making.
11. Decentralization.
12. Appropriate technology.
13. Accountability for results and
expenditures.
14. Sustainability.
46. WHO FOCUS
• Prevention
• Early detection.
• Screening.
• Diagnosis and staging
• Treatment.
• Palliative care.
• Survivorship care.
47.
48. PREVENTION
• Eliminating or minimizing exposure to the causes of cancer and reducing
susceptibility to the effects of such causes.
• This approach offers the greatest public health potential and generally the most cost-
effective interventions.
• Common priority cancer prevention activities include: controlling tobacco use
through the Framework Convention for Tobacco Control (FCTC); reducing alcohol
consumption; promoting a healthy diet and physical activity, reducing obesity; and
vaccination for hepatitis B and the human papillomavirus.
49. EARLY DIAGNOSIS
• Priority public health activity aimed to raise awareness of signs and symptoms
consistent with cancer, increase access to care, and diagnose and treat cancer at the
earliest possible stage.
• The primary objective of early diagnosis is to improve survival and quality of life of
individuals with cancer, by detecting and treating the cancer at its earliest possible,
potentially curable, stage.
50. SCREENING
• Public health programmes intended to identify and treat patients at risk, at an early
stage of cancer, should be done in an organized manner.
• That includes systematic invitation to a defined target population, application of a
screening test to asymptomatic individuals, notification of the results, diagnostic
examination of the screen positives, and treatment of the screen-detected cases.
• The primary objective of cancer screening is to reduce cancer-specific mortality at a
population level, by detecting the cancer at its earliest curable stage.
51. DIAGNOSING AND STAGING
• Accurate cancer diagnosis is essential for effective cancer management.
• This calls for a combination of careful clinical assessment and diagnostic
investigations including endoscopy, medical imaging, histopathology, cytology and
laboratory studies, which are selected taking into account the disease being evaluated.
• Once a diagnosis has been established, it is necessary to determine the location of the
disease and its spread (staging), in order to help in the selection of the appropriate
therapy and to establish the prognosis.
• Diagnostic techniques are also essential in the follow-up of patients to detect early
relapses and evaluate the efficacy of the established treatment.
52. TREATMENT
• Interventions intended to cure, prolong life, and/or improve quality of life. Treatment
may involve surgery, radiation therapy, chemotherapy, hormonal therapy, or a
combination of these.
• Supportive care is an essential component of cancer treatment.
53. PALLIATIVE CARE
• Palliative care is an approach that improves the quality of life of patients and their
families facing the problems associated with life threatening illness, through the
prevention and relief of pain and symptoms.
• Palliative care services should be available in every country and should be given high
priority, especially in resource-limited settings where cure of the majority of cancer
patients is likely to remain beyond reach for years to come.
54. SURVIVORSHIP CARE
• Set of services that include surveillance for recurrence or new primaries; prevention,
detection of new cancers; monitoring and managing long term toxicities; and
coordination of care to ensure survivor care needs are met.
• Survivorship care includes a detailed plan that contains a summary of the patient’s
treatment and follow-up care.
55. STUDIES ON MALE REPRODUCTIVE CANCERS
• Msyamboza, K. P., Manda, G., Tembo, B., Thambo, C., Chitete, L., Mindiera, C., Finch, L. K., & Hamling,
K. (2014). Cancer survival in Malawi: a retrospective cohort study. The Pan African medical journal, 19,
234. https://doi.org/10.11604/pamj.2014.19.234.4675.
• Mukhula, V., Sibale, D., Tarmahomed, L., Dzamalala, C., Msyamboza, K., & Chasimpha, S. (2017).
Characterising cancer burden and quality of care at two palliative care clinics in Malawi. Malawi medical
journal : the journal of Medical Association of Malawi, 29(2), 130–135.
https://doi.org/10.4314/mmj.v29i2.10
• Msyamboza, K. P., Dzamalala, C., Mdokwe, C., Kamiza, S., Lemerani, M., Dzowela, T., & Kathyola, D.
(2012). Burden of cancer in Malawi; common types, incidence and trends: national population-based cancer
registry. BMC research notes, 5, 149. https://doi.org/10.1186/1756-0500-5-149
• Makene, F.S., Ngilangwa, R., Santos, C. et al. Patients’ pathways to cancer care in Tanzania: documenting
and addressing social inequalities in reaching a cancer diagnosis. BMC Health Serv Res 22, 189 (2022).
https://doi.org/10.1186/s12913-021-07438-5
56. STUDIES ON MALE REPRODUCTIVE CANCERS
• Makau-Barasa, L. K., Manirakiza, A., Carvalho, A. L., & Rebbeck, T. R. (2022).
Prostate Cancer Screening, Diagnostic, Treatment Procedures and Costs in Sub-
Saharan Africa: A Situational Analysis. Cancer control : journal of the Moffitt
Cancer Center, 29, 10732748221084932.
https://doi.org/10.1177/10732748221084932
• David P Weller, Julietta Patnick, Heather M McIntosh, Allen J Dietrich (2009),
Uptake in cancer screening programmes,The Lancet Oncology, Volume 10, Issue 7,
Pages 693-699, ISSN 1470-2045, https://doi.org/10.1016/S1470-2045(09)70145-7.
57. PROGRAMMES EVALUATIONS
PROGRAMMES
• Prostate cancer awareness month, November 2019, ‘no shave’(by FDH BANK)
• Opening of the National Cancer Treatment Centre (NCTC) in Lilongwe, early 2020.
• Palliative care
58. NATIONAL CANCER CENTER
● The National Cancer Treatment Center (NCTC) in Lilongwe which was earmarked
for opening in 2019.
● The development and operationalization of the cancer centre is the single most
important initiative in the national cancer control program of Malawi given the fact
that cancer treatment is currently highly fragmented and provided in overextended
hospitals with limited infrastructure, consumable supply chain problems and limited
skilled and experienced human resources.
● The cancer center is planned within the campus of KCH, as a matrix type of cancer
centre with its own cancer surgery, radiotherapy, chemotherapy, hormone therapy,
palliative care, pathology and other allied diagnostic services, medical records and
hospital cancer registry services.
59. PALLIATIVE CARE
● Government of Malawi recognizes the importance of palliative care to improve the
quality of life and symptom burden for all patients and families affected by life
threatening illnesses including cancer.
● In October 2014, Ministry of Health, Government of Malawi formulated a national
palliative care policy to take forward the national agenda for the health sector.
● In Malawi, palliative care has a desk officer under the nursing directorate of Ministry
of Health.
60. PALLIATIVE CARE
● Palliative care services are conducted either as home visits, hospital visits or outreach
clinics in about 78 nationwide sites in 2016.
● This represented an increase of 15% from 72 sites in 2015.
● There were 1141 trained service providers in the same reporting period.
● There were 61,323 patients that accessed palliative care services representing 36% of
the cases that needed it. Adults contributed 76% while 24% were children.
61. CHALLENGES FOR CANCER TREATMENT
• Lack of awareness about male cancer among the general public, health care providers
and policy-makers
• Unavailable or non-existent high quality male cancer prevention and control services
• Fragmented or dysfunctional healthcare infrastructure
• Lack of effective referral systems
• Lack of appropriate public health policies
• Other competing health priorities (Inequalities)
62. CHALLENGES
Key challenges in the provision of cancer treatment services in the country include;
• High rate of late diagnosis while other cases go undiagnosed due to inadequate cancer services,
low awareness of symptoms;
• Low rate of treatment acceptance and adherence because of challenges of geographical access
,personal resources and use of alternative therapy instead of conventional therapies.
• Low index of suspicion by health providers;
• Inadequate and deficient diagnostic and treatment infrastructure;
• Poor referral systems, inadequate cancer specialists, lack of effective patient navigation systems
and direct and indirect costs associated with cancer treatment.
63. CHALLENGES
• Anti-cancerous drugs are in short supply with erratic supply chain, despite the
availability of the national essential medicine list.
• There are no radiotherapy services in the country.
• Significant proportion of patients present in advanced clinical stages and do not
complete the prescribed course of treatment due to various barriers, limitations and
challenges.
64. AREAS FOR RESEARCH
• Laboratory (e.g. biological mechanisms underlying cancer)
• Epidemiological (e.g. environmental or human behavioral factors)
• Clinical (e.g. determining most effective treatment)
• Psychosocial and behavioral (e.g. factors impacting on prevention, the response to
screening and impact of diagnosis and treatment)
• Health systems and health policies (e.g. how services can best be implemented and
organized
• Inequalities in cancer control
65. LEADERSHIP ROLES
• Advocate for government funding for cancer research.
• Develop a research agenda for cancer prevention and control in the national research
agenda.
• Create dissemination channels for research on cancer such as annual cancer
symposiums.
• Work with other research institutions to develop strategic process for facilitating
cancer research.
66. RECOMMENDATION
• Develop an effective training program for awareness on male reproductive
cancers.(Awareness-campaign)
• Counselling and information sharing about screening for male cancers.
• At a minimum, screening for every man > 55 years of age at least once in a year.
• Advocacy- for male reproductive cancer services.
67. References
• Assessing national capacity for the prevention and control of noncommunicable
diseases: report of the 2019 global survey. Geneva: World Health Organization;
2020
• Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. Global Cancer
Observatory: Cancer Today. Lyon: International Agency for Research on Cancer;
2020 (https://gco.iarc.fr/today, accessed February 2021).
• Msyamboza, K. P., Dzamalala, C., Mdokwe, C., Kamiza, S., Lemerani, M.,
Dzowela, T., & Kathyola, D. (2012). Burden of cancer in Malawi; common types,
incidence and trends: national population-based cancer registry. BMC research
notes, 5, 1-8.
68. References
• Fu, L., Tian, T., Yao, K., Chen, X. F., Luo, G., Gao, Y., Lin, Y. F., Wang, B., Sun, Y.,
Zheng, W., Li, P., Zhan, Y., Fairley, C. K., Grulich, A., & Zou, H. (2022). Global
Pattern and Trends in Penile Cancer Incidence: Population-Based Study. JMIR public
health and surveillance, 8(7), e34874. https://doi.org/10.2196/34874
• Rawla P. (2019). Epidemiology of Prostate Cancer. World journal of oncology, 10(2),
63–89. https://doi.org/10.14740/wjon1191
Editor's Notes
However, in the absence of a national cancer registry, it is difficult to achieve the true incidence at a national level
Surprisingly, genetic alterations alone contribute to about 25% of the causes for TC. The remaining
75% can be attributed to yet unknown factors (Int. J. Mol. Sci. 2015,)
The change can be largely attributed to the increasing aging of the population, as penile cancer mostly affects older men with a peak in incidence in the sixth decade .
The treatments for penile cancer can be disfiguring and affects the patient’s quality of life and sexual function
This increase in the incidence rates appears to be related to an increased life expectancy.
Increasing incidence rate trends in developing countries is likely due to improved access to medical care as well as increased documentation and reporting of cases.
Finally, the fact that incidence rates are increasing in those regions where PSA testing is not routinely used suggests that this phenomenon reflects westernization of the lifestyle including obesity, physical inactivity and dietary factors.
Smoking (can be changed),.
2. Like a person’s age or family history -cannot be changed.
•prostate cancer rises rapidly after age 50. About 6 in 10 cases of prostate cancer are found in men older than 65.
•
3. Race/ethnicity
•More in African American men and in Caribbean men
•less often in Asian American, Hispanic, and Latino men.
The reasons for these racial and ethnic differences are not clear
Geography
•Prostate cancer is most common in North America, northwestern Europe, Australia, and on Caribbean islands.
•It is less common in Asia, Africa, Central America, and South America.The reasons for this are not clear.
5. Family history
•Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor.
Screening programmes should be undertaken after a demonstration project has been completed, when resources (personnel, equipment etc.) are sufficient to cover the entire target group, when facilities exist for confirming diagnoses and for treatment and follow-up of those with abnormal results, and when prevalence of the disease is high enough to justify the effort and costs of screening.
While screening for cervical cancer can be performed in all countries, screening for other cancers (e.g. breast) should only be performed in countries with strong health systems.
Common activities for survivorship care may include clinical evaluations and medical tests to monitor for cancer recurrence or new cancers as well as to assess for evidence of long-term complications from cancer treatment.
Additional survivorship care needs can include services to support the emotional, social, legal, and financial needs of the patient.