Cancer Lecture

CANCER
AB RAJAR
ASSOCIATE PROFESSOR
COMMUNITY MEDICINE.
MUHAMMAD MEDICAL COLLEGE
Email:drabrajar@gmail.com

INTRODUCTION
 Cancer may regarded as a group of diseases characterized by an:
• Abnormal growth of cells
• Ability to invade tissue and even distant organs
• The eventually death of the affected patient if the tumor has
Progressed beyond the stage when it can be successful
removed

MAJOR CATEGORIES OF CANCER
 CARCINOMA:
• Arises from the epithelial cells lining the internal surface of various
organs (e.g. mouth, esophagus, uterus)
 SARCOMA:
• Arises from the mesodermal cells constituting the various
connective tissues (e.g. fibrous tissue, bone)
 LYMPHOMA, MYELOMA AND LEUKEMIA:
• Arising from the cells of the bone marrow and immune system

Global Burden
 Second leading cause of death globally
 Estimated 9.6 million deaths in 2018
 About 1 in 6 deaths is due to cancer
 Approximately 70% of deaths from cancer occur in low- and
middle-income countries.
 Tobacco use is the most important risk factor for cancer and is
responsible for approximately 22% of cancer deaths
 The total annual economic cost of cancer in 2010 was
estimated at approximately US$ 1.16 trillion.

The Problem
 Cancer is a leading cause of death worldwide, an estimated
9.6 million deaths in 2018.
I. Lung (2.09 million cases)
II. Breast (2.09 million cases)
III. Colorectal (1.80 million cases)
IV. Prostate (1.28 million cases)
V. Skin cancer (non-melanoma) (1.04 million cases)
VI. Stomach (1.03 million cases)

Burden in Pakistan
 Breast 19.6%
 Lip, oral cavity 10.9 %
 Lungs 5.6%
 Esophagus 4.6%
 Leukemia 4.1%
 Other cancers 53.3%

Number of new cases 2018,females all ages
 Breast 36.8%
 Lip, Oral cavity 6.4%
 Cervix, Uterus 6%
 Ovary 4.9 %
 Esophagus 3.5 %
 Other cancers 42.4%

Number of new cases 2018,Males all ages
 Lip, oral Cavity 15.9%
 Lungs 9.8%
 Esophagus 5.8%
 Prostate 5.6%
 Leukemia 5.2 %
 Other cancers 57.77 %

CAUSES OF CANCER

CAUSES OF CANCER
 There are lot of international variations in the pattern of cancer
which are attributed to a number of factors divided such as:
A.Environmental Factors
B.Genetic Factors
C. Life Style
D. Food Habits
E. Inadequacy in detection and reporting of cases

A. ENVIRONMENTAL FACTORS
 TOBACCO
 Tobacco in various forms of usage can cause cancer of lungs,
larynx, mouth, pharynx, esophagus, bladder, pancreas and
probably kidney
 Cigarette smoking is now responsible for more than 1 million
death each year

 ALCOHOL
 Excess intake of alcohol can cause esophageal and liver
cancer
 Beer consumption may be associated with rectal cancer
 Alcohol contributes about 3 % of all cancer deaths

 DIETARY FACTOR
Smoked fish is related to stomach cancer
Dietary fiber to intestinal cancer
Beef consumption to bowel cancer
High fat diet to breast cancer
Food additives and contaminants have fallen under suspicion
as causative agents

 OCCUPATIONAL EXPOSURES
 These includes exposure to benzene, cadmium, arsenic,
chromium, vinyl chloride, asbestos, polycyclic hydrocarbons, etc.
 The risk of occupational exposure is said to be increased if the
individual also smokes cigarette
 Occupational exposure is usually reported 1-5% of human
cancer

 VIRUS
 Hepatitis B & C - hepatocarcinoma
 HIV infection – Kaposi's carcinoma
 AIDS – non Hodgkin’s lymphoma
 Epstein – bar virus – Burkett's lymphoma and naso –
pharyngeal carcinoma
 Cytomegalovirus – Kaposi’s Sarcoma
 Papilloma virus – cervix cancer
 Human T cell leukemia virus – T cell leukemia

 PARASITE
 May be a cause of cancer
 Schistosomiasis can produce Ca of bladder
 CUSTOMS, HABITS AND LIFE STYLE
 May be associated with an increased risk of cancer
 Smoking and lung cancer
 Tobacco and beetle chewing and oral cancer

B. GENETIC FACTORS
 Genetic influences have long been suspected
 Retinoblastoma occurs in children of the same
parent
 Mongols are more likely to develop leukemia
 There is probably a complex relationship between
hereditary susceptibility and environmental
carcinogenic stimuli in the causation of cancer

PREVENTION AND CONTROL

PREVENTION AND CONTROL
 It consists of
 Prevention, detection, diagnosis, treatment, after care and
rehabilitation, reducing incidence and prevalence.
 It can achieved by:
A.PRIMARY PREVENTION
B.SECONDARY PREVENTION

PRIMARY PREVENTION
 Control of Tabaco and alcohol consumption
 Control of these two will reduce the total burden of cancer
by 1 million cases per year
 Personal hygiene:
 Improvement in hygiene may decline the incidence of
certain types of cancers

PRIMARY PREVENTION
 Radiation
 Effort should be made to reduce the amount of radiation
received by each individuals to a minimum without
reducing the benefits
 Occupational Exposure
 Should protect worker s from exposure to industrial
carcinogens.

PRIMARY PREVENTION
 Food, drugs, and cosmetics
 Should be tested for carcinogens
 Air pollutions
 Control of air pollution is a preventive measure
 Treatment of pre cancerous lesions
 Early detection and prompt treatment of precancerous
lesions

PRIMARY PREVENTION
 Cancer Education
 Should be directed in high risk groups
 To motivate people for early diagnosis and treatment
 A lump or hard area in the breast
 A change in a wart or mole
 A persistent change in digestive and bowel habits

PRIMARY PREVENTION
 To motivate people for early diagnosis and treatment
 A persistent cough or hoarseness
 Excessive loss of blood at the monthly period or loss of
blood
 outside the usual dates
 Blood loss from any natural orifice
 A swelling or sore that does not get better
 Unexplained loss of weight

SECONDARY PREVENTION
 Cancer registration
 Hospital-based registries
 Population based registries
 Early detection of cases
 By screening for pre-malignant conditions in high risk
groups.

SECONDARY PREVENTION
 Treatment
 Surgical removal
 Radiotherapy
 Chemotherapy

CANCER SCREENING
 FOR CERVICAL CANCER
 Pap Smear
 Periodic Pelvic Examination
 FOR LUNG CANCER
 Chest x-rays
 Sputum cytology.

CANCER SCREENING
 FOR BREAST CANCER
 Breast self examination (BSE) by the patient
 Palpation by physician
 Thermography mammography

ThankYou

Cancer Lecture

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