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Jaypee Business School
       A constituent of Jaypee Institute of Information Technology
                              (Deemed University)

                      A-10, Sector 62, Noida (UP) India 201 307
                                    www.jbs.ac.in



                    Social Internship Report
                              On
                    CANCER AWARENESS


Submitted as a partial fulfillment for the award of the Two year Full Time
                                Program in

                   Master of Business Administration


                         Name: NEETU YADAV

                                MBA 2009-11



     NGO- SIDDHARTHA VASHISHTA CHARITABLE TRUST



                   Supervisor’s Name: Mr. A.K Passy
                  Contact Details : 011- 45751984, 9971796526



                  Start Date for Internship: 23-02-2011

                  End Date for Internship: 25-03-2011
Cancer is a class of diseases in which a group of cells display uncontrolled growth, invasion
that intrudes upon and destroys adjacent tissues, and sometimes metastasis, or spreading to
other locations in the body via lymphor blood. These three malignant properties of cancers
differentiate them from benign tumors, which do not invade or metastasize.

Researchers divide the causes of cancer into two groups:

       •   Those with an environmental cause

       •   Those with a hereditary genetic cause.

    Cancer is primarily an environmental disease, though genetics influence the risk of some
cancers.

Common          environmental    factors     leading    to      cancer        include: tobacco,    diet
and obesity, infections, radiation,   lack     of    physical     activity,      and      environmental
pollutants. These environmental factors cause or enhance abnormalities in the genetic
material of cells. Cell reproduction is an extremely complex process that is normally tightly
regulated by several classes of genes, including oncogenes and tumor suppressor genes.
Hereditary or acquired abnormalities in these regulatory genes can lead to the development of
cancer. A small percentage of cancers, approximately five to ten percent, are entirely
hereditary.

The presence of cancer can be suspected on the basis of symptoms, or findings on radiology.
Definitive diagnosis of cancer, however, requires the microscopic examination of
a biopsy specimen.       Most      cancers     can     be       treated.       Possible      treatments
include chemotherapy,radiotherapy and surgery. The prognosis is influenced by the type of
cancer and the extent of disease. While cancer can affect people of all ages, and a few types
of cancer are more common in children, the overall risk of developing cancer increases with
age. In 2007 cancer caused about 13% of all human deaths worldwide (7.9 million). Rates are
rising as more people live to an old age and lifestyles change in the developing world.

Cancers are classified by the type of cell that the tumor resembles and is therefore presumed
to be the origin of the tumor. These types include:

     Carcinoma: Cancer derived from epithelial cells. This group includes many of the most
      common cancers, including those of the breast, prostate, lung and colon.
     Sarcoma: Cancer derived from connective tissue, or mesenchymal cells.
     Lymphoma and leukemia: Cancer derived from hematopoietic (blood-forming) cells
   Germ cell tumor: Cancer derived from pluripotent cells. In adults these are most often
    found in the testicle and ovary, but are more common in babies and young children.
   Blastoma: Cancer derived from immature "precursor" or embryonic tissue. These are also
    commonest in children.

Cancers are usually named using -carcinoma, -sarcoma or -blastoma as a suffix, with the
Latin or Greek word for the organ or tissue of origin as the root. For example, a cancer of the
liver is called hepatocarcinoma; a cancer of fat cells is called a liposarcoma. For some
common cancers, the English organ name is used. For example, the most common type
of breast cancer is called ductal carcinoma of the breast. Here, the adjective ductal refers to
the appearance of the cancer under the microscope, which suggests that it has originated in
the milk ducts.

Benign tumors (which are not cancers) are named using -oma as a suffix with the organ name
as the root. For example, a benign tumor of smooth muscle cells is called a leiomyoma(the
common name of this frequently occurring benign tumor in the uterus is fibroid).
Confusingly,      some   types   of   cancer   also    use   the   -oma    suffix,   examples
including melanoma and seminoma.



                                  Signs and symptoms
Symptoms of cancer metastasis depend on the location of the tumor.

Cancer symptoms can be divided into three groups:

    Local symptoms: are restricted to the site of the primary cancer. They can include lumps
     or    swelling       (tumor), hemorrhage (bleeding       from       the   skin,      mouth    or
     anus), ulceration and pain. Although local pain commonly occurs in advanced cancer, the
     initial swelling is often painless.
    Metastatic symptoms: are due to the spread of cancer to other locations in the body.
     They can include enlarged lymph nodes (which can be felt or sometimes seen under the
     skin), hepatomegaly (enlarged liver) or splenomegaly (enlarged spleen) which can be felt
     in the abdomen, pain or fracture of affected bones, and neurological symptoms.
    Systemic symptoms: occur due to distant effects of the cancer that are not related to direct
     or   metastatic     spread.   Some    of    these   effects   can   include weight    loss (poor
     appetite and cachexia), fatigue, excessive sweating (especially night sweats), anemia (low
     red blood cell count) and other specific conditions termed paraneoplastic phenomena.
     These may be mediated by immunological or hormonal signals from the cancer cells.




                                                Causes

Cancers are primarily an environmental disease with 90-95% of cases attributed to
environmental factors and 5-10% due to genetics.[1]Environmental, as used by cancer
researchers, means any cause that is not genetic. Common environmental factors that
contribute          to         cancer           death       include: tobacco (25-30%),            diet
and obesity (30-35%), infections (15-20%), radiation (both ionizing and non ionizing, up to
10%), stress, lack of physical activity, and environmental pollutants.
The incidence of lung cancer is highly correlated with smoking

Cancer pathogenesis is traceable back to DNA mutations that impact cell growth and
metastasis. Substances that cause DNA mutations are known as mutagens, and mutagens that
cause cancers are known as carcinogens. Particular substances have been linked to specific
types of cancer. Tobacco smoking is associated with many forms of cancer, and causes 90%
of lung cancer.

Many mutagens are also carcinogens, but some carcinogens are not mutagens. Alcohol is an
example of a chemical carcinogen that is not a mutagen. Such chemicals may promote
cancers through stimulating the rate of cell division. Faster rates of replication leaves less
time for repair enzymes to repair damaged DNA during DNA replication, increasing the
likelihood of a mutation.

Decades of research has demonstrated the link between tobacco use and cancer in
the lung, larynx, head, neck, stomach, bladder, kidney, esophagus and pancreas. Tobacco
smoke contains over fifty known carcinogens, including nitrosamines and polycyclic
aromatic hydrocarbons. Tobacco is responsible for about one in three of all cancer deaths in
the developed world and about one in five worldwide. Lung cancer death rates in the United
States have mirrored smoking patterns, with increases in smoking followed by dramatic
increases in lung cancer death rates and, more recently, decreases in smoking followed by
decreases in lung cancer death rates in men. However, the numbers of smokers worldwide is
still rising, leading to what some organizations have described as the tobacco epidemic.

Cancer related to one's occupation is believed to represent between 2-20% of all cases. Every
year, at least 200,000 people die worldwide from cancer related to their workplace. Currently,
most cancer deaths caused by occupational risk factors occur in the developed world. It is
estimated that approximately 20,000 cancer deaths and 40,000 new cases of cancer each year
in the U.S. are attributable to occupation. Millions of workers run the risk of developing
cancers such as lung cancer and mesothelioma from inhaling asbestos fibers and tobacco
smoke, or leukemia from exposure to benzene at their workplaces.




                                      Diet and exercise


Diet, physical inactivity, and obesity are related to approximately 30-35% of cancer cases. In
the United States excess body weight is associated with the development of many types of
cancer and is a factor in 14-20% of all cancer death. Physical inactivity is believed to
contribute to cancer risk not only through its effect on body weight but also through negative
effects on immune system and endocrine system.

Diets that are low in vegetables, fruits and whole grains, and high in processed or red meats
are linked with a number of cancers. A high salt diet is linked to gastric cancer, aflatoxin B1,
a frequent food contaminate, with liver cancer, and Betel nut chewing with oral cancer.This
may partly explain differences in cancer incidence in different countries for examplegastric
cancer is more common in Japan with its high salt diet and colon cancer is more common in
the United States. Immigrants develop the risk of their new country, often within one
generation, suggesting a substantial link between diet and cancer.



                                            Infection


Worldwide approximately 18% of cancers are related to infectious diseases. This proportion
varies in different regions of the world from a high of 25% in Africa to less than 10% in the
developed     world. Viruses are      usual      infectious     agents        that      cause    cancer
but bacteria and parasites may also have an effect.

A   virus   that   can     cause   cancer   is   called   an oncovirus.       These      include human
papillomavirus (cervical      carcinoma), Epstein-Barr        virus (B-cell          lymphoproliferative
disease and nasopharyngeal          carcinoma), Kaposi's            sarcoma              herpesvirus (Kaposi's
Sarcoma and       primary       effusion        lymphomas), hepatitis        B and hepatitis        C viruses
(hepatocellular carcinoma), and Human T-cell leukemia virus-1 (T-cell leukemias). Bacterial
infection may also increase the risk of cancer, as seen in Helicobacter pylori-induced gastric
carcinoma. Parasitic infections strongly associated with cancer include Schistosoma
haematobium (squamous cell carcinoma of the bladder) and the liver flukes, Opisthorchis
viverrini and Clonorchis sinensis (cholangiocarcinoma).



                                                Radiation
Up to 10% of cancers are related to radiation exposure either ionizing or
nonionizing. Sources    of ionizing        radiation,      include medical       imaging,      and radon gas.
Radiation can cause cancer in most parts of the body, in all animals, and at any age, although
radiation-induced solid tumors usually take 10–15 years, and up to 40 years, to become
clinically manifest, and radiation-induced leukemias typically require 2–10 years to
appear. Some      people,       such       as     those      with nevoid         basal      cell   carcinoma
syndrome or retinoblastoma, are more susceptible than average to developing cancer from
radiation exposure. Children and adolescents are twice as likely to develop radiation-induced
leukemia as adults; radiation exposure before birth has ten times the effect. Ionizing radiation
is not a particularly strong mutagen. Residential exposure to radon gas, for example, has
similar cancer risks as passive smoking. Low-dose exposures, such as living near a nuclear
power plant, are generally believed to have no or very little effect on cancer
development. Radiation is a more potent source of cancer when it is combined with other
cancer-causing agents, such as radon gas exposure plus smoking tobacco.

Unlike chemical or physical triggers for cancer, ionizing radiation hits molecules within cells
randomly. If it happens to strike a chromosome, it can break the chromosome, result in
anabnormal number of chromosomes, inactivate one or more genes in the part of the
chromosome that it hit, delete parts of the DNA sequence, cause chromosome translocations,
or cause other types of chromosome abnormalities. Major damage normally results in the cell
dying, but smaller damage may leave a stable, partly functional cell that may be capable of
proliferating and developing into cancer, especially if tumor suppressor genes were damaged
by the radiation. Three independent stages appear to be involved in the creation of cancer
with   ionizing    radiation:     morphological           changes   to     the     cell,    acquiring cellular
immortality (losing normal, life-limiting cell regulatory processes), and adaptations that favor
formation of a tumor. Even if the radiation particle does not strike the DNA directly, it
triggers responses from cells that indirectly increase the likelihood of mutations.

Medical use of ionizing radiation is a growing source of radiation-induced cancers. Ionizing
radiation may be used to treat other cancers, but this may, in some cases, induce a second
form of cancer. It is also used in some kinds of medical imaging. One report estimates that
approximately 29,000 future cancers could be related to the approximately 70 million CT
scans performed in the US in 2007. It is estimated that 0.4% of current cancers in the United
States are due to CTs performed in the past and that this may increase to as high as 1.5-2%
with 2007 rates of CT usage.

Prolonged exposure to ultraviolet radiation from the sun can lead to melanoma and other skin
malignancies. Clear evidence establishes ultraviolet radiation, especially the medium
wave UVB, as the cause of most non-melanoma skin cancers, which are the most common
forms of cancer in the world.

Non-ionizing radio frequency radiation from mobile phones, electric power transmission, and
other similar sources has also been proposed as a cause of cancer, but there is currently little
established evidence of such a link.



                                          Heredity
Less than 0.3% of the population are carriers of a genetic mutation which has a large effect
on cancer risk. They cause less than 3-10% of all cancer. [25] Some of these syndromes
include:

   certain inherited mutations in the genes BRCA1 and BRCA2 with a more than 75% risk
    of breast cancer and ovarian cancer
   tumors of various endocrine organs in multiple endocrine neoplasia (MEN types 1, 2a,
    2b)
   Li-Fraumeni syndrome (various tumors such as osteosarcoma, breast cancer, soft tissue
    sarcoma, brain tumors)
   Turcot syndrome (brain tumors and colonic polyposis)
   Familial adenomatous polyposis an inherited mutation of the APC gene that leads to early
    onset of colon carcinoma.
   Hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome) can
    include familial cases of colon cancer, uterine cancer, gastric cancer, and ovarian cancer,
    without a preponderance of colon polyps.
   Retinoblastoma, when occurring in young children, is due to a hereditary mutation in the
    retinoblastoma gene.
   Down syndrome patients, who have an extra chromosome 21, are known to develop
    malignancies such as leukemia and testicular cancer, though the reasons for this
    difference are not well understood.



                                       Physical agents


Some substances cause cancer primarily through their physical, rather than chemical, effects
on cells.

A prominent example of this is prolonged exposure to asbestos, naturally occurring mineral
fibers which are a major cause of mesothelioma, a type of lung cancer. Other substances in
this category include both naturally occurring and synthetic asbestos-like fibers, such
as wollastonite, attapulgite, glass wool, and rock wool, are believed to have similar effects.

Nonfibrous      particulate     materials     that     cause      cancer     include        powdered
metallic cobalt and nickel, and crystalline silica (quartz, cristobalite, and tridymite).

Usually, physical carcinogens must get inside the body (such as through inhaling tiny pieces)
and require years of exposure to develop cancer.

                           Physical trauma and inflammation
Physical trauma resulting in cancer is relatively rare. Claims that breaking bone resulted in
bone cancer, for example, have never been proven. Similarly, physical trauma is not accepted
as a cause for cervical cancer, breast cancer, or brain cancer.

One accepted source is frequent, long-term application of hot objects to the body. It is
possible that repeated burns on the same part of the body, such as those produced
by kanger and kairo heaters (charcoal hand warmers), may produce skin cancer, especially if
carcinogenic chemicals are also present. Frequently drinking scalding hot tea may produce
esophageal cancer.
Generally, it is believed that the cancer arises, or a pre-existing cancer is encouraged, during
the process of repairing the trauma, rather than the cancer being caused directly by the
trauma. However, repeated injuries to the same tissues might promote excessive cell
proliferation, which could then increase the odds of a cancerous mutation. There is no
evidence that inflammation itself causes cancer.




                                         Hormones
Some hormones cause cancer, primarily by encouraging cell proliferation. Hormones are an
important cause of sex-related cancers such as cancer of the breast, endometrium, prostate,
ovary, and testis, and also of thyroid cancer and bone cancer.

An individual's hormone levels are mostly determined genetically, so this may at least partly
explains the presence of some cancers that run in families that do not seem to have any
cancer-causing genes. For example, the daughters of women who have breast cancer have
significantly higher levels of estrogen and progesterone than the daughters of women without
breast cancer. These higher hormone levels may explain why these women have higher risk
of breast cancer, even in the absence of a breast-cancer gene. Similarly, men of African
ancestry have significantly higher levels of testosterone than men of European ancestry, and
have a correspondingly much higher level of prostate cancer. Men of Asian ancestry, with the
lowest levels of testosterone-activating androstanediol glucuronide, have the lowest levels of
prostate cancer.

However, non-genetic factors are also relevant: Obese people have higher levels of some
hormones associated with cancer, and a higher rate of those cancers. Women who
takehormone replacement therapy have a higher risk of developing cancers associated with
those hormones.[27] On the other hand, people who exercise far more than average have lower
levels of these hormones, and lower risk of cancer. Osteosarcoma may be caused by growth
hormones Some treatments and prevention approaches leverage this cause by artificially
reducing hormone levels, and thus discouraging hormone-sensitive cancers.
Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell
somewhat.

Cancer is fundamentally a disease of failure of regulation of tissue growth. In order for a
normal cell to transform into a cancer cell, the genes which regulate cell growth and
differentiation must be altered.

The affected genes are divided into two broad categories. Oncogenes are genes which
promote cell growth and reproduction. Tumor suppressor genes are genes which inhibit cell
division and survival. Malignant transformation can occur through the formation of novel
oncogenes, the inappropriate over-expression of normal oncogenes, or by the under-
expression or disabling of tumor suppressor genes. Typically, changes in many genes are
required to transform a normal cell into a cancer cell.
Genetic changes can occur at different levels and by different mechanisms. The gain or loss
of an entire chromosome can occur through errors in mitosis. More common are mutations,
which are changes in the nucleotide sequence of genomic DNA.

Large-scale mutations involve the deletion or gain of a portion of a chromosome. Genomic
amplification occurs when a cell gains many copies (often 20 or more) of a small
chromosomal locus, usually containing one or more oncogenes and adjacent genetic
material. Translocation occurs when two separate chromosomal regions become abnormally
fused, often at a characteristic location. A well-known example of this is the Philadelphia
chromosome, or translocation of chromosomes 9 and 22, which occurs in chronic
myelogenous leukemia, and results in production of the BCR-abl fusion protein, an
oncogenic tyrosine kinase.

Small-scale mutations include point mutations, deletions, and insertions, which may occur
in the promoter region of a gene and affect its expression, or may occur in the gene's coding
sequence and alter the function or stability of its protein product. Disruption of a single gene
may also result fromintegration of genomic material from a DNA virus or retrovirus, and
resulting in the expression of viral oncogenes in the affected cell and its descendants.

Replication of the enormous amount of data contained within the DNA of living cells
will probabilistically result in some errors (mutations). Complex error correction and
prevention is built into the process, and safeguards the cell against cancer. If significant error
occurs, the damaged cell can "self destruct" through programmed cell death,
termed apoptosis. If the error control processes fail, then the mutations will survive and be
passed along to daughter cells.

Some environments make errors more likely to arise and propagate. Such environments can
include the presence of disruptive substances calledcarcinogens, repeated physical injury,
heat, ionising radiation, or        hypoxia. The errors which cause cancer are self-
amplifying and compounding, for example:

   A mutation in the error-correcting machinery of a cell might cause that cell and its
    children to accumulate errors more rapidly
   A further mutation in an oncogene might cause the cell to reproduce more rapidly and
    more frequently than its normal counterparts.
   A further mutation may cause loss of a tumour suppressor gene, disrupting the apoptosis
    signalling pathway and resulting in the cell becoming immortal.
   A further mutation in signaling machinery of the cell might send error-causing signals to
    nearby cells

The transformation of normal cell into cancer is akin to a chain reaction caused by initial
errors, which compound into more severe errors, each progressively allowing the cell to
escape the controls that limit normal tissue growth. This rebellion-like scenario becomes an
undesirable survival of the fittest, where the driving forces of evolution work against the
body's design and enforcement of order. Once cancer has begun to develop, this ongoing
process, termed clonal evolution drives progression towards more invasive stages.



                                         Diagnosis




Chest x-ray showing lung cancer in the left lung.



                                        Pathology


A cancer may be suspected for a variety of reasons, but the definitive diagnosis of most
malignancies must be confirmed by histologicalexamination of the cancerous cells by
a pathologist. Tissue can be obtained from a biopsy or surgery. Many biopsies (such as those
of the skin, breast or liver) can be done in a doctor's office. Biopsies of other organs are
performed under anesthesia and require surgery in anoperating room.
The tissue diagnosis given by the pathologist indicates the type of cell that is proliferating,
its histological grade, genetic abnormalities, and other features of the tumor. Together, this
information is useful to evaluate the prognosis of the patient and to choose the best
treatment. Cytogenetics and immunohistochemistry are other types of testing that the
pathologist may perform on the tissue specimen. These tests may provide information about
the molecular changes (such as mutations, fusion genes, and numerical chromosome changes)
that has happened in the cancer cells, and may thus also indicate the future behavior of the
cancer (prognosis) and best treatment.

                                  




An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of
whitish scar tissue in the surrounding yellow fatty tissue.




                                  




An invasive colorectal carcinoma (top center) in acolectomy specimen.




                                         




A squamous cell carcinoma (the whitish tumor) near the bronchi in a lung specimen.





A large invasive ductal carcinoma in amastectomy specimen.



                                          Prevention

Cancer prevention is defined as active measures to decrease the incidence of cancer. The vast
majority of cancer risk factors are environmental or lifestyle-related, thus cancer is largely a
preventable disease. Greater than 30% of cancer is preventable via avoiding risk factors
including: tobacco, overweight or obesity,     low     fruit   and   vegetable   intake, physical
inactivity, alcohol, sexually transmitted infections, and air pollution.

                                             Dietary

Dietary recommendations to reduce the risk of developing cancer, including:

(1) reducing intake of foods and drinks that promote weight gain, namely energy-dense foods
and sugary drinks

(2) eating mostly foods of plant origin

(3) limiting intake of red meat and avoiding processed meat

(4) limiting consumption of alcoholic beverages

(5) reducing intake of salt and avoiding mouldy cereals (grains) or pulses (legumes).



                                          Medication

The concept that medications could be used to prevent cancer is an attractive one, and many
high-quality clinical trials support the use of such chemoprevention in defined
circumstances. Aspirin has been found to reduce the risk of death from cancer. Daily use
of tamoxifen or raloxifene has been demonstrated to reduce the risk of developing breast
cancer in high-risk women by about 50%. Finasteride has been shown to lower the risk of
prostate cancer, though it seems to mostly prevent low-grade tumors. The effect of COX-2
inhibitors such as rofecoxib and celecoxib upon the risk of colon polyps have been studied
in familial adenomatous polyposis patients and in the general population. In both groups,
there were significant reductions in colon polyp incidence, but this came at the price of
increased cardiovascular toxicity.

Vitamins have not been found to be effective at preventing cancer, although low levels
of vitamin D are correlated with increased cancer risk. Whether this relationship is causal and
vitamin     D    supplementation      is   protective     is   yet     to        be    determined. Beta-
carotene supplementation has been found to increase slightly, but not significantly, risks
of lung cancer. Folic acid supplementation has not been found effective in preventing colon
cancer and may increase colon polyps.



                                           Vaccination
Vaccines have been developed that prevent some infection by some viruses that are
associated with cancer, and therapeutic vaccines are in development to stimulate an immune
response               against        cancer-specific epitopes. Human                     papillomavirus
vaccine (Gardasil and Cervarix)        decreases        the    risk         of        developing cervical
cancer. The hepatitis B vaccine prevents infection with hepatitis B virus and thus decreases
the risk of liver cancer.

Advances in cancer research have made a vaccine designed to prevent cancers available. In
2006, the U.S. Food and Drug Administration approved a human papilloma virus vaccine,
called Gardasil. The vaccine protects against 6,11,16,18 strains of HPV, which together cause
70% of cervical cancers and 90% of genital warts. It also lists vaginal and vulvar cancers as
being     protected.     In   March   2007,   the   US Centers        for    Disease       Control   and
Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) officially
recommended that females aged 11–12 receive the vaccine, and indicated that females as
young as age 9 and as old as age 26 are also candidates for immunization. There is a second
vaccine from Cervarix which protects against the more dangerous HPV 16,18 strains only. In
2009, Gardasil was approved for protection against genital warts. In 2010, the Gardasil
vaccine was approved for protection against anal cancer for males and reviewers stated there
was no anatomical, histological or physiological anal differences between the genders so
females would also be protected.
Unlike diagnosis efforts prompted by symptoms and medical signs, cancer screening involves
efforts to detect cancer after it has formed, but before any noticeable symptoms appear. This
may involve physical examination, blood or urine tests, or medical imaging.

Cancer screening is not currently possible for some types of cancers, and even when tests are
available,   they   are   not    recommended       to     everyone. Universal   screening or mass
screeninginvolves screening everyone. Selective screening identifies people who are known
to be at higher risk of developing cancer, such as people with a family history of cancer.

Several factors are considered to determine whether the benefits of screening outweigh the
risks and the costs of screening. These factors include:

   Possible harms from the screening test: Some types of screening tests, such as X-ray
    images, expose the body to potentially harmful ionizing radiation. There is a small chance
    that the radiation in the test could cause a new cancer in a healthy person. Screening
    mammography, used to detect breast cancer, is not recommended to men or to young
    women because they are more likely to be harmed by the test than to benefit from it.
    Other tests, such as a skin check for skin cancer, have no significant risk of harm to the
    patient. A test that has high potential harms is only recommended when the benefits are
    also high.
   The likelihood of the test correctly identifying cancer: If the test is not sensitive, then it
    may miss cancers. If the test is not specific, then it may wrongly indicate cancer in a
    healthy person. All cancer screening tests produce both false positives and false
    negatives, and most produce more false positives. Experts consider the rate of errors
    when making recommendations about which test, if any, to use. A test may work better in
    some populations than others. The positive predictive value is a calculation of the
    likelihood that a positive test result actually represents cancer in a given individual, based
    on the results of people with similar risk factors.
   Possible harms from follow-up procedures: If the screening test is positive, further
    diagnostic testing is normally done, such as a biopsy of the tissue. If the test produces
    many false positives, then many people will undergo needless medical procedures, some
    of which may be dangerous.
   Whether suitable treatment is available and appropriate: Screening is discouraged if no
    effective treatment is available. When effective and suitable treatment is not available,
    then diagnosis of a fatal disease produces significant mental and emotional harms. For
example, routine screening for cancer is typically not appropriate in a very frail
    elderly person, because the treatment for any cancer that is detected might kill the patient.
   Whether early detection improves treatment outcomes: Even when treatment is available,
    sometimes early detection does not improve the outcome. If the treatment result is the
    same as if the screening had not been done, then the only screening program does is
    increase the length of time the person lived with the knowledge that he had cancer. This
    phenomenon is called lead-time bias. A useful screening program reduces the number
    of years of potential life lost (longer lives) and disability-adjusted life years lost (longer
    healthy lives).
   Whether the cancer will ever need treatment: Diagnosis of a cancer in a person who will
    never be harmed by the cancer is called overdiagnosis. Overdiagnosis is most common
    among older people with slow-growing cancers. Concerns about overdiagnosis are
    common for breast and prostate cancer.
   Whether the test is acceptable to the patients:If a screening test is too burdensome, such
    as requiring too much time, too much pain, or culturally unacceptable behaviors, then
    people will refuse to participate.
   Cost of the test: Some expert bodies, such as the U.S. Preventive Services Task Force,
    completely ignore the question of money. Most, however, include a cost-effectiveness
    analysis that, all else being equal, favors less expensive tests over more expensive tests,
    and attempt to balance the cost of the screening program against the benefits of using
    those funds for other health programs. These analyses usually include the total cost of the
    screening program to the healthcare system, such as ordering the test, performing the test,
    reporting the results, and biopsies for suspicious results, but not usually the costs to the
    individual, such as for time taken away from employment.




                                     Recommendations
The U.S. Preventive Services Task Force (USPSTF) strongly recommends cervical
cancer screening in women who are sexually active and have a cervix at least until the age of
65. They recommend that Americans be screened for colorectal cancer via fecal occult
blood testing, sigmoidoscopy, or colonoscopy starting at age 50 until age 75. There is
insufficient evidence to recommend for or against screening for skin cancer, oral cancer, lung
cancer or prostate cancer in men under 75. Routine screening is not recommended forbladder
cancer, testicular cancer, ovarian cancer, pancreatic cancer, or prostate cancer in men over
75.The USPTF recommends mammography for breast cancer screening every two years for
those    50–74 years    old;   however,     they     do   not   recommend      either breast   self-
examination orclinical breast examination. A 2009 Cochrane review came to slightly
different conclusions with respect to breast cancer screening stating that routine
mammography may do more harm than good.

Japan screens for gastric cancer using photofluorography due to the high incidence there.



                                        Genetic testing
See also: Cancer syndrome


  Gene                                                Cancer types


  BRCA1, BRCA2                                        Breast, ovarian, pancreatic


                                                      Colon, uterine, small bowel, stomach,
  HNPCC, MLH1, MSH2, MSH6, PMS1, PMS2
                                                      urinary tract

Genetic testing for individuals at high-risk of certain cancers is recommended. Carriers of
these mutations may than undergo enhanced surveillance, chemoprevention, or preventative
surgery to reduce their subsequent risk.



                                           Management

Many     management       options    for    cancer    exist     including: chemotherapy, radiation
therapy, surgery, immunotherapy, monoclonal antibody therapy and other methods. Which
treatments are used depends upon the type of cancer, the location and grade of the tumor, and
the stage of the disease, as well as the general state of a person's health.

Complete removal of the cancer without damage to the rest of the body is the goal of
treatment for most cancers. Sometimes this can be accomplished by surgery, but the
propensity of cancers to invade adjacent tissue or to spread to distant sites by microscopic
metastasis often limits its effectiveness. Surgery often required the removal of a wide surgical
margin or afree margin. The width of the free margin depends on the type of the cancer, the
method of removal (CCPDMA, Mohs surgery, POMA, etc.). The margin can be as little as
1 mm for basal cell cancer using CCPDMA or Mohs surgery, to several centimeters for
aggressive cancers. The effectiveness of chemotherapy is often limited by toxicity to other
tissues in the body. Radiation can also cause damage to normal tissue.

Because cancer is a class of diseases, it is unlikely that there will ever be a single "cure for
cancer" any more than there will be a single treatment for all infectious diseases.
Angiogenesis inhibitors were once thought to have potential as a "silver bullet" treatment
applicable to many types of cancer, but this has not been the case in practice.

Experimental cancer treatments are treatments that are being studied to see whether they
work. Typically, these are studied in clinical trials to compare the proposed treatment to the
best existing treatment. They may be entirely new treatments, or they may be treatments that
have been used successfully in one type of cancer, and are now being tested to see whether
they are effective in another type.

Alternative cancer treatments are treatments used by alternative medicine practitioners. These
include mind–body interventions, herbal preparations, massage, electrical devices, and strict
dietary regimens. Alternative cancer treatments are ineffective at killing cancer cells. Some
are dangerous, but more are harmless or provide the patient with a degree of physical or
emotional comfort. Alternative cancer treatment has also been a fertile field for hoaxes aimed
at stripping desperate patients of their money.

                                             Prognosis

Cancer has a reputation as a deadly disease. Taken as a whole, about half of patients
receiving treatment for invasive cancer (excluding carcinoma in situ and non-melanoma skin
cancers) die from cancer or its treatment. However, the survival rates vary dramatically by
type of cancer, with the range running from basically all patients surviving to almost no
patients surviving.

Patients who receive a long-term remission or permanent cure may have physical and
emotional    complications     from    the     disease   and   its   treatment.   Surgery     may
have amputated body parts or removed internal organs, or the cancer may have damaged
delicate structures, like the part of the ear that is responsible for the sense of balance; in some
cases, this requires extensive physical rehabilitation or occupational therapy so that the
patient can walk or engage in other activities of daily living. Chemo brain is a usually short-
term cognitive impairmentassociated with some treatments. Cancer-related fatigue usually
resolves shortly after the end of treatment, but may be lifelong. Cancer-related pain may
require ongoing treatment. Younger patients may be unable to have children. Some patients
may be anxious or psychologically traumatized as a result of their experience of the diagnosis
or treatment.Survivors generally need to have regular medical screenings to ensure that the
cancer has not returned, to manage any ongoing cancer-related conditions, and to screen for
new cancers. Cancer survivors, even when permanently cured of the first cancer, have
approximately double the normal risk of developing another primary cancer. Some advocates
have promoted "survivor care plans"—written documents detailing the diagnosis, all previous
treatment, and all recommended cancer screening and other care requirements for the future
—as a way of organizing the extensive medical information that survivors and their future
healthcare providers need.

Progressive and disseminated malignant disease harms the cancer patient's quality of life, and
some cancer treatments, including common forms of chemotherapy, have severe side effects.
In the advanced stages of cancer, many patients need extensive care, affecting family
members and friends. Palliative care aims to improve the patient's immediate quality of life,
regardless of whether further treatment is undertaken. Hospice programs assist patients
similarly, especially when a terminally ill patient has rejected further treatment aimed at
curing the cancer. Both styles of service offer home health nursing and respite care.

Predicting either short-term or long-term survival is difficult and depends on many factors.
The most important factors are the particular kind of cancer and the patient's age and overall
health. Medically frail patients with many comorbidities have lower survival rates than
otherwise healthy patients. A centenarian is unlikely to survive for five years even if the
treatment is successful. Patients who report a higher quality of life tend to survive
longer. People with lower quality of life may be affected by major depressive disorder and
other complications from cancer treatment and/or disease progression that both impairs their
quality of life and reduces their quantity of life. Additionally, patients with worse prognoses
may be depressed or report a lower quality of life directly because they correctly perceive
that their condition is likely to be fatal.
Despite strong social pressure to maintain an upbeat, optimistic attitude or act like a
determined "fighter" to "win the battle", personality traits have no connection to survival.



                                       Epidemiology



Main article: Epidemiology of cancer




Death rate from malignant cancer per 100,000 inhabitants in 2004.[87]
 no data
 ≤ 55
 55-80
 80-105
 105-130
 130-155
 155-180
 180-205
 205-230
 230-255
 255-280
 280-305
 ≥ 305

In 2008 approximately 12.7 million cancers were diagnosed (excluding non-melanoma skin
cancers and other non-invasive cancers) and 7.6 million people died of cancer
worldwide. Cancers as a group account for approximately 13% of all deaths each year with
the most common being: lung cancer (1.3 million deaths), stomach cancer (803,000
deaths), colorectal cancer (639,000 deaths), liver      cancer (610,000 deaths), and breast
cancer (519,000 deaths). This makes invasive cancer the leading cause of death in
the developed world and the second leading cause of death in the developing world.[3] Over
half of cases occur in the developing world.

Global cancer rates have been increasing primarily due to an aging population and lifestyle
changes in the developing world. The most significant risk factor for developing cancer is old
age.[89] Although it is possible for cancer to strike at any age, most people who are diagnosed
with invasive cancer are over the age of 65. According to cancer researcher Robert A.
Weinberg, "If we lived long enough, sooner or later we all would get cancer." Some of the
association between aging and cancer is attributed to immunosenescence errors accumulated
in DNA over a lifetime, and age-related changes in the endocrine system.

Some slow-growing cancers are particularly common. Autopsy studies in Europe and Asia
have shown that up to 36% of people have undiagnosed and apparently harmless thyroid
cancer at the time of their deaths, and that 80% of men develop prostate cancer by age 80. As
these cancers, often very small, did not cause the person's death, identifying them would have
represented overdiagnosis rather than useful medical care.

The three most common childhood cancers are leukemia (34%), brain tumors (23%),
and lymphomas (12%). Rates of childhood cancer have increased between 0.6% per year
between 1975 to 2002 in the United States and by 1.1% per year between 1978 and 1997 in
Europe. In the developed world, one in three people will be diagnosed with invasive cancer
during their lifetimes. If all people with cancer survived and cancer occurred randomly, the
lifetime odds of developing a second primary cancer would be one in nine. However, cancer
survivors have an increased risk of developing a second primary cancer, and the odds are
about two in nine. About half of these second primaries can be attributed to the normal one-
in-nine risk associated with random chance. The increased risk is believed to be primarily due
to the same risk factors that produced the first cancer (such as the person's genetic profile,
alcohol and tobacco use, obesity, and environmental exposures), and partly due to the
treatment for the first cancer, which typically includes mutagenic chemotherapeutic drugs or
radiation. Cancer survivors may also be more likely to comply with recommended screening,
and thus may be more likely than average to detect cancers.
History

Hippocrates (ca. 460 BC – ca. 370 BC) described several kinds of cancers, referring to them
with the Greek word carcinos (crab or crayfish), among others. This name comes from the
appearance of the cut surface of a solid malignant tumour, with "the veins stretched on all
sides as the animal the crab has its feet, whence it derives its name". Since it was against
Greek tradition to open the body, Hippocrates only described and made drawings of
outwardly visible tumors on the skin, nose, and breasts. Treatment was based on the humor
theory of four bodily fluids (black and yellow bile, blood, and phlegm). According to the
patient's humor, treatment consisted of diet, blood-letting, and/or laxatives. Through the
centuries it was discovered that cancer could occur anywhere in the body, but humor-theory
based treatment remained popular until the 19th century with the discovery of cells.




Engraving with two views of a Dutch woman who had a tumor removed from her neck
in 1689.

Celsus (ca. 25 BC - 50 AD) translated carcinos into the Latin cancer, also meaning
crab. Galen (2nd century AD) called benign tumoursoncos, Greek for swelling, reserving
Hippocrates' carcinos for malignant tumours. He later added the suffix -oma, Greek for
swelling, giving the name carcinoma.

The oldest known description and surgical treatment of cancer was discovered in Egypt and
dates back to approximately 1600 BC. ThePapyrus describes 8 cases of ulcers of the breast
that were treated by cauterization, with a tool called "the fire drill." The writing says about
the disease, "There is no treatment."

Another very early surgical treatment for cancer was described in the 1020s by Avicenna (Ibn
Sina) in The Canon of Medicine. He stated that the excision should be radical and that all
diseased tissue should be removed, which included the use of amputation or the removal
of veinsrunning in the direction of the tumor. He also recommended the use
of cauterization for the area treated if necessary.
In the 16th and 17th centuries, it became more acceptable for doctors to dissect bodies to
discover the cause of death. The German professor Wilhelm Fabry believed that breast cancer
was caused by a milk clot in a mammary duct. The Dutch professor Francois de la Boe
Sylvius, a follower of Descartes, believed that all disease was the outcome of chemical
processes, and that acidic lymph fluid was the cause of cancer. His contemporary Nicolaes
Tulp believed that cancer was a poison that slowly spreads, and concluded that it
was contagious.

The first cause of cancer was identified by British surgeon Percivall Pott, who discovered in
1775 that cancer of the scrotum was a common disease among chimney sweeps. The work of
other individual physicians led to various insights, but when physicians started working
together they could make firmer conclusions.

With the widespread use of the microscope in the 18th century, it was discovered that the
'cancer poison' spread from the primary tumor through the lymph nodes to other sites
("metastasis"). This view of the disease was first formulated by the English
surgeon Campbell De Morgan between 1871 and 1874. The use of surgery to treat cancer had
poor results due to problems with hygiene. The renowned Scottish surgeon Alexander
Monro saw only 2 breast tumor patients out of 60 surviving surgery for two years. In the 19th
century, asepsisimproved surgical hygiene and as the survival statistics went up, surgical
removal of the tumor became the primary treatment for cancer. With the exception
of William Coley who in the late 19th century felt that the rate of cure after surgery had been
higher before asepsis (and who injected bacteria into tumors with mixed results), cancer
treatment became dependent on the individual art of the surgeon at removing a tumor. During
the same period, the idea that the body was made up of various tissues, that in turn were made
up of millions of cells, laid rest the humor-theories about chemical imbalances in the body.
The age of cellular pathology was born.

The genetic basis of cancer was recognised in 1902 by the German zoologist Theodor Boveri,
professor of zoology at Munich and later in Würzburg. He discovered a method to generate
cells with multiple copies of the centrosome, a structure he discovered and named. He
postulated that chromosomes were distinct and transmitted different inheritance factors. He
suggested that mutations of the chromosomes could generate a cell with unlimited growth
potential which could be passed onto its descendants. He proposed the existence of cell cycle
check points, tumour suppressor genes and oncogenes. He speculated that cancers might be
caused or promoted by radiation, physical or chemical insults or by pathogenic
microorganisms.




1938 poster identifying surgery, x-rays and radium as the proper treatments for cancer.

When Marie Curie and Pierre Curie discovered radiation at the end of the 19th century, they
stumbled upon the first effective non-surgical cancer treatment. With radiation also came the
first signs of multi-disciplinary approaches to cancer treatment. The surgeon was no longer
operating in isolation, but worked together with hospital radiologists to help patients. The
complications in communication this brought, along with the necessity of the patient's
treatment in a hospital facility rather than at home, also created a parallel process of
compiling patient data into hospital files, which in turn led to the first statistical patient
studies.

A founding paper of cancer epidemiology was the work of Janet Lane-Claypon, who
published a comparative study in 1926 of 500 breast cancer cases and 500 control patients of
the same background and lifestyle for the British Ministry of Health. Her ground-breaking
work on cancer epidemiology was carried on by Richard Doll and Austin Bradford Hill, who
published "Lung Cancer and Other Causes of Death In Relation toSmoking. A Second Report
on the Mortality of British Doctors" followed in 1956 (otherwise known as the British
doctors study). Richard Doll left the London Medical Research Center (MRC), to start
the Oxford unit for Cancer epidemiology in 1968. With the use of computers, the unit was the
first to compile large amounts of cancer data. Modern epidemiological methods are closely
linked to current concepts of disease andpublic health policy. Over the past 50 years, great
efforts have been spent on gathering data across medical practise, hospital, provincial, state,
and even country boundaries to study the interdependence of environmental and cultural
factors on cancer incidence.

Cancer patient treatment and studies were restricted to individual physicians' practices
until World War II, when medical research centers discovered that there were large
international differences in disease incidence. This insight drove national public health bodies
to make it possible to compile health data across practises and hospitals, a process that many
countries do today. The Japanese medical community observed that the bone marrow of
victims of the atomic bombings of Hiroshima and Nagasaki was completely destroyed. They
concluded that diseased bone marrow could also be destroyed with radiation, and this led to
the discovery of bone marrow transplants for leukemia. Since World War II, trends in cancer
treatment are to improve on a micro-level the existing treatment methods, standardize them,
and globalize them to find cures through epidemiology and international partnerships.



                                    Society and culture

While many diseases (such as heart failure) may have a worse prognosis than most cases of
cancer, it is the subject of widespread fear and taboos. Euphemisms, once "a long illness",
and now informally as "the big C", provide distance and soothe superstitions. This deep belief
that cancer is necessarily a difficult and usually deadly disease is reflected in the systems
chosen by society to compile cancer statistics: the most common form of cancer—non-
melanoma skin cancers, accounting for about one-third of all cancer cases worldwide, but
very few deaths are excluded from cancer statistics specifically because they are easily
treated and almost always cured, often in a single, short, outpatient procedure.

Cancer is regarded as a disease that must be "fought" to end the "civil insurrection"; a War on
Cancer has been declared. Military metaphors are particularly common in descriptions of
cancer's human effects, and they emphasize both the parlous state of the affected individual's
health and the need for the individual to take immediate, decisive actions himself, rather than
to delay, to ignore, or to rely entirely on others caring for him. The military metaphors also
help rationalize radical, destructive treatments.

In the 1970s, a relatively popular alternative cancer treatment was a specialized form of talk
therapy, based on the idea that cancer was caused by a bad attitude. People with a "cancer
personality"—depressed, repressed, self-loathing, and afraid to express their emotions—were
believed to have manifested cancer through subconscious desire. Some psychotherapists said
that treatment to change the patient's outlook on life would cure the cancer. Among other
effects, this belief allows society to blame the victim for having caused the cancer (by
"wanting" it) or having metaphysically prevented its cure (by not becoming a sufficiently
happy, fearless, and loving person). It also increases patients' anxiety, as they incorrectly
believe that natural emotions of sadness, anger or fear shorten their lives. The idea was
excoriated by the notoriously outspoken Susan Sontag, who published Illness as
Metaphor while recovering from treatment for breast cancer in 1978.

Although the original idea is now generally regarded as nonsense, the idea partly persists in a
reduced form with a widespread, but incorrect, belief that deliberately cultivating a habit of
positive thinking will increase survival. This notion is particularly strong in breast cancer
culture.

                                          Research

Cancer research is the intense scientific effort to understand disease processes and discover
possible therapies.

Research about cancer causes focusses on the following issues:

   Agents (e.g. viruses) and events (e.g. mutations) which cause or facilitate genetic changes
    in cells destined to become cancer.
   The precise nature of the genetic damage, and the genes which are affected by it.
   The consequences of those genetic changes on the biology of the cell, both in generating
    the defining properties of a cancer cell, and in facilitating additional genetic events which
    lead to further progression of the cancer.

The improved understanding of molecular biology and cellular biology due to cancer research
has led to a number of new, effective treatments for cancer since President Nixon declared
"War on Cancer" in 1971. Since 1971 the United States has invested over $200 billion on
cancer research; that total includes money invested by public and private sectors and
foundations. Despite this substantial investment, the country has seen a five percent decrease
in the cancer death rate (adjusting for size and age of the population) between 1950 and 2005.
Leading cancer research organizations and projects include the American Association for
Cancer Research, the American Cancer Society (ACS), the American Society of Clinical
Oncology, the European Organisation for Research and Treatment of Cancer, the National
Cancer Institute, the National Comprehensive Cancer Network, and The Cancer Genome
Atlasproject at the NCI.



                        Environmental Factors and Cancer Deaths




                                   Exposure Issues



   •   Home environment

   •   Current events

   •   Workplace

   •   School

   •   Government Decisions
•   Global and local environment




                                        What causes cancer ?

        •   Organic chemicals

        •   Inorganic chemicals

        •   Fiber

        •   Hormonal Carcinogenesis

                                The Effects of Cancer on Social Behavior
    Cancer takes a physical toll, but it also takes a social toll. Because of feelings that occur
    before, during and after treatment, you may find your relationships uncomfortable or even
    strained. Fortunately, there is help.

    Cancer arises largely as a result of lifestyle, and is thus a consequence of the conditions in
    which individuals live and work. For some cancers, specific causal relationships to chemicals
    are well established; leukaemia as a result of exposure to benzene used in tyre manufacture is
    one example. Lifestyle influences are relevant for most cancers. The changes in incidence of
    different forms of cancer among migrants who have moved from one part of the world to
    another probably reflects major lifestyle changes resulting from acculturation to the way of
    life in the host country.


                                                 Types

•   Both internal and external factors affect a cancer patient's social behavior. For example, the
    fatigue from cancer treatment often leads to withdrawal, and the pressure from piling medical
    bills often leads to worry and negativity.

    Time Frame

•   Every cancer patient is different: some patients beat cancer in a matter of months while others
    battle it for years. The National Cancer Institute (2009) stresses that regardless of how long
    your cancer lasts, you must focus on living.
Misconceptions

•   Misconceptions about cancer will weigh on your social energy. Contrary to popular belief,
    depression is not the norm, and not everyone diagnosed with cancer will endure prolonged
    suffering or a painful death.

    Upsides

•   Although negative emotions such as guilt, anger and depression can alienate those around
    you, cancer can also sweeten your social relationships. Cancer patients commonly report
    feelings of hope and gratitude, and the people in your social support system will help you
    maintain a positive outlook.

    Prevention
•   Talk about how you feel with your family members, friends and, if appropriate, clergy. Also,
    seek help from your care center, where doctors and nurses will help you cope with cancer's
    social effects.
    Male Cancer Death Rates
Female Cancer Death Rate (Rate per 10,000)

100


 80


 60


 40


 20


  0
       0        5     0    5     0      5      0     5      0      5     0      5      0     5       0
       3        3     4    4     5      5      6     6      7      7     8      8      9     9       0
       9        9     9    9     9      9      9     9      9      9     9      9      9     9       0
       1        1     1    1     1      1      1     1      1      1     1      1      1     1       2




                      Managing national cancer control programmes

 With careful planning and appropriate priorities, within the scope of prevention, early
 detection, treatment and palliation, the establishment of national cancer control programmes
 offers the most rational means of achieving a substantial degree of cancer control, even where
 resources are severely limited. It is for this reason that the establishment of a national cancer
 control programme is recommended wherever the burden of the disease is significant, there is
 a rising trend of cancer risk factors and there is a need to make the most efficient use of
 limited resources.

 Effective and efficient cancer control programmes need competent management to identify
 priorities and resources (planning), and to organize and coordinate those resources to
 guarantee sustained progress to meet the planned objectives (implementation, monitoring and
 evaluation).
Good management is essential to maintain momentum and introduce any necessary
modifications. A quality management approach is essential to improving the performance of
the programme.

The four principal approaches to cancer control are:

    Prevention Prevention means eliminating or minimizing exposure to the causes of
       cancer, and includes reducing individual susceptibility to the effect of such causes.
       This approach offers the greatest public health potential and the most cost-effective
       long-term method of cancer control. Tobacco is the leading single cause of cancer
       worldwide and in the fight against cancer every country should give highest priority
       to tobacco control.

    Early detection         Increasing awareness of the signs and symptoms of cancer
       contributes to early detection of the disease. Where tests for cancer of specific sites
       are available, and facilities are appropriate, screening of apparently healthy
       individuals can disclose cancer in early or precursor stages, when treatment may be
       most effective. Early detection is only successful when linked to effective treatment.

    Diagnosis and treatment Cancer diagnosis calls for a combination of careful clinical
       assessment and diagnostic investigations. Once a diagnosis is confirmed, it is
       necessary to ascertain cancer staging to evaluate the extension of the disease and be
       able to provide treatment accordingly. Cancer treatment aims at curing, prolonging
       useful life and improving quality of life. Treatment services should give priority to
       early detectable tumours and potentially curable cancers. In addition, treatment
       approaches should include psychosocial support, rehabilitation and close coordination
       with palliative care to ensure the best possible quality of life for cancer patients.

    Palliative care In most of the world, the majority of the cancer patients present with
       advanced disease. For them, the only realistic treatment option is pain relief and
       palliative care. Effective approaches to palliative care are available to improve the
       quality of life for cancer patients.

Cancer prevention should be a key element in all national cancer control programmes.
Prevention not only focuses on the risks associated with a particular illness or problem but
also on protective factors. Among prevention activities, emphasis should be placed on:
– tobacco control;

– healthy diet;

– physical activities and avoidance of obesity;

– reducing alcohol use;

– reducing carcinogenic occupational and environmental exposures;

– immunization against hepatitis B virus;

– combating schistosomiasis;

– avoidance of prolonged exposure to the sun;

– health education, relating to sexual and reproductive factors associated with cancer.

Action on tobacco use is universally needed, but the priorities accorded to other components
of the programme will depend on the results of a situation analysis of the country concerned,
covering the actual and forecast burden of cancer cases in the country, and the estimated
proportion of potentially preventable cases.




Cancer rates in India are considerably lower than those in more developed countries such as
the United States…data from population based cancer registries in India show that the most
frequently reported cancer sites in males are lung, oesophagus, stomach, and larynx. In
females, cancers of the cervix, breast, ovary, and oesophagus are the most commonly
encountered…




In India, the incidence of breast cancer is increasing, with an estimated 80,000 new cases
diagnosed annually. The incidence of breast cancer increased by approximately 50%
between 1965 and 1985. Much of this increase may be associated with greater urbanization
and improved life expectancy…
Cancer Control in India

India is one of the first few developing countries where a nation-wide cancer control
programs were launched. Government of India took its first initiative in 1971. The National
Cancer Control Program for India was formulated in 1984 with four major goals 13:

   1. Primary prevention of tobacco related cancer
   2. Early detection of the cancers of easily accessible sites
   3. Augmentation of treatment facilities
   4. Establishment of equitable, pain control and palliative care network throughout the
       country

Cancer Prevention

According to Mayo Clinic, there are 7 steps to prevent cancer

    Avoid tobacco use: As already discussed, tobacco is the major risk factor for cancer.
       Hence, it is important to avoid tobacco in all forms, like both active and passive
       smoking and chewing tobacco.
   •   Eat a variety of healthy foods: It is important to consume plant-based foods, rich in
       fruits and vegetables, reduce the intake of fat and alcohol.
   •   Stay active and maintain a healthy weight: Regular exercise should be an integral
       part of one’s daily routine.
   •   Protect yourself from the sun: Exposure to sun is the major cause of skin cancer. It
       is important to avoid the sun’s ultraviolet rays, especially from 10 am to 4 pm and
       applying adequate amounts of sunscreen lotion with a sun-protecting factor (SPF) of
       at least 15, especially before venturing outdoors during these hours
   •   Get immunized: Vaccination against Hepatitis B should be regularly administered, as
       this infection could lead to liver cancer.
•   Healthy practices: Sexually transmitted diseases like human papilloma virus
       infection, hepatitis B and HIV can lead to an increased incidence of various cancers. It
       is thus important to practice safe sex by using condoms, limit the number of sexual
       partners, or abstain from sex and never share needles. In case of drug addiction, it is
       important to seek help.
   •   Get screened: Regular screening and self-examination for certain cancers helps in
       early detection of cancer and improves the prognosis.
The Government of India launched the National Cancer Control Programme (NCCP) in
1975–76 to tackle the increasing incidence of cancers in the country. This was later revised in
1984–85 stressing on primary prevention and early detection of cancers. The primary
prevention focused on health education regarding hazards of tobacco consumption, genital
hygiene, and sexual and reproductive health. Secondary prevention aims at early diagnosis of
cancers of uterine cervix, breast and oro-pharyngeal cancers by screening methods. For the
purpose of detecting cancer of cervix at an early stage, early cancer detection centres in
different medical colleges and postpartum smear testing units in medical colleges in the
country have been established. A National Cancer Control Board was constituted at the
Centre to operationalize the programme. Similar boards were suggested at the state levels
called as State Cancer Control Board (SCCB) for the proper co-ordination of activities.
Several states have formulated SCCB.

During the period 1990–91, a demonstration project named district cancer control programme
(DCCP) was initiated in selected districts of the country for early detection of cervical, oral
and breast cancers at the doorsteps of rural community. The programme created awareness
amongst people regarding early symptoms of cancer, importance of observation of personal
hygiene and healthy lifestyle, ill effects of tobacco consumption, etc. The project has five
components, viz. health education, early detection, training of medical and para-medical
personnel, palliative treatment and pain relief and co-ordination and monitoring. The district
projects are linked with Regional Cancer Centres (RCC), medical college hospitals having
infrastructure for treatment of cancer and the appropriate institutions that supervise and
monitor the programme in collaboration with the concerned state governments

The DCCP scheme has been further reoriented on a pilot basis as Modified District Cancer
Control Programme.
The project has been implemented in the states of Bihar, Tamil Nadu, Uttar Pradesh and West
Bengal under the supervision of the state Regional Cancer Centres. Twenty/ten rural blocks
from each of the above states have been selected. For each block, 20 female non-
communicable workers have been appointed to advice women abouthealthy lifestyles, ill
effects of tobacco and to detect the early symptoms of cancers

Dietary guidelines

· It is essential to maintain appropriate weight for height,thus avoiding both under and over-
nutrition.

· Physical activity needs to be promoted to avoid obesity and accumulation of fat.

· Intake of protective foods such as vegetables and fruits, preferably fresh, need to be
increased to avoid deficiency and protection against environmental insults.

· Plant foods such as cereals, pulses, roots and tubers, green leafy and yellow vegetables,
other vegetables/fruits and spices providing nutrients, as well as fibre and protective
phytochemicals, should be preferable items in the diet.

· Animal foods (meat and fat) except fish should be curtailed. It is necessary to avoid salted,
pickled, smoked and charred food substances.

· Mouldy and damaged foods should be totally eliminated from the diet.




                             GOVERNMENT POLICIES

Radient Pharmaceuticals Corporation (RPC) and its exclusive India-based distribution
partner Jaiva Technologies, Inc. (JTI) and Jaiva’s Indian subsidiary Gaur Diagno, Pvt
Ltd (GDL) announced the launch of a cancer education and screening program in India — a
key international market where GDL is actively commercializing RPC’s Onko-Sure(R) in
vitro diagnostic (IVD) cancer test. The goal of the program is to drive public education; raise
market awareness; and offer Onko-Sure(R) as a commercialized cancer screening test that
can potentially help stem the rising cancer epidemic in India.

According to the Cancer Foundation of India, cancer impacts up to 2.5 million people in
India annually and the fight against cancer — in both the public and private healthcare
sectors — is largely restricted to improving diagnostic and treatment facilities throughout the
country. Because of this, it has become increasingly vital to enhance activities and programs
that support cancer education and offer treatment options to potential and existing cancer
patients.

With the launch of its cancer education and screening program on behalf of RPC, GDL is
taking an aggressive leadership role in India with two distinct launch strategies. The first
comprises a widespread deployment of GDL’s mobile cancer screening laboratory units
where Indian-based physicians and other medical staff travel to local towns to provide
counseling and education, along with patient screening using RPC’s Onko-Sure(R) IVD
cancer test. The second program is focused on Company collaboration with Indian
government agencies to establish GDL-sponsored cancer screening and testing facilities
directly on-site in government hospitals. Physician-referred general cancer screening will also
be conducted at these hospitals and it is anticipated that RPC’s Onko-Sure(R) IVD cancer
tests will be administered to patients contacted through the program. The goal of both
strategies is to reduce the incidence of cancer in India, and through each program, patients
will be provided with registered health cards that will track a patient’s health records for
future reference and statistical analysis.

RPC’s projected Onko-Sure(R) IVD test kit purchase plan is focused primarily on the ramp-
up of the government sponsored cancer testing program.

The introduction of GDL’s new cancer education and screening program in India is the next
most important and major milestone in the commercialization of Onko-Sure(R) in India.
GDL is taking a leadership role in providing a market with 2.5 million cancer patients with
not only educational resources and support through this program, but also the potential of
early disease detection and on-going monitoring though our USFDA approved Onko-Sure(R)
IVD cancer test.

This government screening program is a breakthrough project and we believe a continuous
and aggressive approach is necessary if we are to reduce the incidence of cancer in India. We
anticipate this is just the beginning of additional large-scale screening programs we employ.
GDL is committed to continuing all efforts to work with Indian government agencies with the
ultimate goal of reducing cancer rates in this country.
RPC’s Onko-Sure(R) IVD cancer test is a simple, non-invasive, patent-pending and
regulatory-approved in vitro diagnostic (IVD) test used for the detection, screening, and
monitoring of various types of cancer. The test enables physicians and healthcare
professionals to effectively monitor and/or detect certain types of cancers by measuring the
accumulation of Fibrin and Fibrinogen Degradation Products (FDP) in the blood. FDP levels
rise dramatically with the progression of cancer. Onko-Sure(R) is approved by the US FDA
for the monitoring of colorectal cancer and by Health Canada as a lung cancer detection and
monitoring test.




               Palliative care body to draw national policy in India


The Indian Association of Palliative Care (IAPC) has named a committee to formulate a
national policy for it. The committee will submit the drafted policy to the Centre and request
that it be adopted across the country.
The decision was taken by the Executive Council of the Association, which met on Saturday
at the Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow, during its 10th
Annual Conference. “The committee was formed by the Executive Council, which met here
yesterday. The chairman of the committee is Dr Stanley Macaden, a palliative care specialist
at Bangalore,” said Dr Anil Agarwal, Professor of Anesthesiology, SGPGI and Executive
Council Member of IAPC.

The four-member committee is expected to submit its first draft within three months.

“Palliative care is the treatment of pain caused by life limiting diseases like cancer,” said Dr
MR Rajagopal, one of the committee members. “Besides being a medical care, it is also about
social and psychological assistance to patients and their families. Kerala is the only state that
has a palliative care policy and the need for a national policy was felt for long.”

Founder of Pallium India, one of the charitable trusts rendering palliative care in Kerala,
Rajagopal is a pioneer in the field here and was also a members of the committee that
formulated the policy in Kerala.

“With palliative care being recognised as a human right, it is the obligation of the Union
health ministry to arrange for its provision at all government hospitals,” said Rajagopal.
A possible recommendation in the policy will be that all medical colleges should have
palliative care within two years and government hospitals within five years, said Rajagopal.

The Medical Council of India has given approval for an MD course in Palliative Care




                                 Cancer Insurance Policy


     Indian Cancer Society and The New India Assurance Company Limited ( NIA)
     have pioneered cancer specific insurance policy to benefit large sections of
     people. The policy offered by New India Assurance is unique and extremely
     cheap compared to general health insurance policies. It can also be taken as an
     ‘Add on’ to top up your existing health policy.

     This insurance policy is open to any person upto 70 years provided they have had no
     cancer earlier. According to the agreement with NIA, anyone who wants to avail of
     this cover has to become a member of the Indian Cancer Society at a small cost of
     Rs.200. The policy comes into operation only after the one month of membership.



     Benefits of Cancer Insurance Policy
        • There is no medical test. Only Declaration of good health signed by a doctor

             is required.
         •   The Cancer Insurance Policy offers adequate coverage towards the costs of
             diagnosis, biopsy, surgery, chemotherapy and/or radiotherapy, hospitalization
             and rehabilitation at an extremely low premium.
         •   Reimbursement of claims is made every quarter for actual expenses incurred,
             until the entire sum insured is exhausted or the insured person is declared
             cured, whichever is earlier.
         •   Free access to cancer related literature available with the Society.
         •   At the Society's discretion, check-up facilities can be made available at its
             Cancer Detection Centre at Pedder Road, Mumbai. For Cancer Insurance
             policy holders, first time check up facility for cancer would be free of cost
             and for the second time onwards, the same facility would be available at 50%
of cost.
          •   The entire administration of the policy is done by the society. As a result
              policy holder does not have to interact with NIA. Both premium payment and
              claim settlement are handled by society without any hassles for the
              policyholders.



      Amount Covered through Cancer Insurance Policy
      The Cancer Medical Expenses Insurance Policy offers two options of sum assured:
         • Coverage of Rs. 50,000 + 5% additional sum insured upto Rs. 75,000 for

              every claim free renewal.

          •   Coverage of Rs. 200000 +5% additional sum insured upto Rs. 300,000 for
             every claim free renewal.
      The policy covers both the member and spouse regardless of whose name the
      membership is in. But once either of them contracts the disease the other would not
      be entitled for any benefits under the same policy. However, he/she can always take
      another policy.




A non-governmental organization (NGO) is a legally constituted organization
created by natural or legal persons that operates independently from any government and a
term usually used by governments to refer to entities that have no government status. In the
cases in which NGOs are funded totally or partially by governments, the NGO maintains its
non-governmental status by excluding government representatives from membership in the
organization. The term is usually applied only to organizations that pursue some
wider social aim that has political aspects, but that are not overtly political organizations such
as political parties. Unlike the term "intergovernmental organization", the term "non-
governmental organization" has no generally agreed legal definition. In many jurisdictions,
these types of organization are called "civil society organizations" or referred to by other
names.
Types of NGOs

NGO type can be understood by orientation and level of co-operation.

NGO type by orientation

   Charitable orientation;
   Service orientation;
   Participatory orientation;
   Empowering orientation;

NGO type by level of co-operation

   Community- Based Organization;
   City Wide Organization;
   National NGOs;
   International NGOs;




                                 Steps in establishing NGOs



The first step in the establishment of the NGO is to identify the area of peculiar needs of the
society, such as health, HIV/AIDS, Maternal Mortality, Polio, food, shelter,education, civil
liberty and poverty alleviation among others.

The second step is to identify people of similar minds; there must be a unity of purpose. The
third step is to engage the services of a qualified legal practitioner for guidance for the
Registration process. Some NGOs can be registered with the regional or central government
and that depends on the scope of the operations of the proposed NGO. The next important
step also is to identify the internal or external partners with a clearly stated objectives and
plan of actions.
SIDDHARTHA VASHISHTA CHARITABLE TRUST



Vision


The Jail system is like kidneys of society which filters out the toxins & re-introduces the
clean fluid back into our system. This aspect is important and has to be understood that
everybody who is in jail will one day be re-introduced into the society. Therefore, we have to
try & reform these people and not punish them, as punishment will only bring in ill-will &
bitterness.


Ours is the land of the Vedas, the Upanishads and of Gandhi where love & forgiveness
conquers all. Therefore, this approach of punishment and hate has to transcend into one of
reform & change. It is the future of society that is at stake, therefore let it not be someone
else’s problem. Make a difference. And you can do it by just changing your attitude of
negativeness towards those in jail, to an open mind and to look at the positive side also
because everyone has a positive side.


People who are in Jail are just like everyone else, they just happened to be at the wrong place
at the wrong time. Maybe there are a few rotten apples but they are just about 5% of the
people in jail, the rest are in jail because of incidents & accidents, which can happen to
anyone. So extend a hand and don’t shrug off your responsibilities towards the future of our
society. This is a cause for the betterment of all. I understood it after spending more than 8
years in jail & I feel it is my responsibility to let it be known to as many people as possible.



Ongoing Activities:

    1. Child Education program- provides education fees, books and uniform to the
         children of convicts.

    2. Cancer Awareness & detection program- SVCT holds medical and cancer
         detection camps for the underprivileged: organizes film shows to demonstrate self
examination techniques, exhibition of educational posters on cancer prevention and
       hazards of tobacco consumption.

   3. Rehabilitation of convicts- Facilitate their vocational training, help them in getting
       suitable jobs or setting up their own business enterprise.

   4. Art exhibition- Promotion of creativity by supporting fine arts amongst inmates.




Programs of the NGO:

    CATCH THE CANCER
    CANCER AWARENESS & DETECTION PROGRAM


   •   Vision
       Cancer is the most rapidly growing disease in India and is now reaching epidemic
       proportions. The largest segment affected by cancer is Breast & Uterus Can-cer in
       Women and Mouth & Throat Cancer in Men. These happen to be amongst the most
       ignored symp-toms of illness as there is very little or no awareness about them in
       people & especially in the urban poor. We at SVCT feel that if detected in time, these
       can be easily treated. Our vision at SVCT is to help spread awareness and help detect
       these problems in as many people as possible.


       Objectives
   •   To help create awareness about Breast, Uterus, Mouth & Throat Cancer in the urban
       poor.

   •   To hold medical & cancer detection camps in underprivileged areas to diagnose &
       treat cancer patients.

   •   To hold seminars & video conferences in the slums to teach them self-detection
       methods and spread awareness.
CHANCE FOR CHANGE
                           REHABILITATION OF CONVICTS


Vision
All people who are convicted are not per say criminals. They are more often that not victims
of circum-stances. They too were normal citizens who made a mistake & ultimately they too
will join mainstream society and therefore they should be given a chance to change. We at
SVCT strongly believe that human beings are not bad but circumstances fare differently for
different people. Therefore, SVCT is trying to help effect this change.


Objectives
     Training in different fields (vocational training) with certification.

     Help in getting suitable jobs.

     To create awareness among youth & business enterprises to help them rehabilitate.

     Help them in becoming self-reliant, build self-worth & live a dignified life post
         release.

     To finance & support needy inmates after their release.




                                       HUMAN TOUCH
                            CHILD EDUCATION PROGRAM


Vision


The children of jail inmates suffer for want of education, books and medical attention as
usually their earning parents are in jail and they also become stigmatic. Therefore, we at
SVCT feel that it is our moral duty to try and help out & support as many families as
possible. These children have done nothing wrong & deserve a chance to build their future
like all other children. They should not pay for the mistakes of their parents. By helping these
children, we will help build a better society.


Objectives


The objective of this program is

    To make Educational & Medical Aid available to all the families of poor & under-
       privileged jail inmates.

    To develop self worth in them.

    To help them face life with their heads held high.

    To give them a feeling that they are not outcast from the society.

    To ensure they do not get frustrated & take to wrong ways.

    To help build a secure society which has love & forgiveness & not condemnation?



                            CAMPS organised by the NGO

HEALTH CAMP ( 26-02-2011 )


A Health Camp was organised on 26th february 2011 at Tilak Vihar, New Delhi by SVCT.
120 O.P.Ds were conducted. people appriciated this camp.


HEALTH CAMP ( 23-02-2011 )


A Camp was organised on 23rd february 2011 at PeeraGarhi Jhuggi Camp ( The Slum Basti )
.Here a street children meeting was organised for Non-Forma Education in PeeraGarhi ( Slum
Basti). 30 students were participated in this camp. It was successful attempt by SVCT.


HEALTH CAMP ( 19-02-2011 )
A Health Camp was organised on 19th february 2011 at PeeraGarhi Jhuggi. 220 O.P.Ds were
conducted. The camp was succesfully completed and people appreaciated the efforts done by
this camp.




HEART CAMP ( 16-02-2011)


A Heart Camp was organised on 16th february 2011 at Allahabad Bank. 102 O.P.Ds were
conducted . People were very happy due to SVCT's efforts.




Participation in Mirenda House College (09 -02-11 to 11-02-11)
HEALTH CAMP(05-02-2011)


A camp was organised on 5th february 2011 at Shiv Mandir, Sangam Vihar Old Kakrola
Road, New Delhi from 11a.m. to 3p.m. with the help of Dr. U.P. Singh(Roshan Garden).245
O.P.Ds were conducted. People appreciated the efforts done by SVCT.




HEALTH CAMP(04-02-2011)


A camp was organised on 1st february 2011 at MCD Primary School, Janakpuri C-4 Block,
New Delhi from 10a.m. to 1p.m. with the help of Mata Chaudhary Heera Devi
CharitableTrust.208 O.P.Ds were conducted. People appreciated this activity, done by SVCT.




HEALTH CAMP(01-02-2011)


A camp was organised on 1st february 2011 at MCD Primary School, Janakpuri C-4 Block,
New Delhi from 10a.m. to 1p.m. 275 O.P.Ds were conducted. People appreciated this
activity, done by SVCT.




HEART CHECK UP CAMP(30-01-2011)
A free heart check up camp was organised on 30 january 2011 at Shree Sanatan Dharam
Mandir sabha D-Block, Janakpuri, New Delhi from 11a.m. to 3p.m. in association with Metro
Hospital and Cancer Institute, Preet Vihar,Delhi. 89 O.P.Ds, 75 E.C.Gs, 75 R.B.S(Sugar
Test) and 26 Echo Test were conducted.




HEALTH CAMP(29-01-2011)


A general health camp was organised on 29th january 2011 at Ranaji Enclave, Najafgarh
Road, New Delhi from 11a.m. to 3p.m. with the help of Mr. Bhola Nath and Mrs. Suman
Taneja. 22 O.P.Ds were conducted.Efforts of SVCT were appreciated by everyone.


BREAST CANCER CAMP(24-01-2011)


A camp was organised on 24th january 2011 at Gita Mandir Complex, C-2 Block, Janakpuri,
New Delhi from 10a.m. to 3 p.m.with the help of ROKO Cancer. The camp was held to get
people awared about the effects of breast cancer.46 O.P.Ds and 27 Memography were
conducted.


Drawing Competition(23-01-2011):


A drawing competion was organized for different age groups (i.e. 5-7 years,8-10 years and
11-12 years) at Shree Ram Vatika Park, Mayur Vihar-2, Delhi with the help of Resident
Welfare Society(Regd) from 10a.m. to 1p.m.. Prizes were distributed by MLA Ch. Anil
Kumar and Counsellor Mr. Devendar Kumar to best two of each group. Mr. Anil
Grover(Presint of Resident Welfare Society) thanked SVCT for this event.


Health Camp(22-01-2011)
This camp was organised on 22nd january 2011 at Bharat Jodo Complex, 109 Tara
Nagar(Near Kakrola Dairy), New Delhi from 11p.m. to 3p.m. It was helped by Mr. Satnam
Singh of Bharat Jodo to make it a success. 244 O.P.Ds were conducted.


Health Camp(15-01-2011)


This camp was organised on 15th january 2011 at Shiv Mandir, Shyam Vihar(Kakrola area)
near Dwarka Sector-14, New Delhi from 11p.m. to 3p.m. It was helped by Mr. Nawab Singh,
Mr. Rajinder Chopper and Mr. Ashwini Ranga to make it successful. 125 O.P.Ds were
conducted.


General Camp(26-12-2010)


A Camp was organised with the help of Aster Eye Care at Allahabad Bank premises in Lajpat
Nagar from 11a.m. to 3p.m. In this camp 41 O.P.Ds were conducted. A small informatic
exhibition on cancer and tobacco was also placed. Many people and bank staff appreciated
the efforts done by SVCT.


Health camp At Vikas Nagar(25-12-2010)


A Camp was organised at Vikas Nagar on 25th December 2010 at F-1, Kernal Bhatia Road,
Green Avenue, Vikas Marg, Hospital Road,New Delhi from 11a.m. to 3p.m. with the help of
Bhagwan Dass Chauhan( President, Block- E, Vikas Nagar). In this camp, 203 O.P.Ds were
conducted. Patients were screened and dispensed the required medicine.


Quiz Competition for Immunization & Nutrition at Uttam Nagar(15-12-2010):


A Quiz competition was organized on nutrition and immunization on15th December 2010 at
Ideal Radiant Public School in Shiv Vihar in Uttam Nagar from 11:30a.m to 2p.m.
In this Quiz competition 50 Ladies participated and 25 question were asked. 1st prize goes to
Mrs.Sarita who scored 12/25, 2nd goes to Nilam Rai who scored 12/25. 3rd goes to Mirra
who scored 9/25 markes. Consolation Prize were distributed who have given more than 2
Question.
Health camp At Uttam Nagar(11-12-2010):


A Camp was organized on 11th December 2010 at Shiv Vihar in Uttam Nagar from 10a.m to
2p.m. Three doctors provide their services to 136 patients. This camp programme contains
the O.P.D was conducted to scrutnize the cancer patients for further detection. Cards were
issuied to the patients and medicines were distributed to them.
People were very happy by this activity, done by SVCT.


AIDS Awareness Camp At Uttam Nagar(09-12-2010):


AIDS Awareness Camp was organized on 9th December 2010 in Shiv Vihar in Uttam Nagar
from 10a.m to 2p.m. 18 Ladies ware participate In This camp. In this camp people know how
to prevent from AIDS. This was the first activity in this area.
People appreciated this activity,done by SVCT.


Health camp At Dwarka(04-12-2010):


A Camp was organized on 4th December 2010 in Dada Mainder in Dwarka from 10a.m to
2p.m. Two doctors from E.S.I and CIVIL Hospital(Gurgaon)offered services as volunteers to
110 patients. This camp programme contains the O.P.D was conducted to scrutnize the cancer
patients for further detection. Medicines were distributed to them.
People appreciated this activity, done by SVCT.


Cancer camp(28-11-2010):


A camp was organized in collaboration with MKS ROKO Cancer Charitable Trust,with the
help of CRPF Camp at Jhadhoda Kalan on 28th Nov. 2010 from 10.00am to 5.00 pm. A team
of Doctor’s, technicians, nursing staff has screened 36 suspected patients. A complete Mobile
Cancer Van with in fitted Potable Mammography X-Ray machine brought by ROKO. in
which 21 Mammography was done. Details Reports given at the camp side. Every person’s is
not affected by the Cancer. A doctor was engaged where 74 OPD patients were screened and
all patients were given required medicines. On this occasion some posters was also displayed
and leaflets regarding Tobacco and Breast Cancer were distributed amongst the patients and
general public. People were very happy and appreciated about this arrangement done by
SVCT.


Health camp At J.J.Colony,Dwarka(18-11-2010):


A Camp was organized on 18 November 2010 in J.J. Colony (Sector- 7) in Dwarka from
10a.m to 2p.m. Two doctors from E.S.I hospital offered services to 188 patients. Mr. Bijender
Singh and Mr. Chiranjee Lal did the innaugration of camp and support alot in this task. Mr.
Daya Prasad who is a MCD worker helped in this camp. This camp programme contains the
O.P.D was conducted to scrutnize the cancer patients for further detection. Cards were issuied
to the patients and medicines were distributed to them.
People were very happy by this activity, done by SVCT.
We give God all the glory and honour for his grace and mercy towards all those who were
involved in the medical camp directly or indirectly, his grace was sufficient.


Cancer camp At Udham Singh Park,Wazirpur(27-10-2010):


A camp was organized in collaboration with MKS ROKO Cancer Charitable Trust, at Udam
Singh Park, Wazirpur Industrial Area on 27th Oct. 2010 from 10.00am to 5.00 pm. A team of
Doctor’s, technicians, nursing staff has screened 66 suspected patients. A complete Mobile
Cancer Van with in fitted Potable Mammography X-Ray machine brought by ROKO. in
which 24 Mammography was done. Details Reports given at the camp side. Every person’s is
not affected by the Cancer. So similar OPD for general public was also arranged by SVCT, A
doctor (Dr. Naveen Tyagi) was engaged where 175 OPD patients were screened and all
patients were given required medicines. On this occasion some posters was also displayed
and leaflets regarding Tobacco and Breast Cancer were distributed amongst the patients and
general public. People were very happy and appreciated about this arrangement done by
SVCT. Mr.Ram Kumar Pradhan (Jhuggi cluster) gave special thanks for organizing the
activity.


Cancer camp At Wazirpur(20-10-2010):


A camp was organized in collaboration with Indian Cancer Society (Regd) at Udam Singh
Park, Wazirpur Industrial Area on 20th Oct.2010 from 2.00pm to 6.00 pm. A team of
Doctor’s including 1 Male, 1 Female, technicians, nursing staff.They screened 41 patients by
the team of Doctors of Indian Cancer Society (Regd.) which includs Pep Test and collected
blood samples for Hemogram. Investigation Report in detail will be given to the patients after
2 weeks. we arrange some medicines for genral O.P.D and required items from local market
and hold the camp. Dr (Mrs.) Vandana Mehta took initiate and screened 125 OPD (54 female,
65 male & 6 children). A drive against Tobacco was also launched; hand bills and posters
were displayed and distributed amongst general public.

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Cancer Report by SVCT Intern Neetu yadav(JBS)

  • 1. Jaypee Business School A constituent of Jaypee Institute of Information Technology (Deemed University) A-10, Sector 62, Noida (UP) India 201 307 www.jbs.ac.in Social Internship Report On CANCER AWARENESS Submitted as a partial fulfillment for the award of the Two year Full Time Program in Master of Business Administration Name: NEETU YADAV MBA 2009-11 NGO- SIDDHARTHA VASHISHTA CHARITABLE TRUST Supervisor’s Name: Mr. A.K Passy Contact Details : 011- 45751984, 9971796526 Start Date for Internship: 23-02-2011 End Date for Internship: 25-03-2011
  • 2. Cancer is a class of diseases in which a group of cells display uncontrolled growth, invasion that intrudes upon and destroys adjacent tissues, and sometimes metastasis, or spreading to other locations in the body via lymphor blood. These three malignant properties of cancers differentiate them from benign tumors, which do not invade or metastasize. Researchers divide the causes of cancer into two groups: • Those with an environmental cause • Those with a hereditary genetic cause. Cancer is primarily an environmental disease, though genetics influence the risk of some cancers. Common environmental factors leading to cancer include: tobacco, diet and obesity, infections, radiation, lack of physical activity, and environmental pollutants. These environmental factors cause or enhance abnormalities in the genetic material of cells. Cell reproduction is an extremely complex process that is normally tightly regulated by several classes of genes, including oncogenes and tumor suppressor genes. Hereditary or acquired abnormalities in these regulatory genes can lead to the development of cancer. A small percentage of cancers, approximately five to ten percent, are entirely hereditary. The presence of cancer can be suspected on the basis of symptoms, or findings on radiology. Definitive diagnosis of cancer, however, requires the microscopic examination of a biopsy specimen. Most cancers can be treated. Possible treatments include chemotherapy,radiotherapy and surgery. The prognosis is influenced by the type of cancer and the extent of disease. While cancer can affect people of all ages, and a few types of cancer are more common in children, the overall risk of developing cancer increases with age. In 2007 cancer caused about 13% of all human deaths worldwide (7.9 million). Rates are rising as more people live to an old age and lifestyles change in the developing world. Cancers are classified by the type of cell that the tumor resembles and is therefore presumed to be the origin of the tumor. These types include:  Carcinoma: Cancer derived from epithelial cells. This group includes many of the most common cancers, including those of the breast, prostate, lung and colon.  Sarcoma: Cancer derived from connective tissue, or mesenchymal cells.  Lymphoma and leukemia: Cancer derived from hematopoietic (blood-forming) cells
  • 3. Germ cell tumor: Cancer derived from pluripotent cells. In adults these are most often found in the testicle and ovary, but are more common in babies and young children.  Blastoma: Cancer derived from immature "precursor" or embryonic tissue. These are also commonest in children. Cancers are usually named using -carcinoma, -sarcoma or -blastoma as a suffix, with the Latin or Greek word for the organ or tissue of origin as the root. For example, a cancer of the liver is called hepatocarcinoma; a cancer of fat cells is called a liposarcoma. For some common cancers, the English organ name is used. For example, the most common type of breast cancer is called ductal carcinoma of the breast. Here, the adjective ductal refers to the appearance of the cancer under the microscope, which suggests that it has originated in the milk ducts. Benign tumors (which are not cancers) are named using -oma as a suffix with the organ name as the root. For example, a benign tumor of smooth muscle cells is called a leiomyoma(the common name of this frequently occurring benign tumor in the uterus is fibroid). Confusingly, some types of cancer also use the -oma suffix, examples including melanoma and seminoma. Signs and symptoms
  • 4. Symptoms of cancer metastasis depend on the location of the tumor. Cancer symptoms can be divided into three groups:  Local symptoms: are restricted to the site of the primary cancer. They can include lumps or swelling (tumor), hemorrhage (bleeding from the skin, mouth or anus), ulceration and pain. Although local pain commonly occurs in advanced cancer, the initial swelling is often painless.  Metastatic symptoms: are due to the spread of cancer to other locations in the body. They can include enlarged lymph nodes (which can be felt or sometimes seen under the skin), hepatomegaly (enlarged liver) or splenomegaly (enlarged spleen) which can be felt in the abdomen, pain or fracture of affected bones, and neurological symptoms.  Systemic symptoms: occur due to distant effects of the cancer that are not related to direct or metastatic spread. Some of these effects can include weight loss (poor appetite and cachexia), fatigue, excessive sweating (especially night sweats), anemia (low red blood cell count) and other specific conditions termed paraneoplastic phenomena. These may be mediated by immunological or hormonal signals from the cancer cells. Causes Cancers are primarily an environmental disease with 90-95% of cases attributed to environmental factors and 5-10% due to genetics.[1]Environmental, as used by cancer researchers, means any cause that is not genetic. Common environmental factors that contribute to cancer death include: tobacco (25-30%), diet and obesity (30-35%), infections (15-20%), radiation (both ionizing and non ionizing, up to 10%), stress, lack of physical activity, and environmental pollutants.
  • 5. The incidence of lung cancer is highly correlated with smoking Cancer pathogenesis is traceable back to DNA mutations that impact cell growth and metastasis. Substances that cause DNA mutations are known as mutagens, and mutagens that cause cancers are known as carcinogens. Particular substances have been linked to specific types of cancer. Tobacco smoking is associated with many forms of cancer, and causes 90% of lung cancer. Many mutagens are also carcinogens, but some carcinogens are not mutagens. Alcohol is an example of a chemical carcinogen that is not a mutagen. Such chemicals may promote cancers through stimulating the rate of cell division. Faster rates of replication leaves less time for repair enzymes to repair damaged DNA during DNA replication, increasing the likelihood of a mutation. Decades of research has demonstrated the link between tobacco use and cancer in the lung, larynx, head, neck, stomach, bladder, kidney, esophagus and pancreas. Tobacco smoke contains over fifty known carcinogens, including nitrosamines and polycyclic aromatic hydrocarbons. Tobacco is responsible for about one in three of all cancer deaths in the developed world and about one in five worldwide. Lung cancer death rates in the United States have mirrored smoking patterns, with increases in smoking followed by dramatic increases in lung cancer death rates and, more recently, decreases in smoking followed by decreases in lung cancer death rates in men. However, the numbers of smokers worldwide is still rising, leading to what some organizations have described as the tobacco epidemic. Cancer related to one's occupation is believed to represent between 2-20% of all cases. Every year, at least 200,000 people die worldwide from cancer related to their workplace. Currently, most cancer deaths caused by occupational risk factors occur in the developed world. It is
  • 6. estimated that approximately 20,000 cancer deaths and 40,000 new cases of cancer each year in the U.S. are attributable to occupation. Millions of workers run the risk of developing cancers such as lung cancer and mesothelioma from inhaling asbestos fibers and tobacco smoke, or leukemia from exposure to benzene at their workplaces. Diet and exercise Diet, physical inactivity, and obesity are related to approximately 30-35% of cancer cases. In the United States excess body weight is associated with the development of many types of cancer and is a factor in 14-20% of all cancer death. Physical inactivity is believed to contribute to cancer risk not only through its effect on body weight but also through negative effects on immune system and endocrine system. Diets that are low in vegetables, fruits and whole grains, and high in processed or red meats are linked with a number of cancers. A high salt diet is linked to gastric cancer, aflatoxin B1, a frequent food contaminate, with liver cancer, and Betel nut chewing with oral cancer.This may partly explain differences in cancer incidence in different countries for examplegastric cancer is more common in Japan with its high salt diet and colon cancer is more common in the United States. Immigrants develop the risk of their new country, often within one generation, suggesting a substantial link between diet and cancer. Infection Worldwide approximately 18% of cancers are related to infectious diseases. This proportion varies in different regions of the world from a high of 25% in Africa to less than 10% in the developed world. Viruses are usual infectious agents that cause cancer but bacteria and parasites may also have an effect. A virus that can cause cancer is called an oncovirus. These include human papillomavirus (cervical carcinoma), Epstein-Barr virus (B-cell lymphoproliferative
  • 7. disease and nasopharyngeal carcinoma), Kaposi's sarcoma herpesvirus (Kaposi's Sarcoma and primary effusion lymphomas), hepatitis B and hepatitis C viruses (hepatocellular carcinoma), and Human T-cell leukemia virus-1 (T-cell leukemias). Bacterial infection may also increase the risk of cancer, as seen in Helicobacter pylori-induced gastric carcinoma. Parasitic infections strongly associated with cancer include Schistosoma haematobium (squamous cell carcinoma of the bladder) and the liver flukes, Opisthorchis viverrini and Clonorchis sinensis (cholangiocarcinoma). Radiation Up to 10% of cancers are related to radiation exposure either ionizing or nonionizing. Sources of ionizing radiation, include medical imaging, and radon gas. Radiation can cause cancer in most parts of the body, in all animals, and at any age, although radiation-induced solid tumors usually take 10–15 years, and up to 40 years, to become clinically manifest, and radiation-induced leukemias typically require 2–10 years to appear. Some people, such as those with nevoid basal cell carcinoma syndrome or retinoblastoma, are more susceptible than average to developing cancer from radiation exposure. Children and adolescents are twice as likely to develop radiation-induced leukemia as adults; radiation exposure before birth has ten times the effect. Ionizing radiation is not a particularly strong mutagen. Residential exposure to radon gas, for example, has similar cancer risks as passive smoking. Low-dose exposures, such as living near a nuclear power plant, are generally believed to have no or very little effect on cancer development. Radiation is a more potent source of cancer when it is combined with other cancer-causing agents, such as radon gas exposure plus smoking tobacco. Unlike chemical or physical triggers for cancer, ionizing radiation hits molecules within cells randomly. If it happens to strike a chromosome, it can break the chromosome, result in anabnormal number of chromosomes, inactivate one or more genes in the part of the chromosome that it hit, delete parts of the DNA sequence, cause chromosome translocations, or cause other types of chromosome abnormalities. Major damage normally results in the cell dying, but smaller damage may leave a stable, partly functional cell that may be capable of proliferating and developing into cancer, especially if tumor suppressor genes were damaged by the radiation. Three independent stages appear to be involved in the creation of cancer with ionizing radiation: morphological changes to the cell, acquiring cellular
  • 8. immortality (losing normal, life-limiting cell regulatory processes), and adaptations that favor formation of a tumor. Even if the radiation particle does not strike the DNA directly, it triggers responses from cells that indirectly increase the likelihood of mutations. Medical use of ionizing radiation is a growing source of radiation-induced cancers. Ionizing radiation may be used to treat other cancers, but this may, in some cases, induce a second form of cancer. It is also used in some kinds of medical imaging. One report estimates that approximately 29,000 future cancers could be related to the approximately 70 million CT scans performed in the US in 2007. It is estimated that 0.4% of current cancers in the United States are due to CTs performed in the past and that this may increase to as high as 1.5-2% with 2007 rates of CT usage. Prolonged exposure to ultraviolet radiation from the sun can lead to melanoma and other skin malignancies. Clear evidence establishes ultraviolet radiation, especially the medium wave UVB, as the cause of most non-melanoma skin cancers, which are the most common forms of cancer in the world. Non-ionizing radio frequency radiation from mobile phones, electric power transmission, and other similar sources has also been proposed as a cause of cancer, but there is currently little established evidence of such a link. Heredity Less than 0.3% of the population are carriers of a genetic mutation which has a large effect on cancer risk. They cause less than 3-10% of all cancer. [25] Some of these syndromes include:  certain inherited mutations in the genes BRCA1 and BRCA2 with a more than 75% risk of breast cancer and ovarian cancer  tumors of various endocrine organs in multiple endocrine neoplasia (MEN types 1, 2a, 2b)  Li-Fraumeni syndrome (various tumors such as osteosarcoma, breast cancer, soft tissue sarcoma, brain tumors)  Turcot syndrome (brain tumors and colonic polyposis)  Familial adenomatous polyposis an inherited mutation of the APC gene that leads to early onset of colon carcinoma.
  • 9. Hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome) can include familial cases of colon cancer, uterine cancer, gastric cancer, and ovarian cancer, without a preponderance of colon polyps.  Retinoblastoma, when occurring in young children, is due to a hereditary mutation in the retinoblastoma gene.  Down syndrome patients, who have an extra chromosome 21, are known to develop malignancies such as leukemia and testicular cancer, though the reasons for this difference are not well understood. Physical agents Some substances cause cancer primarily through their physical, rather than chemical, effects on cells. A prominent example of this is prolonged exposure to asbestos, naturally occurring mineral fibers which are a major cause of mesothelioma, a type of lung cancer. Other substances in this category include both naturally occurring and synthetic asbestos-like fibers, such as wollastonite, attapulgite, glass wool, and rock wool, are believed to have similar effects. Nonfibrous particulate materials that cause cancer include powdered metallic cobalt and nickel, and crystalline silica (quartz, cristobalite, and tridymite). Usually, physical carcinogens must get inside the body (such as through inhaling tiny pieces) and require years of exposure to develop cancer. Physical trauma and inflammation Physical trauma resulting in cancer is relatively rare. Claims that breaking bone resulted in bone cancer, for example, have never been proven. Similarly, physical trauma is not accepted as a cause for cervical cancer, breast cancer, or brain cancer. One accepted source is frequent, long-term application of hot objects to the body. It is possible that repeated burns on the same part of the body, such as those produced by kanger and kairo heaters (charcoal hand warmers), may produce skin cancer, especially if carcinogenic chemicals are also present. Frequently drinking scalding hot tea may produce esophageal cancer.
  • 10. Generally, it is believed that the cancer arises, or a pre-existing cancer is encouraged, during the process of repairing the trauma, rather than the cancer being caused directly by the trauma. However, repeated injuries to the same tissues might promote excessive cell proliferation, which could then increase the odds of a cancerous mutation. There is no evidence that inflammation itself causes cancer. Hormones Some hormones cause cancer, primarily by encouraging cell proliferation. Hormones are an important cause of sex-related cancers such as cancer of the breast, endometrium, prostate, ovary, and testis, and also of thyroid cancer and bone cancer. An individual's hormone levels are mostly determined genetically, so this may at least partly explains the presence of some cancers that run in families that do not seem to have any cancer-causing genes. For example, the daughters of women who have breast cancer have significantly higher levels of estrogen and progesterone than the daughters of women without breast cancer. These higher hormone levels may explain why these women have higher risk of breast cancer, even in the absence of a breast-cancer gene. Similarly, men of African ancestry have significantly higher levels of testosterone than men of European ancestry, and have a correspondingly much higher level of prostate cancer. Men of Asian ancestry, with the lowest levels of testosterone-activating androstanediol glucuronide, have the lowest levels of prostate cancer. However, non-genetic factors are also relevant: Obese people have higher levels of some hormones associated with cancer, and a higher rate of those cancers. Women who takehormone replacement therapy have a higher risk of developing cancers associated with those hormones.[27] On the other hand, people who exercise far more than average have lower levels of these hormones, and lower risk of cancer. Osteosarcoma may be caused by growth hormones Some treatments and prevention approaches leverage this cause by artificially reducing hormone levels, and thus discouraging hormone-sensitive cancers.
  • 11. Cancers are caused by a series of mutations. Each mutation alters the behavior of the cell somewhat. Cancer is fundamentally a disease of failure of regulation of tissue growth. In order for a normal cell to transform into a cancer cell, the genes which regulate cell growth and differentiation must be altered. The affected genes are divided into two broad categories. Oncogenes are genes which promote cell growth and reproduction. Tumor suppressor genes are genes which inhibit cell division and survival. Malignant transformation can occur through the formation of novel oncogenes, the inappropriate over-expression of normal oncogenes, or by the under- expression or disabling of tumor suppressor genes. Typically, changes in many genes are required to transform a normal cell into a cancer cell.
  • 12. Genetic changes can occur at different levels and by different mechanisms. The gain or loss of an entire chromosome can occur through errors in mitosis. More common are mutations, which are changes in the nucleotide sequence of genomic DNA. Large-scale mutations involve the deletion or gain of a portion of a chromosome. Genomic amplification occurs when a cell gains many copies (often 20 or more) of a small chromosomal locus, usually containing one or more oncogenes and adjacent genetic material. Translocation occurs when two separate chromosomal regions become abnormally fused, often at a characteristic location. A well-known example of this is the Philadelphia chromosome, or translocation of chromosomes 9 and 22, which occurs in chronic myelogenous leukemia, and results in production of the BCR-abl fusion protein, an oncogenic tyrosine kinase. Small-scale mutations include point mutations, deletions, and insertions, which may occur in the promoter region of a gene and affect its expression, or may occur in the gene's coding sequence and alter the function or stability of its protein product. Disruption of a single gene may also result fromintegration of genomic material from a DNA virus or retrovirus, and resulting in the expression of viral oncogenes in the affected cell and its descendants. Replication of the enormous amount of data contained within the DNA of living cells will probabilistically result in some errors (mutations). Complex error correction and prevention is built into the process, and safeguards the cell against cancer. If significant error occurs, the damaged cell can "self destruct" through programmed cell death, termed apoptosis. If the error control processes fail, then the mutations will survive and be passed along to daughter cells. Some environments make errors more likely to arise and propagate. Such environments can include the presence of disruptive substances calledcarcinogens, repeated physical injury, heat, ionising radiation, or hypoxia. The errors which cause cancer are self- amplifying and compounding, for example:  A mutation in the error-correcting machinery of a cell might cause that cell and its children to accumulate errors more rapidly  A further mutation in an oncogene might cause the cell to reproduce more rapidly and more frequently than its normal counterparts.  A further mutation may cause loss of a tumour suppressor gene, disrupting the apoptosis signalling pathway and resulting in the cell becoming immortal.
  • 13. A further mutation in signaling machinery of the cell might send error-causing signals to nearby cells The transformation of normal cell into cancer is akin to a chain reaction caused by initial errors, which compound into more severe errors, each progressively allowing the cell to escape the controls that limit normal tissue growth. This rebellion-like scenario becomes an undesirable survival of the fittest, where the driving forces of evolution work against the body's design and enforcement of order. Once cancer has begun to develop, this ongoing process, termed clonal evolution drives progression towards more invasive stages. Diagnosis Chest x-ray showing lung cancer in the left lung. Pathology A cancer may be suspected for a variety of reasons, but the definitive diagnosis of most malignancies must be confirmed by histologicalexamination of the cancerous cells by a pathologist. Tissue can be obtained from a biopsy or surgery. Many biopsies (such as those of the skin, breast or liver) can be done in a doctor's office. Biopsies of other organs are performed under anesthesia and require surgery in anoperating room.
  • 14. The tissue diagnosis given by the pathologist indicates the type of cell that is proliferating, its histological grade, genetic abnormalities, and other features of the tumor. Together, this information is useful to evaluate the prognosis of the patient and to choose the best treatment. Cytogenetics and immunohistochemistry are other types of testing that the pathologist may perform on the tissue specimen. These tests may provide information about the molecular changes (such as mutations, fusion genes, and numerical chromosome changes) that has happened in the cancer cells, and may thus also indicate the future behavior of the cancer (prognosis) and best treatment.  An invasive ductal carcinoma of the breast (pale area at the center) surrounded by spikes of whitish scar tissue in the surrounding yellow fatty tissue.  An invasive colorectal carcinoma (top center) in acolectomy specimen.  A squamous cell carcinoma (the whitish tumor) near the bronchi in a lung specimen.
  • 15.  A large invasive ductal carcinoma in amastectomy specimen. Prevention Cancer prevention is defined as active measures to decrease the incidence of cancer. The vast majority of cancer risk factors are environmental or lifestyle-related, thus cancer is largely a preventable disease. Greater than 30% of cancer is preventable via avoiding risk factors including: tobacco, overweight or obesity, low fruit and vegetable intake, physical inactivity, alcohol, sexually transmitted infections, and air pollution. Dietary Dietary recommendations to reduce the risk of developing cancer, including: (1) reducing intake of foods and drinks that promote weight gain, namely energy-dense foods and sugary drinks (2) eating mostly foods of plant origin (3) limiting intake of red meat and avoiding processed meat (4) limiting consumption of alcoholic beverages (5) reducing intake of salt and avoiding mouldy cereals (grains) or pulses (legumes). Medication The concept that medications could be used to prevent cancer is an attractive one, and many high-quality clinical trials support the use of such chemoprevention in defined circumstances. Aspirin has been found to reduce the risk of death from cancer. Daily use of tamoxifen or raloxifene has been demonstrated to reduce the risk of developing breast cancer in high-risk women by about 50%. Finasteride has been shown to lower the risk of prostate cancer, though it seems to mostly prevent low-grade tumors. The effect of COX-2
  • 16. inhibitors such as rofecoxib and celecoxib upon the risk of colon polyps have been studied in familial adenomatous polyposis patients and in the general population. In both groups, there were significant reductions in colon polyp incidence, but this came at the price of increased cardiovascular toxicity. Vitamins have not been found to be effective at preventing cancer, although low levels of vitamin D are correlated with increased cancer risk. Whether this relationship is causal and vitamin D supplementation is protective is yet to be determined. Beta- carotene supplementation has been found to increase slightly, but not significantly, risks of lung cancer. Folic acid supplementation has not been found effective in preventing colon cancer and may increase colon polyps. Vaccination Vaccines have been developed that prevent some infection by some viruses that are associated with cancer, and therapeutic vaccines are in development to stimulate an immune response against cancer-specific epitopes. Human papillomavirus vaccine (Gardasil and Cervarix) decreases the risk of developing cervical cancer. The hepatitis B vaccine prevents infection with hepatitis B virus and thus decreases the risk of liver cancer. Advances in cancer research have made a vaccine designed to prevent cancers available. In 2006, the U.S. Food and Drug Administration approved a human papilloma virus vaccine, called Gardasil. The vaccine protects against 6,11,16,18 strains of HPV, which together cause 70% of cervical cancers and 90% of genital warts. It also lists vaginal and vulvar cancers as being protected. In March 2007, the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) officially recommended that females aged 11–12 receive the vaccine, and indicated that females as young as age 9 and as old as age 26 are also candidates for immunization. There is a second vaccine from Cervarix which protects against the more dangerous HPV 16,18 strains only. In 2009, Gardasil was approved for protection against genital warts. In 2010, the Gardasil vaccine was approved for protection against anal cancer for males and reviewers stated there was no anatomical, histological or physiological anal differences between the genders so females would also be protected.
  • 17. Unlike diagnosis efforts prompted by symptoms and medical signs, cancer screening involves efforts to detect cancer after it has formed, but before any noticeable symptoms appear. This may involve physical examination, blood or urine tests, or medical imaging. Cancer screening is not currently possible for some types of cancers, and even when tests are available, they are not recommended to everyone. Universal screening or mass screeninginvolves screening everyone. Selective screening identifies people who are known to be at higher risk of developing cancer, such as people with a family history of cancer. Several factors are considered to determine whether the benefits of screening outweigh the risks and the costs of screening. These factors include:  Possible harms from the screening test: Some types of screening tests, such as X-ray images, expose the body to potentially harmful ionizing radiation. There is a small chance that the radiation in the test could cause a new cancer in a healthy person. Screening mammography, used to detect breast cancer, is not recommended to men or to young women because they are more likely to be harmed by the test than to benefit from it. Other tests, such as a skin check for skin cancer, have no significant risk of harm to the patient. A test that has high potential harms is only recommended when the benefits are also high.  The likelihood of the test correctly identifying cancer: If the test is not sensitive, then it may miss cancers. If the test is not specific, then it may wrongly indicate cancer in a healthy person. All cancer screening tests produce both false positives and false negatives, and most produce more false positives. Experts consider the rate of errors when making recommendations about which test, if any, to use. A test may work better in some populations than others. The positive predictive value is a calculation of the likelihood that a positive test result actually represents cancer in a given individual, based on the results of people with similar risk factors.  Possible harms from follow-up procedures: If the screening test is positive, further diagnostic testing is normally done, such as a biopsy of the tissue. If the test produces many false positives, then many people will undergo needless medical procedures, some of which may be dangerous.  Whether suitable treatment is available and appropriate: Screening is discouraged if no effective treatment is available. When effective and suitable treatment is not available, then diagnosis of a fatal disease produces significant mental and emotional harms. For
  • 18. example, routine screening for cancer is typically not appropriate in a very frail elderly person, because the treatment for any cancer that is detected might kill the patient.  Whether early detection improves treatment outcomes: Even when treatment is available, sometimes early detection does not improve the outcome. If the treatment result is the same as if the screening had not been done, then the only screening program does is increase the length of time the person lived with the knowledge that he had cancer. This phenomenon is called lead-time bias. A useful screening program reduces the number of years of potential life lost (longer lives) and disability-adjusted life years lost (longer healthy lives).  Whether the cancer will ever need treatment: Diagnosis of a cancer in a person who will never be harmed by the cancer is called overdiagnosis. Overdiagnosis is most common among older people with slow-growing cancers. Concerns about overdiagnosis are common for breast and prostate cancer.  Whether the test is acceptable to the patients:If a screening test is too burdensome, such as requiring too much time, too much pain, or culturally unacceptable behaviors, then people will refuse to participate.  Cost of the test: Some expert bodies, such as the U.S. Preventive Services Task Force, completely ignore the question of money. Most, however, include a cost-effectiveness analysis that, all else being equal, favors less expensive tests over more expensive tests, and attempt to balance the cost of the screening program against the benefits of using those funds for other health programs. These analyses usually include the total cost of the screening program to the healthcare system, such as ordering the test, performing the test, reporting the results, and biopsies for suspicious results, but not usually the costs to the individual, such as for time taken away from employment. Recommendations The U.S. Preventive Services Task Force (USPSTF) strongly recommends cervical cancer screening in women who are sexually active and have a cervix at least until the age of 65. They recommend that Americans be screened for colorectal cancer via fecal occult blood testing, sigmoidoscopy, or colonoscopy starting at age 50 until age 75. There is insufficient evidence to recommend for or against screening for skin cancer, oral cancer, lung cancer or prostate cancer in men under 75. Routine screening is not recommended forbladder
  • 19. cancer, testicular cancer, ovarian cancer, pancreatic cancer, or prostate cancer in men over 75.The USPTF recommends mammography for breast cancer screening every two years for those 50–74 years old; however, they do not recommend either breast self- examination orclinical breast examination. A 2009 Cochrane review came to slightly different conclusions with respect to breast cancer screening stating that routine mammography may do more harm than good. Japan screens for gastric cancer using photofluorography due to the high incidence there. Genetic testing See also: Cancer syndrome Gene Cancer types BRCA1, BRCA2 Breast, ovarian, pancreatic Colon, uterine, small bowel, stomach, HNPCC, MLH1, MSH2, MSH6, PMS1, PMS2 urinary tract Genetic testing for individuals at high-risk of certain cancers is recommended. Carriers of these mutations may than undergo enhanced surveillance, chemoprevention, or preventative surgery to reduce their subsequent risk. Management Many management options for cancer exist including: chemotherapy, radiation therapy, surgery, immunotherapy, monoclonal antibody therapy and other methods. Which treatments are used depends upon the type of cancer, the location and grade of the tumor, and the stage of the disease, as well as the general state of a person's health. Complete removal of the cancer without damage to the rest of the body is the goal of treatment for most cancers. Sometimes this can be accomplished by surgery, but the propensity of cancers to invade adjacent tissue or to spread to distant sites by microscopic metastasis often limits its effectiveness. Surgery often required the removal of a wide surgical
  • 20. margin or afree margin. The width of the free margin depends on the type of the cancer, the method of removal (CCPDMA, Mohs surgery, POMA, etc.). The margin can be as little as 1 mm for basal cell cancer using CCPDMA or Mohs surgery, to several centimeters for aggressive cancers. The effectiveness of chemotherapy is often limited by toxicity to other tissues in the body. Radiation can also cause damage to normal tissue. Because cancer is a class of diseases, it is unlikely that there will ever be a single "cure for cancer" any more than there will be a single treatment for all infectious diseases. Angiogenesis inhibitors were once thought to have potential as a "silver bullet" treatment applicable to many types of cancer, but this has not been the case in practice. Experimental cancer treatments are treatments that are being studied to see whether they work. Typically, these are studied in clinical trials to compare the proposed treatment to the best existing treatment. They may be entirely new treatments, or they may be treatments that have been used successfully in one type of cancer, and are now being tested to see whether they are effective in another type. Alternative cancer treatments are treatments used by alternative medicine practitioners. These include mind–body interventions, herbal preparations, massage, electrical devices, and strict dietary regimens. Alternative cancer treatments are ineffective at killing cancer cells. Some are dangerous, but more are harmless or provide the patient with a degree of physical or emotional comfort. Alternative cancer treatment has also been a fertile field for hoaxes aimed at stripping desperate patients of their money. Prognosis Cancer has a reputation as a deadly disease. Taken as a whole, about half of patients receiving treatment for invasive cancer (excluding carcinoma in situ and non-melanoma skin cancers) die from cancer or its treatment. However, the survival rates vary dramatically by type of cancer, with the range running from basically all patients surviving to almost no patients surviving. Patients who receive a long-term remission or permanent cure may have physical and emotional complications from the disease and its treatment. Surgery may have amputated body parts or removed internal organs, or the cancer may have damaged delicate structures, like the part of the ear that is responsible for the sense of balance; in some
  • 21. cases, this requires extensive physical rehabilitation or occupational therapy so that the patient can walk or engage in other activities of daily living. Chemo brain is a usually short- term cognitive impairmentassociated with some treatments. Cancer-related fatigue usually resolves shortly after the end of treatment, but may be lifelong. Cancer-related pain may require ongoing treatment. Younger patients may be unable to have children. Some patients may be anxious or psychologically traumatized as a result of their experience of the diagnosis or treatment.Survivors generally need to have regular medical screenings to ensure that the cancer has not returned, to manage any ongoing cancer-related conditions, and to screen for new cancers. Cancer survivors, even when permanently cured of the first cancer, have approximately double the normal risk of developing another primary cancer. Some advocates have promoted "survivor care plans"—written documents detailing the diagnosis, all previous treatment, and all recommended cancer screening and other care requirements for the future —as a way of organizing the extensive medical information that survivors and their future healthcare providers need. Progressive and disseminated malignant disease harms the cancer patient's quality of life, and some cancer treatments, including common forms of chemotherapy, have severe side effects. In the advanced stages of cancer, many patients need extensive care, affecting family members and friends. Palliative care aims to improve the patient's immediate quality of life, regardless of whether further treatment is undertaken. Hospice programs assist patients similarly, especially when a terminally ill patient has rejected further treatment aimed at curing the cancer. Both styles of service offer home health nursing and respite care. Predicting either short-term or long-term survival is difficult and depends on many factors. The most important factors are the particular kind of cancer and the patient's age and overall health. Medically frail patients with many comorbidities have lower survival rates than otherwise healthy patients. A centenarian is unlikely to survive for five years even if the treatment is successful. Patients who report a higher quality of life tend to survive longer. People with lower quality of life may be affected by major depressive disorder and other complications from cancer treatment and/or disease progression that both impairs their quality of life and reduces their quantity of life. Additionally, patients with worse prognoses may be depressed or report a lower quality of life directly because they correctly perceive that their condition is likely to be fatal.
  • 22. Despite strong social pressure to maintain an upbeat, optimistic attitude or act like a determined "fighter" to "win the battle", personality traits have no connection to survival. Epidemiology Main article: Epidemiology of cancer Death rate from malignant cancer per 100,000 inhabitants in 2004.[87] no data ≤ 55 55-80 80-105 105-130 130-155 155-180 180-205 205-230 230-255 255-280 280-305 ≥ 305 In 2008 approximately 12.7 million cancers were diagnosed (excluding non-melanoma skin cancers and other non-invasive cancers) and 7.6 million people died of cancer worldwide. Cancers as a group account for approximately 13% of all deaths each year with the most common being: lung cancer (1.3 million deaths), stomach cancer (803,000 deaths), colorectal cancer (639,000 deaths), liver cancer (610,000 deaths), and breast cancer (519,000 deaths). This makes invasive cancer the leading cause of death in
  • 23. the developed world and the second leading cause of death in the developing world.[3] Over half of cases occur in the developing world. Global cancer rates have been increasing primarily due to an aging population and lifestyle changes in the developing world. The most significant risk factor for developing cancer is old age.[89] Although it is possible for cancer to strike at any age, most people who are diagnosed with invasive cancer are over the age of 65. According to cancer researcher Robert A. Weinberg, "If we lived long enough, sooner or later we all would get cancer." Some of the association between aging and cancer is attributed to immunosenescence errors accumulated in DNA over a lifetime, and age-related changes in the endocrine system. Some slow-growing cancers are particularly common. Autopsy studies in Europe and Asia have shown that up to 36% of people have undiagnosed and apparently harmless thyroid cancer at the time of their deaths, and that 80% of men develop prostate cancer by age 80. As these cancers, often very small, did not cause the person's death, identifying them would have represented overdiagnosis rather than useful medical care. The three most common childhood cancers are leukemia (34%), brain tumors (23%), and lymphomas (12%). Rates of childhood cancer have increased between 0.6% per year between 1975 to 2002 in the United States and by 1.1% per year between 1978 and 1997 in Europe. In the developed world, one in three people will be diagnosed with invasive cancer during their lifetimes. If all people with cancer survived and cancer occurred randomly, the lifetime odds of developing a second primary cancer would be one in nine. However, cancer survivors have an increased risk of developing a second primary cancer, and the odds are about two in nine. About half of these second primaries can be attributed to the normal one- in-nine risk associated with random chance. The increased risk is believed to be primarily due to the same risk factors that produced the first cancer (such as the person's genetic profile, alcohol and tobacco use, obesity, and environmental exposures), and partly due to the treatment for the first cancer, which typically includes mutagenic chemotherapeutic drugs or radiation. Cancer survivors may also be more likely to comply with recommended screening, and thus may be more likely than average to detect cancers.
  • 24. History Hippocrates (ca. 460 BC – ca. 370 BC) described several kinds of cancers, referring to them with the Greek word carcinos (crab or crayfish), among others. This name comes from the appearance of the cut surface of a solid malignant tumour, with "the veins stretched on all sides as the animal the crab has its feet, whence it derives its name". Since it was against Greek tradition to open the body, Hippocrates only described and made drawings of outwardly visible tumors on the skin, nose, and breasts. Treatment was based on the humor theory of four bodily fluids (black and yellow bile, blood, and phlegm). According to the patient's humor, treatment consisted of diet, blood-letting, and/or laxatives. Through the centuries it was discovered that cancer could occur anywhere in the body, but humor-theory based treatment remained popular until the 19th century with the discovery of cells. Engraving with two views of a Dutch woman who had a tumor removed from her neck in 1689. Celsus (ca. 25 BC - 50 AD) translated carcinos into the Latin cancer, also meaning crab. Galen (2nd century AD) called benign tumoursoncos, Greek for swelling, reserving Hippocrates' carcinos for malignant tumours. He later added the suffix -oma, Greek for swelling, giving the name carcinoma. The oldest known description and surgical treatment of cancer was discovered in Egypt and dates back to approximately 1600 BC. ThePapyrus describes 8 cases of ulcers of the breast that were treated by cauterization, with a tool called "the fire drill." The writing says about the disease, "There is no treatment." Another very early surgical treatment for cancer was described in the 1020s by Avicenna (Ibn Sina) in The Canon of Medicine. He stated that the excision should be radical and that all diseased tissue should be removed, which included the use of amputation or the removal of veinsrunning in the direction of the tumor. He also recommended the use of cauterization for the area treated if necessary.
  • 25. In the 16th and 17th centuries, it became more acceptable for doctors to dissect bodies to discover the cause of death. The German professor Wilhelm Fabry believed that breast cancer was caused by a milk clot in a mammary duct. The Dutch professor Francois de la Boe Sylvius, a follower of Descartes, believed that all disease was the outcome of chemical processes, and that acidic lymph fluid was the cause of cancer. His contemporary Nicolaes Tulp believed that cancer was a poison that slowly spreads, and concluded that it was contagious. The first cause of cancer was identified by British surgeon Percivall Pott, who discovered in 1775 that cancer of the scrotum was a common disease among chimney sweeps. The work of other individual physicians led to various insights, but when physicians started working together they could make firmer conclusions. With the widespread use of the microscope in the 18th century, it was discovered that the 'cancer poison' spread from the primary tumor through the lymph nodes to other sites ("metastasis"). This view of the disease was first formulated by the English surgeon Campbell De Morgan between 1871 and 1874. The use of surgery to treat cancer had poor results due to problems with hygiene. The renowned Scottish surgeon Alexander Monro saw only 2 breast tumor patients out of 60 surviving surgery for two years. In the 19th century, asepsisimproved surgical hygiene and as the survival statistics went up, surgical removal of the tumor became the primary treatment for cancer. With the exception of William Coley who in the late 19th century felt that the rate of cure after surgery had been higher before asepsis (and who injected bacteria into tumors with mixed results), cancer treatment became dependent on the individual art of the surgeon at removing a tumor. During the same period, the idea that the body was made up of various tissues, that in turn were made up of millions of cells, laid rest the humor-theories about chemical imbalances in the body. The age of cellular pathology was born. The genetic basis of cancer was recognised in 1902 by the German zoologist Theodor Boveri, professor of zoology at Munich and later in Würzburg. He discovered a method to generate cells with multiple copies of the centrosome, a structure he discovered and named. He postulated that chromosomes were distinct and transmitted different inheritance factors. He suggested that mutations of the chromosomes could generate a cell with unlimited growth potential which could be passed onto its descendants. He proposed the existence of cell cycle check points, tumour suppressor genes and oncogenes. He speculated that cancers might be
  • 26. caused or promoted by radiation, physical or chemical insults or by pathogenic microorganisms. 1938 poster identifying surgery, x-rays and radium as the proper treatments for cancer. When Marie Curie and Pierre Curie discovered radiation at the end of the 19th century, they stumbled upon the first effective non-surgical cancer treatment. With radiation also came the first signs of multi-disciplinary approaches to cancer treatment. The surgeon was no longer operating in isolation, but worked together with hospital radiologists to help patients. The complications in communication this brought, along with the necessity of the patient's treatment in a hospital facility rather than at home, also created a parallel process of compiling patient data into hospital files, which in turn led to the first statistical patient studies. A founding paper of cancer epidemiology was the work of Janet Lane-Claypon, who published a comparative study in 1926 of 500 breast cancer cases and 500 control patients of the same background and lifestyle for the British Ministry of Health. Her ground-breaking work on cancer epidemiology was carried on by Richard Doll and Austin Bradford Hill, who published "Lung Cancer and Other Causes of Death In Relation toSmoking. A Second Report on the Mortality of British Doctors" followed in 1956 (otherwise known as the British doctors study). Richard Doll left the London Medical Research Center (MRC), to start the Oxford unit for Cancer epidemiology in 1968. With the use of computers, the unit was the first to compile large amounts of cancer data. Modern epidemiological methods are closely linked to current concepts of disease andpublic health policy. Over the past 50 years, great
  • 27. efforts have been spent on gathering data across medical practise, hospital, provincial, state, and even country boundaries to study the interdependence of environmental and cultural factors on cancer incidence. Cancer patient treatment and studies were restricted to individual physicians' practices until World War II, when medical research centers discovered that there were large international differences in disease incidence. This insight drove national public health bodies to make it possible to compile health data across practises and hospitals, a process that many countries do today. The Japanese medical community observed that the bone marrow of victims of the atomic bombings of Hiroshima and Nagasaki was completely destroyed. They concluded that diseased bone marrow could also be destroyed with radiation, and this led to the discovery of bone marrow transplants for leukemia. Since World War II, trends in cancer treatment are to improve on a micro-level the existing treatment methods, standardize them, and globalize them to find cures through epidemiology and international partnerships. Society and culture While many diseases (such as heart failure) may have a worse prognosis than most cases of cancer, it is the subject of widespread fear and taboos. Euphemisms, once "a long illness", and now informally as "the big C", provide distance and soothe superstitions. This deep belief that cancer is necessarily a difficult and usually deadly disease is reflected in the systems chosen by society to compile cancer statistics: the most common form of cancer—non- melanoma skin cancers, accounting for about one-third of all cancer cases worldwide, but very few deaths are excluded from cancer statistics specifically because they are easily treated and almost always cured, often in a single, short, outpatient procedure. Cancer is regarded as a disease that must be "fought" to end the "civil insurrection"; a War on Cancer has been declared. Military metaphors are particularly common in descriptions of cancer's human effects, and they emphasize both the parlous state of the affected individual's health and the need for the individual to take immediate, decisive actions himself, rather than to delay, to ignore, or to rely entirely on others caring for him. The military metaphors also help rationalize radical, destructive treatments. In the 1970s, a relatively popular alternative cancer treatment was a specialized form of talk therapy, based on the idea that cancer was caused by a bad attitude. People with a "cancer
  • 28. personality"—depressed, repressed, self-loathing, and afraid to express their emotions—were believed to have manifested cancer through subconscious desire. Some psychotherapists said that treatment to change the patient's outlook on life would cure the cancer. Among other effects, this belief allows society to blame the victim for having caused the cancer (by "wanting" it) or having metaphysically prevented its cure (by not becoming a sufficiently happy, fearless, and loving person). It also increases patients' anxiety, as they incorrectly believe that natural emotions of sadness, anger or fear shorten their lives. The idea was excoriated by the notoriously outspoken Susan Sontag, who published Illness as Metaphor while recovering from treatment for breast cancer in 1978. Although the original idea is now generally regarded as nonsense, the idea partly persists in a reduced form with a widespread, but incorrect, belief that deliberately cultivating a habit of positive thinking will increase survival. This notion is particularly strong in breast cancer culture. Research Cancer research is the intense scientific effort to understand disease processes and discover possible therapies. Research about cancer causes focusses on the following issues:  Agents (e.g. viruses) and events (e.g. mutations) which cause or facilitate genetic changes in cells destined to become cancer.  The precise nature of the genetic damage, and the genes which are affected by it.  The consequences of those genetic changes on the biology of the cell, both in generating the defining properties of a cancer cell, and in facilitating additional genetic events which lead to further progression of the cancer. The improved understanding of molecular biology and cellular biology due to cancer research has led to a number of new, effective treatments for cancer since President Nixon declared "War on Cancer" in 1971. Since 1971 the United States has invested over $200 billion on cancer research; that total includes money invested by public and private sectors and foundations. Despite this substantial investment, the country has seen a five percent decrease in the cancer death rate (adjusting for size and age of the population) between 1950 and 2005.
  • 29. Leading cancer research organizations and projects include the American Association for Cancer Research, the American Cancer Society (ACS), the American Society of Clinical Oncology, the European Organisation for Research and Treatment of Cancer, the National Cancer Institute, the National Comprehensive Cancer Network, and The Cancer Genome Atlasproject at the NCI. Environmental Factors and Cancer Deaths Exposure Issues • Home environment • Current events • Workplace • School • Government Decisions
  • 30. Global and local environment What causes cancer ? • Organic chemicals • Inorganic chemicals • Fiber • Hormonal Carcinogenesis The Effects of Cancer on Social Behavior Cancer takes a physical toll, but it also takes a social toll. Because of feelings that occur before, during and after treatment, you may find your relationships uncomfortable or even strained. Fortunately, there is help. Cancer arises largely as a result of lifestyle, and is thus a consequence of the conditions in which individuals live and work. For some cancers, specific causal relationships to chemicals are well established; leukaemia as a result of exposure to benzene used in tyre manufacture is one example. Lifestyle influences are relevant for most cancers. The changes in incidence of different forms of cancer among migrants who have moved from one part of the world to another probably reflects major lifestyle changes resulting from acculturation to the way of life in the host country. Types • Both internal and external factors affect a cancer patient's social behavior. For example, the fatigue from cancer treatment often leads to withdrawal, and the pressure from piling medical bills often leads to worry and negativity. Time Frame • Every cancer patient is different: some patients beat cancer in a matter of months while others battle it for years. The National Cancer Institute (2009) stresses that regardless of how long your cancer lasts, you must focus on living.
  • 31. Misconceptions • Misconceptions about cancer will weigh on your social energy. Contrary to popular belief, depression is not the norm, and not everyone diagnosed with cancer will endure prolonged suffering or a painful death. Upsides • Although negative emotions such as guilt, anger and depression can alienate those around you, cancer can also sweeten your social relationships. Cancer patients commonly report feelings of hope and gratitude, and the people in your social support system will help you maintain a positive outlook. Prevention • Talk about how you feel with your family members, friends and, if appropriate, clergy. Also, seek help from your care center, where doctors and nurses will help you cope with cancer's social effects. Male Cancer Death Rates
  • 32. Female Cancer Death Rate (Rate per 10,000) 100 80 60 40 20 0 0 5 0 5 0 5 0 5 0 5 0 5 0 5 0 3 3 4 4 5 5 6 6 7 7 8 8 9 9 0 9 9 9 9 9 9 9 9 9 9 9 9 9 9 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 Managing national cancer control programmes With careful planning and appropriate priorities, within the scope of prevention, early detection, treatment and palliation, the establishment of national cancer control programmes offers the most rational means of achieving a substantial degree of cancer control, even where resources are severely limited. It is for this reason that the establishment of a national cancer control programme is recommended wherever the burden of the disease is significant, there is a rising trend of cancer risk factors and there is a need to make the most efficient use of limited resources. Effective and efficient cancer control programmes need competent management to identify priorities and resources (planning), and to organize and coordinate those resources to guarantee sustained progress to meet the planned objectives (implementation, monitoring and evaluation).
  • 33. Good management is essential to maintain momentum and introduce any necessary modifications. A quality management approach is essential to improving the performance of the programme. The four principal approaches to cancer control are:  Prevention Prevention means eliminating or minimizing exposure to the causes of cancer, and includes reducing individual susceptibility to the effect of such causes. This approach offers the greatest public health potential and the most cost-effective long-term method of cancer control. Tobacco is the leading single cause of cancer worldwide and in the fight against cancer every country should give highest priority to tobacco control.  Early detection Increasing awareness of the signs and symptoms of cancer contributes to early detection of the disease. Where tests for cancer of specific sites are available, and facilities are appropriate, screening of apparently healthy individuals can disclose cancer in early or precursor stages, when treatment may be most effective. Early detection is only successful when linked to effective treatment.  Diagnosis and treatment Cancer diagnosis calls for a combination of careful clinical assessment and diagnostic investigations. Once a diagnosis is confirmed, it is necessary to ascertain cancer staging to evaluate the extension of the disease and be able to provide treatment accordingly. Cancer treatment aims at curing, prolonging useful life and improving quality of life. Treatment services should give priority to early detectable tumours and potentially curable cancers. In addition, treatment approaches should include psychosocial support, rehabilitation and close coordination with palliative care to ensure the best possible quality of life for cancer patients.  Palliative care In most of the world, the majority of the cancer patients present with advanced disease. For them, the only realistic treatment option is pain relief and palliative care. Effective approaches to palliative care are available to improve the quality of life for cancer patients. Cancer prevention should be a key element in all national cancer control programmes. Prevention not only focuses on the risks associated with a particular illness or problem but also on protective factors. Among prevention activities, emphasis should be placed on:
  • 34. – tobacco control; – healthy diet; – physical activities and avoidance of obesity; – reducing alcohol use; – reducing carcinogenic occupational and environmental exposures; – immunization against hepatitis B virus; – combating schistosomiasis; – avoidance of prolonged exposure to the sun; – health education, relating to sexual and reproductive factors associated with cancer. Action on tobacco use is universally needed, but the priorities accorded to other components of the programme will depend on the results of a situation analysis of the country concerned, covering the actual and forecast burden of cancer cases in the country, and the estimated proportion of potentially preventable cases. Cancer rates in India are considerably lower than those in more developed countries such as the United States…data from population based cancer registries in India show that the most frequently reported cancer sites in males are lung, oesophagus, stomach, and larynx. In females, cancers of the cervix, breast, ovary, and oesophagus are the most commonly encountered… In India, the incidence of breast cancer is increasing, with an estimated 80,000 new cases diagnosed annually. The incidence of breast cancer increased by approximately 50% between 1965 and 1985. Much of this increase may be associated with greater urbanization and improved life expectancy…
  • 35. Cancer Control in India India is one of the first few developing countries where a nation-wide cancer control programs were launched. Government of India took its first initiative in 1971. The National Cancer Control Program for India was formulated in 1984 with four major goals 13: 1. Primary prevention of tobacco related cancer 2. Early detection of the cancers of easily accessible sites 3. Augmentation of treatment facilities 4. Establishment of equitable, pain control and palliative care network throughout the country Cancer Prevention According to Mayo Clinic, there are 7 steps to prevent cancer  Avoid tobacco use: As already discussed, tobacco is the major risk factor for cancer. Hence, it is important to avoid tobacco in all forms, like both active and passive smoking and chewing tobacco. • Eat a variety of healthy foods: It is important to consume plant-based foods, rich in fruits and vegetables, reduce the intake of fat and alcohol. • Stay active and maintain a healthy weight: Regular exercise should be an integral part of one’s daily routine. • Protect yourself from the sun: Exposure to sun is the major cause of skin cancer. It is important to avoid the sun’s ultraviolet rays, especially from 10 am to 4 pm and applying adequate amounts of sunscreen lotion with a sun-protecting factor (SPF) of at least 15, especially before venturing outdoors during these hours • Get immunized: Vaccination against Hepatitis B should be regularly administered, as this infection could lead to liver cancer.
  • 36. Healthy practices: Sexually transmitted diseases like human papilloma virus infection, hepatitis B and HIV can lead to an increased incidence of various cancers. It is thus important to practice safe sex by using condoms, limit the number of sexual partners, or abstain from sex and never share needles. In case of drug addiction, it is important to seek help. • Get screened: Regular screening and self-examination for certain cancers helps in early detection of cancer and improves the prognosis. The Government of India launched the National Cancer Control Programme (NCCP) in 1975–76 to tackle the increasing incidence of cancers in the country. This was later revised in 1984–85 stressing on primary prevention and early detection of cancers. The primary prevention focused on health education regarding hazards of tobacco consumption, genital hygiene, and sexual and reproductive health. Secondary prevention aims at early diagnosis of cancers of uterine cervix, breast and oro-pharyngeal cancers by screening methods. For the purpose of detecting cancer of cervix at an early stage, early cancer detection centres in different medical colleges and postpartum smear testing units in medical colleges in the country have been established. A National Cancer Control Board was constituted at the Centre to operationalize the programme. Similar boards were suggested at the state levels called as State Cancer Control Board (SCCB) for the proper co-ordination of activities. Several states have formulated SCCB. During the period 1990–91, a demonstration project named district cancer control programme (DCCP) was initiated in selected districts of the country for early detection of cervical, oral and breast cancers at the doorsteps of rural community. The programme created awareness amongst people regarding early symptoms of cancer, importance of observation of personal hygiene and healthy lifestyle, ill effects of tobacco consumption, etc. The project has five components, viz. health education, early detection, training of medical and para-medical personnel, palliative treatment and pain relief and co-ordination and monitoring. The district projects are linked with Regional Cancer Centres (RCC), medical college hospitals having infrastructure for treatment of cancer and the appropriate institutions that supervise and monitor the programme in collaboration with the concerned state governments The DCCP scheme has been further reoriented on a pilot basis as Modified District Cancer Control Programme.
  • 37. The project has been implemented in the states of Bihar, Tamil Nadu, Uttar Pradesh and West Bengal under the supervision of the state Regional Cancer Centres. Twenty/ten rural blocks from each of the above states have been selected. For each block, 20 female non- communicable workers have been appointed to advice women abouthealthy lifestyles, ill effects of tobacco and to detect the early symptoms of cancers Dietary guidelines · It is essential to maintain appropriate weight for height,thus avoiding both under and over- nutrition. · Physical activity needs to be promoted to avoid obesity and accumulation of fat. · Intake of protective foods such as vegetables and fruits, preferably fresh, need to be increased to avoid deficiency and protection against environmental insults. · Plant foods such as cereals, pulses, roots and tubers, green leafy and yellow vegetables, other vegetables/fruits and spices providing nutrients, as well as fibre and protective phytochemicals, should be preferable items in the diet. · Animal foods (meat and fat) except fish should be curtailed. It is necessary to avoid salted, pickled, smoked and charred food substances. · Mouldy and damaged foods should be totally eliminated from the diet. GOVERNMENT POLICIES Radient Pharmaceuticals Corporation (RPC) and its exclusive India-based distribution partner Jaiva Technologies, Inc. (JTI) and Jaiva’s Indian subsidiary Gaur Diagno, Pvt Ltd (GDL) announced the launch of a cancer education and screening program in India — a key international market where GDL is actively commercializing RPC’s Onko-Sure(R) in vitro diagnostic (IVD) cancer test. The goal of the program is to drive public education; raise market awareness; and offer Onko-Sure(R) as a commercialized cancer screening test that can potentially help stem the rising cancer epidemic in India. According to the Cancer Foundation of India, cancer impacts up to 2.5 million people in India annually and the fight against cancer — in both the public and private healthcare
  • 38. sectors — is largely restricted to improving diagnostic and treatment facilities throughout the country. Because of this, it has become increasingly vital to enhance activities and programs that support cancer education and offer treatment options to potential and existing cancer patients. With the launch of its cancer education and screening program on behalf of RPC, GDL is taking an aggressive leadership role in India with two distinct launch strategies. The first comprises a widespread deployment of GDL’s mobile cancer screening laboratory units where Indian-based physicians and other medical staff travel to local towns to provide counseling and education, along with patient screening using RPC’s Onko-Sure(R) IVD cancer test. The second program is focused on Company collaboration with Indian government agencies to establish GDL-sponsored cancer screening and testing facilities directly on-site in government hospitals. Physician-referred general cancer screening will also be conducted at these hospitals and it is anticipated that RPC’s Onko-Sure(R) IVD cancer tests will be administered to patients contacted through the program. The goal of both strategies is to reduce the incidence of cancer in India, and through each program, patients will be provided with registered health cards that will track a patient’s health records for future reference and statistical analysis. RPC’s projected Onko-Sure(R) IVD test kit purchase plan is focused primarily on the ramp- up of the government sponsored cancer testing program. The introduction of GDL’s new cancer education and screening program in India is the next most important and major milestone in the commercialization of Onko-Sure(R) in India. GDL is taking a leadership role in providing a market with 2.5 million cancer patients with not only educational resources and support through this program, but also the potential of early disease detection and on-going monitoring though our USFDA approved Onko-Sure(R) IVD cancer test. This government screening program is a breakthrough project and we believe a continuous and aggressive approach is necessary if we are to reduce the incidence of cancer in India. We anticipate this is just the beginning of additional large-scale screening programs we employ. GDL is committed to continuing all efforts to work with Indian government agencies with the ultimate goal of reducing cancer rates in this country.
  • 39. RPC’s Onko-Sure(R) IVD cancer test is a simple, non-invasive, patent-pending and regulatory-approved in vitro diagnostic (IVD) test used for the detection, screening, and monitoring of various types of cancer. The test enables physicians and healthcare professionals to effectively monitor and/or detect certain types of cancers by measuring the accumulation of Fibrin and Fibrinogen Degradation Products (FDP) in the blood. FDP levels rise dramatically with the progression of cancer. Onko-Sure(R) is approved by the US FDA for the monitoring of colorectal cancer and by Health Canada as a lung cancer detection and monitoring test. Palliative care body to draw national policy in India The Indian Association of Palliative Care (IAPC) has named a committee to formulate a national policy for it. The committee will submit the drafted policy to the Centre and request that it be adopted across the country. The decision was taken by the Executive Council of the Association, which met on Saturday at the Sanjay Gandhi Post Graduate Institute of Medical Science, Lucknow, during its 10th Annual Conference. “The committee was formed by the Executive Council, which met here yesterday. The chairman of the committee is Dr Stanley Macaden, a palliative care specialist at Bangalore,” said Dr Anil Agarwal, Professor of Anesthesiology, SGPGI and Executive Council Member of IAPC. The four-member committee is expected to submit its first draft within three months. “Palliative care is the treatment of pain caused by life limiting diseases like cancer,” said Dr MR Rajagopal, one of the committee members. “Besides being a medical care, it is also about social and psychological assistance to patients and their families. Kerala is the only state that has a palliative care policy and the need for a national policy was felt for long.” Founder of Pallium India, one of the charitable trusts rendering palliative care in Kerala, Rajagopal is a pioneer in the field here and was also a members of the committee that formulated the policy in Kerala. “With palliative care being recognised as a human right, it is the obligation of the Union health ministry to arrange for its provision at all government hospitals,” said Rajagopal.
  • 40. A possible recommendation in the policy will be that all medical colleges should have palliative care within two years and government hospitals within five years, said Rajagopal. The Medical Council of India has given approval for an MD course in Palliative Care Cancer Insurance Policy Indian Cancer Society and The New India Assurance Company Limited ( NIA) have pioneered cancer specific insurance policy to benefit large sections of people. The policy offered by New India Assurance is unique and extremely cheap compared to general health insurance policies. It can also be taken as an ‘Add on’ to top up your existing health policy. This insurance policy is open to any person upto 70 years provided they have had no cancer earlier. According to the agreement with NIA, anyone who wants to avail of this cover has to become a member of the Indian Cancer Society at a small cost of Rs.200. The policy comes into operation only after the one month of membership. Benefits of Cancer Insurance Policy • There is no medical test. Only Declaration of good health signed by a doctor is required. • The Cancer Insurance Policy offers adequate coverage towards the costs of diagnosis, biopsy, surgery, chemotherapy and/or radiotherapy, hospitalization and rehabilitation at an extremely low premium. • Reimbursement of claims is made every quarter for actual expenses incurred, until the entire sum insured is exhausted or the insured person is declared cured, whichever is earlier. • Free access to cancer related literature available with the Society. • At the Society's discretion, check-up facilities can be made available at its Cancer Detection Centre at Pedder Road, Mumbai. For Cancer Insurance policy holders, first time check up facility for cancer would be free of cost and for the second time onwards, the same facility would be available at 50%
  • 41. of cost. • The entire administration of the policy is done by the society. As a result policy holder does not have to interact with NIA. Both premium payment and claim settlement are handled by society without any hassles for the policyholders. Amount Covered through Cancer Insurance Policy The Cancer Medical Expenses Insurance Policy offers two options of sum assured: • Coverage of Rs. 50,000 + 5% additional sum insured upto Rs. 75,000 for every claim free renewal. • Coverage of Rs. 200000 +5% additional sum insured upto Rs. 300,000 for every claim free renewal. The policy covers both the member and spouse regardless of whose name the membership is in. But once either of them contracts the disease the other would not be entitled for any benefits under the same policy. However, he/she can always take another policy. A non-governmental organization (NGO) is a legally constituted organization created by natural or legal persons that operates independently from any government and a term usually used by governments to refer to entities that have no government status. In the cases in which NGOs are funded totally or partially by governments, the NGO maintains its non-governmental status by excluding government representatives from membership in the organization. The term is usually applied only to organizations that pursue some wider social aim that has political aspects, but that are not overtly political organizations such as political parties. Unlike the term "intergovernmental organization", the term "non- governmental organization" has no generally agreed legal definition. In many jurisdictions, these types of organization are called "civil society organizations" or referred to by other names.
  • 42. Types of NGOs NGO type can be understood by orientation and level of co-operation. NGO type by orientation  Charitable orientation;  Service orientation;  Participatory orientation;  Empowering orientation; NGO type by level of co-operation  Community- Based Organization;  City Wide Organization;  National NGOs;  International NGOs; Steps in establishing NGOs The first step in the establishment of the NGO is to identify the area of peculiar needs of the society, such as health, HIV/AIDS, Maternal Mortality, Polio, food, shelter,education, civil liberty and poverty alleviation among others. The second step is to identify people of similar minds; there must be a unity of purpose. The third step is to engage the services of a qualified legal practitioner for guidance for the Registration process. Some NGOs can be registered with the regional or central government and that depends on the scope of the operations of the proposed NGO. The next important step also is to identify the internal or external partners with a clearly stated objectives and plan of actions.
  • 43. SIDDHARTHA VASHISHTA CHARITABLE TRUST Vision The Jail system is like kidneys of society which filters out the toxins & re-introduces the clean fluid back into our system. This aspect is important and has to be understood that everybody who is in jail will one day be re-introduced into the society. Therefore, we have to try & reform these people and not punish them, as punishment will only bring in ill-will & bitterness. Ours is the land of the Vedas, the Upanishads and of Gandhi where love & forgiveness conquers all. Therefore, this approach of punishment and hate has to transcend into one of reform & change. It is the future of society that is at stake, therefore let it not be someone else’s problem. Make a difference. And you can do it by just changing your attitude of negativeness towards those in jail, to an open mind and to look at the positive side also because everyone has a positive side. People who are in Jail are just like everyone else, they just happened to be at the wrong place at the wrong time. Maybe there are a few rotten apples but they are just about 5% of the people in jail, the rest are in jail because of incidents & accidents, which can happen to anyone. So extend a hand and don’t shrug off your responsibilities towards the future of our society. This is a cause for the betterment of all. I understood it after spending more than 8 years in jail & I feel it is my responsibility to let it be known to as many people as possible. Ongoing Activities: 1. Child Education program- provides education fees, books and uniform to the children of convicts. 2. Cancer Awareness & detection program- SVCT holds medical and cancer detection camps for the underprivileged: organizes film shows to demonstrate self
  • 44. examination techniques, exhibition of educational posters on cancer prevention and hazards of tobacco consumption. 3. Rehabilitation of convicts- Facilitate their vocational training, help them in getting suitable jobs or setting up their own business enterprise. 4. Art exhibition- Promotion of creativity by supporting fine arts amongst inmates. Programs of the NGO:  CATCH THE CANCER  CANCER AWARENESS & DETECTION PROGRAM • Vision Cancer is the most rapidly growing disease in India and is now reaching epidemic proportions. The largest segment affected by cancer is Breast & Uterus Can-cer in Women and Mouth & Throat Cancer in Men. These happen to be amongst the most ignored symp-toms of illness as there is very little or no awareness about them in people & especially in the urban poor. We at SVCT feel that if detected in time, these can be easily treated. Our vision at SVCT is to help spread awareness and help detect these problems in as many people as possible. Objectives • To help create awareness about Breast, Uterus, Mouth & Throat Cancer in the urban poor. • To hold medical & cancer detection camps in underprivileged areas to diagnose & treat cancer patients. • To hold seminars & video conferences in the slums to teach them self-detection methods and spread awareness.
  • 45. CHANCE FOR CHANGE REHABILITATION OF CONVICTS Vision All people who are convicted are not per say criminals. They are more often that not victims of circum-stances. They too were normal citizens who made a mistake & ultimately they too will join mainstream society and therefore they should be given a chance to change. We at SVCT strongly believe that human beings are not bad but circumstances fare differently for different people. Therefore, SVCT is trying to help effect this change. Objectives  Training in different fields (vocational training) with certification.  Help in getting suitable jobs.  To create awareness among youth & business enterprises to help them rehabilitate.  Help them in becoming self-reliant, build self-worth & live a dignified life post release.  To finance & support needy inmates after their release. HUMAN TOUCH CHILD EDUCATION PROGRAM Vision The children of jail inmates suffer for want of education, books and medical attention as usually their earning parents are in jail and they also become stigmatic. Therefore, we at
  • 46. SVCT feel that it is our moral duty to try and help out & support as many families as possible. These children have done nothing wrong & deserve a chance to build their future like all other children. They should not pay for the mistakes of their parents. By helping these children, we will help build a better society. Objectives The objective of this program is  To make Educational & Medical Aid available to all the families of poor & under- privileged jail inmates.  To develop self worth in them.  To help them face life with their heads held high.  To give them a feeling that they are not outcast from the society.  To ensure they do not get frustrated & take to wrong ways.  To help build a secure society which has love & forgiveness & not condemnation? CAMPS organised by the NGO HEALTH CAMP ( 26-02-2011 ) A Health Camp was organised on 26th february 2011 at Tilak Vihar, New Delhi by SVCT. 120 O.P.Ds were conducted. people appriciated this camp. HEALTH CAMP ( 23-02-2011 ) A Camp was organised on 23rd february 2011 at PeeraGarhi Jhuggi Camp ( The Slum Basti ) .Here a street children meeting was organised for Non-Forma Education in PeeraGarhi ( Slum Basti). 30 students were participated in this camp. It was successful attempt by SVCT. HEALTH CAMP ( 19-02-2011 )
  • 47. A Health Camp was organised on 19th february 2011 at PeeraGarhi Jhuggi. 220 O.P.Ds were conducted. The camp was succesfully completed and people appreaciated the efforts done by this camp. HEART CAMP ( 16-02-2011) A Heart Camp was organised on 16th february 2011 at Allahabad Bank. 102 O.P.Ds were conducted . People were very happy due to SVCT's efforts. Participation in Mirenda House College (09 -02-11 to 11-02-11) HEALTH CAMP(05-02-2011) A camp was organised on 5th february 2011 at Shiv Mandir, Sangam Vihar Old Kakrola Road, New Delhi from 11a.m. to 3p.m. with the help of Dr. U.P. Singh(Roshan Garden).245 O.P.Ds were conducted. People appreciated the efforts done by SVCT. HEALTH CAMP(04-02-2011) A camp was organised on 1st february 2011 at MCD Primary School, Janakpuri C-4 Block, New Delhi from 10a.m. to 1p.m. with the help of Mata Chaudhary Heera Devi CharitableTrust.208 O.P.Ds were conducted. People appreciated this activity, done by SVCT. HEALTH CAMP(01-02-2011) A camp was organised on 1st february 2011 at MCD Primary School, Janakpuri C-4 Block, New Delhi from 10a.m. to 1p.m. 275 O.P.Ds were conducted. People appreciated this activity, done by SVCT. HEART CHECK UP CAMP(30-01-2011)
  • 48. A free heart check up camp was organised on 30 january 2011 at Shree Sanatan Dharam Mandir sabha D-Block, Janakpuri, New Delhi from 11a.m. to 3p.m. in association with Metro Hospital and Cancer Institute, Preet Vihar,Delhi. 89 O.P.Ds, 75 E.C.Gs, 75 R.B.S(Sugar Test) and 26 Echo Test were conducted. HEALTH CAMP(29-01-2011) A general health camp was organised on 29th january 2011 at Ranaji Enclave, Najafgarh Road, New Delhi from 11a.m. to 3p.m. with the help of Mr. Bhola Nath and Mrs. Suman Taneja. 22 O.P.Ds were conducted.Efforts of SVCT were appreciated by everyone. BREAST CANCER CAMP(24-01-2011) A camp was organised on 24th january 2011 at Gita Mandir Complex, C-2 Block, Janakpuri, New Delhi from 10a.m. to 3 p.m.with the help of ROKO Cancer. The camp was held to get people awared about the effects of breast cancer.46 O.P.Ds and 27 Memography were conducted. Drawing Competition(23-01-2011): A drawing competion was organized for different age groups (i.e. 5-7 years,8-10 years and 11-12 years) at Shree Ram Vatika Park, Mayur Vihar-2, Delhi with the help of Resident Welfare Society(Regd) from 10a.m. to 1p.m.. Prizes were distributed by MLA Ch. Anil Kumar and Counsellor Mr. Devendar Kumar to best two of each group. Mr. Anil Grover(Presint of Resident Welfare Society) thanked SVCT for this event. Health Camp(22-01-2011)
  • 49. This camp was organised on 22nd january 2011 at Bharat Jodo Complex, 109 Tara Nagar(Near Kakrola Dairy), New Delhi from 11p.m. to 3p.m. It was helped by Mr. Satnam Singh of Bharat Jodo to make it a success. 244 O.P.Ds were conducted. Health Camp(15-01-2011) This camp was organised on 15th january 2011 at Shiv Mandir, Shyam Vihar(Kakrola area) near Dwarka Sector-14, New Delhi from 11p.m. to 3p.m. It was helped by Mr. Nawab Singh, Mr. Rajinder Chopper and Mr. Ashwini Ranga to make it successful. 125 O.P.Ds were conducted. General Camp(26-12-2010) A Camp was organised with the help of Aster Eye Care at Allahabad Bank premises in Lajpat Nagar from 11a.m. to 3p.m. In this camp 41 O.P.Ds were conducted. A small informatic exhibition on cancer and tobacco was also placed. Many people and bank staff appreciated the efforts done by SVCT. Health camp At Vikas Nagar(25-12-2010) A Camp was organised at Vikas Nagar on 25th December 2010 at F-1, Kernal Bhatia Road, Green Avenue, Vikas Marg, Hospital Road,New Delhi from 11a.m. to 3p.m. with the help of Bhagwan Dass Chauhan( President, Block- E, Vikas Nagar). In this camp, 203 O.P.Ds were conducted. Patients were screened and dispensed the required medicine. Quiz Competition for Immunization & Nutrition at Uttam Nagar(15-12-2010): A Quiz competition was organized on nutrition and immunization on15th December 2010 at Ideal Radiant Public School in Shiv Vihar in Uttam Nagar from 11:30a.m to 2p.m. In this Quiz competition 50 Ladies participated and 25 question were asked. 1st prize goes to Mrs.Sarita who scored 12/25, 2nd goes to Nilam Rai who scored 12/25. 3rd goes to Mirra who scored 9/25 markes. Consolation Prize were distributed who have given more than 2 Question.
  • 50. Health camp At Uttam Nagar(11-12-2010): A Camp was organized on 11th December 2010 at Shiv Vihar in Uttam Nagar from 10a.m to 2p.m. Three doctors provide their services to 136 patients. This camp programme contains the O.P.D was conducted to scrutnize the cancer patients for further detection. Cards were issuied to the patients and medicines were distributed to them. People were very happy by this activity, done by SVCT. AIDS Awareness Camp At Uttam Nagar(09-12-2010): AIDS Awareness Camp was organized on 9th December 2010 in Shiv Vihar in Uttam Nagar from 10a.m to 2p.m. 18 Ladies ware participate In This camp. In this camp people know how to prevent from AIDS. This was the first activity in this area. People appreciated this activity,done by SVCT. Health camp At Dwarka(04-12-2010): A Camp was organized on 4th December 2010 in Dada Mainder in Dwarka from 10a.m to 2p.m. Two doctors from E.S.I and CIVIL Hospital(Gurgaon)offered services as volunteers to 110 patients. This camp programme contains the O.P.D was conducted to scrutnize the cancer patients for further detection. Medicines were distributed to them. People appreciated this activity, done by SVCT. Cancer camp(28-11-2010): A camp was organized in collaboration with MKS ROKO Cancer Charitable Trust,with the help of CRPF Camp at Jhadhoda Kalan on 28th Nov. 2010 from 10.00am to 5.00 pm. A team of Doctor’s, technicians, nursing staff has screened 36 suspected patients. A complete Mobile Cancer Van with in fitted Potable Mammography X-Ray machine brought by ROKO. in which 21 Mammography was done. Details Reports given at the camp side. Every person’s is not affected by the Cancer. A doctor was engaged where 74 OPD patients were screened and all patients were given required medicines. On this occasion some posters was also displayed and leaflets regarding Tobacco and Breast Cancer were distributed amongst the patients and
  • 51. general public. People were very happy and appreciated about this arrangement done by SVCT. Health camp At J.J.Colony,Dwarka(18-11-2010): A Camp was organized on 18 November 2010 in J.J. Colony (Sector- 7) in Dwarka from 10a.m to 2p.m. Two doctors from E.S.I hospital offered services to 188 patients. Mr. Bijender Singh and Mr. Chiranjee Lal did the innaugration of camp and support alot in this task. Mr. Daya Prasad who is a MCD worker helped in this camp. This camp programme contains the O.P.D was conducted to scrutnize the cancer patients for further detection. Cards were issuied to the patients and medicines were distributed to them. People were very happy by this activity, done by SVCT. We give God all the glory and honour for his grace and mercy towards all those who were involved in the medical camp directly or indirectly, his grace was sufficient. Cancer camp At Udham Singh Park,Wazirpur(27-10-2010): A camp was organized in collaboration with MKS ROKO Cancer Charitable Trust, at Udam Singh Park, Wazirpur Industrial Area on 27th Oct. 2010 from 10.00am to 5.00 pm. A team of Doctor’s, technicians, nursing staff has screened 66 suspected patients. A complete Mobile Cancer Van with in fitted Potable Mammography X-Ray machine brought by ROKO. in which 24 Mammography was done. Details Reports given at the camp side. Every person’s is not affected by the Cancer. So similar OPD for general public was also arranged by SVCT, A doctor (Dr. Naveen Tyagi) was engaged where 175 OPD patients were screened and all patients were given required medicines. On this occasion some posters was also displayed and leaflets regarding Tobacco and Breast Cancer were distributed amongst the patients and general public. People were very happy and appreciated about this arrangement done by SVCT. Mr.Ram Kumar Pradhan (Jhuggi cluster) gave special thanks for organizing the activity. Cancer camp At Wazirpur(20-10-2010): A camp was organized in collaboration with Indian Cancer Society (Regd) at Udam Singh Park, Wazirpur Industrial Area on 20th Oct.2010 from 2.00pm to 6.00 pm. A team of
  • 52. Doctor’s including 1 Male, 1 Female, technicians, nursing staff.They screened 41 patients by the team of Doctors of Indian Cancer Society (Regd.) which includs Pep Test and collected blood samples for Hemogram. Investigation Report in detail will be given to the patients after 2 weeks. we arrange some medicines for genral O.P.D and required items from local market and hold the camp. Dr (Mrs.) Vandana Mehta took initiate and screened 125 OPD (54 female, 65 male & 6 children). A drive against Tobacco was also launched; hand bills and posters were displayed and distributed amongst general public.