CANCERCANCER

Dr. Gopalrao Jogdand, M.D. Dr. Gopalrao Jogdand, M.D. Ph.D.Ph.D.

Professor & Head, Professor & Head,

Community MedicineCommunity Medicine

DefinitionDefinition

• A group of diseases characterized by:A group of diseases characterized by:• a. abnormal growth of the cells.a. abnormal growth of the cells.• b. ability of these cells to invade the b. ability of these cells to invade the

adjacent cells and tissues.adjacent cells and tissues.• c. involving distant organs through c. involving distant organs through

metastasis.metastasis.• d. Death of the patient in the event of d. Death of the patient in the event of

growth of the tumor beyond the stage, growth of the tumor beyond the stage, when it could be removed. when it could be removed.

Magnitude of the Magnitude of the problemproblem• Global:- Accounts for 13% of all deaths.Global:- Accounts for 13% of all deaths.

• 7.9 million deaths due to cancer.7.9 million deaths due to cancer.

• Approximately 30.4 million people living Approximately 30.4 million people living with cancer.with cancer.

• Statistics indicates 19% increase in Statistics indicates 19% increase in incidence of the disease.incidence of the disease.

• 18% increase in the mortality in the last 18% increase in the mortality in the last decade (2005).decade (2005).

South East Asia RegionSouth East Asia Region

• 3.4% of all deaths are due to cancer 3.4% of all deaths are due to cancer in India.in India.

• 6.6% from Indonesia.6.6% from Indonesia.• 5.5% from Thailand.5.5% from Thailand.• 4.2% from Sri Lanka.4.2% from Sri Lanka.• 2.9% from Myanmar.2.9% from Myanmar.• 0.8% from Nepal.0.8% from Nepal.• Statistics for 2002.Statistics for 2002.

Cancer deaths S.E.A.R.Cancer deaths S.E.A.R.

• Statistical reports of W.H.O. 2005 show Statistical reports of W.H.O. 2005 show following mortality statistics for SEAR.following mortality statistics for SEAR.

• India- 8 lakh 66 thousand deaths.India- 8 lakh 66 thousand deaths.

• Indonesia- 2 lakh 6 thousand deaths.Indonesia- 2 lakh 6 thousand deaths.

• Thailand- 66000 deaths.Thailand- 66000 deaths.

• Myanmar- 39000 deaths.Myanmar- 39000 deaths.

• Sri Lanka- 21000 deaths.Sri Lanka- 21000 deaths.

Five leading cancers & their Five leading cancers & their mortality in the world, mortality in the world, 2005.2005.• Lung cancer- 1.4 million deaths.Lung cancer- 1.4 million deaths.

• Stomach cancer- 8 lakh 66 thousand Stomach cancer- 8 lakh 66 thousand deaths.deaths.

• Colon cancer- 6 lakh 77 thousand Colon cancer- 6 lakh 77 thousand deaths.deaths.

• Liver cancer- 6 lakh 53 thousand Liver cancer- 6 lakh 53 thousand deaths.deaths.

• Breast cancer- 5 lakh 48 thousand.Breast cancer- 5 lakh 48 thousand.

Global pattern of cancersGlobal pattern of cancers

• Globally lung cancer is very common.Globally lung cancer is very common.

• Stomach cancer is very common in Stomach cancer is very common in Japan.Japan.

• Breast and colorectal cancer is very Breast and colorectal cancer is very common in European countries.common in European countries.

• S.E.A.R. great majority of cancers are S.E.A.R. great majority of cancers are the oral and Ca. uterine cervix.the oral and Ca. uterine cervix.

Origin of major categories Origin of major categories of cancersof cancers

• Carcinomas- arising from epithelial lining of Carcinomas- arising from epithelial lining of the internal surface of the organs, mouth, the internal surface of the organs, mouth, esophagus, intestine, uterus and skin.esophagus, intestine, uterus and skin.

• Sarcomas- arising from mesodermal cells Sarcomas- arising from mesodermal cells of various connective tissues, fibrous of various connective tissues, fibrous tissues, fat and bone.tissues, fat and bone.

• Lymphomas, mylomas and leukemia's- Lymphomas, mylomas and leukemia's- arising from the cells of bone marrow and arising from the cells of bone marrow and immune system. immune system.

Causes of cancerCauses of cancer

• Environmental factors:Environmental factors:

• Use of tobacco: for smoking or Use of tobacco: for smoking or chewing purpose causes cancer after chewing purpose causes cancer after long term use.long term use.

• Alcohol: Excessive use of alcoholic Alcohol: Excessive use of alcoholic drinks can cause cancer, a causal drinks can cause cancer, a causal relationship is shown between beer relationship is shown between beer consumption and rectal cancer.consumption and rectal cancer.

Causes……Causes……

• Dietary factors: Dietary factors:

• Consumption of smoked fish is Consumption of smoked fish is related to stomach cancer. related to stomach cancer.

• Beef consumption is related to bowel Beef consumption is related to bowel cancer.cancer.

• High dietary fat consumption to High dietary fat consumption to breast cancer.breast cancer.

Causes….Causes….

• Occupational exposure:Occupational exposure:

• Exposure to benzene, arsenic, cadmium, Exposure to benzene, arsenic, cadmium, chromium, asbestos, vinyl chloride, poly cyclic chromium, asbestos, vinyl chloride, poly cyclic hydrocarbons and aniline dyes cause various hydrocarbons and aniline dyes cause various types of cancers.types of cancers.

• Viruses: Hepatitis b, c and d virus, Epstein-Barr Viruses: Hepatitis b, c and d virus, Epstein-Barr virus, cytomegalovirus, human papilloma virus, cytomegalovirus, human papilloma virus.virus.

• Parasites: Schistosomiasis causing ca. bladder Parasites: Schistosomiasis causing ca. bladder in Egypt. in Egypt.

Causes….Causes….

• Habits and life style factors:Habits and life style factors:

• Smoking, tobacco chewing, betel Smoking, tobacco chewing, betel chewing, smoking and alcohol intake.chewing, smoking and alcohol intake.

• Genetic factors: Retinoblastoma Genetic factors: Retinoblastoma amongst siblings, leukemia in amongst siblings, leukemia in Mongols is suggestive of a genetic Mongols is suggestive of a genetic linkage.linkage.

Prevention and control of Prevention and control of cancercancer

• Cancer screening: In affluent countries Cancer screening: In affluent countries community based or clinic based screening community based or clinic based screening for cancer is done.for cancer is done.

• Breast cancer: 1. Breast Self Examination.Breast cancer: 1. Breast Self Examination.

• 2. Mammography. 3. Thermo-mammography.2. Mammography. 3. Thermo-mammography.

• Lung cancer: Mass radiography and sputum Lung cancer: Mass radiography and sputum cytology.cytology.

• Ca. Cervix: Pap smear screening of women Ca. Cervix: Pap smear screening of women over 35 years of age.over 35 years of age.

Prevention and controlPrevention and control

• Strategy for cancer control:Strategy for cancer control:

• 1. Public information and education.1. Public information and education.

• 2. Legislative and restrictive measures.2. Legislative and restrictive measures.

• 3. Community based cessation programs.3. Community based cessation programs.

• 4. National and international coordination.4. National and international coordination.

• 5. Better diagnostic and treatment 5. Better diagnostic and treatment facilities.facilities.

Warning signs of cancerWarning signs of cancer

• Any change in the bowel and bladder habits.Any change in the bowel and bladder habits.

• Persistent cough or hoarseness of voice.Persistent cough or hoarseness of voice.

• Bleeding form natural orifices.Bleeding form natural orifices.

• Any change in the size of a mole or wart.Any change in the size of a mole or wart.

• Hard and palpable lump in any part of the Hard and palpable lump in any part of the body.body.

• Chronic non healing ulcer.Chronic non healing ulcer.

• Excessive bleeding during menses.Excessive bleeding during menses.

• Sudden and unexplained loss of body weight.Sudden and unexplained loss of body weight.

Thank youThank you