understanding facts and myths about cancer and its cure by dr. sunita polampalli
TRANSCRIPT
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UNDERSTANDING FACTS & MYTHS OF CANCER & ITS CUREDR SUNITA POLAMPALLI, MD PathDirectorSNP Molecular Genetics Diagnostic & Research Centre
Email id: [email protected]
Phn no: +919004674321
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What does the word
cancer mean to you?
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Cancer stigmasDISBELIEFPANICUNCURABLE DISEASEDEPRESSIONGRIEFFEAR OF DEATHFINANCIAL STRESSEMOTIONAL STRESS
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Common views on cancer
“in the popular imagination cancer equals death”
(Susan Sontag,1977)
“Cancer forces us to confront our lack of control over our own or others death”Kleinman (1988)
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What is Cancer ??
What is Cancer ??
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How cancer occurs..?MUTATION IN ONE GENE OR MULTIPLE
GENES
Which leads to ……
Uncontrolled cell growth Problem in removing damaged cells –
(defective apoptosis)
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Basic understanding of cell & genes…..helps to understand cancer pathology better
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From phenotype (external appearance) to genotype (internal apperance)
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Nucleus Chromosomes DNA Genes
Each cell has 23 pairs of chromosomes + 2 sex chromosomes (X/Y)Male- 46 + X,YFemale- 46 + X,X
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DNA made of multiple genes….similar to pearls on string
Pearls on string
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What are genes ?
Bunch or cluster of nucleic acid sequences - A=T,G=C
Genes are store house of all cellular information – like a “Janampatri of you life”
Genes carry information/codes in them to carry out various activities or functions of the cells.
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Genes consists of codonsEach codon made of 3 nucleic acids– ATG, TGC, etc
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Genetic coding similar to binary coding of computer (1,0)
COMPUTER CODING
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Genetic coding similar to binary coding of computer (1,0)
GENETIC CODING
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What is mutation?
Change or defect in normal genetic (amino acid) sequence which leads to formation of new proteins with new functions which may be beneficial or harmful to normal functioning of cells.
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Effects of mutation
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Effects of mutation – analogy
Just like by adding, deleting or substituting one letter, the expression of word changes to new word
Similarly by adding, deleting or substituting one amino acid, the expression of protein changes to new proteins
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Mutations can be harmful or helpful
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Mutations are normal physiological phenomenon… Our body is subjected to several
mutations during the process of formation of new cells – CELL CYCLE.
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Continuous turn over of cells ….new cells formed & old cells die
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Defense Mechanism during cell cycle
Help to destroy these mutated or damaged cells.
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Strong Defense mechanism…to repair damaged cell & DNA
Regulatory genes of cell cycle
DNA Repair mechanism
Immunity
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Regulatory genes of cell cycle
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Proto Oncogenes…promotes cell activation
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Tumor Suppressor Genes…inhibits cell growth of damaged cells
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DNA Repair genes…repairs damaged DNA during cell cycle
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Immune Surveillance..
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What prompts a cell to turn cancerous ?
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Defective defense mechanism leads to disease or cancer
Imbalance immune responseIncreased exposure to Free radicals
Defective DNA repair mechanismAccumulation of mutations or mutated genes which leads to imbalanced cellular functions
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Imbalance immune response…very important reason
Poor nutrition
Stress
Infections
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Exposure to Free radicals …cause cell damage & DNA damage
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Free radicals …
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Free radicals causing many diseases..
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Abnormal expression of Mutated genes
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Abnormal expression of Mutated genes
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Defective DNA Repair Mechanism
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Cancer is multifactorialMultiple mutations in one gene or many genes
required to cause cancer
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Points to remember… There is continuous turn over of cells in our body daily
– old cells die and new cells born -CELL CYCLE
Number of mutations take place during this cellular turn over.
Balanced immunity , DNA repair mechanism along with tumor suppressor genes and oncogenes helps to maintain cell cycle in proper process and destroy mutated cells.
But sometimes because of stress and decreased immune functions, mutations get accumulated and can lead to cancer.
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Etiological factors which …cause cancer
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Causes of cancer Irregular lifestyle (most neglected etiology):
stress, sedentary & tech savy lifestyle
Improper diet: junk food, diet rich in saturated fats, refined sugars, vitamins(Vit D) deficiency
Harmful chemicals: pesticides, food additives/preservatives, pollutants (smoke, plastic,), cosmetics
Addictions: smoking (nicotene), ghutka, pan masala, heavy alcohol consumption, etc
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Causes of cancer Ionising Radiation: X’rays , gamma rays, TV
& mobile towers (cell phones, electric appliances – not so
much of a threat)
Occupational hazards : asbestos, coal tar, benzene, arsenic, etc, exposure to radiation
Infections: HPV (cervical cancer), H.Pylori (stomach cancer), HBV (liver cancer), EBV (Blood cancer-lymphoma) etc
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Different etiological factors cause DNA damage which leads to cancer..
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Types of tumors in body Benign – e.g. polyps, fibroids
Not always due to genetic mutations but due to functional / physiological reasons
Controlled over growth of cells localized curable
Malignant – e.g cancers
Due to genetic mutations Uncontrolled over growth of cells spreads to other organs difficult to cure
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Cancer occurrence
Is cancer a inheritable disease? Sporadic ? contagious disease?
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Cancer occurrence Sporadic – occurrence by chance by external
etiology - 70 to 80% Hereditary – cancer genes inherited from one of
the parents – 15 – 20%
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Sporadic cancers ….due to acquired genetic mutations
Blood cancers Lung cancer Stomach cancer Brain cancer Bone cancer Soft tissue cancer (muscle) Cancer in head & neck part (tongue, jaws, etc) Urinary bladder cancer Kidney cancer Thyroid cancer Prostate cancer
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Hereditary Cancers ….due to inherited genetic mutations
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Points to remember…
70-80% cancers are sporadic occurring because of different kind of stress.
15 – 20% are hereditary because of inherited genes from parents.
Patients with family history of cancer are at high risk of developing cancer with increasing age
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Cancer symptoms Symptoms depend on site of cancer
General symptoms – fever, loss of appetite, weight loss, weakness,
jaundice
Specific symptoms – Unexplained Blood in cough (hemoptysis),
blood in urine (hematuria), blood in stools Lump in abdomen or any part of body, Cough,Diarrhoea, Ulcer present for long
duration and not getting cured.
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Investigations Pathological tests (study of cancer related
markers in blood )
Blood test for blood cell count Liver & kidney function tests Tumor marker studies
Radiological tests (study of size, shape & location of lump in body)
X’ray, Ultra-sonography CT Scan, MRI Endoscopy, colonoscopy
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Investigations Biopsy tests (study of cells in tumor tissue) Fine needle aspiration cytology (FNAC) Histopathology examination of excised tumor/lump
Genetic tests (study of defective chromosomes or mutated genes in tumor tissue) – gaining importance as more cancer genes identified
Chromosomes - Cytogenetics (karyotyping, FISH) DNA or genes – Molecular Genetics (PCR,
Sequencing)
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Importance of genetic testing in Hereditary Cancers
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BRCA gene mutation testing in Breast Cancer
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Inherited doesn’t mean he/she will develop cancer
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Points to remember… Pay attention to your symptoms and do
not ignore them if they are sustaining for long time inspite of antibiotic or other treatment.
Get a thorough check up done.
Early detection of cancer is very important for better cure.
Regular health check ups important especially after age of 40yrs
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Points to remember… People with family history of cancer need to
get genetic testing done for those cancers.
If test comes positive ..not to panic. Test only tells about susceptibility of cancer but does not confirm that u have or will have cancer.
Precautionary measures can be taken in such cases to prevent cancer.
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Treatment Chemotherapy
Radiation therapy
Targeted therapy (monoclonal antibodies)
Immuno therapy (modified immune cells) – under research and clinical trials
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Chemo drugs are cytotoxic…kills cancer cells & normal cells
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Radiation therapy…. destroys cancer & surrounding tissue
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Side effects of chemo therapy & radiation….decreases IMMUNITY
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Side effects of chemo therapy & radiation….decreases IMMUNITY
Cytotoxic..kills cancer as well as normal cells.
This decreases immunity of patients.
Because of decreased immunity patient is susceptible to infections.
Tolerance not good..patient becomes non complaint.
Response to treatment not good – re occurance possible.
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Targeted therapy …targeting cancer proteins
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Targeted therapy….targets cancer genes
With newer genetic techniques, more and more cancer genes identified.
Drugs manufactured to target these specific cancer genes in cancer cells.
These specific drugs destroy only specific cancer cells and does not kill normal cells.
This prevents toxic side effects and helps to maintain immunity.
Tolerance to such therapy is good with good response.
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Pros & Cons of chemo & radiation therapy Easily available & affordable
Highly cytotoxic and many side effects. Patient compliance not good.
Not targeting specific cancer genes…cancer cells might survive even after treatment and can cause re occurance of disease.
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Pros & Cons of targeted therapy Not cytotoxic and patient compliance is
good.
Targeting specific cancer genes & kills all cancer cells..so chances of re-occurance is rare.
Treatment is costly
Knowledge of all cancer genes important in order to detect these genes and design a drug for them…difficult task.
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How to build up immunity during cancer therpay
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Integration of Holistic approach to combat cancer..very very important
DietYogaMeditationExerciseMindful activitiesCounseling
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Importance of well balanced diet during treatment
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Importance of well balanced diet during treatment
Proteins Fibre Vitamins Anti oxidants Minerals
In cancer & during treatment- cells are damaged which decreases immunity.
Well balanced diet very important.
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Importance of water & anti-oxidant supplements
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Importance of exercise, yoga & meditation…very important
Pranayam or simple yoga techniquesVery helpful
Even meditation alone can reduce stress and pain.
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Importance of exercise, yoga & meditation…very important Activates dopamine & serotonin, natural
pain relievers
Improves oxygenation of organs Provides anti oxidants to combat free
radicals
Improves immunity
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Importance of mindful activities
Engaging patients in activities of their interest.
Do not leave them alone !!!
Do not let them have any negative thoughts.
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Need of the hour for treating cancer patients besides chemo or radiation
Counseling centres – counsel patients & their family to allay fear of cancer, proper treatment guidance.
Emotional support - Family members and friends have to provide all kind of emotional support to the patient to help fight the disease.
Rehabilitation centres: Patients are helped to adopt and revive healthy lifestyle and continue to live their lives positively.
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Need of the hour for treating cancer patients besides chemo or radiation Group therapies – patients can gain insight
about each other’s conditions. This will prevent patients from being isolated and give them the feeling that they are not the only unfortunate ones.
Testimonies of cancer survivals to boost moral of other patients
Holistic approach – proper nutrition guide, yoga, mediation, mindful activities.
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Integrated approach… Very effective to cure internal physical
disease as well as psychological problems.
Better cure and survival rate, improving overall patient’s quality of life.
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Changing trends in cancer survival ….from glim to hopeful
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Changing trends in cancer survival
Many cancers are now completely cured like certain blood cancers, breast cancers, gastro intestinal and genito-urinary cancers.
Some cancers are lethal like lung cancer, liver cancer, pancreatic cancer, few of the blood and brain cancers.
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Please remember…Do not believe in cancer survival statistics.
Treatment response varies from patient to patient.
Believe on your own body and in yourself.
Doctors only treat but…
You are your own HEALER !
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Take home message...
Cancer is not as deadly as it seems.
Cancer is curable.
Do not fear it but fight it .
Believe in urself & your body.
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How to prevent cancer ??….billion dollar question !!
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Cancer cannot be prevented but can be constrained..
With the ever advancing technology , man has made lot of progress.
But we are paying a big cost for it.
We are becoming more dependant on machines and robots.
Destroying our environment and isolating ourselves from nature.
We cannot avoid harmful radiation and chemicals in our day to day lives.
But we can constrain it by adopting a healthy & holistic lifestyle.
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Adopting holistic lifestyle
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Cancer related information… http://www.cancer.gov/about-cancer