CANCER AND ITS TREATMENT VARIOUS MEDICAL APPROACHES FROM VARIOUS AUTHENTIC REFERENCES.pptx

MALIGNANCY/ CANCER ITS INTRODUCTION IN DETAIL WITH VARIOUS GRAPHS TABLES AND CHARTS, REFERRING VARIOUS AUTHENTIC SOURCE BOOKS AND THEIR LATEST EDITIONS ...
CANCER - HOW TO MEDICAL STUDENTS TO APPROACH, BASIC KNOWLEDGE REQUIRED, MEDICAL ACCUMEN AND VISUAL CLINICAL SOUND SENSES FOR THE SAME , VARIOUS TREATMENTS AVAILABLE AND FURTHUR LATEST UPDATED INFORMATIONS

1. MALIGNANCY “ A life touched by cancer is not a life destroyed by cancer.” —Drew Boswell, Climbing the Cancer Mountain BY MD.SANEN S 2019 BATCH AMSHMC BELGAUM

2. CANCER AROUND THE WORLD In 2018, 17 million new cancer cases and 9.5 million cancer deaths were estimated worldwide,  According to estimates of GLOBOCAN 2018, developed by the International Agency for Research on Cancer (IARC). Rates are increasing worldwide.  When broken down by region of the world, ∼45% of cases were in Asia (which has 59.5% of the world’s population),  26% in Europe (9.8% of the world’s population)

3. Cancer is now the third leading cause of death worldwide.  By 2030, it is projected that there will be 26 million new cancer cases and 17 million cancer deaths per year.  In 2008, developing nations with low per capita expenditure on health care accounted for 56% of new cancer cases and 75% of cancer deaths.  Lung cancer is the most common cancer and the most common cause of cancer death in the world. Its incidence is highly variable, affecting only 2 per 100,000 African women but as many as 61 per 100,000 North American men.  Breast cancer is the second most common cancer worldwide; however, it ranks fourth as a cause of death behind lung, stomach, and liver cancer

4. NINE MODIFIABLE RISK FACTORS It has been estimated that nine modifiable risk factors are responsible for more than one-third of cancers worldwide. These include- smoking,  alcohol consumption,  obesity,  physical inactivity,  low fruit and vegetable consumption,  unsafe sex,  air pollution,  indoor smoke from household fuels,  and contaminated injections

5. PREVENTION Lifestyle modification could reduce these if steps were taken to avoid animal fat and red meat, reduce alcohol, increase fibre , increase fresh fruit and vegetable intake and avoid obesity.  Infections account for a further 15% of cancers, including those of the cervix, stomach, liver, nasopharynx and bladder, and some of these could be prevented by infection control and vaccination

6. 10 HALLMARKS OF CANCER Genome instability and Mutation Resistance to Cell Death Sustained Proliferative Signalling Evasion of Growth suppressors Replicative Immortality Induction of Angiogenesis Activation of Invasion & Metastasis Reprogramming of Energy Metabolism Tumour-promoting Inflammation Evasion of Immune Destruction

7. IMMUNOHISTOCHEMISTRY OF BIOPSIES IHC staining for tumour markers can provide useful diagnostic information and guide treatment decisions. Common examples include: Oestrogen and progesterone receptors : Indicate that the tumour may be sensitive to hormonal manipulation.  Alpha-fetoprotein (AFP) and human chorionic gonadotrophin  ( hCG ) ; Favour germ-cell tumours .  Prostatic specific antigen (PSA): Favours prostate cancer.  Carcinoembryonic antigen, cytokeratin and epithelial membrane antigen (EMA): These favour epithelial carcinomas.  HER2 receptor : In breast cancer, high HER2 levels predict response to trastuzumab (Herceptin), an antibody to the HER2 receptor.  IHC of lymphoma biopsies : Helpful in the diagnosis and classification of lymphomas .

8. IMAGING Imaging is critical for locating the primary tumour , staging the disease and determining the response to treatment. The various modalities are complementary: Ultrasound is useful for lesions in the liver, kidney, pancreas and reproductive organs. It is also used for guiding biopsies in breast and liver.  Endoscopic ultrasound is helpful in staging upper gastrointestinal and pancreatic cancers. CT is particularly useful in imaging the thorax and abdomen. With modern scanners it is possible to detect colorectal cancers and adenomas ≥ 10 mm diameter. MRI is the preferred technique for brain and pelvic imaging, and is widely employed to stage rectal, cervical and prostate cancers. Positron emission tomography (PET) visualises metabolic activity of tumour cells and is widely used, often in combination with CT ( PET–CT ), to evaluate the extent of the disease, particularly potential distant metastasis

9. Presenting problems in oncology-

10. CUTANEOUS MANIFESTATIONS OF CANCER

11. EMERGENCY COMPLICATIONS OF CA

12. METASTATIC DISEASES-

13. Bone metastases Bone is the third most common metastatic site, after lung and liver.  Bone metastases are a major problem in patients with myeloma, breast or prostate cancers, but are also seen with kidney, thyroid and OTHER CANCERS 

14. Therapeutics in oncology- Palliative chemotherapy is used to treat patients with metastatic disease. Adjuvant chemotherapy is given after an initial intervention designed to remove all macroscopic disease. Neoadjuvant chemotherapy is where chemotherapy is given before a planned major treatment. Chemoprevention is the use of medication to prevent cancer developing in patients identified as being at particular risK .

15. SURGERY IN CANCER BIOPSY ( Diagnosis- needle aspiration) EXCISION (localised colorectal, breast & Lung Ca) PALLIATION 

16. RADIATION THERAPY- Teletherapy Brachytherapy Intravenous radioisotope HORMONE THERAPY - This is most commonly used in the treatment of breast and prostate cancer. IMMUNO THERAPY - Stimulating the patient’s immune system with interferons can sometimes alter the natural history of a malignancy. BIOLOGICAL THERAPIES - Novel treatments designed to block the signalling pathways responsible for the growth of specific tumours are emerging.

17. THANK YOU BY MD.SANEN S 2019 BATCH AMSHMC BELGAUM