PPT on Cancer.pptx - PPT Presentation on Cancer

Cancer

1. Cancer

2. Contents What is cancer ? Carcinogenesis Type of Tumor Type of Cancer Causes of cancer Problem statement Cancer Patterns Diagnosis Method of Cancer Treatment Prevention and Control of Cancer References

3. What is cancer? Cancer is medically called Malignant Neoplasm. It involves unregulated cell growth . In cancer, cells grow continuously and uncontrollably which forms malignant tumors and invade nearby parts of the body . There are about 200 different types of cancer. It can start in any type of body tissue. What affects one body tissue may not affect another for example, tobacco smokes that you breath in may help to cause lung cancer. Cancer is a term used to describe a large group of diseases that are characterized by a cellular malfunction. Cancerous cells do not have this programming and therefore grow and replicate out of control. They also serve no physiological function. These cells are now termed a neoplasm Cancer generally spreads through lymphatic system or blood stream .

4. There are several types of cancer depending on the organ they effect. They possess same common properties of: Abnormal cell growth Capacity to invade other tissues Capacity to spread to distant organs via blood or lymph . The body is made up of trillions of living cells. These cells grow divide and die in an orderly fashion. This process is regulated and controlled by DNA. In an adult person most cells divide to replace the damaged or dying cells or to repair tissues injuries . When cells at particular site starts to grow out of control, they may become cancerous. Cancer cell growth is different from normal cell growth. Instead of dying, cancer cells continue to grow and form new abnormal cells . Tumor - Any abnormal swelling, lump or mass inside body . Neoplasm – Scientific term to describe abnormal proliferation of genetically altered cells.

5. Carcinogenesis Carcinogenesis is also called Oncogenesis or tumorigenesis. It is a process by which normal cells are transformed into cancer cells. Cell division is a physiological process which maintain balance between proliferation and programmed cell death in form of apoptosis. Carcinogenesis is caused by mutation and epimutation of genetic material of normal cells, which upsets the normal balance between proliferation and cell death. More than one mutation to certain classes of gene are required for carcinogenesis. Large scale mutation : it involves gain or deletion of a portion of chromosome. Genomic duplication occurs when a cell gains many copies of a small chromosomal region containing one or more oncogenes and genetic material.

6. Types of tumor Benign Tumor In Benign Tumor cells do not grow uncontrollably and do not invade neighboring tissues. It is Non cancerous and can be removed. Benign tumors are named using - oma as suffix with the organ name as the root. Eg- BT of uterus smooth muscle : Leiomyoma Malignant Tumor In Malignant Tumor cells grow uncontrollably and invade neighboring tissues. It is Cancerous and are usually named using - carcinoma, - sarcoma , - blastoma as a suffix Eg- Liver : hepatocarcinoma Breast cancer : D uctal carcinoma

7. T ypes of C ancer : Carcinoma : cancer that begins in the skin or tissue that covers internal organs. eg: Adenocarcinoma – a malignant epithelial tumor arising from glandular structure which are constituent parts of most organs of the body. Esophageal cancer, Colorectal cancer . Sarcoma : cancer that begins in bone, cartilage, fat, muscles, Blood vessels or other connective or supportive tissue . Leukemia : cancer that starts in blood forming tissues like bone marrow and causes large number of abnormal blood cells to be produced and enter the blood. Lymphoma & myeloma : cancer that begins in the cells of immune system. CNS cancer : cancer that begins in the tissues of brain and spinal cord.

8. 6) Germ cell tumor : tumor derived from totipotent cells. In adults most often found in testes & ovary. In children it is found in tip of tailbone 7) Blastic tumor/ Blastoma : a tumor which resembles an immature or embryonic tissue. Metastasis : The distant spread of malignant tumor from its site of origin by three routes blood lymph and body cavities. Eg : carcinoma- via lymphatic sarcoma – via blood stream

9. Causes of cancer : 90- 95% is due to Environment causes. 5- 10 % is due to Genetic causes. Enviornmental causes include: tobacco – 25- 30% Diet & obesity – 30- 35% Infection – 15- 20% Radiations – 10% Stress & lack of physical activity 1) Tobacco & cancer – Tobacco smoking is associated with many forms of cancer and causes 90% of lung cancer. It causes cancer in lungs, larynx, stomach, head , neck, bladder, kidney, esophagus, pancreas. Tobacco smoking contains 50 known carcinogens including nitrosamines and polycyclic aromatic hydrocarbons. Diet and exercise – Diet, physical inactivity and obesity are related to 30- 35% of cancer deaths. Eg : High salt diet – Gastric cancer Betel nut chewing – oral cancer 90

10. 3) Infection – A virus that can cause cancer is called oncovirus. Eg: Viral infection cancer: Human papilloma virus- cervical carcinoma Kaposis sarcoma herpesvirus – Kaposi’s sarcoma : a malignant tumor arising from blood vessel in the skin and appear as purple plaques or nodules. Hepatitis B and C virus – Hepatocellular carcinoma Human T cell leukemia virus 1 – T cell leukemias . Bacterial : Helicobacter pylori- Gastric carcinoma 4) Radiations : causative radiations are both ionizing and non- ionizing UV radiations . Sources of radiations – Medical imaging, Radon gas . Non ionising radiations – UV rays, mobile radiations . Radon : A radioactive gas released from normal decay of elements like uranium, thorium and radium in rocks, soil. Radon decay quickly giving off cancerous radioactive particles.

11. 5) Physical agents : Asbestos causes mesothelioma: tumor of pleura , peritonium or pericardium. other elements are cobalt, nickel, crystalline silica, hair dyes , formaldehyde. 6) Hormones : Increase in sex hormones (contraceptives, menopausal hormones) can cause cancer. Diethylstylbesterol – synthetic form of estrogen which can cause breast cancer if taken during pregnancy.

12. Worldwide In Year 2022, 20 million people are diagnosed and more then 9.7 million die with cancer The estimated number of people who were alive within 5 years following a cancer diagnosis was 53.5 million. Most common cancer worldwide are Lungs cancer (18.7%) Breast cancer (11.6%) Colorectal cancer (9.6%) Prostate Cancer (7.3%) Respiratory tract cancer is most common site of cancer in India, Indonesia, srilanka and Thailand Cancer of cervix is most common in India and Indonesia Cancer associated with tobacco constitute 44.6% of cancer in men and 20% in female Problem statement

13. India The four most common cancer in India are Male-oropharynx, esophagus, stomach and lower respiratory tract Female-breast, cervix, oropharynx and esophagus Tabaco is used widely used in India 91% cases of oropharynx is due to Tabaco use 60% cases in female are breast, cervix and ovary cancer

14. Cancer Patterns There are lot of international variations in the pattern of cancer which are attributed to a number of factors such as E nvironmental F actors F ood H abit Lifestyle G enetic Factor I nadequacy in Detection and Reporting of Cases

15. Environmental factors Tobacco Tobacco in various forms of usage can cause cancer of lungs, larynx, mouth, pharynx, esophagus, bladder, pancreas and probably kidney Cigarette smoking is now responsible for more than 1 million death each year Alcohol Excess intake of alcohol can cause esophageal and liver cancer Beer consumption may be associated with rectal cancer Alcohol contributes about 3 % of all cancer deaths Food Habits Dietary factor Smoked fish is related to stomach cancer Dietary fiber to intestinal cancer Beef consumption to bowel cancer High fat diet to breast cancer Food additives and contaminants have fallen under suspicion as causative agents

16. Occupational exposures These includes exposure to benzene, cadmium, arsenic, chromium, vinyl chloride, asbestos, polycyclic hydrocarbons, etc. The risk of occupational exposure is said to be increased if the individual also smokes cigarette Occupational exposure is usually reported 1-5% of human cancer Parasite May be a cause of cancer Schistosomiasis can produce Ca of bladder Customs, habits and life style May be associated with an increased risk of cancer Smoking and lung cancer Tobacco and beetle chewing and oral cancer Life Style

17. Genetic factors Genetic influences have long been suspected Retinoblastoma occurs in children of the same parent Mongols are more likely to develop leukemia There is probably a complex relationship between hereditary susceptibility and environmental carcinogenic stimuli in the causation of cancer Others Sunlight, radiation, water and air pollution, medication and pesticides These are related to cancer as environmental factors Inadequacy in Detection and Reporting of Cases too late due to lack of awareness also a major factor of cancer burden globally.

18. Diagnosis Method of Cancer Biopsy FNAC Endoscopy Blood Test Bone Marrow Aspiration Pap Test Sputum Analysis Imaging Studies (Mammogram, Cat Scan, Mri , Ultrasound) Genetic Analysis

19. T reatment SURYA Surgery Radiation Therapy Chemotherapy Targeted Therapy Immunotherapy Hormonal Therapy Angiogenesis Inhibitor SURGERY – Non haematological cancer can be cured if entirely removed by surgery. But if cancer has already spread to other sites in the body i.e Metastasis, then removing all cancer by surgery is not possible. Initially cancer grows locally and then spread to lymph nodes and then to rest of the body. So for small cancer surgery became popular treatment. Eg : for Breast cancer – Mastectomy surgery for prostate cancer - prostatectomy CANCER

20. CANCER 2) RADIATION THERAPY – also called Radiotherapy. It is the medical use of Ionizing Radiation as a part of cancer treatment to control malignant cells. Radiotherapy is used for curative therapy or adjuvant cancer treatment or palliative treatment (where cure is not possible and aim is to control disease or provide symptomatic relief). Total Body Irradiation (TBI) is a radiotherapy technique used to prepare the body to receive bone marrow transplant. 3) CHEMOTHERAPY – C hemotherapy means use of chemical agents to destroy cancer cells . It has the ability to treat widespread and metastatic cancer. While radiotherapy and surgery are confined to specific areas only . 4) TARGETED THERAPY : it refers to a medication that targets a specific pathway in the growth and development of tumor. The target themselves are typically various molecules in the body known to play role in cancer formation .

21. 5) IMMUNOTHERAPY : it does not interfere with growth by binding to target but it triggers immune signals. Antigens on cancer cell surface are captured by antibodies (specific) which leads to antitumor immune reaction. These Ab are monoclonal. When there is a radioisotope attached these drugs are called radioimmunotherapy. Eg : Alemtuzumab – chronic lymphocytic leukemia. Beracizumab – colon cancer. 6) HORMONAL THERAPY : by administering hormones (steroid), endocrine system is manipulated and particular hormone activity is inhibited due to which certain cancer cells cease growing or they die. It is used in breast cancer, prostate cancer, endometrium cancer, adrenal cortex cancer. Inhibitors of hormone synthesis – a) Aromatase inhibitors – used for breast cancer in postmenopausal women. At menopause, estrogen production in ovaries stops, but other organs continue to produce estrogen by the help of aromatase. CANCER SURYA

22. Prevention and Control of Cancer Primary Prevention Health education to people regarding the following: Maintaining personal and genital hygiene. Exercise regularly to reduce the risk of obesity and early menarche BSE- encourages women to perform BSE every month, a week after menstruation. Women after menopause also should perform BSE every month Testicular Self Examination should be performed by men regularly to detect any lump in the testis. Avoid exposure to radiation : Special efforts should be made to reduce the radiation amount received by each individual to a minimum without reducing the benefits. Health education: Educate to use fruit, vegetables at least 500 g/day, legumes and whole grain cereals and avoid foods, junk foods and avoid coloring agents. Fatty foods should be avoided and obesity should be prevented to prevent breast cancer. 

23. High Risk strategy : This is aimed at bringing preventive care to those people who are at special risk of getting cancer. High risk individuals should be educated regarding the association or risk factor with cancer smoking, use of tobacco, alcohol, eating beef, smoked fish. Nurses can teach the following to high risk groups : To quit smoking and stop chewing tobacco. Alcohol intake should be restricted To have only one faithful married partner. Family history breast cancer. Change dietary habits. Women should have marriage at appropriate age. Practice good personal hygiene and perinel hygiene Women should have pap smear test for screening cervical cancer Individuals who have the above risk factors should be referred for screening for cancer.

24. Population Strategy: Cancer education to general public regarding the warning signals of cancer which are the following: A lump in the breast A non healing ulcer of more than two weeks duration A change in mole or wart A persistent cough A lump in the testicle Unexplained loss of weight Difficulty in chewing and swallowing Legislative and restrictive measures: Government of India has enacted an act, the cigarettes(regulation of production, supply and distribution) act of 1975 states all the persons trading in cigarettes have to display a statuary warning prominently that is “cigarette smoking is injurious to health”. Legislative measures to control air pollution also exists, aimed at prevention of lung cancer

25. Secondary Prevention Cancer Registration : NCRP- National Cancer Registry Program It provides a baseline data regarding magnitude of the cancer problem and for planning and implementing the required services they are of two types Hospital Based Registries : It includes all out patient as well as in patients on treatment in the hospital. It should be done as per “WHO handbook for standardized cancer registers ” Population Based Registries : It should include situation in a given geographical area. The optimum size of base population recommended for cancer registry is from 2-7million such data can provide significant information about incident of cancer and causes of cancer time trends common cancer for planning and evaluation of operational activities related to all cancer control activities .

26. Tertiary Prevention Tertiary prevention aims at disability limitation and rehabilitation Disability limitation: This is done by intensive treatment to prevent development of disability patient may develop disability due to pain, decreased vitality, loss of weight, fatigue, and discomfort in advance stage of cancer. Rehabilitation: Patients who have undergone surgery are rehabilitated. After amputation of leg they are given prostheses and physiotherapy in order to train them to walk with prostheses. Rehabilitation also includes management of psychological problem of the patient and management of the social spiritual and family problem.

27. References www.google.com www.wikipedia.com www.byju’s.com https:// www.who.int/news-room/fact-sheets/detail/cancer https ://www.ncdirindia.org/

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