CANCERA SILENT KILLER

BYDR DUUM NWACHUKWU

CONSULTANT OBSTETRICIAN AND GYNAECOLOGISTMBBS. FWACS. FMCOG

&

DR ALABI A.OCONSULTANT OBSTETRICIAN AND GYNAECOLOGISTMBBS. FWACS.

• What is this Cancer and where does it come from? These are questions many of us have asked over the years. Cancer knows no age, race, religion, or culture. This silent killer slips into our lives without a word. Unaware we go on day by day while it silently poisons our body.

• Throughout the world cancer touches and takes lives at a rapid speed. Many believe cancer will never find them, they are sure they are safe. We must learn that cancer has no friends and it's enemies, have much work to win the war. Each battle fought gives hope but he is silent and sneaky, he's patient and determined, and too often the winner.

• Cancer has entered our lives many times in the last few years, it has lost some of the battles, but sadly it has won also. What tares my heart out is the fact that many he has taken fed his existence for years. It scares me to think many we love are still feeding him.

REALITY IN NIGERIA

• Dr. Beko Ransome-Kuti, died at 65 from lung cancer. Before he passed on, Yemi Tella, erstwhile Under-17 World Golden eaglets' Coach, was diagnosed with cancer of the lungs. Afro-reggae musician and crusader, Evangelist Sunny Okosuns, recently died of colon cancer at the age of 61. Even human rights activist and Senior Advocate of Nigeria, Chief Gani Fawehimi, was recently diagnosed with cancer of the lungs.

Normal body cells

• Normal body cells grow, divide, and die in an orderly fashion. During the early years of a Person's life, normal cells divide more rapidly until the person becomes an adult. After that, normal cells of most tissues divide only to replace worn-out or dying cells and to repair injuries.

Introduction: What is Cancer?

•Cancer is the abnormal and unrestrained growth of otherwise normal cells.

Cancer cells

• Cancer cells accumulate and form tumors (lumps) that may compress, invade, and destroy normal tissue. If cells break away from such a tumor, they can travel through the bloodstream, or the lymph system to other areas of the body.

Classifications of Cancer

• Carcinomas – Most common site for cancer. Epithelial cells (breast, lung, intestines, skin, mouth) – metastasize initially, then form solid tumors

• Sarcomas – Less common – but more virulent – form solid tumors – mesodermal (middle) layer – bones, muscles, general connective tissue Lymphomas – lymphatic system Leukemias – blood-forming parts – nonsolid tumor

BURDEN OF CANCER

• The burden of cancer in Nigeria is appreciable. According to the World Health Organization, there are an estimated 100,000 new cancer cases in the country each year although observers believe the figure could become as high as 500,000 new cases annually by 2015. It is feared that by 2020, cancer incidence for Nigerian males and females may rise to 90.7/100,000 and 100.9/100,000 respectively. It is also anticipated that by 2020, death rates from cancer in Nigerian males and females may reach 72.7/100,000 and 76/100,000 respectively.

2008 Estimated US Cancer Deaths*

ONS=Other nervous system.Source: American Cancer Society, 2008.

Men294,120

Women271,530

26% Lung & bronchus

15% Breast9% Colon & rectum

6% Pancreas 6% Ovary 3% Non-Hodgkin

lymphoma 3% Leukemia3% Uterine corpus

2% Liver & intrahepaticbile duct

2% Brain/ONS25% All other sites

Lung & bronchus 31%Prostate 10%Colon & rectum 8%Pancreas 6%Liver & intrahepatic 4%

bile ductLeukemia 4%Esophagus 4%Urinary bladder 3% Non-Hodgkin 3% lymphoma Kidney & renal pelvis 3%All other sites 24%

How to Recognize the Signs of Cancer-CAUTION

• Change in bowel or bladder habits • A sore that does not heal • Unusual bleeding or discharge • Thickening or lump in breast or elsewhere • Indigestion or difficulty in swallowing • Obvious change in wart or mole • Nagging cough or hoarseness

BREAST CANCER

BREAST CANCER

BREAST CANCER

AFTER MASTECTOMY

CANCER OF THE NOSE

FACE CANCER

CERVICAL CANCER

CAUSES/PREDISPOSING FACTORS

• SMOKING• CHEMICALS eg Asbestos, Coal tar,Lead• Dangerous Radiations eg X-Rays.• Genetic eg Leukemias, • Viruses eg HPV, EBV, HIV.• Decreased Immunity.• Obesity• Alcohol• Multiple Sexual partners• Dietary Habits

PREVENTION OF CANCERS

• Health Education/Public Awareness

• Change of Life style• Avoidance of predisposing factors• Regular self examination• Regular medical check up

WAYS TO TREAT CANCERS

•Radiation•Surgery•Chemotherapy•Psychotherapy

Prognosis• 1/3 can be prevented, • another 1/3 can be effectively

treated with early diagnosis,• and palliative care can

improve the quality of life of the last third”

Screening Guidelines for the Early Detection of Breast Cancer,

Yearly mammograms are recommended starting at age 40.

A clinical breast exam should be part of a periodic health exam, about every 3 years for women in their 20s and 30s, and every year for women 40 and older.

Women should know how their breasts normally feel and report any breast changes promptly to their health care providers. Breast self-exam is an option for women starting in their 20s.

Screening Guidelines for the Early Detection of

Cervical Cancer Screening should begin approximately three years after a women

begins having vaginal intercourse, but no later than 21 years of age. Screening should be done every year with regular Pap tests or every

two years using liquid-based tests. At or after age 30, women who have had three normal test results in a

row may get screened every 2-3 years. However, doctors may suggest a woman get screened more frequently if she has certain risk factors, such as HIV infection or a weakened immune system.

Women 70 and older who have had three or more consecutive Pap tests in the last ten years may choose to stop cervical cancer screening.

Screening after a total hysterectomy (with removal of the cervix) is not necessary unless the surgery was done as a treatment for cervical cancer.

Screening Guidelines for the Early Detection of Colorectal Cancer and Adenomas,• Beginning at age 50, men and women

should follow one of the following examination schedules:

A flexible sigmoidoscopy (FSIG) every five years

A colonoscopy every ten years A double-contrast barium enema every five

years A Computerized Tomographic (CT)

colonography every five years A guaiac-based fecal occult blood test (FOBT)

or a fecal immunochemical test (FIT) every year

A stool DNA test (interval uncertain)

Screening Guidelines for the Early Detection of Prostate Cancer, American Cancer Society

• The prostate-specific antigen (PSA) test and the digital rectal examination (DRE) should be offered annually, beginning at age 50, to men who have a life expectancy of at least 10 years.

• Men at high risk ( strong family history of one or more first-degree relatives diagnosed with prostate cancer at an early age) should begin testing at age 45.

Common losses experienced by cancer patients

• 1. Loss of health and physical integrity (resulting from disease, disfigurement, and discomfort)

• 2. Loss of friends and loved ones (including separation to receive treatment, rejection by some friends or family members)

• 3. Inability to perform routine activities (such as self-care, job, and hobbies)

• 4. Loss of finances (resulting from cost of treatment and loss of job)

• 5. Loss of self-esteem • 6. Loss of religious convictions (“What did I do wrong to deserve

this?”)

LIMITATIONS• Late presentations• Inadequate Specialist• Poor Political will• Lack of Screening programme• Lack of Cancer centers• Few radiotherapy centers• Poorly funded and incomprehensive health care

system.• Expensive cost of care.• Superstitions.

WAY FORWARD

• greater awareness of cancer,• improved access to health care through new

programme such as the National Health Insurance Scheme, screening.

• empowerment of women, • improving economic and social factors will

increase rates of cancer diagnosis.

World cancer campaign • The International Union Against Cancer (UICC) initiated the

World Cancer Campaign in 2005 in response to the Charter of Paris of 2000. "Today's children, tomorrow's world" – prevent cancer with healthy habits

• From 2008 to 2011, each year will focus on a different issue: • 2008 – give children and young people a smoke-free

environment • 2009 – encourage an energy-balanced lifestyle based on

healthy diet and physical activity • 2010 – learn about vaccines against viruses that cause

cancers (e.g. HBV vaccines) • 2011 – teach children and teenagers to avoid UV exposure by

being "sun smart"

• Lastly, cancer control would greatly benefit if the government were to establish a National Cancer Institute, with the objectives of providing clinical and investigative facilities for cancer care and research, the provision of postgraduate training in cancer, the coordination of cancer control activities in Nigeria and the encouragement of collaboration with cancer centers in other parts of the world. In order to identify areas deserving of major efforts, and to monitor the outcome of interventions, a Nigerian Cancer Institute should also monitor cancer trends in the country.

•WE CAN WIN THIS WAR, ONLY IF WE TRY.

THANKS FOR LISTENING