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WORLD
Cancer
cause
21%
Otis
occurred in 2008
About
International
2008
12.7
7.6
INDIA
Metric
Count
Incidence Male
477,482
Incidence Female
537,452
Mortality Male
356,730
Mortality Female
326,100
Prevalence Male
664,538
Prevalence Female
1,125,960
CANCER EPIDEMIOLOGY
Tobacco
40 to 50% men
20% to women
DIET
10-70%
of cancers
Cancers
Smoking
and alcohol
and alcohol
oral cancer
Tobacco
India
Risk factors
single child
High fat diets during the pubertal age and obesity in the
post-menopausal age are risk factors for breast cancer.
Risk factors
Prevention
RISK FACTORS
A)
Alcohol
Breast cancer in women
Primary liver cancer
Ovarian cancer
Prostate cancer
Thyroid cancer
Dietary factors
causative agents
Occupational exposures
Viruses
HepB & C -hepatic cancer.
HIV- Kaposi Sarcoma.
Ebstein Barr -Burkitt's lymphoma and nasopharyngeal
carcinoma
Hodgkin disease is also believed to be caused by virus.
B) GENETIC FACTORS
Retinoblastoma
parent
Mongols
PATHOPHYSIOLOGY OF THE
MALIGNANT PROCESS
proliferate abnormally,
LOCAL SYMPTOMS
Lump or swelling
Haemorrhage
Pain or ulceration
SYMPTOMS
OF METASTASIS
Cough
Haemoptysis
Hepatomegaly
Bone pain
Fracture
Neurological symptoms
SYSTEMIC
SYMPTOMS
Weight loss
Poor appetite
Fatigue
Cachexia
Diaphoresis
Anaemia
CAUTION
C:
A:
U:
T:
elsewhere
I:
O:
N:
CLASSIFICATION
BSED ON THE TISSUE PRESUMED TO BE
THE ORIGIN OF THE TUMOR..
Carcinoma:
Germ
BENIGN
MALIGNANT
Grows slowly
Enlarging
and
Grows rapidly
expanding Infiltrating
growth
surrounding
tissues
Capsule present
Capsule absent
Recurrence is common
host
Poor prognosis
neoplasms
Fibromas ( uterus)
Malignant
neoplasms
Sarcoma ( mesenchyma)
Lymphoma ( hematopoetic)
DIAGNOSIS
TNM CLASSIFICATION
MANAGEMENT OF CANCER
surgery
chemotherapy
radiation therapy
immunotherapy
monoclonal antibody therapy
hormonal therapy
biologic response modifier (BRM) therapy
complimentary & alternative therapies
CHEMOTHERAPY
MONOCLONAL
In
this,
ANTIBODY THERAPY
therapeutic
agent
is
an
IMMUNOTHERAPY
It refers to a diverse set of therapeutic
PREVENTION OF CANCER
A)
Primordial prevention
B)
C)
D)
Tertiary prevention
PRIMORDIAL PREVENTION
Minimize future hazards to health
Inhibit the establishment factors known to
increase the risk of disease (environmental,
economic, social, behavioural, cultural)
Personal Hygiene
Radiation
Occupational exposures
Immunization
Air Pollution
Legislation
Health Education
Cancer vaccine
C) SECONDARY PREVENTION OF
CANCER
Cancer
Early
Registration
Detection of cases
Treatment
D) TERTIARY PREVENTION
Programme
Aims
ORAL CANCER
BREAST CANCER
Mammographic
Regular
screening
cancer.
Breast
smear
Mammography
Periodic examination
1. Prevention
2. Early Detection
4. Palliative Care
EVOLUTION OF NCCP
cancer
hospital/institutions.
Central
2004
after evaluation
specially
regarding
hazards
of
breast
and
of
the
oro-pharyngeal cancer
by
STRATEGIES
1. Prevention and early detection of cancer through
district cancer activities and strengthened IEC
campaign.
2. Development of early diagnostic capacities in
district hospitals.
3. Encouraging public private partnership.
4. Increase capacity for palliative are in cancer
Promote
innovation
in
cancers
care
and
10.
Health
education
of
the
general
public
2. STRENGTHENING OF EXISTING
REGIONAL CANCER CENTRES
detection
and
prevention
of
cancers
officers
and
and
supportive care.
d.
Training
of
medical
health
and
supportive
care
should
be
g.
The
RCC
will
have
to
undergo
periodic
a.
3. Financial Provisions:
The
selected
government
institute
will
be
Launched in 1990-91
2. Early detection.
3. Training of medical & paramedical personnels.
ACHIEVEMENTS
Centres,
including
NGOs,
providing
Oncology wing:
Support has been given to 82 institutes in
both
Government
Medical
Colleges
and
facilities
across
the
country,
IEC Activities:
populous States.
NEW INITIATIVES:
Telemedicine in cancer
National
Cancer
Registry
Programme
was
cancer
prevalence
and
incidence.
Cancer
collecting
malignant neoplasm.
information
on
Objectives
1. To generate authentic data on the magnitude of
cancer problem in India;
2. To undertake epidemiological investigations and
advice control measures; and
3. Promote human resource development in cancer
epidemiology.
2 TYPES OF REGISTRIES
1.
2.
At
Chandigarh,
dibrugarh,
thiruvanathapuram,
CANCER ATLAS
for
the
year
2001-02
from
105
Main
objectives:
JOURNAL PRESENTATION
Indian Journal of cancer
Title:- Risk factors of female breast carcinoma: A case
control study at Puducherry
Investigators:-SM Balasubramaniam, SB Rotti, S
Vivekanandam
Objective: To identify and quantify various demographic,
reproductive, socio-economic and dietary risk factors
among women with breast cancer.
Study Design: Case control study.
Study Period : February 2004 to May 2005.
Study Setting: Departments of Surgery, Medicine and
Radiotherapy of JIPMER
surgery
wards
without
any
current
breast
Investigators:-
Arunima
Gupta,
Siddhartha
Das,
and
socioeconomic
condition.
For
RESULT: During the study period 1524 cases and their controls
were accounted. Change in trend was observed in
patients diagnosed at younger age of 57.48 0.56 years
in 2010 with adenocarcinoma unlike 62.89 1.21 years
in 2006. Females show increase in incidence of lung
cancer in 2010, p value < 0.001 . The active smokers
and years of smoking were significantly high among
cases. The incidence of squamous cell carcinoma declined
from 47.4% in 2006 to 15% in 2010 whereas
adenocarcinoma increased, p value 0.001. Significant
change in trend involving younger age at presentation
specially for female who also show increased incidence of
lung cancer has been observed. This hypothesis needs
confirmation through further studies.