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Lecture 15

Cancer is the second leading cause of death globally. Some key facts about cancer include that it is characterized by uncontrolled cell growth and can spread to other parts of the body. Risk factors include lifestyle choices, family history, and environmental exposures. Prevention strategies aim to reduce risk factors while screening and early detection aim to find cancer early when treatment is most effective.

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21 views17 pages

Lecture 15

Cancer is the second leading cause of death globally. Some key facts about cancer include that it is characterized by uncontrolled cell growth and can spread to other parts of the body. Risk factors include lifestyle choices, family history, and environmental exposures. Prevention strategies aim to reduce risk factors while screening and early detection aim to find cancer early when treatment is most effective.

Uploaded by

Abuboker Mahady
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Cancer

Course Instructor: Munia Zain Islam


Department of Public Health
School of Health and Life Sciences
North South University
munia.islam01@northsouth.edu
A Global Perspective

• The second leading cause of death globally


• Cumulative data until 2018 has shown an estimated 18.1 million new cases of
cancer and 9.6 million deaths occur globally (1 in 6 deaths or 26,000 people each
day)
• About 20% of males and 17% of females will get cancer at some point in time while
13% of males and 9% of females will die from it
• Approximately 70% of deaths from cancer occur in low- and middle-income
countries
• In Bangladesh (2020)
• Number of new cases: 156,775
• Total # cancer deaths: 108,990
• Top cancers include esophageal, oral, breast, lung and cervical cancers
What is Cancer?

• A large group of diseases (over 100) that can start in almost any
organ or tissue of the body characterized by uncontrolled cell growth
with the potential to spread beyond their usual boundaries to invade
adjoining parts of the body and/or spread to other organs (a process
is called metastasizing)
• A neoplasm and malignant tumor are other common names for
cancer
Normal vs Cancer Cells

• Cancer cells are a transformation of normal cells into tumor cells in a


multistage process that generally progresses from a pre-cancerous lesion
to a malignant tumor
• Changes occur due to interactions between a person's genetic factors and
3 categories of external agents
• Cancer cells:
• Lose control, over-growth and multiplication
• Cancer cells reproduces every 2-6 weeks
• Do not self-destruct when they become worn out or damaged
• Crowd out healthy cells
Six Hallmarks of Cancer

• All tumor cells show the six hallmarks of cancer. These characteristics are
required to produce a malignant tumor.
• Cell growth and division absent the proper signals
• Continuous growth and division even given contrary signals
• Avoidance of programmed cell death
• Limitless number of cell divisions
• Promoting blood vessel construction
• Invasion of tissue and formation of metastases
• The progression from normal cells to cells that can form a detectable mass
to outright cancer involves multiple steps known as malignant progression
Types of Tumors

• Benign Tumor
• Not a cancer
• Tumor cell grows only locally and cannot spready by invasion or metastasis

• Malignant Tumor
• Cancer
• Cells invade neighboring tissues, enter blood vessels, and metastasizes in
different sites
Metastasis

• Metastasis is the spread of cancer to other locations in the body


• The dispersed tumors are called metastatic tumors, while the original
is called the primary tumor
• Almost all cancers can metastasize
• Most cancer deaths are due to cancer that has metastasized
Risk Factors and Causes of Cancer

Family History Lifestyle Environmental


• Less than 3-10% of cancers • Tobacco use (including • Second-hand smoke
are inherited cigarettes and smokeless • Occupational and chemical
• Genetic mutations linked tobacco) and alcohol use exposures
with inherited cancers • Diets high in fat and low in • Urban air pollution and
(including colon cancer, fruit and vegetable intake indoor smoke from
breast, ovarian, prostate, • Lack of exercise and household use of solid fuels
and skin) physical activity • Infectious agents such as
• Unprotected exposure to parasites, viruses, or
the sun, UV rays bacteria
• Being overweight or obese
• Infections such as sexually
transmitted HPV-infection,
hepatitis or other
carcinogenic infections
Most Common Types of Cancers

• The most common cancers are lung cancer, breast cancer,


colorectal cancer, prostate cancer, skin cancer and stomach cancer.
• The most common causes of cancer death are cancers of lung
cancer, colorectal cancer, stomach cancer, liver cancer, and breast
cancer.
• The most common types of cancers:
• …in Men are lung, prostrate, colorectal, stomach and liver cancers
• …in Women are breast colorectal, lung cancer, cervical and thyroid cancers
Prevention Strategies

• To prevent cancer, people may:


• Increase avoidance of the lifestyle and environmental risk factors
• Most importantly avoiding tobacco and alcohol and maintaining a healthy diet,
weight and exercise
• Vaccinate against HPV and hepatitis B virus
• Vaccination against these HPV and hepatitis B viruses could prevent 1 million
cancer cases each year
• Control occupational hazards
• Reduce exposure to ultraviolet radiation and reduce exposure to ionizing
radiation (occupational or medical diagnostic imaging)
• Know family history and get regular cancer screenings
Symptoms

• Although early cancer may have no symptoms, some symptoms can


include:
• Change in bowel habits or bladder functions
• Sores that do not heal
• Unusual bleeding or discharge
• Lumps or thickening of the breast of other parts of the body
• Indigestion or difficulty swallowing
• Recent change in wart or mole
• Persistent coughing or hoarseness
Diagnosis

• Screening
• Colon, breast, cervical, prostate

• Self-examinations
• Skin, breast, and testicular
• Biopsy
• X-rays, CT scans, MRI scans, PET scans, and ultrasound scans
• Molecular diagnostic test
Early Detection and Diagnosis

• Cancer mortality can be reduced if cases are detected and treated early
• Early diagnosis
• Early identification of a cancer is more likely to respond to effective treatment
• Greater probability of surviving, less morbidity
• Less expensive treatment
• Steps for early diagnosis:
• awareness and accessing care
• clinical evaluation, diagnosis and staging
• access to treatment
Screening

• Screening aims to identify individuals with abnormalities suggestive of a


specific cancer or pre-cancer who have not developed any symptoms and
refer them promptly for diagnosis and treatment
• Examples of screening methods are:
• visual inspection with acetic acid (VIA) for cervical cancer in low-income settings
• HPV testing for cervical cancer
• PAP cytology test for cervical cancer in middle- and high-income settings
• mammography screening for breast cancer in settings with strong or relatively
strong health systems
Treatment Options

• Surgery
• Radiotherapy
• a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors
• Chemotherapy
• an aggressive form of chemical drug therapy meant to destroy rapidly growing cells in the body
• Immunotherapy
• a type of cancer treatment that helps your immune system fight cancer
• Hormone therapy
• a form of systemic therapy—a way of administering drugs that travels throughout the body, rather
than being delivered directly to the cancer—that works to add, block or remove hormones from the
body to slow or stop the growth of cancer cells
• Gene therapy
• a new treatment modality that introduces new genes into a cancerous cell or the surrounding
tissue to cause cell death or slow the growth of the cancer
Palliative care

• Palliative care is treatment to relieve, rather than cure, symptoms


caused by cancer and improve the quality of life of patients and their
families
• For patients with advanced stages of cancer where there is little
chance of cure
• Palliative care can help people live more comfortably
Key Summary Points

• Though there is a genetic predisposition of cancers, there are


several lifestyle and environmental causes of cancer that can be
prevented by avoiding those risk factors.
• Early detection, screenings, and regular check-ups can also help to
prevent late diagnosis of cancers and start the various treatment
options for care immediately.

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