CANCER

AN OVERVIEW
DR. M. PRABAGAR, MD., DM.,
Associate Professor,
Dept. Medical Oncology
Regional Cancer Centre
Coimbatore medical college Hospital
Contents
What is cancer?
What is the magnitude of the problem?
What is the cause?
When to consult a doctor?
How cancer is diagnosed?
How cancer is treated?
How can be prevent cancer?
What is cancer?
No Harmony Disorder
 CANCER
• Cancer (malignant neoplasm) is a
class of diseases in which a group
of cells display uncontrolled growth,
invasion and sometimes metastasis.

• Cancer is the world’s second leading

cause of death.

• Tumor, is any abnormal swelling, lump or mass.

- Neoplasm, is the scientific term to describe an abnormal
proliferation of genetically altered cells.
- Neoplasm's can be benign or malignant.
 Benign neoplasm or benign tumors:

Tumors that lacks the ability to

spread.

 Malignant neoplasm or malignant tumors:

Synonymous with cancer.

Cells invades and spread

rapidly (Metastasis).
 Hippocrates used the Greek words carcinos and carcinoma to
describe tumors.

 World’s oldest documented case of ancient Egypt in 1500 b.c

 Rudolph Virchow in late 19th century recognized that

cancerous cell were derived from other cells.
Mechanism of cancer cell formation
 Characteristics of cancer cell

Self-sufficient Motility Immortality Sustained Invasion and

growth signals • Resistance to cell angiogenesis metastasis
High motility
• Constitutively behaviour of cells death. • Cells allowed to • Benign cells
activated growth results in easy • Activated anti- grow and spread. grows locally
factor signalling. spread of cell death while malignant
• Resistance to malignant cells to signalling. cells invade
anti-growth other tissues. • Inactivated cell neighboring
signals. death pathway tissues enter
blood vessels and
metastasize to
different sites.
What is the magnitude of the
problem?
A Public Health Problem Worldwide

• 7.6 million
7.6 million people worldwide died from cancer in
2008.
• 70%
Approximately 70% of cancer deaths occur in
low- and middle-income countries.
• 30%
30 % of cancers could be prevented. 11

http://www.who.int/cancer/en/
Proportion of global NCD deaths by
cause of death

NCD= Non communicable http://www.who.int/cancer/en/

SCENARIO IN INDIA
• Projection of total cancer cases in India1
• Year 2010- 979,786
• Year 2020-1,148,757

• 10,14,934 new cancer cases each year

• 6,82,830 deaths due to cancer every year

1. Asian Pacific J Cancer Prev. 2010; 11:1045-1049

2. GLOBOCON 2012
 INDIA GLOBOCAN
2012
Male Female

Lung: 11 per 1,00,000 Breast: 25.8 per 1,00,000

Oral, lips: 10.1 per Cervix: 22.0 per 1,00,000
5 most frequent cancers in India
(ranking defined by total number of cases)

Both 
Rank Male Female
sexes
1 Lip, oral cavity Breast Breast
2 Lung Cervix uteri Cervix uteri
3 Stomach Colorectum Lip, oral cavity
4 Colorectum Ovary Lung
5 Other pharynx Lip, oral cavity Colorectum

http://globocan.iarc.fr/
What is the cause?
 Causes of cancer Cont..

 Chemicals
 Diet and lack of exercise
Infection

 Radiation
 Heredity
Unknown causes
• Gutka industry grew from 0 to $ 500m in 15- 20 yr

• One of the highest growing industry - 25-30% / yr

Cigarette some
• contain 4000 toxic substance
• 400 of them are injurious to health
• 40 are carcinogens

• Carcinogens are
• Gaseous
• Hydrazine
• Vinyl chloride
• Particulate
• Neutral - benzene
• Acidic - catherol
• Alkaline - nitrosamine
• Sediments - nickel
•CANCER
• Mouth
• Lung
• Throat
• Food pipe
• Wind pipe
• Stomach
• Pancreas
• Bladder
• Cervix
• Breast
• Prostate
• Skin
12 times more likely to die
from lung cancer.
BREAST
CANCER
• Type A personality
• Spinster
• No Children
• Late Children
• No Breast Feeding
CERVIX CANCER

• Poor Hygiene
• Unsafe Sex
• Multi-parity
Scrotal Cancer

Kangri Cancer

Bladder Cancer
Causes of Cancer

From: Targeting Cancer. An action plan for cancer prevention and detection . Cancer
2020. Cancer Care Ontario. May, 2003
When to consult a doctor?
• Persistent cough or blood-tinged saliva

• A change in bowel habits

• Blood in the stool

• Unexplained pallor (anemia), extreme tiredness,

weakness
• Breast lump or breast discharge

• Lumps in the testicles

• Change in urination or blood in the urine

• Hoarseness in voice

• Persistent lumps or swollen glands

• Obvious change in a wart or a mole

• Indigestion or difficulty swallowing

• Unusual vaginal bleeding or discharge

• Unexpected weight loss, night sweats, or fever

• Non-healing sores

• Back pain, pelvic pain, bloating, or indigestion

How cancer in diagnosed?
Biopsy

• Removing a bit of tissue or whole tumor

Histopathological Examination
Staging
• Stage I - Limited to Organ of origin

• Stage II – Spread to regional lymph node

• Stage III – Locally advanced disease

• Stage IV – Distant spread (Lung, Liver, Bone, Brain etc)

 X- ray
•
USG (Ultra Sono Gram)
 CT scan
(Computerized tomography)

Liver Metastases

Brain Metastases

Lung Metastases
 MRI Scan
(Magnetic Resonance Imaging)
Tc 99 Bone Scan
 PET SCAN
(Positron Emission Tomography)
Is cancer curable?
 YES

Majority of the cancers are curable

Early diagnosis and intervention is

what is needed
Treatment
TUMOR BOARD
 Surgery
Done by Surgical Oncologist
 Radiotherapy
Given by Radiation Oncologist
• Radiotherapy is used to shrink a tumor or destroy cancer
cells by focusing high-energy rays.

• Radiotherapy utilizes
• high-energy gamma rays that are emitted from radium
or
• high energy x-rays that are generated in a special
machine.

• Early radiation treatments caused severe side-effects

because the energy beams would damage normal,
healthy tissue, but technologies have improved so that
beams can be more accurately targeted.

•
 Chemotherapy
Given by Medical Oncologist
• Chemotherapy utilizes chemicals that interfere with the cell
division process, damaging proteins or DNA, so that cancer cells
will be destroyed.

• These treatments target any rapidly dividing cells (not

necessarily just cancer cells), but normal cells usually can
recover from any chemical induced damage while cancer cells
cannot.

• Chemotherapy is generally used to treat cancer that has spread

because the medicines travel throughout the entire body.
• Chemotherapy treatment given in cycles with some time
interval so the body has time to heal between doses.
How can we prevent cancer?
 Balanced, low-fat diet with at least
11 servings of fruits, Veggies , grains
& beans / day reduces the chances of

colon cancer breast cancer lung cancer

by 75 percent by 50 percent by 30 percent.
Vaccines
• Vaccines to prevent cervical cancer
• Gradasil and Cervarix
• To be given in female between 9 to 26 years of
age

• Hepatitis B vaccine
• Prevents liver cancer
Screening
• Done in general population at risk

• Done on asymptomatic individuals

• To pick up cancers at early stages even before they

manifest.

• Screening programme available for cancer cervix, breast,

ovary, colon, pancreas

• Screening may be useful skin cancer, oral cancer, lung

cancer, or prostate cancer.
Take home message
• Cancer is a dreaded disease BUT

• Cancer is preventable
• Eat healthy food rich in vegetables and fruits and low on fat
• Maintain body weight by regular exercise and avoiding junk
foods
• Avoid tobacco in any form
• Cancer is curable
• Early diagnosis is the key
• Do not ignore warning signs
• Consult a doctor as early as possible