CANCER AWARENESS

1. DR KANHU CHARAN PATRO
RADIATION ONCOLOGIST
M.D,D.N.B[RT],FAROI[USA],MBA[ICFAI],PDCR,CEPC

2. O
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VISAKHAPATNAM,1/7-MVP[AP]
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3. Are you scared about
cancer ?
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5. Myth
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6. Cancer

7. Myth
cancer means death

8. Myth –contd.
cancer means
costly tratment

9. Myth –contd.
All cancers are same

10. Myth –contd.
Even after treatment cancer
comes again

11. Myth –contd.
Cancer is contagious

12. Myth –contd.
Cancer treatment is painful

13. Myth –contd.
Cure for sometime

14. 5 year survival data in cancer cervix
80 to 90% of women with stage I cancer
50 to 65% of those with stage II cancer.
25 to 35% of women with stage III cancer
15% or fewer of those with stage IV cancer
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15. 5 year survival data in cancer breast
• 0------93%
• I------88%
• IIA----81%
• IIB----74%
• IIIA---67%
• IIIB----41%*
• IIIC-----49%*
• IV------15%
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17. What is cancer
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19. Statistics
• >9.7 million cases are detected each
year
• 6.7 million people will die from
cancer
• Every day, around 1700 Americans
die of the disease
• 20.4 million people living with
cancer in the world today
• 1 in 3 people will be diagnosed with
cancer in the UK and 1 in 4 will die
from their disease

20. Cancer-introduction
• Cancer is one of the most common diseases in the
developed world:
• 1 in 4 deaths are due to cancer
• 1 in 17 deaths are due to lung cancer
• Lung cancer is the most common cancer in men
• Cervix, Breast cancer is the most common cancer in
women
• There are over 100 different forms of cancer

21. What is Cancer?
• Division – uncontrolled cell division
• Growth – formation of a lump (tumour) or large
numbers of abnormal white cells in the blood
• Mutation – changes to how the cell is viewed by the
immune system
• Spread – ability to move within the body and survive
in another part

22. Lung
Breast
Colon/Rectum
Stomach
Liver
Prostate
Cervix uteri
Oesophagus
Bladder
Non-Hodgkin
Lymphoma
Leukaemia
Oral cavity
Pancreas
Kidney
Ovary
1000 800 600 400 200 0 200 400 600 8001000
Men Women
From: D.M. Parkin The Lancet Oncology 2: 533-543 (2001)
(Thousands)
Incidence
Mortality
337
293
105
0370
241
318
446
234
165
166
471
233
133
111
76
33
121
68
113
86
47
97
101
101
34
71
192
114
810
902
558
405
255
499
398
384
204
543
279
260
227
99
93
167
144
109
81
170
116
112
57
119
5.3 million cases
3.5 million deaths
4.7 million cases
2.7 million deaths
The Global Burden of Cancer 2000

24. Malignant versus benign tumours

25. Normal and abnormal cell growth

26. Cancerous growth

27. Metastatic cancer

28. Carcinogenesis.
Some factors to consider…
• Heredity
• Immunity
• Chemical
• Physical
• Viral
• Bacterial
• Lifestyle

29. Cancer
• The division of normal cells is precisely controlled.
New cells are only formed for growth or to replace
dead ones.
• Cancerous cells divide repeatedly out of control even
though they are not needed, they crowd out other
normal cells and function abnormally. They can also
destroy the correct functioning of major organs.

31. Cancer stages
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32. CAUTION
C - Change in bowel or bladder habits
A - A sore that does not heal
U - Unusual bleeding or discharge
T - Thickening or lump in the breast or any part of the body
I - Indigestion or difficulty swallowing
O - Obvious change in a wart or mole
N - Nagging cough or hoarseness

33. Change in bowel habits
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34. Change in bladder habits
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35. A sore that does not heal
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36. Unusual bleeding or discharge
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37. Thickening or lump in the breast or any
part of the body
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38. Indigestion or difficulty swallowing
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39. Obvious change in a wart or mole
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40. Nagging cough or hoarseness
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41. Causes of cancer
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42. Heredity
• Genes isolated for several
classic familial cancer
syndromes:
– RB1 (retinoblastoma)
– APC (familial polyposis)
– Human Non Polyposis
Colon Cancer (HNPCC)
– BRCA 1&2 (breast cancer)
– p53 (many cancers)

43. Heredity
• 5-10% of Cancers
• ?15% of all cancers
• Molecular biology
and Human
Genome Project

44. Immunity
• HIV / AIDS
• Immunosuppression

45. Virus’s
• Hepatitis B
• Human T-cell
Leukaemia virus
• Epstein Barr Virus
• Human Papilloma Virus
(HPV)

46. Bacterial• H. pylori
• Other Parasites:
– Schistosoma spp
– Clonorchis sinensis

47. Estimated Burden of Cancer from Infection Worldwide in 2000
Liver 509,000 HBV, HCV, flukes 5.1
Cervix 471,000 HPV 4.7
Stomach 442,000 H. pylori 4.4
Kaposi’s (HIV related) 134,000 HHV-8 1.3
Non Hodgkin lymphoma 72,000 H. pylori, EBV, HIV 0.7
Ano-genital 65,000 HPV 0.6
Nasopharyngeal 63,000 EBV 0.6
Hodgkin disease 33,000 EBV, HIV 0.3
Bladder 10,000 Schistosoma 0.1
Leukaemia 3,000 HTLV1 0.03
Total 1,801,000 17.9
No. of cases Agent % World
cancer

48. Chemical
• Alcohol
• Asbestos
• Wood dust
• Rubber, plastics, dyes
• Tar / bitumen
• Aflatoxin
• Alkylating agents
• Tobacco

49. Smoking and alcohol

50. Industrial pollution

51. Physical causes
• Ultraviolet radiation
– Sunlight
– Certain industrial sources
•Radiation
–Radon
–Cancer treatment

52. Lifestyle
• Age
• Occupation
• Ethnicity
• Deprivation

53. Smoking
• Single biggest cause of
cancer
• 25-40% smokers die in
middle age
• 9 in 10 lung cancers
• Know to cause cancer in
1950

54. Who is smoking whom
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55. Tobacco forms-bidi

56. 56
Smoking

57. 57

58. Tobacco forms-picca
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59. Tobacco forms-cigars
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60. 60

61. Tobacco forms-passive smoking

62. Tobacco forms-snuff

63. Tobacco forms-gutkha

65. 65
Tobacco & Gutkha chewing

66. The smoking epidemic
• 1 billion smokers
• 5 million people die every year
• This figure will have doubled by 2030
World Health Organization. The Tobacco Atlas. http://www.who.int/tobacco/statistics/tobacco_atlas/en
75% of smokers want to quit
<2% of smokers quit each year
Primary care can help increase quit rate

67. What’s in a cigarette?
• 4,000 chemicals
• tar
• carbon monoxide
• nicotine

68. 68

69. 69

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75. Health Effects of Smoking
• Heart disease
• Lung disease – COPD, asthma
• Cancer
– Lung, ENT, pancreas
– Cervix, colorectal
– Skin (squamous cell)
• Vascular disease - impotence
• Stroke
• Cataracts
• Gum disease
• Dementia, Early menopause
• Osteoporosis
• Wound healing
• Anxiety
• Miscarriage
• SIDS
• Hearing loss
• Rheumatoid arthritis
• Macular degeneration
• Tooth decay
• Depression
• Multiple sclerosis

76. Smoking kills more people each
year than
 alcohol
 cocaine
 crack
 heroin
 homicide
 suicide
 car accidents
 fires
 AIDS
C O M B I N ED!!!

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79. Tobacco-injuries

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83. Result of reverse smoking

87. Gutkha

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91. Lung cancer
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92. 92

94. Polythene and cancer
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95. Alcohol and cancer
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96. 96
Occupation

97. 97
Dietary

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106. 106
Air Pollution

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109. Obesity and cancer
• obesity
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110. 110

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119. Prevention-passive smoking

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121. 121
Solar radiation

122. Chemicals

123. Papiloma virus infection

124. EBV-infection

126. Hepatitis virus infection

127. Kaposi sarcoma-HHV8

128. Burkit’s lymphoma

129. 129
Indian scenario

130. 130
Indian scenario
MALES
• Lung cancer is the most common in Northern &
Western parts of INDIA (Delhi,
Mumbai, Bhopal )
• Stomach cancer is most common in Southern
India ( Bangalore & Chennai )
• In rural India, oral cavity & hypo pharyngeal
cancers are more common.

131. 131
FEMALES :
• In Urban INDIA , Breast Cancer is more
common (Except in Chennai) than cervical
cancer.
• In Rural Cancer Registry , Cervix ca is more
common.
Indian scenario

132. 132
High incidence of Nasopharyngeal cancer is
observed in North-eastern states.
The gall bladder cancer is high in geographical
band extending from Punjab to West Bengal to
North East.
Thyroid cancer is high from the southern tip
and extending upward along the southwest
cost to Goa state.

133. Calculation
• One cigar-5 rupees
• 10 cigars/day-50 rupees
• 1500 rupees per month
• Around RS -15000per year
• Around RS -1.5L per 10 year
• Around 4.5 lakhs per 30 year
• If cancer developes-no

134. Spent on smoking

137. I have cancer
but
No money for treatment

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139. Cancer treatment
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142. ? ?
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146. Oncologist
Diagnosis
Treatment
Radiologist
Cytopathologist
Surgeon
HistopathologistMolecular
Pathologist
Geneticist
psychiatrist
Nursing
And
Support staff
Audit

147. CHOOSING DOCTORS
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148. Cancer board
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149. Choosing hospital
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150. Cancer surgery
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151. Cancer surgery
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153. Radiation oncology
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154. chemotherapy
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155. hormonal
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156. All specialities under one roof
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157. 6/1/2018 3:29:49 AM 157
LOTS OF BLOOD REQUIRE

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TABLET FORMS

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160. Hair loss
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161. Radiation side effect
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163. Nicotine replacement
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164. Nicotine patches
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165. What can I do for society
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166. SELF –I will not smoke
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167. HOME
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168. I will not a victim of passive smoking
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169. I will not sell tobacco
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171. Education
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172. FAMILIAL BURDEN
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173. ECONOMIC BURDEN
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174. SOCIAL BURDEN
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175. Social Support
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176. Emotional Support
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177. Financial Support
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178. Living Celebrities-cancer
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179. Former Secretary of Defense Colin
Powell was treated for prostate cancer
in 2003
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180. NELSON MANDELA-PROSTATE
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181. Barbari- mori-breast cancer
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182. Lisa ray-myeloma cancer
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183. George Bush Sr - US President - skin
cancer
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184. Lance Armstrong - cyclist - testicular
cancer
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185. 6/1/2018 3:29:49 AM 185

186. Escape yourself from cancer

189. Prevention-passive smoking

190. Liver cancer-
hepatitis B vaccine

191. Cervix cancer vaccine
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192. Promise-Stop drinking alcohol
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193. RELAX

194. Meditation
10/20/12 01:12 PM 194

195. 195
Dietary protective factors

196. 196
Dietary protective factors

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199. Breast feeding

200. REGULAR CHECK-UP

201. Exercise

202. REGULAR CHECK-UP

203. 7erwwwwwwwwwwwwwwwwwwwA
WEEUUp2 22u
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204. 204

205. 205

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211. Reduce
• Stop smoking.
• Stop taking alcohol
• Get more exercise.
• Maintain a healthy weight..
• Reduce your exposure to estrogen..
• Eat your fruits and vegetables!
• Learn about good nutrition and start eating for
good health.
• Regular check-up
• Relax

212. 10/20/12 01:12 PM 212

213. 6/1/2018 3:29:49 AM 213

214. “ We must become the change we want to see”

215. DEDICATION-patients
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216. 10/20/12 01:12 PM 216

217. 10/20/12 01:12 PM 217

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220. 6/1/2018 3:29:49 AM 220

222. Final truths about cancer
• Cancer is preventable before diagnosis
• After diagnosis 70 to 80 % cancers are curable
• Remaining incurable cancers ,we can prolong
the life with comfort

223. THANKS

224. 224
?

229. TEAM OF EXPERTS IN SURGICAL ONCOLOGY
1. Dr.Murali Krishna Voonna M.S.,M.Ch.,
(Adyar Cancer Institute ,Chennai)
2. Dr.Karthik Chandra Vallam M.S., M.Ch,DNB.,
(TATA Memorial ,Mumbai)
3. Dr.M.P.S.Chandra Kalyan M.S,, M.Ch.,
(TATA Memorial ,Mumbai)

230. TEAM OF EXPERTS IN RADIATION ONCOLOGY
1. Dr. Kanhu Charan Patro M.D(RT).,DNB(RT)
(ex. TATA Memorial ,Mumbai)
2. Dr. Partha Sarathi Bhattacharyya M.D (RT)
(ex. AIIMS,NEW DELHI)
3. Dr. Chittaranjan Kundhu M.D(RT)
(S.C.B.M.C ,Cuttack)
4. Dr. Venkata Krishna Reddy M.D (RT)
(Christian Medical College ,Vellore)

231. TEAM OF EXPERTS IN MEDICAL ONCOLOGY
1. Dr. B.Rakesh Reddy M.D(Paed).,DM
(Medical Oncology) (AIIMS ,New Delhi)
2. Dr. M.Vamshi Krishna M.D.,D.M., (Medical Oncology)
(Tata Memorial ,Mumbai)
3. Dr.R.Madhan Mohan M.D. (Hematology)
(AIIMS ,New Delhi)

232. TEAM OF EXPERTS IN CRITICAL CARE AND PAIN
1. Dr. K.V.D. Praveen M.D(Anesthesiology)
(PGIMER, Chandigarh)
2. Dr. A.Shirisha M.D (Anesthesiology)
(AMC ,Visakhapatnam)
3. Dr. Surendra Nadh D.A, DNB(Anesthesiology)
(ISPAT General Hospital, Odisha)

233. TEAM OF EXPERTS-- Radiology
1. Dr. P.Madhuri D.M.R.D
( AMC ,Visakhapatnam)
2. Dr. B.Revathi D.M.R.D
( RMC ,Kakinada)

234. GYNAEC ONCOLOGY :
Dr.Jyoti Doki M.D. (Gynaec & Obg)
(AMC,Visakhapatnam)

235. Nuclear Medicine :
Dr. K.Raghava Kashyap M.D (Nuclear Medicine)
(PGIMER, Chandigarh)

236. EXPERTS FROM VARIOUS PRESTIGIOUS
INSTITUTIONS
1. ADYAR CANCER INSTITUTE, CHENNAI-1
2. TATA MEMORIAL HOSPITAL, MUMBAi
3. AIIMS,NEWDELHI-2
4. CM-VELLORE-1
5. PGI-CHANDIGARH-2

237. DECISIONS IN TUMOR BOARD