::::::::: Cancer Screening & Cancer Prevention
 

 

Cancer Screening

 

Cancer Prevention

Protect yourself from Cancer

Health Message from : Kidwai Memorial Institute of Oncology

1

Stop using Tobacco (Smoking or Chewing)

2

Consume 4 – 5 Cups of Mixed fruits every day

3

Consume more Vegetables

4

Perform 45 – 60 minutes of Exercise every day

50% of new cancers can be prevented

Target: Healthy Population

 
Cancer Screening

The following background briefing has been prepared In public interest by Kidwai Memorial Institute of Oncology, Bangalore

Cancer can affect people of all ages the risk of developing cancer generally increases with age. Cancer has a reputation as a deadly disease. Cancer is an illness that afflicts large numbers of people, from all backgrounds, and is feared by individuals and families alike. When cancer begins it invariably produces no symptoms with signs and symptoms only appearing as the mass continues to grow orulcerates.

In India Cancer is an important public health problem with more than 9 lakh cases occurring every year. Four lakh deaths are estimated to occur every year due to cancer. Forty per cent of the cancers in the country are due to tobacco. Hence Tobacco related cancers are very common among males, namely, cancers of the lungs and oral cavity. Among women, cancer of uterine cervix and breast are common.

Taken as a whole, about 50% of patients with invasive cancer Survive if treated. About 13% ofall human deathsworldwide (7.9million) is due to cancer. Cancers are primarily an environmental disease with 90-95% of cases attributed to environmental factors and 5-10% due to genetics. Common environmental factors that contribute to cancer death includetobacco(25-30%), diet andobesity(30-35%), infections(15-20%), stress, lack ofphysical activity, andenvironmental pollutants.

The incidence rates of new cancers are rising as more people live to old age and simultaneously there are mass lifestyle changes occurring in the developing world. At least one-third of all cancer cases are preventable. Detecting cancer early remains the best strategy for reducing cancer deaths. Prevention offers the most cost-effective long-term strategy for the control of cancer. Public health action by the government and the promotion of healthy lifestyles could prevent as many as one third of cancers.
Cancer Screening: Screening, in medicine, is a strategy used in apopulationto detect adiseasein individuals withoutsignsorsymptomsof that disease.The intention of screening is to identify disease in a community early, thus enabling earlier intervention and management in the hope to reduce mortality and suffering from a disease. Although screening may lead to an earlier diagnosis,
Unlike diagnosis efforts prompted bysymptomsandmedical signs, cancer screening involves efforts to detect cancer after it has formed, but before any noticeable symptoms appear. This may involvephysical examination,bloodorurine tests, ormedical imaging.
Cancer Prevention: Cancer Education and Lifestyle Modification plays an important role in Cancer Prevention. Tobacco use is the single greatest avoidable risk factor for cancer mortality worldwide, causing an estimated 22% of cancer deaths per year. People who chew betel quid (whether mixed with tobacco or not) are also at high risk. Individuals with persistent oral infection by carcinogenic strains of human papillomavirus (HPV) are also at increased risk. Diet,physical inactivity, andobesityare related to approximately 30–35% of cancer deaths. body weight is associated with the development of many types of cancer and is a factor in 14–20% of all cancer deaths. Physical inactivity is believed to contribute to cancer risk not only through its effect on body weight but also through negative effects onimmune system andendocrine system.
Prevention of cancer, early diagnosis and treatment are a major challenge for our society.

Cancer Prevention in a target population involves an integrated and cohesive approach. It is desirable to have centers with expertise and experience in such cancer screening and prevention. Such programmes requires adequate funding, operational planning and strategic implementation. With Monitoring and management plans. For effective implementation there is a need for necessary funds, trained human resource, technology. Evolution of workplace roles and changes in service-delivery models shall also be addressed

Strategies to develop a cancer prevention workforce plan & support in terms of manpower & funds for the needs for this cancer control system has to be addressed. This would include the creation of a register of trained cancer control personnel and enhancement of coordination between bodies responsible for training and research on service delivery models and personnel issues.

There is a need to Determine culturally relevant ways to secure an educated target population. Determine a cost-effective approach to securing compliance with screening in our country. Determine optimal ages for initiating and stopping screening. Determine the required period of intensive follow-up for those treated for high-grade lesions.

A cancer control plan that is goal oriented, realistic and carefully prepared through a participatory process is more likely to move into effective implementation. In lower resource settings, a plan that considers a primary health care approach and the gradual implementation of few, affordable, cost-effective interventions will have a better chance of moving into effective action.

 
Overview
  • Cancer Health Education Programme
    • Cancer Awareness
    • Nutritional Aspect of Cancer prevention
    • Life style modification for Cancer prevention
    • Education on Tobacco in various form and its ill effects
    • Use of Media for Education – Television programme / Radio / Camps / SMS
    • Provision of importation health information - printed matter with pictures and diagrams
  • Cancer Screening :
    • Target Cancers:
      • Breast Cancer
        • Breast self-examination(BSE) Education :
          • Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.
        • Clinical breast exam (CBE) about every 3 years for women in their 20s and 30s and every year for women 40 and over
        • all women between 50 and 70 years old for breast screening.
      • Oral Cancers
        • Clinical Examination
        • Details of the suspicious area/lesion
          • (colour, texture, size, position, mobility)
        • Whether any regional nodes are palpable
      • Cervical Cancers
        • PS/PV – PAP Smear
        • recommends screening for cervical cancer in women who have been sexually active
        • Cervical cancer screening (testing) can begin at age 21.Women under age 21 shouldnotbe tested.
  • All other Screened Subjects with suspicion of Cancer and Incidentally detected new cancers will be further evaluated and investigated in the Host Cancer Center for the District.

Cancer Education Overview:
There are more than 200 different types of cancer with a wide range of different signs and symptoms.
Typical symptoms of cancer include:

  • The presence of an unusuallumpin the body
  • Changes in amoleon theskin
  • A persistent cough or hoarseness
  • A change in bowelhabits, such as unusualdiarrheaorconstipation
  • Difficulty in swallowing or continuing indigestion
  • Any abnormal bleeding, including bleedingfrom the vagina, or blood in urine or faeces
  • A persistentsore or ulcer
  • Difficulty passing urine
  • Unexplained weight loss
  • Unexplained pain
  • Unexplained tiredness or fatigue
  • Skin changes such as an unexplained rash or unusual texture
  • Unexplained night sweats

The key areas of Proposed Cancer Screening in are : Oral Cancer, Breast and Cervical Cancer.

Breast self-examination(BSE) is as creening methodused in an attempt to detect early breast cancer. The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling.
of their menstrual cycle.

Oral Cavity Examination : Possible signs of oral cavity cancer include a sore or lump on the lips or in the mouth. Physical examof the lips and oral cavity: An exam to check the lips and oral cavity forabnormal areas. The doctor ordentistwill feel the entire inside of the mouth with a gloved finger and examine the oral cavity with a small long-handled mirror and lights. This will include checking the insides of the cheeks and lips; the gums; the roof and floor of the mouth; and the top, bottom, and sides of the tongue. The neck will be felt for swollenlymph nodes.
Cervical PAP Smear is an effectivescreening test for malignantneoplasmarising from cervix uteri. One of the most common symptoms of cervicalcanceris abnormalvaginal bleeding, but in some cases there may be no obvious symptoms until the cancer has progressed to an advancedstage. Cancer screeningusing thePap smearcan identify precancerous and potentially precancerous changes in cervical cells andtissue. Cervical cancer screening is typically recommended starting at age 21.

CANCER PREVENTION: General Population Initiative: Steps to reduce your risk of developing cancer

Introduction:
Of the 10 million new cancer cases seen each year worldwide, 4.7 million are in the more developed countries and nearly 5.5 million are in the less developed countries. Cancer is emerging as major public health problems in India. Cancer prevalence in India is estimated to be around 2.5 million, with over 8,00,000 new cases and 5,50,000 deaths occurring each year due to this disease in our country. The common sites for cancer in India are oral cavity, lungs, oesophagus and stomach in males and cervix, breast and oral cavity among females. Over 70% of the cases report for diagnostic and treatment services in advanced stages of the disease, resulting in poor survival and high mortality rates. The disease is associated with a lot of fear and stigma in the country. There are principal approaches to cancer controlis 1. Prevention, 2. Early Detection 3. Diagnosis and Treatment. Prevention is the key element in cancer control. Prevention means eliminating or minimizing exposure to the causes of cancer, and includes reducing individual susceptibility to the effect of such causes. This approach offers the greatest public health potential and the most costeffective long-term method of cancer control.

Small changes in your everyday life might help reduce your risk of cancer.

 
CANCER PREVENTION :
General Population Initiative: Steps to reduce your risk of developing cancer

Introduction:
Of the 10 million new cancer cases seen each year worldwide, 4.7 million are in the more developed countries and nearly 5.5 million are in the less developed countries. Cancer is emerging as major public health problems in India. Cancer prevalence in India is estimated to be around 2.5 million, with over 8,00,000 new cases and 5,50,000 deaths occurring each year due to this disease in our country. The common sites for cancer in India are oral cavity, lungs, oesophagus and stomach in males and cervix, breast and oral cavity among females. Over 70% of the cases report for diagnostic and treatment services in advanced stages of the disease, resulting in poor survival and high mortality rates. The disease is associated with a lot of fear and stigma in the country. There are principal approaches to cancer controlis 1. Prevention, 2. Early Detection 3. Diagnosis and Treatment. Prevention is  the key element in cancer control. Prevention means eliminating or minimizing exposure to the causes of cancer, and includes reducing individual susceptibility to the effect of such causes. This approach offers the greatest public health potential and the most costeffective long-term method of cancer control.

Small changes in your everyday life might help reduce your risk of cancer.

Steps in Cancer prevention :

Step 1: Don't use tobacco (Smoking,Chewing tobacco, Inhaled chewing tobacco)

Tobacco is the single leading cause of cancer worldwide and in the fight against cancer every country should give highest priority to tobacco control. All types of tobacco put you on a collision course with cancer. Rejecting tobacco, or deciding to stop using it, is one of the most important health decisions you can make. It's also an important part of cancer prevention.

Step 2: Eat a variety of healthy foods

he American Cancer Society recommends that you:

  • Eat an abundance of foods from plant-based sources. Eat five or more cups  of mixed fruits and vegetables each day. In addition, eat other foods from plant sources, such as whole grains and beans, several times a day. Replacing high-calorie foods in your diet with fruits and vegetables may help you lose weight or maintain your weight. A diet high in fruits and vegetables has been linked to a reduced risk of cancers of the colon, esophagus, lung and stomach.
  • Limit fat. Eat lighter and leaner by choosing fewer high-fat foods, particularly those from animal sources. High-fat diets tend to be higher in calories and may increase the risk of overweight or obesity, which can, in turn, increase cancer risk.
  • Drink alcohol in moderation, if at all.
Step 3: Stay active and maintain a healthy weight

Maintaining a healthy weight and exercising regularly also may play a role in cancer prevention. Being overweight or obese may increase your risk of cancers of the breast, colon, esophagus, kidney, stomach and uterus.  Physical activity can help you avoid obesity by controlling your weight. Physical activity on its own may also lower your risk of cancers of the breast, colon, prostate and uterus.
Try to be physically active for 30 minutes or more on most days of the week. Once you achieve that goal, adding more vigorous exercise ~ 45-60 mins every day to your days schedule may reduce your risk by 50% for certain cancers further.

Step 4: Get immunized

Certain cancers are associated with viral infections that can be prevented with immunizations. Talk to your doctor about immunization against:

  • Hepatitis B. Hepatitis B can increase your risk of developing liver cancer. Vaccination is recommended for all babies in the United States. Certain high-risk adults also may need to be vaccinated.
  • Human papillomavirus (HPV). HPV is a sexually transmitted virus that can lead to cervical cancer. The vaccine that protects against two cancer-causing types of HPV is recommended for girls ages 11 to 12. In addition, the Centers for Disease Control, and Prevention recommends that the HPV vaccine be given to girls and women ages 13 to 26 who haven't completed the full vaccine series.

Step 5: Avoid risky behaviors

Reduce your risk of certain cancers by avoiding risky behaviors that can lead to infections that may increase your risk of cancer. Viruses transmitted sexually or by sharing contaminated needles include:

  • HPV. HPV is most often associated with cervical cancer. But HPV may also increase the risk of cancers of the anus, penis, throat, vulva and vagina. The more sexual partners you have in your lifetime, the more likely you are to have HPV.
  • Human immunodeficiency virus (HIV). People with HIV or AIDS have an increased risk of anal cancer, cervical cancer, liver cancer, lymphoma and Kaposi's sarcoma. People with multiple sexual partners and intravenous (IV) drug users who share needles have an increased risk of HIV.
  • Hepatitis B and C. Chronic hepatitis B or hepatitis C infection can increase your risk of liver cancer. Both forms of hepatitis can be passed through sexual contact with an infected person or sharing needles with an infected drug user.

Reduce your risk of these cancers by avoiding risky behaviors. Abstain from sex or use condoms and limit the number of sexual partners you have. Never share needles. Seek help for your addiction if you use drugs.

 
A. American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention

ACS Recommendations for Individual Choices

Maintain a healthy weight throughout life.

  • Balance caloric intake with physical activity.
  • Avoid excessive weight gain throughout the life cycle.
  • Achieve and maintain a healthy weight if currently overweight or obese.

Adopt a physically active lifestyle.

  • Adults: engage in at least 30 minutes of moderate to vigorous physical activity, above usual activities, on 5 or more days of the week. Forty-five to 60 minutes of intentional physical activity are preferable.
  • Children and adolescents: engage in at least 60 minutes per day of moderate to vigorous physical activity at least 5 days per week.

Consume a healthy diet, with an emphasis on plant sources.

  • Choose foods and beverages in amounts that help achieve and maintain a healthy weight.
  • Eat five or more servings of a variety of vegetables and fruits each day.
  • Choose whole grains in preference to processed (refined) grains.
  • Limit consumption of processed and red meats.

If you drink alcoholic beverages, limit consumption.

  • Drink no more than one drink per day for women or two per day for men.

ACS Recommendations for Community Action

Public, private, and community organizations should work to create social and physical environments that support the adoption and maintenance of healthful nutrition and physical activity behaviors.

  • Increase access to healthful foods in schools, worksites, and communities.
  • Provide safe, enjoyable, and accessible environments for physical activity in schools, and for transportation and recreation in communities.
 
B. What Counts as a Serving

Fruits
  • 1 medium apple, banana, orange
  • 1/2 cup of chopped, cooked, orcanned fruit
  • 1/2 cup of 100% fruit juice

Vegetables

  • 1 cup of raw leafy vegetables
  • 1/2 cup of other cooked or raw vegetables, chopped
  • 1/2 cup of 100% vegetable juice

Grains

  • 1 slice bread
  • 1 ounce ready-to-eat cereal
  • 1/2 cup of cooked cereal, rice, pasta

Beans and nuts

  • 1/2 cup cooked dry beans
  • 2 tablespoons peanut butter
  • 1/3 cup nuts

Dairy foods and eggs

  • 1 cup milk or yogurt
  • 1 1/2 ounces of natural cheese
  • 2 ounces processed cheese
  • 1 egg

Meats

2–3 ounces of cooked lean meat, poultry, fish

 
C. Examples of Moderate and Vigorous Intensity Physical Activities
 

Moderate Intensity Activities


Vigorous Intensity Activities



Exercise and leisure

Walking, dancing, leisurely bicycling, ice and roller skating, horseback riding, canoeing, yoga

Jogging or running, fast bicycling, circuit weight training, aerobic dance, martial arts, jumping rope, swimming

Sports

Volleyball, golfing, softball, baseball, badminton, doubles tennis, downhill skiing

Soccer, field or ice hockey, lacrosse, singles tennis, racquetball, basketball, cross-country skiing

Home activities

Mowing the lawn, general yard and garden maintenance

Digging, carrying and hauling, masonry, carpentry

Occupational activity

Walking and lifting as part of the job (custodial work, farming, auto or machine repair)

Heavy manual labor (forestry, construction, firefighting)

 
D. Suggested Ways to Reduce Sedentary Behavior
  • Use stairs rather than an elevator.
  • If you can, walk or bike to your destination.
  • Exercise at lunch with your coworkers, family, or friends.
  • Take an exercise break at work to stretch or take a quick walk.
  • Walk to visit coworkers instead of sending an e-mail.
  • Go dancing with your spouse or friends.
  • Plan active vacations rather than only driving trips.
  • Wear a pedometer every day and increase your daily steps.
  • Join a sports team.
  • Use a stationary bicycle or treadmill while watching TV.
  • Plan your exercise routine to gradually increase the days per week and minutes per session.
  • Spend time playing with your kids.
 
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Kidwai Memorial Institute of OncologyDr. M.H Marigowda Road,Bangalore - 560029, Karnataka , India
Phone: 091-080-26094000 , Fax: 091-080-6560723, e-mail:kidwai@nic.in
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