Could Cancer Be Prevented ?!

Dr.Hisham Abid Aldabbagh

MSc. Internal Medicine

Kingdom of Saudi ArabiaMinistry of HealthDirectorate of Health Affairs in GurayatGurayat General Hospital

Cancer Definition

• Cancer refers to a large number of diseases characterized by the proliferation of abnormal cells irregularly, which have the ability to penetrate and destroy normal body tissue.

• Cancer also has the potential to spread throughout the body.

• Cancer is the second leading cause of death in the United States.

The risk of cancer occurrence

• Calculated at the age of 75 years, the risk of any type of cancer is:

• 1 in 4 women and 1 out of every 3 men.

• The risk of common cancers

• - Prostate 1 out of every 9 men

• - Breast 1 out of every 11 women

• - Colorectal 1 out of every 28 people

• - Skin (melanoma) 1 out of every 31 people

• - Lung 1 out of every 42 people

Report on the Incidence of Cancer Cases in Saudi Arabia in 2010

• Between January 1 and December 31, 2010

• The total number of cancer cases reported to the Saudi Council of cancer was 13706.

• The total cancer cases are more among women than men.

• 6579 (48%) males and 7127 (52%) females.

• 10230 case among Saudis

• 3265 among non-Saudis

• 211 of unknown nationality.

Report on the Incidence of Cancer Cases in Saudi Arabia, 2012

• Between January 01 and December 31, 2012,

• Total number of cancer incident cases reported to the Saudi Cancer Registry (SCR) was 14,846.

• Overall cancer cases were more among women than men;

• 7,048 (47.5%) males and 7,798 (52.5%) females.

• Total of 11,333 cases were reported among Saudis

• 3,393 among Non-Saudis

• 120 of Unknown Nationality.

General incidence rate of all cancers among Saudi Arabia's population

20122010

55.6/100,000 50.8/100,000 among males 60.3/100,000 among females.

53.4 / 100,00048.2 / 100,000 among males58.6 / 100,000 among females.

Distribution of 20 most common malignancies 2012

MALE

HODGKIN’S LYMPHOMA 40 (4.0%) LEUKEMIA 111 (11.2%)

ORAL CAVITY 38 (3.8%) COLON, RECTUM 87 (8.8%)

STOMACH 35 (3.5%)NHL 71 (7.2%) LIVER 58 (5.8%)

SOFT TISSUE 33 (3.3%) LIVER 58 (5.8%)

PROSTATE 28 (2.8%) THYROID 55 (5.5%)

BONE 26 (2.6%) CNS 52 (5.2%)

PANCREAS 23 (2.3%) LUNG, BRONCHUS 50 (5.0%)

OTHER HEMATOPOIETIC 23 (2.3%) KIDNEY, URINARY 45 (4.5%)

ESOPHAGUS 16 (1.6%) NASOPHARYNX 42 (4.2%)

OTHER SKIN CA 14 (1.4%)BLADDER 41 (4.1%)

FEMALE

BRAIN, CNS 33 (2.5%) BREAST 352 (27.2%)

SOFT TISSUE 29 (2.2%)THYROID 171 (13.2%)

KIDNEY, URINARY 29 (2.2%) LEUKEMIA 97 (7.5%)

BONE 24 (1.9%)COLON, RECTUM 76 (5.9%)

LIVER 23 (1.8%)CORPUS UTERI 65 (5.0%)

STOMACH 19 (1.5%)NHL 59 (4.6%)

PANCREAS 19 (1.5%)HODGKIN’S LYMPHOMA 47 (3.6%)

OTHER SKIN CA 15 (1.2%)ORAL CAVITY 41 (3.2%)

LUNG, BRONCHUS 14 (1.1%)OVARY 40 (3.1%)

NASOPHARYNX 13 (1.0%)CERVIX UTERI 33 (2.5%)

Predisposing risk factors of cancer

• Age,

- most patients with cancer are aged 65 years or more, but the cancer can occur at any age.

• Smoking,

- increases the risk of cancer in smokers several times higher than non-smokers, and the risk increases the more the duration of smoking increased or the amount of smoking in the day. Even passive smoking increases the risk of cancer.

- tobacco use is the most important risk factor for cancer, and causes about 20% of cancer deaths, and about 70% of lung cancer deaths.

• Drinking alcohol,

- leads to increased risk of cancers of the digestive tract.

• Excessive exposure to the sun or frequent sun burns,

- lead to an increased risk of skin cancers (melanoma).

• Obesity and non-healthy diet and physical inactivity,

- are major risk factor for cancer, and lead to an increased risk of cancers of the colon.

• Unprotected and illegal sex

- lead to an increased risk of cancers of the genital system.

• Genetics,

- only have a small role; cancers occur due to genetics especially cancers of the blood.

• Environment,

- may contain harmful chemicals that can increase the risk of cancer. Chemicals such as asbestos and benzene, are also associated with an increased risk of cancer.

• Some pathological conditions and biological factors,

• - Ulcerative colitis, predisposes to colon cancer.

• - Infection with the human papillomavirus HPV increases cervical cancer.

• - EBV virus can be significantly increases the risk of developing certain types of cancer.

• - Hepatitis B (HBV), and hepatitis C increase the risk of liver cancer.

• - Infection with HIV dramatically increases the risk of skin cancers and lymphoma.

• Ionizing radiation and non-ionizing radiation from mobile phones .

• Some pollutants, food colorants and additives in the food industry.

• Air pollution in cities, can increase the risk of some cancers.

How to reduce the burden of cancer?

• Effective education to disseminate the knowledge about the predisposing factors of cancer, for early detection of cancer, a timely intervention to prevent disease progression, and management of patients with cancer.

- Many types of cancer have a high chance of cure if detected early and treated adequately

• Modulate and avoid risk factors

- More than 30% of cancer deaths can be prevented by modifying or avoiding key risk factors

Cancer Prevention Strategies

• Avoid the predisposing risk factors that increase cancer occurrence.

• Vaccination against human papilloma virus (HPV) and hepatitis B (HBV)

• Occupational risk control.

• Avoid excessive exposure to sunlight by staying in the shade, wear protective clothing or applying sunscreen.

• Reduce exposure to radiation (diagnostic imaging medical or professional) ionizer.

• Exercise most days of the week, regular exercise for at least 30 minutes a day.

Early detection

• Can reduce cancer deaths if the case detected and treated early.

• This can be done by early diagnosis through the following

- Detect the early signs and symptoms (for different types of cancer, such as skin, cervical, breast and colorectal cancer, bronchus and throat) in order to start the suitable investigations for diagnosis and consequently apply the required treatment at an early stage.

Periodic detection

• Periodic detection, aims to identify individuals with disorders suggest a specific cancer or pre-cancerous stage, and immediately referred for diagnosis, or when it is possible for diagnosis and treatment.

• Periodic detection programs are particularly effective for some types of cancer, acceptable and accessible to the majority of the population at risk.

• Examples of detection programs are:

• HPV test for cervical cancer.

• PAP smear to investigate cervical cancer.

• mammography to detect breast cancer.

• Colonoscope for the detection of colorectal cancer

CANCER PREVENTION RECOMMENDATIONS

• 1- Be as lean as possible without becoming underweight.

• 2- Be physically active for at least 30 minutes every day. Limit sedentary behavior.

• 3- Avoid sugary drinks. Limit consumption of energy-dense foods.

• 4- Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.

• 5- Limit consumption of red meats (such as beef, pork and lamb) and avoid processed

• 6- Avoid alcoholic drinks.

• 7- Limit consumption of salty foods and foods processed with salt (sodium).

• 8- Don't rely on supplements to protect against cancer.

• 9- NEW MOTHERS: Breastfeed babies exclusively for up to 6 months and then add other liquids and foods.

• 10- CANCER SURVIVORS: After treatment, follow the recommendations for cancer prevention.

• And always remember — do not smoke or chew tobacco.

•

Innovation

• Open a new clinic named : Periodic Disclosure Clinic

• Tasks:

- Application of accredited cancer preventive programs

- Application of accredited preventive programs of other conditions

- Follow up of the results and outcomes of these programs

- Coordinate with other clinics and departments about the detected diseases for the proper and timely management

Dear Colleagues,

Du You Think That Cancer Could Be Prevented ?!

I believe Yes

Thanks for Your Interest

Email: dr.hishamdabbagh@gmail.com

Email: haldabag@moh.gov.sa