Awareness on Cancer what are the causes for cancer Terminology Classification of Cancers Signs and Symptoms Stages of Cancers (TSM) Types of Cancer Treatments Surgery, Chemotherapy, Radiation Therapy etc Side effects on treatment Palliative care

1. Dr. A. Amsavel, M.Sc., Ph.D

2. An Overview
 What is cancers
 Terminology
 Classification of Cancers
 Signs and Symptoms
 Signs and Symptoms
 Stages of Cancers (TSM)
 Types of Cancer Treatments
 Surgery, Chemotherapy, Radiation Therapy etc
 Side effects on treatment
 Palliative care

3. Know About Cancer
Cancer is the second leading cause of death globally, As of 2019,
about 18 million new cases occur annually. Annual death 8.8
million due to Cancer(15.7% of deaths)
The most common cancers are:
 Lung (2.09 million cases) (1.76 million deaths)
 Breast (2.09 million cases) (627 000 deaths)
 Colorectal (1.80 million cases) (862 000 deaths)
 Prostate (1.28 million cases)
 Skin cancer (1.04 million cases)
 Stomach (1.03 million cases) (783 000 deaths)
 There are over 200 different types of cancers
 Tobacco use is responsible for approx. 22% of cancer deaths
 10% is due to behavioral & dietary risks: obesity, poor diet, lack of physical activity,
excessive alcohol
 5-10% of cancers are due to inherited genetic defects.
 15% of cancers are due to infections / viruses

4. What is Cancer?
 Cancer is the uncontrolled growth of abnormal cells in the body.
Cancer develops when the body’s normal control mechanism stops
working. Old cells do not die and instead grow out of control, forming
new, abnormal cells.
 Immune system normally removes damaged or abnormal cells from
 Immune system normally removes damaged or abnormal cells from
the body, some cancer cells are able to “hide” from the immune
system.
 These extra cells may form a mass of tissue, called a tumor.
 Some cancers, such as leukemia, do not form tumors.
 The cancerous cells can invade and destroy surrounding healthy
tissue, including organs

5. Mutation of Gene
 Cancer cells have more genetic changes,
such as mutation in DNA, than normal
cells.
 Cancer is a genetic disease- means, it is
 Cancer is a genetic disease- means, it is
caused by changes to genes that control
the way our cells function,
 Genetic changes that cause cancer can
be inherited from our parents. Also can
arise due to errors that occur as cells
divide or because of damage to DNA

6. Normal Cells & Cancer Cells

7. How Normal Cells Become Cancer Cells.
 Before cancer cells form in tissues of the body, the normal cells go through
abnormal changes called Hyperplasia and Dysplasia.
 In hyperplasia, there is an increase in the number of cells in an organ or
tissue that appear normal under a microscope. In dysplasia, the cells look
abnormal under a microscope but are not cancer. Some of the Hyperplasia
and dysplasia may become cancer.
and dysplasia may become cancer.

8. How Cancer Cells Helps to Grow Tumor
Cancer cells can induce nearby normal cells to form
blood vessels that to supply oxygen & nutrients to
Tumors to grow.

9. Know the Terminology
Metastasis: Process that Cancer (primary tumor) begins in one part of
the body before spreading to other areas. Metastases are a major
cause of death from cancer.
Oncology: The branch of medicine dedicated to diagnosing, treating
and researching cancer is known as oncology
Lymph nodes are small, bean-shaped collections of immune cells
Biopsy,: removes a tumor or pieces of a tumor to test in pathology lab
to test for type of cell / cancer .
Neoplasms (not cancer) may grow large (tumor) but do not spread
into, or invade, nearby tissues or other parts of the body.
Malignant ( cancer tumor ) can spread into, or invade, nearby tissues.

10. Most Common Types of Cancers
 The most common types of cancer in males are;
 Lung Cancer, Prostate Cancer, Colorectal Cancer &
Stomach Cancers, skin cancers etc.
 the most common types cancers in females are
 the most common types cancers in females are
 Breast cancer, colorectal cancer, lung cancer, and cervical
cancer , skin cancers etc
 Common in childrens,
 Acute Lymphoblastic Leukemia & Brain Cancer, non-
Hodgkin Lymphoma, etc

11. Classification of Cancer
There are five main categories of cancer based on types of
cancer cell;:
1. Carcinomas begin in the skin or tissues that line the internal
organs.
2. Sarcomas develop in the bone, cartilage, fat, muscle or other
connective tissues.
3. Leukemia begins in the blood and bone marrow.
4. Lymphomas start in the immune system.
5. Central nervous system cancers develop in the brain and
spinal cord.

12. Signs and Symptom of Cancer
Changes to your body's normal processes or unusual, unexplained
Symptoms can sometimes be an early sign of cancer.
Person has to Check with doctor, in case of below symptoms..
 Unexplained weight loss, persistent fever
 Blood in your poo, urine, vomit, prolonged cough
 A lump that suddenly appears on your body / breast
 A lump that suddenly appears on your body / breast
 Unexplained bleeding / bleeding between periods
 Changes to your bowel habits
 Diarrhea or constipation for no obvious reason
 A feeling of not having fully emptied your bowels
 Pain in your stomach or back passage (anus)
 Changes shape or looks uneven mole(s)
 Changes colour, gets darker or has more than 2 colours of mole(s)

13. Signs and Symptom of Cancer

14. What causes cancer?
 Normal cells transforms into tumour (cancer)
cells in a multistage
 Cause for Cancer could be due
 Genetic factors (~ 5%) eg. Colon, uterus,
breast & ovarian cancers are most probable
 Three categories of external factors (90-95%)
 Three categories of external factors (90-95%)
 Physical carcinogens,: Excessive exposure
of ultraviolet and ionizing radiation;
 Chemical carcinogens: Exposure such as
asbestos, tobacco smoke, aflatoxin (a food
contaminant), Benzene, and arsenic
 Biological carcinogens, such as infections
from certain viruses, bacteria, or parasites.

15. Aware the Risk Factors and Reduce
Modifying or avoiding key risk factors can significantly reduce the burden of cancer.
 Tobacco use including cigarettes and smokeless tobacco
 Overweight or obese
 Unhealthy diet with low fruit and vegetable intake or use of red, processed meats
 Lack of physical activity
 Alcohol use
 Infection by hepatitis or other carcinogenic infections
 Ionizing and excessive exposure ultraviolet radiation
 Urban air pollution
 Indoor smoke from household use of solid fuels.
 Exposure of carcinogenic chemicals such as Pesticides
 Hormonal drugs &Immune-suppressing drugs

16. Diagnosis & Tests
Different types of exams and tests can be used to find out a cancer’s stage.
 Physical exam may give some idea as to where & how much cancer is there.
 Imaging tests like X-rays, CT scans, MRIs, ultrasound, and PET scans may also
give information about how much and where cancer is in the body.
 Endoscopy may be used to look for cancer. A thin, lighted tube (usually with a small
video camera on the end) is put inside the body to look for cancer.
video camera on the end) is put inside the body to look for cancer.
 Colonscopy: Exam to detect changes or abnormalities in the large intestine (colon)
and rectum, by inserting tiny video camera
 Biopsy is also needed to find out the spread of cancer. Remove a tumor or pieces of
a tumor and test the specimen. cells or tissues for examination under a microscope.
 Lab tests: test for cancer cells and blood tests can also be used to help stage some
types of cancer.

17. What are the Types of Cancer Curable ?
 Potential for cure among early detectable cancers
Some of the cancer types, such as breast cancer,
cervical cancer, oral cancer, and colorectal cancer have
high cure rates when detected early and treated
high cure rates when detected early and treated
appropriately.
 Potential for cure of some other cancers
Some cancer types, even when cancerous cells have
traveled to other areas of the body, such as testicular
seminoma and leukaemias and lymphomas in children,
can have high cure rates if treated appropriately.

18. Stages of Cancer
Stage What it means
Stage 0
Abnormal cells are present but have not
spread to nearby tissue. Also called carcinoma
in situ, or CIS.
CIS is not cancer, but it may become cancer.
CIS is not cancer, but it may become cancer.
Stage I,
Stage II, &
Stage III
Cancer is present. The higher the number, the
larger the cancer tumor and the more it has
spread into nearby tissues.
Stage IV
The cancer has spread to distant parts of the
body.

19. What are the stages of Cancer?
Stages: The TNM system
In the TNM system, the overall stage is determined after
the cancer is assigned a letter or number to describe the
Tumor (T), Node (N), and Metastasis (M) categories.
Tumor (T), Node (N), and Metastasis (M) categories.
 T describes the original (primary) tumor.
 N tells whether the cancer has spread to the nearby
lymph nodes.
 M tells whether the cancer has spread (metastasized) to
distant parts of the body

20. Stage: Primary Tumor (T)
The primary tumor (T category)
 TX means there’s no information about the primary tumor, or it can’t
be measured.
 T0 means there is no evidence of a primary tumor (can’t be found).
 Tis means that the cancer cells are only growing in the layer of cells
where they started, without growing into deeper layers. This may
also be called in situ cancer or pre-cancer.
 T1, T2, T3, or T4 might describe the tumor size and/or amount of
spread into nearby structures. T4 -the larger the tumor and/or the
more it has grown into nearby tissues.
 T's may be further divided to provide more detail, such as T3a and T3b.

21. Stage: Lymph Nodes (N)
The lymph nodes (N category)
 Lymph nodes are small, bean-shaped collections of immune cells.
Many types of cancer often spread to nearby lymph nodes before
they reach other parts of the body.
 NX means there’s no information about the nearby lymph
 NX means there’s no information about the nearby lymph
nodes, or they can’t be assessed.
 N0 means nearby lymph nodes do not contain cancer.
 N1, N2, or N3- describe the size, location, and/or the
number of nearby lymph nodes affected by cancer.
 N3 is greater the cancer spread to nearby lymph nodes.

22. Stage: Metastasis (M)
Metastasis (M category)
 Cancer spread to parts of the
body far from the primary
tumor is known as metastasis.
tumor is known as metastasis.
 M0 means that no distant
cancer spread has been found.
 M1 means that the cancer has
been found to have spread
to distant organs or tissues.

23. Stages and Survival Rates
 Pognosis (projection) is often expressed as a survival rate for
many types of cancer.
 This is the percentage of people with a certain type and stage
of cancer who are still alive a certain amount of time (usually 5
years) after being diagnosed.
years) after being diagnosed.
 For example, if the 5-year survival rate for a certain stage of a
type of cancer is 80%, it means that 80 out of 100 people who
have that type and stage of cancer will still be expected to be
alive after 5 years.
 Survival rates can’t tell for sure what will happen with any
particular person, because many other factors can also affect
prognosis

24. Cancer Treatments
Treatment options for Cancer.
 The best Possible treatment for an early-stage cancer
may be Surgery or Radiation
 Advanced-stage cancer may need treatments that reach
 Advanced-stage cancer may need treatments that reach
all parts of the body, such as Chemotherapy (chemo),
Targeted therapy, Immunotherapy or Hormone therapy
 Surgery : Directly removing the tumor
 Chemotherapy: using Drugs to kill cancer cells
 Radiation Therapy: using X-rays to kill cancer cells

25. Chemotherapy
 Chemotherapy is one of the most common treatment options for many
cancers. These anti-cancer drugs work by targeting rapidly growing cancer
cells either throughout the body or in a specific area of the body.
 When chemotherapy drugs travel through the bloodstream to reach cancer
cells, it's known as systemic chemotherapy. When the drugs are directed
to a specific area of the body, it's called regional chemotherapy.
 Chemotherapy may be used:
 As a primary treatment to destroy cancer cells
 Before another treatment to shrink a tumor
 After another treatment to destroy remaining cancer cells
 To relieve symptoms of advanced cancer
Drugs :

26. Chemotherapy Treatment
Chemotherapy drugs administered as below;
 Oral: In pill or liquid form are taken by mouth
 Infusion: Delivered directly into a vein through an intravenous
drip, may take several hours.
drip, may take several hours.
 Injection: Delivered through a needle injected into a vein,
muscle or under the skin
 Topically: In cream form and are spread on the skin
 Intrathecal: Delivered directly into the central nervous system
 Intraperitoneal: Given directly into the abdominal cavity

27. Side Effects of Chemotherapy
Vomiting, diarrhea and or hair loss are common
side effects of chemotherapy.
Also other Side effects
 Fever
 Fatigue
 Loss of appetite
 Mucositis, or mouth sores
 Anemia
 Constipation
 Neuropathy
 Memory loss, or difficulty concentrating

28. Radiation Therapy
There are three types of radiation therapies
1) External beam radiation therapy
 External beam radiation therapy (EBRT) directs a beam of radiation
from outside the body at cancerous tissues inside the body.
 Uses doses of radiation to destroy cancerous cells and shrink
tumors.
Side effects of radiation therapy :
 Skin reactions,
 Fatigue,
 Lymphedema

29. Radiation Therapy
2) Internal radiation therapy (also referred as brachytherapy),
 Radioactive material is placed into a catheter or another implantable
device, which carries the radiation directly into or near a tumor.
 Implanting the device is generally painless, and the implants may be
temporary or permanent.
 IRT treatment for prostate Cancer, Cervical Cancer, Head&neck
Cancer and Gynecological cancers.
3) Intraoperative radiation therapy (IORT)
 Delivers a concentrated dose of radiation to the site of a tumor during
surgery.
 IORT may help reduce side effects and the need for additional
radiation treatments.

30. Systemic Radiation Therapy
 Used to treat certain cancers such as Thyroid, bone and
prostate.
 It is delivered via radioactive drugs, or radiopharmaceuticals,
orally or through an injection.
 Radioactive iodine is used to treat thyroid cancers, absorbs
most of the iodine, and is often given after Thyroid surgery to
destroy remaining cancerous tissues.
 Excess radioactive materials leave the body through urine,
saliva and other fluids, special precautions are taken, it may
affect the people around the patient.

31. Other Types of Cancer Treatments
 Immunotherapy: Also known as biological therapy, stimulating or helping
the immune system to fight cancer. Antibodies ( cloning unique white blood
cells). Adoptive cell transfer from others
 Hormone therapy: Some types of cancer are fueled by your body's
hormones. Examples breast cancer and prostate cancer. Removing those
hormones from the body or blocking their effects may cause the cancer cells
to stop growing.
 Targeted drug therapy: Targeted drug treatment focuses on specific
abnormalities within cancer cells that allow them to survive.
 Bone marrow transplant: Your bone marrow (inside bones) that makes
blood cells from blood stem cells. A bone marrow transplant, also knowns as
a stem cell transplant, can use of ones own bone marrow stem cells or those
from a donor.

32. Is cancer treatment effective
 Each persons cancer has unique combination of genetic changes. Specific
genetic changes may make persons cancer more or less likely to respond to
treatments

33. Palliative care
 Palliative care is specialized medical care
 Aims is to focuses on providing patients relief from pain
and improve the quality of life for both patients and their
families.
 It is treatment that attempts to help the patient feel better
and may be combined with treatment of cancer.
 It includes action to reduce physical, emotional, spiritual
and psycho-social distress.
 Attempts to help the patient cope with their immediate
needs and to increase comfort.

34. References
 https://www.cancercenter.com/cancer-types
 https://www.cancer.org/cancer/cancer-basics/what-is-cancer.html
 https://www.cancer.org/
https://www.cancer.org/
 https://www.nhs.uk/conditions/cancer/
 https://www.cancer.gov/about-cancer/
 https://www.mayoclinic.org/diseases-conditions/cancer/
 https://en.wikipedia.org/wiki/Cancer#Immunotherapy