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CANCER INTRODUCTION Cancer is a complex genetic disease that is caused primarily by environmental factors.

The cancer-causing agents(carcinogens) can be present in food and water, in the air,and in chemicals and sunlight that people are exposed to. Since epithelial cells cover the skin, line the respiratory and alimentary tracts, and metabolize ingested carcinogens, it is not surprising that over 90% of cancers occur in epithelia. The causes of serious ill-health in the world are changing. Infection as a major cause is giving way to no communicable diseases such as cardiovascular disease and cancer. In 1996 there were 10 million new cancer cases worldwide and six million deaths attributed to cancer. In 2020 there are predicted to be 20 million new cases and 12 million deaths. Part of the reason for this is that life expectancy is steadily rising and most cancers are more common in an ageing population. More signicantly, a globalization of unhealthy lifestyles, particularly cigarette smoking and the adoption of many features of the modern Western diet (high fat, low bre content) will increase cancer incidence.Tobacco use and diet each account for about 30% of new cancer cases, with infection associated with a further 15%; thus, much of cancer is preventable. No individual can guarantee not to contract the disease, but it is so strongly linked to diet and lifestyle that there are plenty of positive steps that can be taken to reduce the chances: eat more fruit and vegetables, reduce the intake of red meat and denitely do not smoke. Carcinogens interact with the individuals constitution, both inherited and acquired, determining vulnerability to cancer induction. This vulnerability is based on how an individual deals with the carcinogens, ideally eliminating them in a harmless form before they do any genetic damage or being able to repair that damage. The science of classical epidemiology has identied populations at high
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CANCER cancer risk (e.g. users of tobacco products). However, many lifelong smokers do not get cancer, perhaps because of the way they handle potentialcarcinogens metabolically, and the relatively new science of molecular epidemiology attempts to identify high-risk individuals within populations, such as smokers. Many issues concerning diet and cancer are controversial (e.g. fat intake and breast cancer). This may be because only certain polyunsaturated fatty acids generate damaging free radicals; furthermore, the intake level of antioxidant vitamins that can scavenge these harmful radicals is a confounding factor. Reducing infection, particularly in the poorer countries, will lead to reductions in cancer incidence. Infectious agents associated with increased cancer risk include hepatitis B virus (liver), certain subtypes of human papillomavirus (cervix), the bacterium Helicobacter pylori (stomach) and human immunode-ciency virus (many sites).The management of patients with cancer is costly, but there is the daunting prospect that 70% of tomorrows patients are likely to live in countries that between them have only 5% of global resources. Huge steps in improving the prognosis of patients with cancer are almost immediately achievable with present-day technology and sucient nancial resource, and all essentially relate to early detection. Cancer does not develop overnight, instead often evolving over many years with detectable premalignant lesions presaging the development of full-blown malignancy. Malignant tumours not only invade surrounding tissue, but are able to colonize other, often vital,organs, a process known as metastasis. Widespread metastatic disease is usually a harbinger of imminent patient death. Thus, immediate referral to the oncologist after detection of any suspicious lump or symptom is paramount; in many parts of the world with poor health education patients present with very advanced disease. In the same vein, cancer screening programmes are designed to detect not only early asymptomatic
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CANCER malignant tumours but also premalignant lesions. Even in the richer countries, such programmes are a signicant nancial burden, and the more cost-eective programmes target the higher-risk groups denoted by age (e.g. cervical screening, mammography, colonoscopy) or occupation (e.g. blood in the urine of dye workers for bladder cancer)

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CANCER HISTORY Oldest Descriptions Of Cancer Human beings and other animals have had cancer throughout recorded history. So its no surprise that from the dawn of history people have written about cancer. Some of the earliest evidence of cancer is found among fossilized bone tumors, human mummies in ancient Egypt, and ancient manuscripts. Growths suggestive of the bone cancer called osteosarcoma have been seen in mummies. Bony skull destruction as seen in cancer of the head and neck has been found, too. Our oldest description of cancer (although the word cancer was not used) was discovered in Egypt and dates back to about 3000 BC. It is called the Edwin Smith Papyrus and is a copy of part of an ancient Egyptian textbook on trauma surgery. It describes 8 cases of tumors or ulcers of the breast that were treated by cauterization with a tool called the fire drill. The writing says about the disease, There is no treatment. Origin Of The Word Cancer The origin of the word cancer is credited to the Greek physician Hippocrates (460370 BC), who is considered the Father of Medicine. Hippocrates used the terms carcinos and carcinoma to describe non-ulcer forming and ulcer-forming tumors. In Greek, these words refer to a crab, most likely applied to the disease because the finger-like spreading projections from a cancer called to mind the shape of a crab. The Roman physician, Celsus (28-50 BC), later translated the Greek term into cancer, the Latin word for crab. Galen (130200 AD), another Roman physician, used the word oncos (Greek for swelling) to describe tumors. is now used as a part of the name for cancer specialists oncologists.
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CANCER TYPES OF CANCER

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CANCER CANCER SIGNS AND SYMPTOMS Cancer symptoms are changes in the body caused by the presence of cancer. They are usually caused by the effect of a cancer on the part of the body where it is growing, although the disease can cause more general symptoms such as weight loss or tiredness. It is advisable that anyone experiencing unusual symptoms that are not normal for them for more than a few weeks should seek medical attention.

There are more than 200 different types of cancer with a wide range of different signs and symptoms, making it difficult to produce a definitive list. For information about the specific signs and symptoms of a specific type of cancer, please see the Wikipedia entry for that disease. Typical symptoms of cancer include:

The presence of an unusual lump in the body Changes in a mole on the skin A persistent cough or hoarseness A change in bowel habits, such as unusual diarrhea or constipation Difficulty in swallowing or continuing indigestion Any abnormal bleeding, including bleeding from the vagina, or blood in urine or faeces

A persistent sore or ulcer Difficulty passing urine Unexplained weight loss

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CANCER

Unexplained pain Unexplained tiredness or fatigue Skin changes such as an unexplained rash or unusual texture Unexplained night sweats

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CANCER CAUSES OF CANCER

From the table above we see that almost 70% of cancers are believed to be caused by Environmental factors - which mean these cancers should be preventable. However it is not always possible to link a particular cancer-causing substance (carcinogen) and a cancer as there is usually a long interval latent period - between the exposure and the cancer.

SMOKING It is very clear from the table that the link between cancer and smoking is very strong. In addition to the cancer deaths caused by smoking there are deaths from lung, heart and blood vessel diseases caused by smoking. The risk of dying of lung cancer is directly related to the number of cigarettes smoked, age at starting, and smoking habits (how many puffs per cigarette, length of butt left, type of cigarette including filter and tar content). The risk of developing

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CANCER cancers for those who stop smoking gradually falls and after 15 years is similar to those who have never smoked.

FOOD There is a wide difference in the incidence of cancers in different parts of the world. Part of these differences can be attributed to food habits. However the relationship between food and cancers is not as clear as between smoking and cancers. General guidelines on healthy eating would include the

followingrecommendations: Reduce the amount of animal fats consumed. Increase roughage by consuming more unprocessed cereals. Take reasonable amounts of fresh fruits and vegetables. Maintain reasonable body weight.

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CANCER FOOD WRAPPINGS, FOOD ADDITIVES AND PESTICIDES There is no clear association between these and cancers. The following recommendations, though not based on firm scientific foundations, seem reasonable: Reduce the intake of preserved foods. Avoid food additives. Avoid or quickly unwrap food covered with polyvinyl chloride(cling film) wrapping. Wash fruits and vegetables to remove pesticides.

OCCUPATION CAUSES Much of our early understanding of the causes of cancer came from studies of the risks in industry. There is little doubt that exposure to certain chemicals increases the risk of developing cancers. The jobs carrying the greatest risks are those in the petro-chemical industries involving exposure to tars and certain inorganic chemicals. The link between asbestos exposure and lung cancer is well established.

RADIATION AND HIGH VOLTAGE POWER LINES Major studies into the risks of people living close to nuclear power stations or high voltage lines have, suggested that at worst there may be some minor increase of leukemia, though no of other tumors.

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VIRUSES Long term infections with the Hepatitis B & C viruses are well established as causing liver cancers. Hepatitis B vaccination is being carried out to reduce this risk. Less established are the relationship between Herpes Simplex Type ll and cervical cancers. The HIV linked to AIDS may allow cancers to grow by suppressing the immune system.

INHERITANCE For most people with cancer, there is no direct inherited cause. Our genetic make-up may increase our chances of developing a cancer upon exposure to certain carcinogens. This may explain why some people who smoke develop lung cancers and others done. There are certain inherited conditions which run in families where the risk of developing a particular type of cancer is high. One such condition is called Multiple Ployposis Coli where multiple fleshy growths in the large intestine may be found in many members of the same family. There is a great risk that these growths could turn malignant and removal of the large intestine is recommended

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CANCER CANCER SURVIVORS: MANAGING EMOTIONS AFTER CANCER TREATMENT When you began your cancer treatment, you couldn't wait for the day you'd finish. But now that you've completed your treatment, you aren't sure if you're ready for life after treatment as a cancer survivor. With your treatment completed, you'll likely see your cancer care team less often. Though you, your friends and your family are all eager to return to a more normal life, it can be scary to leave the protective cocoon of doctors and nurses who supported you through treatment. Everything you're feeling right now is normal for cancer survivors. Recovering from cancer treatment isn't just about your body it's also about healing your mind. So take time to acknowledge the fear, grief and loneliness you're feeling right now. Then take steps to understand why you feel these emotions and what you can do about them. Fear of recurrence in cancer survivors Fear of recurrence is very common in cancer survivors. Though they may go years without any sign of disease, cancer survivors say the thought of recurrence is always with them. You might worry that every ache or pain is a sign of your cancer recurring. Eventually these fears will fade, though they may never go away completely. Cope with your fear by being honest with yourself about your feelings. Try not to feel guilty about your feelings or ignore them in hopes that they'll go away. Ask your doctor about what you can do to reduce your chance of a cancer recurrence. Once you've done all you can to reduce that risk, acknowledge your fears. Take control of those fears and do what you can to influence your future health. Try to:

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CANCER Take care of your body. Focus on keeping yourself healthy. Eat a healthy diet with plenty of fruits and vegetables. Fit exercise into your day. Go easy at first, but try to increase the intensity and amount of exercise you get as you recover. Get enough sleep so that you wake feeling refreshed. These actions may help your body recover from cancer treatment and also help put your mind at ease by giving you a greater sense of control over your life. Go to all of your follow-up appointments. You may fear the worst when it's time for your next follow-up appointment. Don't let that stop you from going. Use the time with your doctor to ask questions about any signs or symptoms that worry you. Write down your concerns and discuss them at your next appointment. Ask about your risk of recurrence and what signs and symptoms to watch for. Knowing more may help you feel more in control. Be open about your fears. Express your concerns to your friends, family, other cancer survivors, and your doctor or a counselor. If you're uncomfortable with the idea of discussing your fears, try recording your thoughts in a journal. Keep busy. Get out of the house and find activities that will take your mind off your fears. Most cancer survivors report that the fear of recurrence fades with time. But certain events can trigger your fears. The feelings might be especially strong before follow-up visits to your doctor or the anniversary of your cancer diagnosis.

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CANCER STRESS IN CANCER SURVIVORS When you were diagnosed with cancer, you might have focused completely on your treatment and getting healthy. Now that you've completed treatment, all those projects around the house and the things on your to-do list are competing for your attention. This can make you feel stressed and overwhelmed. Dont feel you need to do everything at once. Take time for yourself as you establish a new daily routine. Try exercising, talking with other survivors and taking time for activities you enjoy. DEPRESSION AND ANXIETY IN CANCER SURVIVORS Lingering feelings of sadness and anger can interfere with your daily life. For many people these feelings will dissipate. But for others, these feelings can develop into depression. Tell your doctor about your feelings. If needed, you can be referred to someone who can help you through talk therapy, medication or both. Early diagnosis and prompt treatment are keys to successfully overcoming depression

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CANCER CANCER TREATMENT Treatment options depend on the type of cancer, the stage of cancer, certain characteristics of the cancer cells and your general state of health. Your physician will also consider your personal wishes and goals when planning your treatment with you. Treatment for cancer can be either local or systemic, depending on your diagnosis. Local treatments affect cancer cells in the tumor and the area near it. Systemic treatments travel through the bloodstream, reaching cancer cells all over the body. Surgery and radiation therapy are types of local treatment. Chemotherapy, hormone therapy and biological therapy are examples of systemic treatment.

Types of treatment

Surgery Surgery is therapy to remove the cancerous tumor; the surgeon may also remove some of the surrounding tissue and lymph nodes near the tumor. Sometimes surgery is done on an outpatient basis, or the patient may have to stay in the hospital.

Radiation therapy Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. For some types of cancer, radiation therapy may be used instead of surgery as the primary treatment. Radiation therapy also may be given before surgery (neoadjuvant therapy) to shrink a tumor so that it is easier to remove. In other cases, radiation therapy is given after surgery (adjuvant therapy) to destroy any cancer cells that may remain in the area.

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CANCER Radiation also may be used alone, or along with other types of treatment, to relieve pain or other problems if the tumor cannot be removed.

Chemotherapy Chemotherapy is the use of drugs to kill cancer cells. The doctor may use one drug or a combination of drugs.

Hormone therapy Hormone therapy is used against certain cancers that depend on hormones for their growth. Hormone therapy keeps cancer cells from getting or using the hormones they need. This treatment may include the use of drugs that stop the production of certain hormones or that change the way they work.

Regional perfusion therapy Perfusion therapy is a new treatment that involves administering chemotherapy directly to the organ or area affected by cancer. Perfusion is used most commonly in treating sarcoma and melanoma in the limbs, colorectal cancer, liver cancer, and cancers of the pleura. The treatment has been shown to be more effective for certain cancers than traditional chemotherapy, while avoiding many of chemotherapy's side-effects.

Biological therapy Biological therapy (also called immunotherapy) helps the body's natural ability (immune system) to fight disease or protects the body from some of the side effects of cancer treatment. Monoclonal antibodies, interferon, interleukin-2 and cancer vaccines are some types of biological therapy.

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Stem cell transplantation Stem cell transplantation (SCT) may also be used in cancer treatment. The transplant may be autologous (the person's own cells that were saved earlier), allogeneic (cells donated by another person), or syngeneic (cells donated by an identical twin).

Clinical trials Clinical trials (research studies) offer important treatment options for many people with cancer. Research studies evaluate promising new therapies and answer scientific questions. The goal of such trials is to find treatments that are more effective in controlling cancer with fewer side effects.

Many people with cancer want to take an active part in decisions about their medical care. They want to learn all they can about their disease and their treatment choices. However, the shock and stress that people often feel after a diagnosis of cancer can make it hard for them to think of everything they want to ask the doctor. Often it is helpful to prepare a list of questions in advance. To help remember what the doctor says, patients may take notes or ask whether they may use a tape recorder. Some people also want to have a family member or friend with them when they talk to the doctor -- to take part in the discussion, to take notes, or just to listen.

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CANCER These are some questions a patient may want to ask the doctor before treatment begins:

What is my diagnosis? Is there any evidence the cancer has spread? What is the stage of the disease? What are my treatment choices? Which do you recommend for me? Why? What new treatments are being studied? Would a clinical trial be appropriate for me?

What are the expected benefits of each kind of treatment? What are the risks and possible side effects of each treatment? Is infertility a side effect of cancer treatment? Can anything be done about it? What can I do to prepare for treatment? How often will I have treatments? How long will treatment last? Will I have to change my normal activities? If so, for how long? What is the treatment likely to cost?

Patients do not need to ask all their questions or remember all the answers at one time. They will have many chances to ask the doctor to explain things and to get more information.

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CANCER CONCLUSION Tremendous strides have been made in reducing the rate of cervical cancer. However, women continue to be afflicted by a disease that is potentially preventable and curable. The women who remain most susceptible to the development of cervical cancer are those who are lost to screening or who do not receive screening at all. Therefore, family physicians must remain vigilant by screening all appropriate women with routine Pap smears.

Research is under way to find ways to prevent cervical cancer. The focus of this research is on HPV. Highly antigenic recombinant vaccines without potentially carcinogenic DNA are under investigation. A vaccine for pre-exposure prophylaxis has proved effective in animal models. Clinical trials that investigate post-exposure vaccines are currently under way and appear to be promising.

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CANCER REFRENCE http://www.medindia.net/education/familymedicine/Cervical-CancerConclusion.htm http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002267/ http://en.wikipedia.org/wiki/Cancer http://www.webmd.com/cancer/default.htm http://www.cancer.org/ http://www.naturalnews.com/cancer.html

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