Académique Documents
Professionnel Documents
Culture Documents
THE FUTURE?
• June 3, 1948, Sydney Farber and his colleagues
reported successful use of aminopterin to induce
temporary remission in children with lymphoid
leukemia.
• Gave hope what had been a uniformly fatal disease
might be amenable to treatment and, some dared to
hope, cure.
• In 1970, DeVita and his colleagues
showed that a combination of non–
cross-reactive chemotherapeutic
agents, the MOPP regimen could
induce sustained remission in
advanced Hodgkin's disease.
• From such beginnings, an
extraordinary success story unfolded,
and today, more than 75% of children
with cancer can be cured of their
disease.
• In the United States, there are
approximately 270,000 survivors of
pediatric cancer, or about 1 of every
640 adults between the ages of 20
and 39 years
• SGH survivors: In the last 10 years
• 475 OUT OF 821 STILL ON FOLLOW
UP
• 87 : 10 yr survivor
• 195: 5yr survivor
• Future of these survivors?
• Cure may be accompanied by a
host of adverse events,
• Some may not appear for many
years after treatment has ended
long-term health
consequences
20,227 5-year survivors treated 1970
-1986.
Mortality:
• Second cancers (standardized
mortality ratio 19.4),
• Cardiac causes
• Lungs (SMR, 9.2).
Study of 9535 survivors of childhood
cancer,
• 44% reported having at least one of
below moderately or severely
affected
– general health,
– mental health,
– functional status,
– limitations in activity,
– cancer-related pain, and
– cancer-related fear or anxiety)
Help yourself
Help anyone who gives you medical
care
Do things that will promote your health
No high risk behaviour
Help yourself from the
beginning
During course of treatment.
• Remain positive where outcome is
concerned
• Be caring but firm with the child. Issues
can be discussed with children but
sometimes decisions have to be made
for them especially when they are
depressed.
• Don’t spoil the child
• Eat well
• Education
Help yourself from the
beginning
Know your disease and its
treatment.
• Keeping your onco book which will have
your diagnosis and test results.
• Know what disease you have
• Know what treatment had been given
and side effects of treatment
• Stay in touch with the medical center or
clinic where you were originally treated
for cancer, at least once a year until 10
years post treatment
As the child grows
• Allow them to reach for their limits – don’t
curtail school activities eg camping , National
service etc
• Continue to instil discipline and religious values
– Less problem with mental health
– Less of sick role
• Treat them and siblings as equals
• Education important – delinquency avoided
• Tell the child about their disease once they
understand usu teenage years when they start
to surf the net
• Making use of available resources for
information and support.
• Maintain a good circle of friends
As the child grows
• Check with the doctor what side effects
to expect
• Look out for any abnormal lumps
especially over sites of radiation
• See a doctor immediately if there are
abnormal signs and symptoms eg:
bleeding from the anus, abdominal
distension
• Have checkups once a year, with a
physical examination and
In adulthood
Contains several
phytochemicals,
some of which
have weak
estrogen activity
and appear to
protect against
hormone-
dependent cancers
in animal studies.
Can drinking tea reduce
cancer risk?
• Some research suggest
tea might protect against
cancer because of its
antioxidant content.
• In animal studies, some
teas (including green
tea) shown to reduce
cancer risk,
• But yet to be proven to
reduce cancer risk in
humans.
Does eating fish protect
against
•
cancer?
Fish is a rich source of omega-3 fatty acids.
• Studies in animals: these fatty acids suppress cancer
formation or slow down cancer growth,
• Limited evidence of a possible benefit in humans.
• Beware: some types of fish (large predatory fish such
as swordfish, tilefish, shark, and king mackerel) may
contain high levels of mercury, polychlorinated
biphenyls (PCBs), dioxins, and other environmental
pollutants.
• Women who are pregnant, breast-feeding, or planning
to become pregnant, and young children should not
eat these fish.
• People should vary the types of fish they eat to reduce
the chance of exposure to toxins.
• Research has not yet shown whether taking omega-3
or fish oil supplements produces the same possible
benefits as eating fish. .
Are "organic" foods more
effective in lowering cancer
risk?
• “Organic” is the “in” word.
• Plant grown without pesticides and
genetic modifications.
• No research exists to show such
foods are more effective in reducing
cancer risk than food produced by
usual farms.
Do food additives cause
cancer?
• Many substances are added to foods to
preserve them and to enhance color,
flavor, and texture.
• New additives must be cleared by the
Food and Drug Administration (FDA)
before use.
• Additives are usually present in very
small quantities in food, and no
convincing evidence has shown that
any additive at these levels causes
human cancers.
Do high levels of salt in the
diet increase cancer risk?
• Studies in other
countries link diets
that contain large
amounts of foods
preserved by
salting and pickling
with an increased
risk of stomach,
nasopharyngeal,
and throat cancer.
• No evidence
suggests that
moderate levels of
salt used in cooking
or in flavoring
foods affect cancer
Do irradiated foods cause
cancer?
• No.
• Radiation is used to kill harmful
organisms on foods in order to
extend their "shelf life."
• Radiation does not stay in the foods
after treatment, and eating
irradiated foods does not increase
cancer risk.
Do pesticides in foods
cause cancer?
• HPVs have a role in some cancers of the penis, anus, vagina, and
vulva.
• Also been linked to cancers of the mouth, throat, head, and
neck.
•Vaccines against the types of HPV that cause cancer are now available -
(Gardasil®) and has been shown to help protect against infection from some of
these HPV types, and is now approved for use in females aged 9 to 26, before first
sexual encounter.
Hepatitis B virus (HBV) and
hepatitis C virus (HCV)and
Vaccination
• HBV and HCV cause viral hepatitis, a type of liver infection.
• Hepatitis A virus A can also cause hepatitis but only HBV and HCV can
cause chronic (long-term) infections that increase a person’s chance of
developing liver cancer.
• Liver cancers are related to HBV or HCV infection higher in Asia and
Malaysia, where both the infections and liver cancer are much more
common.
• HBV and HCV are spread much the same way as HIV
-- through sharing needles, unprotected sex, or childbirth and blood
transfusions,
• HBV is more likely to cause symptoms, such as a flu-like illness and a
yellowing of the eyes and skin (jaundice). But most people recover
completely from HBV infection within a few months. Only a very small
percentage go on to become chronic carriers. These people have a
higher risk for liver cancer.
• HCV, on the other hand, is less likely to cause symptoms. But most
people with HCV develop chronic infections, which are more likely to
There are few drugs effective in treating hepatitis B or C,
Vaccine is available to prevent HBV infection.
In Malaysia, all children are vaccinated for Hep B
Unfortunately, there is no vaccine to prevent HCV at this time.
Human immunodeficiency
virus (HIV)
• HIV infection increases a person's risk of getting several types of
cancer, especially some linked to other viruses such as HHV-8 and
HPV.
• HIV is acquired through intimate contact with blood, vaginal
secretions, breast milk, or semen from an HIV-infected person.
• HIV is not spread by insects, through water, or by casual contact
such as talking, shaking hands, hugging, sneezing, sharing dishes,
sharing a bathroom or kitchen, sharing telephones, or sharing
computers.
• Known routes of spread include:
– unprotected sex (oral, vaginal, or anal) with an HIV-infected
person
– injections with needles or injection equipment previously used
on an HIV-infected person
– prenatal and perinatal (during birth) exposure of infants from
mothers with HIV
– breast-feeding by mothers with HIV
– transfusion of blood products containing HIV (blood has been
tested since 1985)
Human immunodeficiency
virus (HIV)
• HIV infects and destroys white blood cells known as helper T cells,
which weakens the body's immune system.
• When the body is less able to fight off infections, other viruses such
as HPV may cause more damage to the cells. This damage may
trigger cancer.
• Many scientists believe that the immune system is also important in
attacking and destroying newly formed cancers. Weak immune
system may allow new cancers to survive to become a serious, life-
threatening tumor.
• HIV infection has been linked to a higher risk of developing of Kaposi
sarcoma, invasive cervical cancer, and certain kinds of lymphoma,
especially non-Hodgkin lymphoma and central nervous system
lymphoma.
• Other forms of cancer that may be more likely to develop include:
– invasive anal cancer
– Hodgkin disease
– lung cancer
– cancer of the mouth and throat
– cancer of the testicles
Helicobacter pylori (H. pylori)
• Stomach cancer fourth most common cancer worldwide.
• Long-term infection of the stomach with H. pylori may lead to chronic
inflammation and damage to the inner layer of the stomach, including
ulcers. Some of these changes could lead to cancer over time,
especially cancer in the lower part of the stomach. H. pylori infection
is also linked with some types of lymphoma of the stomach.
• More than half of all cases of stomach cancer are linked to H. pylori
infection.
• About 1 in 3 adults has evidence of infection with H. pylori, and the
rate of infection is higher in older age groups. Researchers aren't
exactly sure how H. pylori may be spread from one person to another.
But most people who have these bacteria in their stomachs never
develop cancer.
• Cell phone use, even for more than 10 years, was not associated with an
increased risk of developing brain tumors or cancer overall, nor was there an
association with any brain tumor subtypes or with tumors in any location
within the brain.