Transcript Managing Electronic Documents Effectively

Can you avoid cancer?
Peter Isaacs
Gastroenterology Unit
cancer facts
1 common cancers are not preventable
2 cancer only produces symptoms when its too
late to treat
3 if its in your genes there’s nothing you can
do
4 cancer treatment results are the worst in
Europe
5 the nhs cannot provide the latest cancer
drugs
“Cancer facts”
•
WRONG on all counts
what is cancer?
• An abnormal population of cells which do
not have the normal appearance of the
originating organ ( loss of differentiation)
• These cells exhibit uncontrolled growth
• The cells can invade locally or deposit in
distant organs producing displacement
effects
How does cancer start?
• An ABNORMAL GENE(S) which make the
DNA liable to further changes
• ENVIRONMENTAL challenges (chemicals,
viruses or radiation) which push these
changes
• PROLIFERATION of the cells under the
stimulus of inflammation, hormones
increase the likelihood of irreversible
malignancy
How does cancer start?
Mutation of DNA (oncogene)
which can be
• Congenital (eg familial colon cancer)
• Acquired (carcinogens, radiation, ageing)
•
more mutations if cell proliferation is high
eg Barrett’s
• Inflammation
• Hormonal eg breast, prostate
• Viral infections eg HPV, HBV, HCV, HIV, EBV
Cancer etymology
• Latin the crab
• Because of its sideways spread into the
healthy tissue
Carcinoma an epithelium or lining
• Sarcoma
in supporting tissues
• Leukaemias, lymphomas, myeloma in bone
marrow and lymph nodes
• Oncology = (Greek) tumour science
The CMO report 2009
Predicting who will get cancers
•
•
•
•
•
•
•
•
FAMILY HISTORY
ALREADY HAD A CANCER
SMOKERS
DRINKERS
OBESE
MANUAL AND DIRTY INDUSTRIES
High UV and cosmic ray exposure
HIGH INCIDENCE AREA (e.g. radon,
selenium, industrial pollution Pb, As)
• PHYSICALLY INACTIVE
Age and physical activity
• Declines by 9% every decade
how much of this is “cultural”
ACTIVITY: PREDICTED BENEFITS
•
•
•
•
•
•
Coronary disease
Stroke
Diabetes II
Colon cancer
Breast cancer
Hip fracture
-10%
-20%
-40%
-45%
-30%
-50%
• 30 minutes of moderate activity 5X/week
Sir Liam Donaldson 2009 (Eng)
alc xs
Prevalence 7%
smoking obesity inactivity
20%
24%
65%
Cost to UK £20BN
5.2
16
8
NHS COST
2.7
4.2
1.5
2.7
Blackpool annual health report
2008-9
• Population 142,500
• Blackpool 12th of the 354 most deprived LAs
• 41 of the 94 areas of Blackpool are in the
bottom 20% of England
• Male life expectancy males is lowest in
England (73.2 yr)
Blackpool nhs commits to
• improve early detection of cancers
• Better uptake national screen programmes
• Better uptake of HPV vaccination
The Blackpool scene
• 40,000 drink alcohol excessively
• 2,324 problematic drug users
• 6,645 obese (BMI>30)
• Adults taking exercise 7.4% (Eng.10.8%)
• Notifiable disease
•
Hepatitis B 22/year
•
Hepatitis C 106/year
Healthy government
• Minimum alcohol pricing Royal College of
Physicians 2010
• Exercise for kids
• Exercise for oldies Westminster Play park
Blackpool risks
•
•
•
•
•
Alcohol, HCV and liver cancer
Obesity and oesophageal cancer
Cervix cancer
Lung cancer
Colon cancer
Colon cancer (office natl stats)
1971-2003
• Incidence increasing 43 to 55/100k/y
• Mortality FALLING 30 to18/100k/y(M22,F14)
• 1 in 16 men , 1 in 20 women will develop
colon cancer each year
• 5 yr survival rate has doubled in 30 years
• (M 22% in 1970s, now 50%, F 23% now 51%)
MOH
National Bowel cancer screening
National Endoscopy Training Centre at The Mersey School of Endoscopy
How to avoid cancer?
• Remember that about one third of the UK
population will have some form of cancer in
their lifetime, two thirds of these will not die
of it
What foods to minimise?
•
•
•
•
•
•
Red and processed meats
Saturated fats
Barbecues, fried, roasted and burnt
Very high chilli factor
Too hot too swallow
Pickles and high salt foods
Which foods to maximise?
•
•
•
•
•
Fresh green leaf vegetables and carrots
Fresh fruits especially coloured
Olive oil, rapeseed oil, sunflower oil
Oily fish
Whole grain cereals
Daily life and cancer avoidance
•
•
•
•
•
•
•
•
•
Don’t smoke at all (active or passive)
If your body’s function changes seek advice
Don’t drink alcohol daily
Screen skin especially children, but get out more
Become a vegetarian
Take daily exercise
Keep slim
Get appropriate vaccinations and ID treatments
Think about the nhs screening offers (cervix, breast,
colon)
• Don’t worry be happy
CANCER PREVENTION
•
•
•
•
•
•
•
CHOOSE PARENTS CAREFULLY
WALK TO THE VEGETABLE SHOP
FAVOUR THE FISHMONGER
WALK PAST THE PUB
RUN PAST THE TOBACCONIST
KEEP YOUR WEIGHT NEAR IDEAL
VOTE FOR HEALTH
Significant symptoms
• A new lump, change in a skin
• Change in function of bowels or bladder,
appetite, weight, breathing, cough, swallow
• Bleeding from anywhere
• New pains which persist
Cancer research in Blackpool Fylde
and Wyre
The nhs has increased and reorganised
research funding
• Research networks support research in
primary and secondary care
• Research nurses, support for doctors/AHPs
• Research units established
• Research governance
an emphasis on high quality large studies
Gastrointestinal cancer research in
Blackpool
• Barretts oesophagus
ASPECT the value of acid lowering drugs in
low and high dose in combination with
aspirin n preventing oesophageal cancer
BOSS is surveillance endoscopy worthwhile?
Chemotherapy of oesophageal and gastric
cancers
The future
• More longevity= more cancers
• More research = more treatments and more
effective prevention
• DNA profiling will make cancer risk
prediction more accurate
• Targeted screening will focus resource on
those at risk
• Surgery will become safer and even more
centralised
Cancer avoidance for HPs
• Assess risks Family history, occupation, habits,
previous cancers, clinical pointers
• Give properly balanced evidence-based advice to our
patients on whether to choose screening and
surveillance
• Give unasked advice when behavioral risks are
identified
“ BRIEF INTERVENTION”
Cancer in the future
….what can YOU do?
TAKE CARE OF YOUR OWN HEALTH ( Doctors
are not very effective on cures)
Report significant symptoms early
ACT on correctable risks ( obesity, smoking,
alcohol excess, inactivity, poor diet, UV
exposure)
Do you have a genetic risk and require
screening?
Contribute to research ..participation in trials,
surveys, support your local units research
or cancer research UK