Transcript Cancer

Non communicable
diseases
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Introduction
• Non-communicable diseases are the leading killer today and are
on the increase.
• Nearly 80% of these deaths occurred in low- and middle-income
countries.
• More than nine million of all deaths attributed to
noncommunicable diseases (NCDs) occur before the age of 60.
• Around the world, NCDs affect women and men almost equally.
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Introduction
• The leading causes of NCD deaths were:
1. Cardiovascular diseases (17 million deaths, or 48% of NCD deaths);
2. Cancers (7.6 million, or 21% of NCD deaths); and
3. Respiratory diseases, including asthma and chronic obstructive pulmonary
disease (COPD), (4.2 million).
4. Diabetes caused an additional 1.3 million deaths.
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Cardiovascular diseases
• Cardiovascular disease is caused by disorders of the heart and
blood vessels, and includes coronary heart disease (heart attacks),
cerebrovascular disease (stroke), raised blood pressure
(hypertension), peripheral artery disease, rheumatic heart
disease, congenital heart disease and heart failure.
• Although heart attacks and strokes are major killers in all parts of
the world, 80% of premature heart disease and stroke is
preventable
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Cardiovascular diseases:
Contributing factors
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A person’s genetic make-up
The foundations of adult health are laid in early life
Socioeconomic group
Mental health
Diet
Overweight and obesity
Inactivity
Tobacco
Alcohol
Diabetes
Globalization and urbanization
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Cancer
• Cancer is the uncontrolled growth and spread of cells that
arises from a change in one single cell.
• The change may be started by external agents and inherited
genetic factors and can affect almost any part of the body.
• The transformation from a normal cell into a tumour cell is a
multistage process where growths often invade surrounding
tissue and can metastasize to distant sites.
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Common cancers in
Malaysia
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Cancer: Interaction between a person’s genetic
factors and any of three categories of external
agents
• Physical carcinogens; such as ultraviolet and ionizing radiation
or asbestos;
• Chemical carcinogens; components of tobacco smoke, aflatoxin
(a food contaminant) and arsenic (a drinking-water
contaminant);
• Biological carcinogens; such as infections from certain viruses,
bacteria or parasites.
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Cancer:
risk factors for cancer
tobacco use
unhealthy diet
insufficient physical activity
the harmful use of alcohol
Infections (hepatitis B, hepatitis C (liver cancer), human
papillomavirus (HPV; cervical cancer), Helicobacter pylori
(stomach cancer)
• Radiation
• variety of environmental and occupational exposures of varying
importance
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Lung cancer
• The uncontrolled growth of abnormal cells that start off in one or
both lungs; usually in the cells that line the air passages.
• The abnormal cells do not develop into healthy lung tissue, they
divide rapidly and form tumors.
• As tumors become larger and more numerous, they undermine the
lung’s ability to provide the bloodstream with oxygen.
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Risk factors of lung cancers
• Carcinogen - Tobacco, asbestos,
arsenic, radiation such as
gamma and x-rays, the sun, and
compounds in car exhaust fumes
• Genes
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Symptoms of lung cancer
• Persistent or intense coughing
• Pain in the chest shoulder, or back from coughing
• Changes in color of the mucus that is coughed up from the lower airways
(sputum)
• Difficulty breathing and swallowing
• Hoarseness of the voice
• Harsh sounds while breathing (stridor)
• Chronic bronchitis or pneumonia
• Coughing up blood, or blood in the sputum
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Colorectal cancer
• Also known as bowel cancer, colon cancer or rectal
cancer,
• Any cancer (a growth, lump, tumor) of the colon and the
rectum.
• The second most common cancer worldwide, after lung
cancer.
• The colon and rectum belong to our body's digestive
system - together they are also known as the large
bowel.
• The colon reabsorbs large quantities of water and
nutrients from undigested food products as they pass
along it.
• The rectum is at the end of the colon and stores feces
(stools, waste material) before being expelled from the
body.
Symptoms of Colorectal cancer
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Going to the toilet more often.
Diarrhea.
Constipation.
A feeling that the bowel does not empty properly after a bowel movement.
Blood in feces (stools).
Pains in the abdomen.
Bloating in the abdomen.
A feeling of fullness in the abdomen (maybe even after not eating for a while).
Vomiting.
Fatigue (tiredness).
Inexplicable weight loss.
A lump in the tummy or a lump in the back passage felt by your doctor.
Unexplained iron deficiency in men, or in women after the menopause.
Risk factors of colon cancer
• Being elderly - the older you are
the higher the risk is.
• A diet that is very high in animal
protein.
• A diet that is very high in saturated
fats.
• A diet that is very low in dietary
fiber.
• A diet that is very high in calories.
• A diet that is very high in alcohol
consumption.
• Women who have had breast,
ovary and uterus cancers.
A family history of colorectal cancer.
Patients with ulcerative colitis.
Being overweight/obese.
Smoking. This study found that smoking is
significantly associated with an increased
risk for colorectal cancer and death.
• Being physically inactive.
• Presence of polyps in the colon/rectum.
Untreated polyps may eventually become
cancerous.
• Having Crohn's disease or Irritable Bowel
Disease have a higher risk of developing
colorectal cancer.
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Breast cancer
• Breast cancer is a kind of cancer that develops from breast cells.
• Usually starts off in the inner lining of milk ducts or the lobules
that supply them with milk.
• 18.2% of all cancer deaths worldwide, including both males and
females, are from breast cancer.
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Symptoms of breast cancer
• A lump in a breast
• A pain in the armpits or breast that does not seem to be related to
the woman's menstrual period
• Pitting or redness of the skin of the breast; like the skin of an
orange
• A rash around (or on) one of the nipples
• A swelling (lump) in one of the armpits
• An area of thickened tissue in a breast
• One of the nipples has a discharge; sometimes it may contain
blood
• The nipple changes in appearance; it may become sunken or
inverted
• The size or the shape of the breast changes
• The nipple-skin or breast-skin may have started to peel, scale or
flake.
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Risk factors for breast cancers
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Getting older
Genetics
A history of breast cancer
Having had certain types of breast lumps
Dense breast tissue
Estrogen exposure - women who started having periods earlier or entered
menopause later
Obesity
Radiation exposure
HRT (hormone replacement therapy)
Certain jobs
Cosmetic implants may undermine breast cancer survival
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Chronic respiratory diseases (CRDs)
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• Diseases of the airways and other structures of the lung.
• 235 million people have asthma, 64 million people have chronic obstructive pulmonary
disease (COPD) while millions have allergic rhinitis and other often-underdiagnosed
chronic respiratory diseases.
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chronic obstructive pulmonary disease (COPD),
asthma,
occupational lung diseases and
pulmonary hypertension.
• In addition to tobacco smoke, other risk factors include
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air pollution,
allergen
occupational chemicals and dusts, and
frequent lower respiratory infections during childhood
Chronic respiratory diseases
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• According to the WHO Global Status Report on NCDs 2010, smoking is
estimated to cause about 71% of all lung cancer deaths and 42% of chronic
respiratory disease worldwide.
• Second-hand smoke causes severe respiratory health problems in children,
such as asthma and reduced lung function
• CRDs are not curable
• Treatment helps dilate major air passages and improve shortness of breath
can help control symptoms and increase the quality of life for people with
the disease.
Diabetes
• Diabetes is a chronic disease that occurs when the pancreas does
not produce enough insulin (a hormone that regulates blood sugar)
or alternatively, when the body cannot effectively use the insulin
it produces.
• The overall risk of dying among people with diabetes is at least
double the risk of their peers without diabetes.
• About 347 million people worldwide have diabetes.
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Diabetes
• Total deaths from diabetes are projected to rise by more than 50%
in the next 10 years.
• In developed countries most people with diabetes are above the
age of retirement,
• whereas in developing countries those most frequently affected
are aged between 35 and 64.
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Health Care
System in
Malaysia
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Malaysia Health Care System
• The Ministry of Health is the main government agency to provide
health care services
• Other Ministries;
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Ministry of Education
Ministry of Defense
Ministry of Internal Affairs
Ministry of Women, family and Community Development
• The health services is highly centralized
• Most planning and organization of health services being carried
out centrally
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Health care services
• Four types of hospitals
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District hospitals
State General Hospitals
National Referral Centre and Special Insitution
Non-MOH Hospitals
• The District Hospital have 100-200 beds run by 6-10 medical
officers
• State General Hospitals have 500-1500 beds
• Each State has one General Hospitals but Sabah has two.
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Health Care Services
• The National Referral Centre is the highest level of hospital in the
hierarchy
• This hospital has 2800 beds and is located in Kuala Lumpur
• IJN – National Referral Centre for cardiovascular diseases
• Selayang Hospital – National Referral Centre for Liver diseases
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Health Care Services
• The Special Medical Institutions (9)
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One Rehabilitation Hospital,
One Women & Children Hospital,
One Leprosy Hospital,
One Respiratory/Tuberculosis Hospital,
One Cancer Hospital
Four Psychiatrics Institutions
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Health care system in Malaysia
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Health care facilities
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Health care facilities
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Health care
facilities
Population measures
• Prevalence
• Point prevalence
• Period prevalence
• Incidence
• Attack rate
• Mortality
• Crude death rate
• Specific rate
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Prevalence
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• Total number of cases of disease existing in a population
• Point prevalence
No. of person ill at a time point
x
100
Total no. in the group at a time point
• Period prevalence
No. of person ill during a time period
x
Average population during a time period
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Incidence
• A number of new cases in a defined population during a specified
period of time
Num. of newly disease indv. for a specific time period
Total number of population-at-risk for same time period
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Attack rate
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• Incidence rate observed for a short period such as epidemics or outbreak
No. of cases during the epidemic
x 100
Total no. of exposed or at risk during the same period
Crude Death Rate (CDR)
Total deaths per year
X 1000
Average total population of that year
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Cause specific mortality rate (CSMR)
No. of death by certain disease/group/year
X
Total mortality cause population in the same period
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100 000
Mental Health
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Definition of Stress
• The Emotional state which results from discrepancy between the
level of demand and the person’s ability to cope.
Lazarus and Folkman 1980
• Job Demands
• Time Pressure
• Deadline stress
• Excessive workload
• Conflicting demands
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Mental Illnesses
• Depression
• a mood disorder that causes a persistent feeling of sadness and loss of
interest.
• Anxiety
• unpleasant state of inner turmoil, often accompanied by nervous behavior,
such as pacing back and forth, somatic complaints and rumination
• Schizophrenia
• A brain disorder in which people interpret reality abnormally
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Thank you
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