DEFINITIONS

TUMOUR

Mass of tissue: an uncontrolled growth or mass of body cells, which may be malignant or benign, and has no beneficial function.

NEOPLASM

A tumour or tissue containing abnormally growing cells.

CANCER

A malignant tumour or growth caused when cells multiply uncontrollably, destroying healthy tissue.

MALIGNANCY

This refers to a tumour that can invade surrounding tissues and may spread to distant parts of the body by way of the lymphatic or circulatory systems.

CHARACTERISTICS OF CANCER

  • Uncontrolled growth of cells
  • Invasiveness of surrounding tissues
  • Metastasis, i.e. spread to other tissues and organs
  • Excess mass of cells have no beneficial function in the body

MAGNITUDE OF THE PROBLEM

  • All ages can have cancer, even foetuses.
  • 13% of all human deaths are attributable to cancer.
  • 6 million deaths worldwide in 2007.
  • Risk increases with age.
  • Increasing in Nigeria and other developing countries because of:
  1. increased life expectancy
  2. increase in health facilities that diagnose cancer
  • change in diet
  1. promiscuity
  2. obesity

COMMON CANCERS IN WEST AFRICA

  • Breast     15%
  • Cervix     15%
  • Liver        11%
  • Prostate    7%

Most common cancers in men are liver and prostate cancers.

Most common cancers in women are cervix and breast cancers.

Other cancers include cancers of skin, oesophagus, stomach, lung, colon, rectum, oral cavity, and urinary bladder.

CAUSES

  • Carcinogens ….tobacco, asbestos, ionizing radiation, alcohol
  • Viral and bacterial infections…Human Papillovirus, Hepatitis B, Hepatitis C, H. Pylori. Hepatitis C virus causes more cancers than Hepatitis B.
  • Hormonal imbalance, e.g. endometrial cancer
  • Immunosuppressant state. HIV predisposes to Kaposi’s sarcoma and NonHodgkin’s lymphoma.
  • Cancer of the Breast, Cancer of the Ovary, Colon Cancer, and Retinoblastoma (eye cancer) have genetic predisposition.

 

CLASSIFICATION/NOMENCLATURE

  • These are cancers formed from epithelial cells.
  • Sarcomas are cancers developed from connective tissues and mesenchymal cells.
  • Lymphoma and Leukaemia. These develop from haematopoietic (blood-forming) cells.
  • Germ cell Tumours. These develop from cells in testes, ovaries, and foetuses, and are seen in babies and small children.
  • Blastoma . These are tumours resembling embryonic tissues.

SYMPTOMS AND SIGNS OF CANCER

  • 1. LOCAL SYMPTOMS
  • Lump or swelling
  • Pain
  • Bleeding
  • Ulceration
  1. SYMPTOMS OF METASTASIS
  • Enlarged lymph nodes
  • Cough
  • Haemoptysis (coughing out bloody sputum)
  • Hepatomegaly (enlarged liver)
  • Bone pain
  • Fractures
  • Neurological symptoms
  1. SYSTEMIC SYMPTOMS
  • Weight loss
  • Poor appetite
  • Fatigue
  • Night sweats
  • Anaemia

 

INVESTIGATIONS

  • Blood tests
  • X-ray
  • C-T Scan
  • MRI
  • Endoscopy
  • Faecal Occult Blood
  • Histology
  • Ultrasound scanning
  • Microscopic examination of biopsy sample

 

TREATMENT

Treatment comprises of one or combination of two or more of the following:

  • Surgery
  • Radiotherapy
  • Chemotherapy
  • Targeted therapy
  • Hormonal therapy

 

CURE/MORTALITY

This depends on:

  • Type of cancer
  • Location
  • Stage
  • Early or late presentation and diagnosis
  • Prevention of secondary disease and recurrence

 

PRE-CANCER SCREENING

  • Self breast examination
  • Mammography
  • FOB for colorectal Ca
  • Colonoscopy
  • PAP smear to detect precancerous cervical lesion
  • Testicular self examination
  • Rectal examination
  • Prostate Specific Antigen test
  • Ultrasound Scanning

 

PREVENTION

 

  • Change in lifestyle: stopping smoking, drinking of alcohol
  • Vegetarian diet is helpful.
  • Vaccination, e. g. against HPV
  • Genetic testing
  • Chemoprevention
  • Screening tests