COMMUNITY HEALTH SCIENCE II

Group Assignment
Lecturer: Dr. Maria Tibinyane
 Group 4 Members

• Fildah Chimhangwa W2207243

• Florence Harker W2207222
• Frieda Hesekiel W2207215
• Selma Shalimba W2207260
• Henrico Landsberg W2207246
• Hertha Andreas W2207267
• Martha Imbondi W2207257
• Aili Angula W2200100
• Precious Mabung W2207248
• Nambandi Fenni 2100504
• Shikufinde Florensia W220098
• Simon Munee Karunga 2020213
• Elina Shimbango 202100287
• Ndevahoma Ndapwakukulilwa Malenga 2020127
• Beatrice Hamutenya 2020231
• Ndilimeke Shipo 200649
 Topic: Cancer

Objectives

• Define cancer.
• Mention the causes of cancer.
• Identify types of cancers.
• List signs and symptoms cancers.
• Identify cancer screening / required tests.
• Identify special groups at increased risk of developing cancers.
• List the five (5) pillars of WHO’s approach to cancer.
• State the prevention of cancers.
• Outline the management of cancers.
 What is cancer

Cancer is a large group of diseases with one thing in common: They all happen
when normal cells become cancerous cells that multiply and spread.
 What is the difference between a normal cell and a cancerous cell?

Normal cells follow instructions provided by genes. Genes set down rules for cells to follow, such as when
to start and stop growing. Cancerous cells ignore the rules that normal cells follow:
• Normal cells divide and multiply in a controlled manner. Cancerous cells multiply uncontrollably.
• Normal cells are programmed to die (apoptosis). Cancerous cells ignore those directions.
• Normal cells for solid organs stay put. All cancerous cells are able to move around.
• Normal cells don’t grow as fast as cancerous cells.
Global statistics
• ➢ >9.7 million cases are detected each year
• ➢ 6.7 million people will die from cancer.
• ➢ Cancer causes about 13% of all deaths.
• ➢ 20.4 million people living with cancer in the world today
 What causes cancer?

• Cancer is a genetic disorder. It happens when genes that manage cell activity mutate and create
abnormal cells that divide and multiply, eventually disrupting how your body works.
• Medical researchers estimate 5% to 12% of all cancers are caused by inherited genetic mutations that
you can’t control.
• More frequently, cancer happens as an acquired genetic mutation. Acquired genetic mutations
happen over the course of your life. Medical researchers have identified several risk factors that
increase your chance of developing cancer.
• Cancer risk factors you can control
• Smoking: Smoking cigarettes and cigars and using e-cigarettes increases your chance of developing
lung, pancreatic, esophageal and oral cancer.
• Diet: Eating high-fat or high-sugar foods can increase your risk for many types of cancer. You’re also
more vulnerable to disease if you don’t get enough exercise.
 Causes continue…

• Environment: Exposure to toxins in your environment — such as asbestos, pesticides and radon —
can eventually lead to cancer.
• Radiation exposure: Ultraviolet (UV) radiation from the sun significantly increases your risk of
developing skin cancer. Over-exposure to radiation treatment can also be a risk factor.
• Hormone therapy: Women and people AFAB taking hormone replacement therapy may have an
increased risk for breast cancer and endometrial cancer.
• Heredity: Family history
• Immunity: Low immunity due to other conditions: HIV / AIDS, Immunosuppression
• Physical: Poor or no Physical activities
• Viral: Hepatitis B, Human Papilloma Virus (HPV)
• Bacterial: Helicobacter pylori, Other Parasites e.g., Schistosoma spp.
• Early coitus and related STI’s – cancer of the cervix.
 Stages/ Staging of cancer

Healthcare providers use cancer staging systems to plan treatment and develop a prognosis or expected
outcome. TNM is the most widely used cancer staging system. T stands for primary tumor. N stands for
lymph nodes and indicates whether a tumor has spread to your lymph nodes. M stands for metastasis,
when cancer spreads.
• Stage I – Cancer is firmly in one site and not spreading.
• Stage II – The cancer has grown (more than in stage I) but it hasn’t spread.
• Stage III – The cancer has grown larger and has probably spread to lymph nodes and other tissues.
• Stage IV – The cancer has spread to other organs and areas of the body (distant metastasis).
Though stage one through four are the most common, there’s also a Stage 0. This earliest phase describes
cancer that’s still localized to the area in which it started. Cancers that are still in Stage 0 are usually easily
treatable and are considered pre-cancerous by most healthcare providers.
 Type of cancers

Cancers are named according to the affected organs. The following are the types of cancers:
Cancer of the Breast
• Occurs more frequently in women, also occurs in men but the incidence is less. Common
in women between 40 to 65 years old. Treatment improvement has lowered the
mortality. Women who gave birth before age of 20yrs are also at risk. Breast cancer is
usually characterized by: A lump in the upper outer quadrant of the breast. Thickening of
skin around the breast. Skin colour around the breast area changes. Bloody or serous
discharge from nipples. Scaling of the nipples. Ulceration of underlying tissue.
Cancer of Cervix
• Cervical cancer may be localized to the cervix or extend beyond reproductive organs. It
may also involve the bladder and rectum depending on the stage. it is associated with
Blood-stained leucorrhoea(whitish or yellowish discharge from the vagina). Post coital
spotting - bleeding becomes more as tumor becomes larger. Pelvic pain. Unexplained
weight loss. Back ache - referred pain from the pelvis. Bilateral oedema.
 Types of cancers continue…

Brain tumor

Is the growth of cells in the brain or near it.

Kaposi sarcoma

It is a disease in which cancer cells are found in the skin or mucus membranes that line the gastrointestinal
tract, from mouth to anus, including the stomach and the intestines. this tumor appears as purple patches
on nodules on the skin and / mucus membranes and can spread to lymph nodes and lungs.
 Types of cancers continue…

• Leukemia

The broad term for cancer of the blood cells. the type of leukemia depend on the type of the blood cell that
becomes cancerous and whether it grows quickly or slow. it occurs must often in adults older than 65 years
old, but it is also the most common cancer in children younger than 15 years old.
 Types of cancers continue…

Lymphoma or Hodgkin`s disease

• It is the cancer that forms in the germ - fighting lymphatic system. type of lymphoma cancer include:
Hodgkin's and non Hodgkin's lymphoma.

Ovarian cancer

• Is a group of diseases that originate in the ovaries or in the related areas of the fallopian tubes.
 Sign and symptoms of cancer

• A sore that does not heal.

• Changes in bladder or bowel habits
• Unusual bleeding or discharge
• Thickening of lump in breast or elsewhere
• Indigestion.
• Difficulty in swallowing.
• Hoarse voice.
• A nagging cough.
• A mole or wart.
 Cancer screening / required tests

Breast Cancer
• - Self-examination of breast, Mammography, biopsy of breast lump
Cancer of Cervix
• - PAPS Smear, VIA (Vaginal Inspection by acetic acid)
Prostatic Cancer
• - PSA test
Lung cancer
• - chest X-ray
Colon Cancer
• - Colonoscopy
Leukemia
• - Bone marrow biopsy
Lymphoma
• - Bone marrow biopsy
Ovarian
• - X-ray (CXR)
Kaposi sarcoma
• - X- ray (CXR)
 Special groups at increased risk of developing cancers

• Age- poses the greatest risk for cancer. 55% of cancer patients are over 65 years
• Smoking – related to 85% of cancer patients.
• Alcohol – predispose to cancer of the mouth, larynx, throat, liver, esophagus.
• Heredity/genetic – runs in families.
• Diet – high intakes of fats are related to breast cancer, colon and prostate. Low intake of fruits,
vegetables and fiber are related to cancer of the colon, larynx, esophagus, stomach, prostrate.
• Obesity- related to cancer of the breast, colon, uterus, gall bladder.
• Early coitus and related STI’s – cancer of the cervix.
• HIV positive patients
• Albinos
• Women( breast and cervical).
• Occupational exposure to toxins, radio active material etc.
 WHO’s approach to cancer has five (5) pillars:

• Prevention
• Screening
• Early detection
• Treatment
• Palliative care
Prevention
10 million new cases of cancer each year are preventable
• Do not smoke; if you smoke, stop doing so. If you fail to stop, do not smoke in the presence of non-
smokers.
• Avoid Obesity through moderating diet.
• Reducing /avoid alcohol use
• Do physical activity every day.
• Increase your daily intake and variety of vegetables and fruits: eat at least five servings daily. Limit
your intake of foods containing fats from animal sources
• Avoid exposure to radiation and harmful chemical.
• Immunizing against viral hepatitis B.
• Early detection and prompt treatment where resources allow can reduce incidence and further
disease progression
• Well established comprehensive palliative care for the remaining more advanced cases can prevent
early death.
 Management and treatment of Cancers

How do healthcare providers treat cancer?

Healthcare providers may use several different treatments, sometimes combining treatments based on your situation.
Common cancer treatments include:
• Chemotherapy: Chemotherapy is one of the most common cancer treatments. It uses powerful drugs to destroy
cancer cells. You may receive chemotherapy in pill form or intravenously (through a needle into a vein). In some
cases, providers may be able to direct chemotherapy to the specific area affected.
• Radiation therapy: This treatment kills cancer cells with high dosages of radiation. Your healthcare provider
may combine radiation therapy and chemotherapy.
• Surgery: Cancerous tumors that haven’t spread may be removed with surgery. Your healthcare provider may
recommend therapy. This treatment combines surgery with chemotherapy or radiation to shrink a tumor before
surgery or to kill cancer cells that may remain after surgery.
• Hormone therapy: Sometimes, providers prescribe hormones that block other cancer-causing hormones. For
example, men and people AMAB who have prostate cancer might receive hormones to keep testosterone (which
contributes to prostate cancer) lower than usual.
• Biological response modifier therapy: This treatment stimulates your immune system and helps it perform
more effectively. It does this by changing your body’s natural processes.
• Immunotherapy for cancer: Immunotherapy is a cancer treatment that engages your immune system to fight
the disease. The treatment may be called biological therapy.
• Targeted therapy for cancer: Targeted therapy is a cancer treatment that targets the genetic changes or
mutations that turn healthy cells into cancer cells.
• Bone marrow transplant: Also called stem cell transplantation, this treatment replaces damaged stem cells with
healthy ones. Autologous transplantation uses your supply of healthy stem cells. Allogeneic transplantation uses
stem cells donated by another person.
 What are cancer treatment side effects?

• Healthcare providers work to balance the treatment so it destroys cancer without harmful or lasting
side effects. Even so, all cancer treatments have side effects. Some treatments cause side effects that
last for years after treatment is completed. Many people benefit from palliative care that eases cancer
symptoms and treatment side effects. The most common cancer treatment side effects are: Anemia,
nausea and vomiting, fatigue and pain. In clinic and health centers – conduct routine screening tests e
.g Pap smear` and VIA Start Pain management. Refer all suspected cancer cases to the Doctors /
Hospital for further management and palliative care.
 References

• National Cancer Institute. What is Cancer (https://www.cancer.gov/about-

cancer/understanding/what-is-cancer#cell-differences)? Accessed 11/8/2022.
• Clark, M. J. (2008). Community Health Nursing. Advocacy for Population Health (5th ed.).
Stamford, CT: Appleton & Lange.
• Vlok, M. E. 1998. Manual of Nursing, 9 th Ed. Volume 1. Basic Nursing, Cape Town: Juta & Co Viljoen,
M. J. 2000. Nursing Assessment: History Taking and physical Assessment. Cape Town. Mogotlane, S.,
Chauke, M, C., Matlaka, m., Mokoena, J., Young, A. Tuta’s Complete Textbook of Medical and Surgical
Nursing. (2013) Juta and Company LTD. Lansdowne. Cape Town. David McQueen. Handbook on Non
communicable Diseases and Health promotion 1st ed.2013
• Community health nursing fifth edition, advocacy for population health (Jo Clark, M), Juta’s Complete
textbook of medical surgical nursing second edition (Mogotlane, S., Mokoena, J., motshedisi chauke
,mokgadi matlakala,anne young ,bertha randa)