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Cancer

Let’s Target Cancers

Department of Pathology

Faculty of Medicine and Health Sciences

Universiti Putra Malaysia

 

What is Cancer?

  • Cancer is diagnosed when a malignant tumour is identified in a patient.
  • A malignant tumour arises from a single abnormal cell found anywhere in the body.
  • The cell is abnormal because it divides indefinitely and does not follow its natural course to age and die.
  • A cell becomes abnormal usually due to an error in its genetic make-up.
  • High radiation and other mutagenic chemicals can cause these errors.
  • Errors in genetic materials also happen quite frequently during the normal process of cell division.
  • This error is usually corrected, otherwise the cell is caused to die.
  • In unknown circumstances abnormal cells escape these checkpoints and persist.
  • The uncontrolled growth and invasion by these cells disrupt the normal function of the organ and subsequently the rest of the body.
  • If unsuccessfully treated this will lead to the death of cancer patients.

 

Types of Cancers

  • In theory, cancer can arise anywhere in the body.
  • However, there is a higher tendency for certain cancers to be seen.
  • Ten most common cancers in Malaysia are breast, colorectal, lung/trachea/bronchus, lymphoma, nasopharynx, leukaemia, cervix uteri, liver, ovary, stomach.

 

Ten most common cancers in Malaysia by sex, 2007-2011

Male

No

%

Female

No

%

Colorectal

7646

16.4

Breast

18206

32.1

Lung/trachea/bronchus

7415

15.8

Colorectal

6047

10.7

Nasopharynx

3785

8.1

Cervix uteri

4352

7.7

Lymphoma

3171

6.8

Ovary

3472

6.1

Prostate

3132

 

Lung/T/B

3193

5.6

Liver

3054

6.5

Lymphoma

2203

3.9

Leukaemia

2549

5.4

Corpus uteri

2181

3.8

Stomach

2014

4.3

Leukaemia

2024

3.5

Bladder

1477

3.2

Thyroid

1723

3.0

Other skin

1384

3.0

Stomach

1447

2.6

Total

35627

69.5

 

44848

79

Ref: Azizah et al., 2016. Malaysian National Cancer Registry Report, 2007-2011.

 

Cancer Statistics

The National Cancer Registry Malaysia (2007-2011)

•      103,507 new cancer cases.

•      Age-standardised rates per year (ASR) :

86.9 per 100,000 for males

99.3 per 100,000 for females.

National Cancer Institute, United States

•      Rates for new cancer are decreasing on average 1.1% each year over the last 10 years

•      The rate of cancer deaths in US is going down

•      1,762,450 estimates new cases in 2019

•      ASR:

439.2 per 100,000 men and women (2011–2015).

The National Cancer Centre, Singapore (2011-2015)

•      Cancer cases have been rising over the years.

•      Cancer is currently the leading cause of death in Singapore, accounting for 29.7% of deaths in 2015

•      64,341 new cases

•      ASR:

 219.4 per 100,000 men and women.

 

Cancer Death

 

New cases

Death cases

Ratio

Malaysia (2007-2011)

103,507

64,275

0.62

United States (2019)

1,762,450

606,880

0.34

Singapore (2011-2015)

64,341

26,661

0.41

A higher ratio of death occurs among Malaysian cancer patients

 

 

National Cancer Expenses

  • United States spent an estimated $147.3 billion on expenditures for cancer care in 2017.
  • Costs are likely to increase in the future as the population ages and cancer prevalence increases.
  • Inadequacy in current cancer therapy means new, alternative and often more expensive, treatments will be adopted as standards of care which will further increase cost.

 

Cancer situation in Malaysia

  • Incidence of cancer in Malaysia is still low.
  • Incidence may rise.
  • The ratio of death to new cases of cancers is high among Malaysians.
  • Cancer diagnosis tend to occur at late stages among Malaysians.
  • Current treatment has difficult side effects.
  • New treatments are expected to be out of price range of most Malaysians

 

Strategies to improve cancer outcome

  • Cancer screening to detect cancers at early stages.
  • New strategies in preventive medicine by applying medical, social, economic, and behavioral sciences.
  • New therapies catered to the local population.

 

Reduce your cancer risk

  • Avoid all forms of tobacco.
  • Keep a healthy weight.
  • Do regular physical activity.
  • Eat healthy with plenty of fruits and vegetables.
  • Limit consumption of alcohol (if you drink at all).
  • Protect your skin from the sun.
  • Know yourself, your family history, and your risks.
  • Get regular check-ups and cancer screening tests.
  • Vaccinate against viral cancers

Ref: American Cancer Society (modified)

 

Cancer Screening in HPUPM

Who should be assessed for early detection?

Risk factors varies for different cancers. In general: 

Smokers

> 40 years old

Family history of malignancy

Cancer screening package

Breast clinical examination

Pap smear

DRE (digital rectal exam)

Additional procedures/tests when indicated

Colonoscopy

Mammography (>50 years old)

Ultrasonography

Low dose thorax CT

Lab tests

Tumour markers

Fetal occult blood test

 

Tumour markers in clinical practice

Cancer

Tumour marker

Clinical use

Breast

CEA, CA 15-3

4

GI (colorectal, gastric, pancreas)

CEA

CA 19-9

3,4

4

Prostate

PSA

PAP

1(?), 3, 4

3, 4

Hepatocellular

AFP

CEA

1-4

4

Ovarian

CA125

3,4

Testis (germ cell)

AFP, B-HCG

LDH, PLAP (seminoma)

2-4

3,4

Gesta trophoblastic tm

B-HCG

2-4

Small cell lung cancer

NSE

4

Thyroid

Thyroglobulin

Calcitonin (medullary)

4

1,2,4

Neuroblastoma

VMA, Catecholamines

1-4

Myeloma

Immunoglobulins

2,3

  1. Screening 2. Diagnosis 3. Prognosis  4. Evaluation of treatment response and follow-up

Ref: Oyan-Uluc B. Department of Medical Oncology, Yeditepe University Hospital. Screening and Early Diagnosis in Oncology. Lecture notes

 

If you have queries on cancer you may contact our consultants

Family medicine specialists

https://medic.upm.edu.my/jabatan/jabatan_perubatan_keluarga/staf_akademik-939

 

Tumour markers

Assoc. Prof. Dr Subashini Thambiah

        Tel: 97692779 Email: subashini@upm.edu.my

Dr Intan Nureslyan Samsudin

        Tel: 97692374 Email: intanlyna@upm.edu.my

 

Histopathologists

  • Prof. Dr Norhafizah Mohtarrudin

       Tel: 97692383 Email: norhafizahm@upm.edu.my

  • Prof. Dr Maizaton Atmadini Abdullah

       Tel: 97692391 Email: maizaton@upm.edu.my

  • Dr Huzlinda Hussin

       Tel: 97692781 Email: huzlinda@upm.edu.my

  • Dr Razana Mohd Ali

       Tel: 97692384 Email: razanamo@upm.edu.my

  • Dr Fauzah Abd Ghani

       Tel: 97692382 Email: fauzah@upm.edu.my

  • Dr Ikmal Hisyam Bakrin

        Tel: 97692392 Email: ikmalhisyam@upm.edu.my

 

Haematologists

Assoc. Prof. Dr Sabariah Md Noor

      Tel: 97692761  Email: md_sabariah@upm.edu.mu

Assoc. Prof. Dr. Eusni Rahayu Mohd Tohit

      Tel: 97692379 Email: eusni@upm.edu.my

Dr Zainina Seman

      Tel: 97692380 Email: zainina@upm.edu.my

Dr Faridah Idris

Tel: 97692378 Email: i_faridah@upm.edu.my

 

People in Cancer Research in UPM

Breast cancer

  • Dr Rozita Rosli (Genetics)
  • Dr. Seow Heng Fong (Immunology)
  • Dr Rozi Mahmud (Clinical Radiology)

 

Colorectal cancer

  • Dr. Seow Heng Fong (Immunology)
  • Madya Dr. Mohd Faizal Jabar (Colorectal surgeon)
  • Madya Dr. Norhafizah Mohtaruddin (Histopathologist)
  • Dr Zalina Abu Zaid (Dietetics)

 

Leukaemia/Lymphoma

  • Prof. Dr Maha Abdullah (Immunology)
  • Assoc Prof. Dr Sabariah Md Noor (Haematologist)
  • Assoc Prof. Dr Bahariah Khalid (Clinical Haematologist)
  • Prof. Dr Maizaton Atmadini Abdullah (Histopathologist)
  • Dr Zainina Seman (Haematologist)

 

Prostate Cancer

  • Prof. Khairul Asri Mohd Ghani@Mamat (Urologist)
  • Dr Cheah Yoke Kqueen (Genetics)

 

Bladder Cancer

  • Dr Huzlinda Hussin (Histopathologist)

 

Gynae Cancers

  • Dr Razana Mohd Ali (Histopathologist)

 

Cancer Pharmacology

  • Dr Johnson Stanslas (Pharmacotherapeutics)

 

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Updated:: 02/10/2019 [h_nora]

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Universiti Putra Malaysia
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