HEALTH AWARENESS MONTH

HEALTH AWARENESS MONTH

W H O THEME FOR 2017 D E P R E S S I O N : L E T S TA L K

WHAT IS DEPRESSION? Depression is an illness characterized by persistent sadness, and loss of interest in activities that you normally enjoy, accompanied by an inability to carry out daily activities, for at least two weeks. Depression is a common mental disorder that affects people of all ages, from all walks of life, in all countries.

SIGNS OF DEPRESSION Loss of energy Change in appetite Sleeping more or less Anxiety Reduced concentration Indecisiveness Restlessness Feelings of worthlessness, guilt or hopelessness; and Thoughts of self-harm or suicide.

DEPRESSION IS INCREASED BY: Poverty, Unemployment Life events, e.g. death of a love one or relationship break up Physical illness, usually chronic illness or loss of body part / functions Problems caused by alcohol and drug use

DEPRESSED? WHAT SHOULD YOU DO: Talk to someone you trust. Seek professional help pastors, doctors and counsellors. Keep up with activities that you used to enjoy when you are well. Stay connected. Keep in contact with trusted family and friends. Exercise regularly, even if it s just a short walk. Stick to regular eating and sleeping habits. Accept the reality and adjust expectations. Avoid alcohol and dangerous drugs. If you feel suicidal, contact professionals for help immediately. Depression can be treated. If you think you have depression, please seek help. 4/10/2017

CANCER AWARENESS

CANCER Cancer is a public health problem world-wide affecting all categories of persons. It is the second commonest cause of death in developed countries and among the three leading causes of death in developing countries.

WHAT IS CANCER? Cell is the smallest unit of the body. Normal cells divide in an orderly way. They die when they are worn out or damaged, and new cells take their place. Cancer is when the cells start to grow out of control. They crowd out normal cells. There are many types of cancer. It s not just one disease. Cancer is a class of disease, in which a group of cells displays uncontrolled growth and aggressively invade into, destroy adjacent tissues and spread to other locations in the body via lymph or blood.

WHAT ARE TUMORS? Most cancers form a lump called a tumor or a growth. But not all lumps are cancer. Doctors take out a piece of the lump and look at it to find out if it s cancer. Lumps that are not cancer are called benign e.g. myoma, lipoma etc Lumps that are cancer are called malignancy. There are some cancers, like leukemia (cancer of the blood), that don t form tumors. They grow in the blood cells or other cells of the body. 4/10/2017

CANCER TREND World Health Organization reported that about 24.6 million people live with cancer worldwide. Cancer is the second leading cause of death globally and was responsible for about 9 million deaths in 2015. Globally, nearly 1 in 6 deaths is due to cancer. Approximately, 70% of deaths from cancer occur in low and medium income countries. It is estimated that by year 2020, about 16 million new cases will be diagnosed per annum out of which 70% will be in developing countries. It has been reported that among Africans, close to 70 million of the estimated 965 million people are diagnosed of cancer annually.

WHAT CAUSES CANCERS?

Physical Carcinogens. E.g. Asbestos dust. Interactions between genetics and 3 important external factors is responsible for most cancers Chemical Carcinogens e.g. tobacco smoke Biological Carcinogens. E.g. HPV *Carcinogens: cancer causing agents

RISK FACTORS FOR COMMON CANCERS Genetics factors / family history Unhealthy Diet high fibre foods like wholegrain, fruit and vegetables reduce the risk of some cancers. Processed and red meat increase the risk of bowel cancer. Exposure to carcinogens(physical, biological and chemicals) Exposure to specific cancer causing (chronic) infections. E.g. HIV infection. Excessive alcohol intake. Smoking active / passive. Urban air pollution. Obesity or sedentary lifestyle. 4/10/2017

COMMON CANCERS IN NIGERIA 4/10/2017

BREAST CANCER The breast is a part of the female reproductive organ that serves as one of the main attractive features of a woman. Asides its function of feeding for babies, it has various other functions ranging from cosmetics to hormonal function. It is No. 1 cause of cancer death amongst women in Nigeria.

BREAST CANCER: RISK FACTORS Sex: 99% of breast cancer are seen in women, with about 1% of breast cancers are seen in men. Age: found in middle to older age (40-50years) Family History: a woman with a positive history of breast cancer in a first degree relation is at higher risk of breast cancer. Genetic factor: certain abnormal genes (Br Ca I & II and Plab2) have been found in women who have higher than usual occurrence of family history of breast cancer. The presence of these genes is used as a predictive factor. Presence of the genes also increases the risk of Ovarian cancer. *********For these factors, we can only pray!

BREAST CANCER: OTHER RISK FACTORS Weight / obesity: excessive weight especially after menopause is associated with a higher risk of developing breast cancer. Hormonal: prolonged exposure to female hormones via contraceptives etc. Low resistance / immunity status Unhealthy diet/nutrition Lifestyle - lack of physical activity has been linked to ~10% of cases. Exposure to ultraviolent radiation. Smoking

BREAST CANCER: RED FLAGS Breast lump Change in size or shape of the breast Pain in breast that is persistent Redness or flaky skin of the breast Rash on or around the nipple that don't heal easily Bloody nipple discharge or any discharge other than breast milk Pulling in of the nipple, or other parts of the breast.

HOW CAN BREAST CANCER BE DETECTED? Regular self breast examination Routine breast examination by trained health worker Breast Ultrasound scan: to detect lumps in women < 35years Mammography: special x-ray of the breast for women >35yrs Fine needle aspiration cytology for any lump in the breast Excision biopsy and histology for all lumps Genetic testing to test for Br Ca I and II especially for women @ risk

CERVICAL CANCER : FACTS Cervix is the lower part of the uterus that opens at the top of the vagina. The cervix connects the body of the uterus to the vagina. Worldwide cervical cancer is the 2 nd most common and 5 th deadliest cancer in women. In Nigeria, over 10,000 women were said to have died of cervical cancer in 2015, with about 14,000 new cases diagnosed annually.

RISK FACTORS Early sexual intercourse < 18yrs Early child bearing < 17yrs Unhealthy sex life (2 or more sexual partners, high risk male partner,) Prolonged use of oral contraceptives Smoking Weakened immune system (HIV, TB, other cancers) Low economic status History of sexually transmitted disease History of human papilloma virus infection (HPV) Not getting the HPV vaccine Low socio-economic status

Almost all cervical cancers are associated with HPV (human papilloma virus). HPV is a common virus that is spread through sexual intercourse. Type 16 & 18 cause 70% Type 31 & 45 cause 10% There is also evidence linking HPV with cancers of the anus, vulva, vagina and penis. Genital warts caused by HPV

SYMPTOMS Can be completely asymptomatic Increased vaginal discharge initially watery, becoming brown or red Abnormal vaginal bleeding (start and stops between regular menstrual periods), after vagina / cervical examination Pain during intercourse Post coital bleeding Spontaneous irregular vaginal bleeding Pelvic or back pain

Cervical cancer usually develops very slowly. It starts as a precancerous condition called d y s p l a s i a. This precancerous condition can be detected by a pap smear and is 100% treatable. It can take years for precancerous changes to turn into cervical cancer

Pap Smear

Cervical Cancer / HPV Vaccination Cervarix and Gardasil are designed to prevent infection from HPV types 16 and 18, that cause about 70% of cervical cancer cases. The vaccine can be administered between ages 9 and 55 yrs, and effective for about 7-10 yrs. @ 0 (start time), @ 1 month after, @ 6 months after.

SCREENINGS VIA (visual inspection with acetic acid or lugol's iodine): a cheap method of diagnosing cervical changes. Pap smear: Should be done yearly, starting when sexually active or at 18yrs of age till 69 yrs. Liquid-Based Cytology: new and more advanced than pap smear HPV testing Colposcopy and biopsy

PROSTATE CANCER Commonest cancer in men in Nigeria. 100% curable if detected early. Common from 40 years in men. Commoner in the blacks than whites. Average black man has more than 60% chance of being diagnosed than a white man. Beyond 2 nd stage, overall life expectancy is 5-10 years. 50% of 50 year old men will have some changes occurring in their prostate. 80% of 80 year old men will have some form of prostate cancer, although silent and might never be diagnosed. BPH is not prostate cancer, but needs to be treated.

RISK FACTORS Black man Family history in first degree relation with prostate cancer. Unhealthy diet significant red meat consumption or high fat diary diet. Obese men have higher risk of having aggressive type Tobacco smoking Alcohol intake Occupation fire fighters are known to be exposed to toxic combustion products that might increase their risk. Lack of exercise (inactivity) Diabetics

SYMPTOMS

As a man what should I do? Regular Screening Digital Rectal Examination (DRE). Prostatic Surface Antigen (PSA). Yearly screening recommended for men from 40 yrs. Healthy diets Eat fresh foods, avoid processed foods. Vitamin B and E (antioxidants) containing diets fresh tomatoes, fruits, fish, almond fruit etc. Regular exercise Detest inactivity, even if you have retired.

CANCERS: TREATMENT OPTIONS Surgery Chemotherapy Radiotherapy Palliative care

PREVENTION OF CANCERS Avoidance of risk factors Vaccination against risk agents e.g. Human Papilloma Virus and Hepatitis B Virus Control of occupational hazards Reduce exposure to excessive radiation from the sun, equipment and devices Early detection Early diagnosis and treatment Regular exercise Healthy diets

Dr. Adeolu Ogundeji Monday, April 10, 2017