PREVENTION PADA CANCER (Ca)

DR. Dr. Artha Budi Susila Duarsa, M.Kes

PUBLIC HEALTH DEPARTEMENT
FACULTY OF MEDICINE
YARSI UNIVERSITY

Riwayat Alamiah Penyakit 1

 Penyebab Utama Kematian di Amerika Serikat 1900
(abad pemunculan pandemik) vs
1967 (abad penyakit degeneratif)

Pneumonia & Penyakit jantung

influenza Kanker
Tuberculosis Cerebral hemorrhage
Diarrhea & enteritis Kecelakaan
Penyakit jantung Pneumonia &
Nephritis influenza
Kecelakaan Penyakit pada awal
Kanker bayi
Diphtheria Arteriosklerosis
Meningitis Diabetes mellitus
Penyakit sirkulasi
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 Banyak Negara Saat Ini Berada Dalam Tahap Penyakit
Degeneratif & Penyakit Karena Ulah Manusia

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 Insidens Yang Tinggi Untuk Penyakit Tidak Menular
(Non Communicable diseases) Di Negara Maju

Kardiovaskular
Penyakit jantung koroner

Trombosis vena

Respiratori
Emfisema

Kanker paru-paru

Genital perempuan
Endometriosis

Kanker endometrial

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 Payudara
Kanker payudara

Fibrosis kistik

Genital laki-laki
Kanker prostat

Metabolik
NIDDM (Non Insulin Dependent Diabetes Mellitus)

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 Kemungkinan etiologi infeksi
Sirosis makronodular

Karsinoma hepatoselular

Penyakit jantung rematik

Anemia defisiensi Fe (besi)

Berhubungan dengan defisiensi nutrisi

Goiter (gondok) endemik

Malnutrisi yang berkaitan dengan diabetes

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 PREVENTION PENYAKIT DIDASARKAN
KEPADA
RIWAYAT ALAMIAH PERJALANAN PENYAKIT
(The Natural History of Disease)
Riwayat Alamiah Perjalanan Penyakit (Natural History of Disease)
( Mausner & Kramer, 1985 dlm Weber, DJ & Rutala,WA, 2001)
PERIODE PRE PATHOGENESIS

Faktor Risiko Ca:

Faktor Agent:
Chemical carcinogen (organik & non organik)
Physical carsinogen (ultraviolet, electronic rays)
Nutritional
Biological (schistosoma)

Faktor Lingkungan (environmental):

Iklim (inntensitas ultraviolet)
Sanitasi (penyediaan air bersih)
 Faktor Host:

Umur
Ras
Jenis kelamin
Herediter
Perilaku /kebiasaan
Lesi pre ca
PERIODE PATHOGENESIS
Latent Periode
Local cancerous growth

Cancer insitu:
Asymtomatic cancer
Tissu change potentially identifiable

Organ localization with sign & siymptom

Regional spread

Remote metastasis

Chronic state

Terminal state

Death
 LEVEL OF PREVENTION Ca
(Leavell & Clark: Preventive Medicine for Doctor in His
Community)

PRIMARY PREVENTION

Health Promotion
Education of community to change attitudes toward cancer

Increased Index of suspicion

Recruitment & training specialist

Improvement of general hygienic practices

Environmental sanitation
 SPECIFIC PROTECTION

Elimination or protection against known &

suspected carcinogen

Detection & elimination of precancerous

lesions
SECONDARY PREVENTION

Early Diagnosis & Prompt Treatment

Self examination of breast

Cancer detection centers

Selective examination

Diagnosis clinics

Treatment clinics
TERTIARY PREVENTION

Disability Limitation

Treatmen clinics (Radium, Radioactive,

isotops)

Attention to convalescent care

Rehabilitation

Physical & psycologic rehabilitationin cases of

amputation, laryngectomy, facial deformites,
colostomy

Organization of rehabilitation centers