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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