Cancer
Cancer is a condition where cells in the body grow in an uncontrolled way.
Incidence in PNG: Estimated ~12,000 new cancer cases annually with a mortality rate of 60%; under-reported due to poor registry systems.
Common cancers in PNG:
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Women: Cervix (leading, very high HPV prevalence), breast.
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Men: Head & neck (oral), liver (hepatitis B driven), prostate, lung.
Types of cancer
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There are more than 200 different types of cancer.
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Cancer can affect any part of your body, including your organs, blood, bone marrow and immune system.
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Sometimes cancer spreads from one place to another. This is called secondary cancer, or metastasis.
Possible causes of cancer
Anyone can get cancer and it's not always clear what causes it. But there are things that can increase your risk of getting certain types of cancer.These can include:
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getting older
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other people in your family having certain cancers
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your lifestyle – such as smoking, drinking, being overweight, exposure to too much sun
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having certain viruses – such as human papillomavirus (HPV) or hepatitis
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having certain conditions – such as severe acid reflux or Lynch syndrome (a condition that runs in families)
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the environment where you work or live – such as exposure to asbestos or air pollution
Reducing your risk of cancer
You cannot always prevent cancer, but there are things you can do to reduce your risk of getting some types of cancer.
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Do have cancer screening when you're eligible – such as
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cervical cancer screening (HPV testing and pap smear)
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breast cancer screening (mammogram) or
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bowel cancer screening (colonoscopy and fecal occult blood test)
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Do have the HPV vaccine or hepatitis B vaccine as advised by your GP
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Do try to quit alcohol
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Do try to lose weight if you're overweight, or keep to a healthy weight
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Do try to quit smoking
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Do follow advice on sunscreen and sun safety, such as wearing sunscreen of at least 30 SPF and spending time in the shade, to protect your skin
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Do eat a balanced diet
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Be physically active – aim for at least 150 minutes of moderate activity or 75 minutes of vigorous activity a week
Possible symptoms of cancer
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Different types of cancer all have their own symptoms.General symptoms which could be a sign of cancer can include:
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a new lump or swelling anywhere on your body
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sweating a lot (particularly at night) or a high temperature that lasts a long time or keeps coming back
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feeling more tired than usual
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unusual bruising or bleeding (such as bleeding from your bottom, blood in your pee or vomiting blood)
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pain anywhere in your body that's not usual for you
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losing weight without trying or feeling less hungry than usual
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needing to pee more often or more urgently, or pain when you pee
Symptoms of suspected oral cancer
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Unexplained ulceration or growth in the oral cavity lasting for more than 3 weeks or
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Unexplained tooth mobility, not associated with dental issues
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A persistent and unexplained lump in the neck.
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A red or red and white patch in the oral cavity.
Symptoms of suspected throat cancer
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People aged 45 and over with:
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Persistent unexplained hoarseness of voice > 6 weeks or
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An unexplained lump in the neck
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People aged 45 and over with:
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Difficulty in swallowing persisting for > 3 weeks or
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An unexplained lump in the neck
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Symptoms of suspected Breast cancer
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Aged 30 and over and have
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An unexplained breast lump with or without pain or
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An unexplained lump in the axilla.
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Aged 50 and over with any of the following symptoms in one nipple only:
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Discharge
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Retraction
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Symptoms of suspected gynecological cancer (Cervix, Endometrium, ovary)
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vaginal discharge that's not usual for you
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unusual vaginal bleeding, such as bleeding between periods or after sex, or bleeding after the menopause
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unexplained vulval lump, ulceration or bleeding.
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persistent abdominal distension (women often refer to this as 'bloating') and pelvic or abdominal pain
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increased urinary urgency and/or frequency.
Symptoms of suspected urogenital cancer (Male)
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Any lower urinary tract symptoms, such as nocturia, urinary frequency, hesitancy, urgency or retention or
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Erectile dysfunction or Visible haematuria.
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Elevated PSA: Age related cut-off measurements for PSA:
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40-49 years > 2.5 ng / ml
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50-59 years > 3.5 ng / ml
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60-69 years > 4.5 ng / ml
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70-79 years > 6.5 ng / ml
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a non-painful enlargement or change in shape or texture of the testis or unexplained or persistent testicular symptoms.
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A persistent penile lesion after treatment for a sexually transmitted infection has been completed
Symptoms of suspected urological cancer (Urinary bladder, Renal)
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People aged 45 and over and have:
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Unexplained visible haematuria without urinary tract infection or
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Visible haematuria that persists or recurs after successful treatment of urinary tract infection, or
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People aged 60 and over and have unexplained non-visible haematuria and either dysuria or a raised white cell count on a blood test.
Symptoms of suspected hematological cancer (Lymphoma, Myeloma, Leukemia)
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People aged 60 and over with persistent bone pain, particularly back pain, or unexplained fracture
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Adults presenting with
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Unexplained lymphadenopathy or Splenomegaly
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any associated symptoms, particularly
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Fever
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Drenching night sweats
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Shortness of breath
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Generalised itching or
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Weight loss of > 10% in less than 6 months.
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Symptoms of suspected upper gastro-intestinal cancer (Esophagus, Stomach, Liver, Pancreas)
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Difficulty in swallowing or
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Aged 55 and over with weight loss and any of the following:
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Upper abdominal pain
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Reflux
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Heartburn.
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Aged 40 and over and have jaundice.
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People with an upper abdominal mass consistent with gall bladder cancer.
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People with an upper abdominal mass consistent with enlarged liver.
Symptoms of suspected lower gastro-intestinal cancer (Colorectal)
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People with a rectal or abdominal mass consistent with colorectal cancer
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People aged 40 and over with unexplained weight loss and abdominal pain or
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People aged 50 and over with unexplained rectal bleeding or
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People aged 60 and over with:
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Iron-deficiency anaemia or
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Changes in their bowel habit, or
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Tests show occult blood in their feces.
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Symptoms of suspected brain tumor
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Adults with progressive, sub-acute loss of central neurological function such as
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Seizures
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Hemiplegia etc.
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Symptoms of suspected bone tumors / sarcoma
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Adults with an unexplained musculoskeletal lump that is increasing in size.
Symptoms of suspected lung cancer
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Have chest X-ray findings that suggest lung cancer or
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Are aged 40 and over with unexplained haemoptysis.
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People aged 40 and over if they have 2 or more of the following unexplained symptoms, or if they have ever smoked and have 1 or more of the following unexplained symptoms:
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Cough
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Fatigue
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Shortness of breath
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Chest pain
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Weight loss
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Appetite loss.
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Symptoms of suspected skin cancer
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a new mole, or changes to a mole anywhere on your body
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changes in your skin, such as a sore that does not get better
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Important
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Most of these symptoms are very common and can be caused by other conditions.
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Having these symptoms does not definitely mean you have cancer, but it's important to get checked by a GP.
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If your symptoms are caused by cancer, finding it early may mean it's easier to treat.
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See a GP if you have:
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Symptoms of suspected cancer
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Any symptoms or changes that are not normal for you and you're worried could be cancer
If your GP suspects that your symptoms could be a sign of cancer, you may get an urgent referral for more tests or to see a Surgical / Medical specialist in PMGH for initial consultation and further evaluation.
Referral recommendation for the GP​​​​​
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Common treatments for cancer
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The treatment you'll have depends on the type of cancer.
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The most common treatments for cancer include:
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Surgery to remove the cancer
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Chemotherapy, which uses medicines to kill cancer cells
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Radiotherapy, which uses radiation to kill cancer cells
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You'll be looked after by a team of specialists who will work with you to create a treatment plan that is best for you.
