Seeking the right to equality to every women of PNG this International Women’s Day

This is 21st century, and globally women are enjoying more freedom and power than ever before virtually in all aspects of life. Women have gained equal access to education, health care, capital, decision-making powers in the political, social, and business sectors. Certainly, things are changing for better for the women of PNG as well. Despite PNG’s strong patriarchal system of society, women have come a long way in achieving much stronger roles in education and politics. PNG women from all walks of life are trying to break the social taboos and set benchmarks for other women.

 

Today, we have women achievers in PNG who are an inspiration to hundreds of women and girls. Dr. Esther Roibete Apuahe – the first lady surgeon of PNG attributes her success completely to her father who supported in her journey towards being a doctor. She is a live example for every woman in PNG who wish to excel in life. Women empowerment can be achieved only when the family realises the importance of its support to girls/women in fulfilling their dreams. During the June 2012 elections, of the 3500 contestants, 135 contestants were women candidates and 3 of these women were successful in becoming new members of the House – Hon Delilah Gore (Sohe Open), Hon Loujaya Toni (Lae Open) and Hon Julie Soso (Eastern Highlands Regional). Hon Soso was elected from a regional seat, entitling her the position of a Governor of her province.

 

Women like these are bringing about a change in the mindset of the people in PNG.

 

Though small strides have been accomplished in brining gender equality in PNG, much needs to be done. A larger section of women in PNG still face domestic violence, sexual assault, poor health status and many harmful traditional practises. The change that we wish for PNG can only happen when there will be a shift in the mindset of people regarding the importance of the role of females in the family and society.

 

PNG has some of the worst health indicators in the world for women. This majorly includes:

 

  • Poor Maternal Health
  • HIV/AIDS
  • Cervical Cancer Deaths

 

Women in PNG are particularly disadvantaged, as evidenced by poor maternal health and lack of access to family planning. The maternal mortality ratio is 230 per 100,000. PNG National Department of Health and many others estimate that at least 5 women die in childbirth every day. High incidence of sexual assaults on women contributes to their risk of catching HIV or other STI.

 

The changing trends – a ray of hope

 

With the changing times, there is more and more involvement of females in the decision-making roles in the society; we foresee a brighter future for females of PNG. Australian government is supporting PNG’s legal system and police service, to help deal with family and sexual violence. But, change will need to come from within. Ultimately efforts to fight gender inequality must be led by Papua New Guineans. However, in 2013, the parliament passed family protection legislation first drafted back in the early 1990s which criminalises domestic violence, strengthens protection orders, and directs police to pursue family and sexual violence. But, practical efforts to tackle the violence are still not seen as a priority (Low Institute Organisation).

 

This International Women’s Day there is a need for awareness among PNG women to know about their rights. Women of PNG need support and they should be encouraged to partner with organizations and centres who can help them.

 

PIH wishes all women Happy Women’s Day and congratulates its women doctors and staff for their achievement as service providers. They are an inspiration to many women in PNG.

 

Kudos to our team ladies!

 

Importance of Screening Examination in Curbing Cancer in PNG

Cancer is the second leading cause of death in Papua New Guinea (PNG) with around 5200 deaths reported in 2014. There were nearly 2300 cancer deaths in males and 2900 cancer deaths in females,with oral cancer being the most common in PNG males and cervical cancer being the most common in PNG females (CDC 2013, WHO 2014).

The 5 most common cancers among PNG males and females (WHO 2014):

Males Females
Oral and lip cancer (527 cases) Cervical cancer (938 cases)
Liver cancer (334 cases) Breast Cancer (848 cases)
Prostate cancer (245 cases) Oral and lip cancer (475 cases)
Colorectal cancer (198 cases) Thyroid cancer (248 cases)
Lung cancer (196 cases) Uterine or corpus uteri cancer (231 cases)

Making screening tests a regular habit

Why cancer screening?

Cancer screening is necessary to detect cancer even before symptoms appear. The benefits of screening include cancer prevention, early detection, successive treatment and extended life. This usually involves blood tests, urine tests or medical imaging.

Common screening procedures for cancers

Mammogram for breast cancer examination

A Mammogram is a low-dose X-ray procedure to see the internal structure of the breast, and is commonly used in examination of breast cancer. A mammogram can show the earliest signs of breast cancer even before it can be felt by the woman or her physician.

Risk Factors for Breast Cancer:

  1. Family history or personal history of cancer.
  2. Advancing age – Females above 55yrs of age are more prone to breast cancer.
  3. Genetics– The genetic mutations of genes.
  4. Overweight females produce more estrogen. Estrogen can make hormone-receptor-positive breast cancers to develop and grow.
  5. Alcohol consumption and smoking
  6. Late pregnancies can also subject a female to risks for breast cancer.

Preventing breast cancer majorly depends upon how proactive you are with regular screening, self-examination of breast and lifestyle changes.

Getting an annual check-up for females above 25 years of age is recommended by doctors to keep a check on any pre-cancerous or cancerous changes in breast. Women with personal history or family history of cancer are encouraged to have a scan done every 3 months and later every 6 months.

Breast cancer is depicted by pink colour ribbon

Pap SMEAR test for cervical cancer detection

PAP Smear is a test to detect any cancerous development early in the cervix.The procedure involves collecting cells from the cervix so that they can be looked at under a microscope to find cancer and pre-cancers.

Risk Factors for Cervical Cancer:

  1. Human Papilloma Virus (HPV) infections are strongly linked to cancersof the cervix, vulva, and vagina in women, penile cancer in men.
  2. Tobacco consumption and smoking in women can damage the DNA of cervix cells and may contribute to the development of cervical cancer.
  3. Chlamydia is a very common infection of female reproductive tract, spread by sexual contact that can lead to pelvic inflammations and even infertility.
  4. Having a family history of cervical cancer increases the chances of developing the disease by 2 to 3 times.
  5. Having multiple sexual partners, compromised immune system or having HIV.

Keeping a check on the risk factors and modifying lifestyle accordingly can help a lot in preventing cervical cancer. Cervical cancer gives the most positive treatment outcome if detected early. Regular screening for women aged 25 years and above can help in reducing the number of cases as well as the complications associated with this cancer.

Cervical cancer is depicted by teal and white colour ribbon.

Colonoscopy for detecting cancer in colon/rectum

Colonoscopy is an invasive diagnostic procedure used to detect any abnormal growth in the large intestine. Any changes in the rectum and entire colon can be detected using a thin flexible tube inserted in the rectum. This is a preferred and generally painless screening method to detect colorectal cancer and other GI Tract related ailments.

Risk Factors for Colorectal Cancer or Bowel Cancer:

  1. Having a family history or polyp in intestine.
  2. Diseases like Chron’s disease, ulcerative colitis or diabetes are associated with colon/rectum cancer.
  3. Certain types of diets, one that is high in red meats (beef, lamb, or liver) and processed meats.
  4. Smoking and heavy use of alcohol, lack of exercise and physical inactivity are all by default risk factors for bowel cancer as well as many other diseases.

Colorectal cancer being one of the most common cancers among males in PNG requires attention as well as knowledge about how to prevent it. Few risk factors like having a family history cannot be changed but other including changes in the diet, following healthy lifestyle as well as regular screening always goes a long way in saving you from colorectal cancer.

Colon cancer is depicted by dark blue colour ribbon

PSA test for prostate cancer examination

Prostate cancer is one of the most common cancers worldwide in men and ranks to be the third most common cancer in PNG. Any abnormality in the prostate can be detected early by getting a PSA (prostate specific antigen) test done. The test involves having a blood test done and finding the amount of the prostate specific antigen in blood released by the prostate. A higher amount of PSA depicts abnormality with the prostate, which then requires further tests to confirm the diagnosis.

 Risk factors of prostate cancer include:

  1. Age- The risk of prostate cancer increases with age, especially in men over 50 years.
  2. Family History –Prostate cancer that runs in a family is called familial prostate cancer. The family with history of breast cancer increases the chances of males to have prostate cancer.
  3. Smoking.

Getting a PSA test done annually can help in detecting prostate cancer early. Males after 45 years of age should regularly get this blood test done to detect this cancer in time.

Prostate cancer is depicted by light blue colour ribbon

Dental checkups for detecting oral cancer

Many dentists check for mouth or oro-pharyngeal cancer. So they are often the first to spot these cancers in their patients.

Risk factors of oropharyngeal cancers:

  1. Chewing Buai is a widely practised habit in PNG, which is directly associated with oral cancer. It’s been studied that the substance released from the areca nut cause changes in the oral mucosa that subjects a person to oral cancer.
  2. Smoking tobacco and drinking too much alcohol.Cigarettes and alcohol contain nitrosamines and other chemicals that are known to cause cancer.
  3. A poor diet may lead to lack of vitamins and minerals, such as iron or folic acid.
  4. Human papilloma virus (HPV) can cause genetic changes in cells that make individuals more prone to oral cancer.

Prevention entirely depends upon realising the seriousness of the condition and giving up habits that can lead to such cancers.

Oral cancer is depicted by red and white colour

Pacific International Hospital encourages screening tests for early detection of cancers and is offering exclusive cancer screening packages to the people of PNG.

 

Cancer – Yes it can be controlled

Cancer is a cruel word, which can shake the very core of even the strongest. However, the good news is, today, the word ‘CANCER’ is less scary to people than it used to be in the last few years. We have many living testimonies about people who have been victorious over cancer.  This is made possible only because of the proactive initiative taken up by many who have been part of this ordeal, one way or the other.

World Cancer Day is observed on the 4th of February every year; this year’s theme is ‘We Can. I Can.’ The theme emphasises on how you as an individual and we together as a community can do our share in reducing the burden of cancer. The truth is we all have the power to bring a change in minimising the impact of cancer by actively participating in raising awareness about early detection and risk factors.

Cancer is a generic term covering a large group of diseases that can affect any part of body. Cancer has emerged as one of the leading cause of death worldwide with ever increasing number of cases recorded each day. There were nearly 14.1 million cases of cancer and around 8 million deaths due to cancer recorded in 2012 (Globocan 2012). With such a huge number of cancer occurrences, it’s believed that in the next two decades the cases may raise up to 22 million (WHO 2015).

Top Cancers in Men

The 5 most common cancers among men, diagnosed in 2012, were lung, prostate, colorectal, stomach and liver cancers.

Top Cancers in Women

The 5 most common cancers diagnosed in women were breast, colorectal, lung, cervix and stomach cancers.

The most common causes of cancer death include:

  • Lung (1.59 million deaths)
  • Liver (745 000 deaths)
  • Stomach (723 000 deaths)
  • Colorectal (694 000 deaths)
  • Breast (521 000 deaths)
  • Oesophageal cancer (400 000 deaths)

Cancer and its risk factors

There are many factors that can put you at the risk of developing cancer, of which some of the factors can be checked and controlled, but there are few that are not in the scope to changes like aging or having a family history. Top risk factor that increases the chances of cancer is ‘THE USE OF TOBACCO’, nearly 20% of cancer deaths are due to this reason (WHO 2015). Other risk factors are:

  • Lack of physical activity
  • Unhealthy diet with low fruit and vegetable intake
  • Being overweight or obese
  • Alcohol use
  • Sexually transmitted HPV-infection
  • Infection by HBV
  • Exposure to radiation
  • Urban air pollution
  • Indoor smoke from household use of solid fuels

Let us fade away the fear of cancer by spreading the message of ‘We Can. I Can.’

Be the one to inspire action and take action. Encourage healthy lifestyle choices.

  1. Screening Tests – Understand that early screening can detect cancer early and save lives. Early detected cancers have a greater chance of cure. (Pap smear, mammograms, PSA test etc.)
  2. Preventive Measures – Measures like taking vaccination for HPV and HBV, reducing UV rays exposure and adapting healthy lifestyle can reduce the risk factors for cancer.

Cancer screening tests and knowledge about cancer can help in bringing down cancer deaths and improving quality of life. Get educated about signs and symptoms of cancer.

PIH the premier healthcare facility in PNG believes that individuals must take responsibility for their health and well being. Therefore, encourages every one for regular screening and preventive checks regarding cancer. It welcomes everyone to share his or her concerns and doubts regarding cancer and to seek medical attention at the earliest.

Support others. Speak out and Share stories.

World Toothache Day

Dental care or tooth care is the most neglected of all health problems. Those nasty toothaches can be most annoying and painful. Toothache Day is celebrated on 9th February and is a great opportunity to promote good oral health, learn about preventing toothaches and know how best to make them go away. Why you should not neglect your teeth?

Careless approach to dental care can cause gum disease and cavities. The bacteria or inflammatory chemicals in the gums can also cause diabetes, heart disease and cancer by entering the bloodstream.

Make sure you give your best to maintain your oral health and keep yourself away from toothaches.

The most common causes of toothache are:

  • Tooth decay
  • Abscessed tooth
  • Tooth fracture
  • A damaged filling
  • Repetitive motions, such as chewing gum or grinding teeth
  • Infected gums

Maintaining Oral health is very important for the overall health and well being. People often give less importance to this fact. Worldwide, 60–90% of school children and nearly 100% of adults have dental cavities (WHO Factsheet 2012). Globally 30% of people aged 65- 74 have no natural teeth. PNG also faces many dental issues, the most common ones are periodontal (gum) disease and dental caries; one more area of concern in PNG is the habit of chewing buai that is associated with many dental and oral conditions.

Your Teeth and Chewing Tobacco OR Buai Risks

  • Stained Teeth & Bad Breath: Chewing tobacco can stain your teeth and tongue, and give you foul breath.
  • Increased Tooth Decay: The sugar and other agents in tobacco damage your tooth enamel and contribute to cavities.
  • Gum Recession: Chewing tobacco causes permanent damage to your gums and the surrounding bone. Damaged gum tissue pulls away from the teeth, causing sensitivity and additional exposure to tooth decay.  It can even result in permanent tooth loss.
  • Oral Cancer:With its 28-cancer causing agents, chewing tobacco exposes gums, cheeks, lips and throat to  constant unhealthy juices. This can result in cancer of the oral cavity, pharynx, larynx, and esophagus.

Periodontal diseases

Periodontal diseases are infections of the structures around the teeth. Periodontal disease is caused by bacteria found in dental plaque. Plaque is the sticky substance that forms on your teeth. The disease can cause symptoms like toothache, bleeding gums etc.  You can prevent periodontal disease by practicing good oral hygiene and visiting your dentist regularly.

Periodontal disease is linked to many other diseases in the body

  • Gum disease may increase the risk of clogged arteries and heart disease.
  • A woman who has gum disease during pregnancy may be more likely to deliver premature baby or with low birth weight.
  • Diabetic patients with periodontal disease may have more trouble controlling their blood sugar than diabetic patients with healthy gums.
  • Bacteria involved in gum disease may cause lung infections or worsen existing lung conditions.

Dental Caries

Caries or cavity in teeth is caused by bacteria, which leads to holes in the tooth. The symptom is usually toothache. If the condition is not checked it may lead to dental abscess. Caries are commonly found in children and young adults.

Everyday Habits That can Damage Your Teeth

Sugar

Sugar is the No. 1 enemy of your teeth; the longer it stays in your mouth, the worse it is. Acid-producing bacteria grow in your mouth that thrives on the sugar you eat. The acids damage tooth enamel. Avoid foods that stick in your teeth like candies and chocolates.

Beverages

Soda is just as bad for teeth, sugar-free or not. Soda is harmful because of its acidity, and so are juices with added sugar.

Alcohol, even just a glass of wine, is also acidic and can erode the teeth. Rinse your mouth with water between drinks.

Say YES to good oral health and NO to toothache

With little efforts you can maintaining good oral health and avoid painful trips to the dentist.

  • Brush your teeth twice in a day and floss once a day to remove the plaque, to avoid teeth damage, and gum diseases.
  • Use toothpaste that contains fluoride as this helps prevent tooth decay and cavities. Ask your dentist to recommend you the best one.
  • Sugar helps plaque grow. Avoid foods that contain a lot of sugar.
  • Avoid using tobacco products and chewing buai.
  • Clean your tongue with a tongue cleaner or a soft-bristle toothbrush. Cleaning tongue is particularly important for people who smoke or chew buai.
  • Change your toothbrush every three months or sooner if bristles are frayed.
  • More importantly visit a dentist for periodic dental checks.

PIH your dental care partner

With commitment to provide quality and excellent patient service, we believe in providing outstanding quality dental services with the help of our dental experts, our finest technology & equipment

PIH provides full range of dental care services for adults and children from general dentistry to advanced dental specialties.

On this World Toothache day, PIH offers exclusive dental services to keep you going with the smile on your face.

  • Regular general check up
  • Scaling
  • Cleaning & Polishing
  • Filling
  • Root Canal

Make the most out of this day, visit PIH

 

The alarming outbreak of Zika Virus: What you need to know

Zika virus is a mosquito-transmitted infection that can spread to people through an infected mosquito bite (Aedes species mosquito). The Zika virus is a serious threat to pregnant women as it can cause major brain defects in unborn children, a condition called microcephaly. The virus was first identified in humans in 1952 in Uganda and the United Republic of Tanzania.

With Brazil being most affected, the virus is spreading through Africa, America, Asia and Pacific regions at an alarming rate. Currently, there are no vaccine, specific treatments, and rapid diagnostic tests available. The virus is carried by the same species of Aedes mosquitoes that carry dengue and yellow fever viruses.

Transmission of virus:
• Through mosquito bite
• Possible transmission from mother to baby during pregnancy Symptoms

The most common symptoms include:
• Fever
• Skin rashes
• Conjunctivitis
• Muscle and joint pain
• Malaise and headache
• Congenital defect in newborns recorded as abnormally small head with brain disorders
• Neurological conditions like Guillain–Barré syndrome (GBS) that leads to muscular            weakness in adults.

Diagnosis and treatment

There is yet no vaccine or medicine to prevent or treat Zika virus. The treatment approach is similar to that of dengue fever.
• Get plenty of rest
• Drink fluids to prevent dehydration
• Take medicines to relieve fever and pain
• Avoid medicines like aspirin that can increase the risk of bleeding

Pregnancy and Zika: Caution for pregnant women

Pregnant women are recommended to follow maximum preventive measures. They should avoid travelling to affected countries/regions.
Newborn babies of mothers who have had a Zika virus infection especially during the first trimester of pregnancy are at an increased risk of microcephaly.

Microcephaly is a birth defect where a baby’s head is smaller than the normal babies of the same sex and age are. Microcephaly has been linked with the following problems:
• Seizures
• Developmental delay, such as problems with speech or other developmental milestones (like sitting, standing, and walking)
• Intellectual disability (decreased ability to learn and function in daily life)
• Problems with movement and balance
• Feeding problems, such as swallowing difficulty
• Hearing loss
• Vision problems

Precautions to Prevent Zika Virus

The only option is to avoid being bitten by mosquitoes. Preventing mosquitoes from breeding is the best way to control the outbreak.
• Avoid/Clear stagnation of water around your homes, schools or offices
• Empty, clean or cover containers such as buckets, flower pots or tyres
• Use insect repellent
• Cover up with long sleeves and long trousers (preferably light-coloured)
• Close doors and windows to avoid mosquitoes to enter the house
• Sleep under mosquito nets
• The present condition is so critical that it is even advised women in affected countries to delay getting pregnant

Prevention is the best tool to win the war against this virus. Be informed and act accordingly. Your health lies in your hands.

 

Human Papilloma Virus (HPV) and CANCER

Why is it essential to know about Human Papilloma Virus (HPV)?

Education and awareness about HPV infection can help in reducing the burden of HPV cancer.

HPV is the most common sexually transmitted infection (STI). HPV is a group of viruses capable of causing infections. HPV can cause warts (papillomas) in the infected area, cancer (especially cervical cancer) or other health problems. HPV can infect the genital areas of males and females.

How do people get HPV?

HPV is transmitted through intimate skin-to-skin contact. Anyone who is sexually active can get HPV, it happens by having vaginal, anal or oral sex with someone who has the virus. Nearly all sexually active men and women get it at some point of time.

HPV and Cancer

Human Papilloma Virus (HPV) is the most common cause of cervical cancer, which is the second most common cancer among women. There were an estimated 445,000 new cases and 27,000 deaths due to cervical cancer in 2012 globally (WHO 2015).

Other cancers caused by HPV are cancers of the vulva, vagina, penis, anus and cancers of the throat and tongue.

Signs and Symptoms

Generally there are no specific symptoms noticed due to the infection. The signs show up only in advanced stage. The symptoms include:

  1. Genital Warts – Small bumps or group of bumps in the genital area. They can be of various shapes, flat, raised or round.
  2. Cancer- Symptoms usually appear in advanced stages. Specifically for cervical cancer, there might be unusual bleeding from vagina, abnormal discharge, etc. In cases of other cancers caused by HPV, the symptoms can vary.

Detecting HPV

There is no specific test to detect the HPV status of an individual. Generally HPV infections may go unattended. Only in cases of cervical cancer, it can be detected with routine cervical cancer screening (Pap smear test). There is no treatment for the virus itself, but there are treatments for the problems (warts, cervical discharge) that HPV can cause. Therefore, it is better to take up preventive measures to protect yourself from HPV.

Preventing HPV

Practise Safer Sex: The easiest way of reducing the chances of getting infected by HPV is by practising safer sex.

HPV Vaccination: Get vaccinated, this could prevent most cancers and other diseases caused by HPV. There are two recommended vaccines available against HPV infection and are efficacious in preventing cervical cancer. As per the guidelines, the age for vaccination is 11–12 years for girls and boys, and for adults until 26 years of age.

Regular Health Checks: It is important for women to get regular screening for cervical cancer.

Routine Pap Test can help in detecting cancers even before they develop and this can save many lives.

PIH INITIATIVE

In PNG, cervical cancer is a serious health concern among women. There is an increase in number of cervical cancer cases being reported every year (HPV Centre 2015). PIH has partnered with FM Central in promoting awareness about cervical cancer and giving out free PAP Smear Test.  PIH emphasises the need for HPV vaccination for every girl in getting protection against the virus. PIH encourages the community to take part in building awareness about HPV in keeping the numbers down for HPV cancers in PNG.

Image Source: http://www.redorbit.com/

Setting healthy goals this New Year with PIH

Healthy New Year Resolutions for this Year: Remember these are not for breaking!

The year has just begun bringing with it new hopes, new desires and of course your new resolution(s). As every one of us is different so are our resolutions. PIH marks this year as ‘Health for All in PNG’ and hopes to do more than what we did last year in advancing the boundaries of healthcare. The responsibilities must lie with you as well in scoring a 100% on your health report. So let’s set goals for a healthy 2016.

Keep a check on what you eat

First, try with avoiding processed foods, aerated drinks and junk foods. Do mindful eating; eat healthy and nutritious food. Try adding more fruits, vegetable salads, fresh juices in your diet. Healthy eating benefits your body in providing you with necessary minerals and vitamins, boosting your immunity, detoxifying your body and numerous other positive things. For a better diet plan meet a nutritionist and get a customised diet plan for yourself.

Enjoy alcohol but never make it a habit

People who drink alcohol daily or in large quantity often take it very casual and realise only when it starts taking a toll on their health. Alcohol is linked to many diseases like liver problems, diabetes, cancers and many more. Consuming alcohol in a moderate quantity is not that harmful. So this new year go from more alcohol to low or no alcohol, as it’s for your own good.

It is OK to be a quitter – Stop smoking

Cigarette contains nearly 600 ingredients that generate 7000 chemicals when burned, out of which many of them can cause cancer.  Smoking affects each and every system of our body, and also of those who passively inhale the smoke; it can be your loving family or dear friends. Quitting smoking is more like a wonderful gift you give to yourself; your body starts getting detoxifying, and you feel younger, you breathe better, you taste things better and you live long.

Say YES to Exercising

A minimum of 30 minutes of physical activity can do wonders for you in keeping you fit. Indulge yourself in activities that you like such as dancing, swimming, walking, gardening, etc. All these can give you both fun and fitness. Being physically active helps you to live longer, prevent many diseases like diabetes, heart diseases, some cancers, and also helps in strengthening your muscles and bones.  Other benefits include improved self-esteem, sleep quality and energy level.

Make time for family

Family time is important for your happiness and overall wellbeing.  We tend to overlook this aspect because of our busy work schedules. Studies have shown the importance of having fun with family and close friends. Sharing a good family time not only helps you connect with each other better but also is proven to reduce stress.

Positive emotions make us more social and open to new ideas as individuals. So find ways to have fun and do new things with your loved ones to build your happiness. Family outings also contribute a lot to rejuvenate you from your daily monotony. So why not plan a family outing right away

Annual health check up should be on your must to do list

The old saying Health is Wealth is very true; nothing can be more valuable than being healthy and active. Getting yourself checked annually can help you avoid many health hazards. For those who suffer from conditions like diabetes, heart problems etc., regular checks are necessary to have a quality life.

Ultimately, your health matters the most to you and to PIH too.  Be healthy, feel healthy and look healthy; Wonderful health ahead is all that PIH wishes for you.

Know about the medical advancement that created buzz in 2015

Looking back on the year that went by, we wonder what is left behind for us to cherish. The year 2015 saw some of the best advancements and achievements in the medical world and busted quite a few myths about health and wellness.

Medical buzz that made major headlines in healthcare sector in 2015:

  1. The world’s first Vaccination for Dengue fever was approved by the National Regulatory Authority of Mexico, marking a significant landmark in preventing this mosquito-borne infection, which is prevalent worldwide. Nearly half of the world’s population now lives in Dengue-endemic countries, and an estimated 390 million infections occur each year (Break throughs 2015).
  2. New child-friendly TB medicine in correct fixed dose will be now available to health workers. TB Alliance and partners introduced this drug in November 2015 to improve treatment for the one million children who get infected with tuberculosis (TB) each year. Presently there are no appropriate TB drugs for children, and parents need to cut or crush the pills to approximate the correct dose for children creating uncertainty about whether children receive the right dose. The new medicine tastes good and is simple to provide; just apt for children.
  3. First paediatric antimalarial drugs by Pyramax® approved for treatment of multiple episodes of malaria in children. The medicine has received a positive scientific opinion from the European Medicines Agency (EMA) and has made its way for regulatory approval (Break throughs 2015).
  4. Cuba becomes the world’s first country to eliminate mother-to-child transmission of HIV and syphilis, validated from WHO. Dr. Margaret Chan, WHO Director-General, quoted that “Eliminating transmission of a virus is one of the greatest public health achievements possible.” It is a big achievement as every year nearly 1.4 million women living with HIV become pregnant and there are fair chances of transmitting the virus to the baby. Cuba proved that when efforts are directed in right directions anything can be achieved (WHO 2015).
  5. End of Ebola transmission in Guinea, Dr. Mohammed Belhocine, head of WHO country office declared the end of Ebola virus transmission in the Republic of Guinea on the 29th December 2015. Guinea has a heightened surveillance to ensure that any new cases are identified quickly before they can spread to other people.  The new Ebola cured case was reported after 42 days during the surveillance period from the Ebola treatment unit of Nongo, in Conakry (WHO 2015).
  6. The Paris Climate Summit, November 2015: France welcomed leaders from 195 countries coming together and signing an agreement to help implement steps to curb down Global warming in protecting the health of people. It was an appeal to every person to be responsible in conserving natural environment and climate. (CEBu 2015).
  7. World Health Organisation introduced Universal Health Coverage insisting all the countries to introduce health care services to people, which include prevention, treatment, health promotion and palliative care, without suffering financial hardship. The global coalition emphasises the importance of access to quality health care services across the globe.

Did you know?

Consuming processed meat is linked to cancer: In October 2015 a report by WHO conveyed that, eating processed meat like ham, bacon and hot dogs increases your risk for colon cancer (The New York Times 2015).

E-cigarettes too can harm lungs: Electronic cigarettes, seen by many as a healthy alternative to tobacco smoking, can be harmful to the lungs, revealed by a study, published in the New England Journal of Medicine in January 22, 2015. As reported e-cigarettes or vapes contain cancer causing formaldehyde level that is 15 times more than a normal cigarette. (CEBu 2015).

The year 2015 saw many historical medical advancements, new treatments and therapies in preventing life-threatening illnesses paving path towards a healthier life. Hope 2016 comes up with many more advancements in the field of medicine that can promote health and improve the quality of life for all of us.

Know about Cervical Cancer

Cervical Cancer

Cervical cancer is a type of cancer that develops in a woman’s cervix that is the mouth of the uterus. With 528000 new cases every year worldwide, cervical cancer is the fourth most common cancer affecting women worldwide, after breast cancer.[1]

Cervical cancer has no symptoms in its early stages, there may happen to be unusual bleeding at times before or after the menstrual cycle or post sex but that doesn’t always indicates towards cervical cancer.

Screening procedure can find changes in the cervix before cancer develops. It can also find cervical cancer early − in its most curable stage, it’s better to be aware and encourage regular checkups.

Risk factors for Cervical Cancer [2]

Human Papilloma Virus (HPV) Infection

HPV are called high-risk types because they are strongly linked to cancers, including cancer of the cervix, vulva, and vagina in women, penile cancer in men, and cancers of the anus, mouth, and throat in both men and women.

Smoking

It has been found that tobacco by-products damages the DNA of cervix cells and may contribute to the development of cervical cancer and also makes the immune system less effective against HPV infections.

Chlamydia infection

Chlamydia is a very common infection of female reproductive tract, spread by sexual contact leading to pelvic inflammations and even infertility. It has been noticed female with cervical cancer either has the infection or had a history of such infection.

Having a family history of cervical cancer

Cervical cancer may run in some families. If your mother or sister had cervical cancer, your chances of developing the disease are 2 to 3 times higher than if no one in the family had it.

Being overweight

Overweight women are more likely to develop cancer of the cervix.

Oral Contraceptive Pills

Taking oral contraceptives (OCs) for a long time increases the risk of cancer of the cervix.

Multiple Sexual Partners

Increases the risk of sexually transmitted illnesses and eventually cervical cancer.

Compromised Immune system

Damaged immune system puts women at higher risk for HPV infections. Women with AIDS have a higher risk of cervical cancer.

Symptoms of Cervical Cancer

Although there are no warning signs or symptom of cervical cancer. Symptoms appear mostly in the advanced stage of cancer.

  • Irregular vaginal bleeding is the most common symptom. Bleeding occurring between menstrual periods or after sex.
  • Vaginal Discharge- Along with bleeding, other types of vaginal discharge is a common early symptoms of cervical cancer. The discharge may be watery, pale or brownish in colour, foul smelling and sometime blood stained .
  • Back or pelvic pain.
  • Difficulty urinating or defecating due to obstruction.
  • Swelling of one or both legs.
  • Fatigue
  • Weight loss

Screening and Preventing Cervical Cancer

There are no means of completely preventing the condition but one can look towards means of checking the risk factors and reducing the chances of cervical cancer.

Screening

  1. Regular Pap Smear

The Pap test (or Pap smear) is a procedure used to collect cells from the cervix so that they can be looked at under a microscope to find cancer and pre-cancer. The test is needed to detect precancerous abnormalities and early-stage cervical cancer. Women who are 25-49 years of age should be screened every three year and those who are 50-64 years of age are advised every five years. Women with total hysterectomy do not need a Pap smear[3]

  1. HPV Testing

Women above 30 can have a HPV test combined with pap smear. Before 30 years the test is not significant as it’s too common to find and may not be of any risk.

3.   Pelvic Physical Examination and Colposcopy

If you have had an abnormal Pap smear, your doctor may recommend a colposcopy. A colposcopy uses a large magnifying glass to examine your cervix.

 a) Cervical Cancer Vaccination

Cervical cancer vaccination protects against four types of HPV, including the two strains responsible for majority of cancer cases. To know more about cervical cancer vaccine visit you doctor.

b) Having safe sex

As the spread of cancer is associated with HPV infection and as a known fact one of the reason can be not having a safe sex, so using protection while sex can be helpful although it’s known that HPV spreads through skin to skin contact and not due to penetrative sex.

Having multiple partners also increases the risk of cervical cancer.

c) Avoid or reduce smoking

Smokers are more likely to develop cervical cancer.

Cervical cancer is 100% treatable if diagnosed in early stages, so it’s required for every women to understand the importance of getting screened for a healthy life.

Globeathon Cancer Week

KEEPING BREAST CANCER AT BAY

Breast cancer is defined as a disease with an uncontrolled growth of cellsin the breast.

Breast cancer is one of the more common types of cancer, affecting one in eight women.

Breast cancer is emerging as second most leading cause of deaths among women. An estimated 1.7 million women worldwide was diagnosed with breast cancer in 2012 and 6.3 million women were already diagnosed and living with this cancer in the previous five years, according to Globacon 2012. Since 2008, breast cancer incidence has increased by more than 20%, while mortality has increased by 14%. [1]

These alarming statistics about breast cancer indicates the impending need to raise the awareness on breast cancer.

There are annual awareness campaigns and programmes that have helped to a small extent but yet we have a long way to go in achieving better statistics on breast cancer incidence.

While most people are aware of breast cancer, many forget to take the steps to have a plan to detect and control the disease in its early stages and encourage others to do the same.

Types of Breast Cancer

Breast cancer can be categorised according to the nature of the cancer or by the type of tissue affected-

Based nature of cancer

  • Non-invasive (in situ): Cancer that has not spread from its original tissue (stage 0)
  • Invasive (infiltrating): Cancer cells that have spread to surrounding tissues (stages 1-4)

The tissue affected type of cancer:

  • Ductal carcinoma: is when cancer forms in the lining of the milk ducts (most common).
  • Lobular carcinoma: is when cancer is formed in the lobules of the breast (where milk is produced).
  • Sarcoma: is when cancer grows in the breast’s connective tissue (rare)

Risk Factors for developing breast cancer [2]

  1. Advancing age:  Women above 55yrs of age are more prone to breast cancer.
  2. Family history of breast cancer especially first degree blood relative on the  maternal side of the  family increases the risk.
  3. Genetic History – It has been noticed that approximately 5% to 10% of breast  cancer cases have a genetic involvement. The genetic mutations of BRCA1 and  BRCA2 genes are, by far, the most common known causes of inherited breast  cancer.  Everyone has BRCA1 and BRCA2 genes. The function of the BRCA  genes is to repair cell damage and keep breast cells growing normally. But when  these genes contain abnormalities or mutations then they increase the risk of  breast cancer as well as can also be passed from generation to generation.
  4. Some races and ethnic background of females are more prone. White women  are slightly more likely to develop breast cancer than African American,  Hispanic and Asian women. But African American women are more likely to  develop more aggressive, more advanced-stage breast cancer at a young age.
  5. Overweight females are more likely to develop breast cancer because they  produce more estrogen due to fat cells in their body. Estrogen promotes      hormone-receptor-positive breast cancers to develop and grow.
  6. Using Hormone replacement therapy for some reason like easing  menopausal symptoms also increases the chances.
  7.  A personal history of cancer or breast cancer increases the risk because of  already existing cancerous cells and exposure to radiation previously.
  8. Alcohol consumption and smoking also increases the chances of breast  cancer.
  9. Dense Breast increases the chances of having breast cancer. Dense breast  means more of non-Fatty tissue as compared to fatty tissue in the breast.
  10. Late pregnancies (after 30 years of age).
  11. Early menarche (Periods) or late menopause.

Signs and Symptoms of Breast Cancer

  • Lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
  • A mass or lump, which may feel as small as a pea.
  • A change in the size, shape or contour of the breast.
  • A blood-stained or clear fluid discharge from the nipple.
  • A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly or inflamed).
  • Redness of the skin on the breast or nipple.
  • A change in shape or position of the nipple
  • An area that is distinctly different from any other area on either breast.
  • A marble-like hardened area under the skin.
  •  Vaginal pain
  • Unintentional weight loss
  • Visible veins on the breast

Stages

The stages of cancer of based on four characterstics:

Usually a TNM classification is used for cancer classification. [3]Following is a simplified classification for stages of breast cancer

Stages Tumour Size Lymph node Involvement Metastasis(Other organ involvement)
Stage  0 ( Non-invasive, carcinoma in situ) No No No
Stage 1 Up to 2 cm No No
Stage 2 Between 2 cm to 5 cm Yes No
Stage 3 Larger than 5 cm Yes No
Stage 4 Any size tumour Yes Yes

Screening and Diagnosis of Breast Cancer

Physical Examination and Health History

A through breast examination by the doctor along with a detailed health history and family history can help the doctor to judge as well as look for some evidence pointing towards cancer.

Tissue Biopsy: Medical procedures that test samples of tissue can also help in arriving towards a diagnosis. During a biopsy, a sample of the suspicious area is removed to be looked at under a microscope, by a specialised doctor. There are several types of biopsies, such as fine needle aspiration biopsy, core (large needle) biopsy and surgical biopsy.

Imaging procedures:  One of the most important parts of screening and diagnosing the cancer. Different techniques are used depending upon the need of the patient’s condition.

Mammograms: A mammogram is a specialised x-ray of the breast. Screening mammograms are used to look for breast disease in women who have no signs or symptoms of a breast problem. Screening mammograms usually take 2 views (x-ray pictures taken from different angles) of each breast.

Breast ultrasound: Also known as sonography uses sound waves to outline a part of the body.

Magnetic resonance imaging (MRI) of the breast:MRI scans use radio waves and strong magnets instead of x-rays.MRI can be used along with mammograms for screening women who have a high risk of developing breast cancer, or it can be used to better examine suspicious areas found by a mammogram.

Genetic tests: Tests that look for certain gene mutations (changes) that are  linked to some type of cancer like BRCA gene mutation.

Treatment of Breast Cancer

Treatment depends upon the stage of breast cancer. The main treatment types for breast cancer are:

  • Surgery

Surgery for breast cancer depends upon the extent of cancer spread.

1.Breast Conservation Surgery–It involves excision of the lump along with some breast tissue removal.

2.Mastectomy– In this kind of surgery the whole breast is removed to limit the spread of the cancerous cells in the body.

  • Radiotherapy – Using high frequency rays or particles to kill cancer cells is called as radiotherapy. It’s used after the surgery or chemotherapy on the patient, and is given session wise in which each session last for few minutes.
  • Chemotherapy – The therapy using cancer-killing drugs that are given either externally through mouth or intravenously into the body. Chemotherapy can be used both before and after the surgery. Before the surgery it’s given to shrink the tumour and called as neo Adjuvant chemotherapy, post-surgery when chemotherapy is given it is called as adjuvant therapy.
  • Hormone therapy – Some of the breast cancer can be hormone sensitive (oestrogen or progesterone) called as hormone-receptor-positive cancers and grow post hormone stimulation.  To reduce the chances of relapse or avoid further growth of such cancers, it’s important to lower the levels or effects of such hormones requiring Hormone therapy.
  • Biological therapy (targeted therapy) – As we know there is also genetic involvement in breast cancer development, it has been learned that some cancers grow by stimulation of a protein called human epidermal growth factor receptor 2 (HER2). In such cases, this protein is targeted to stop its effects and reduce the cancer cell growth.

Prevention is better than cure-

The best possible way of keeping breast cancer at bay is by preventing it from happening.

Lower your risk by:

  1.  Modifying/changing your lifestyle and adopting healthy practices
  2.  Visiting doctor for regular health checks
  3.  Getting an annual mammogram done for those above 25 years of age
  4. Females having a personal history of cancer need an examination every 3 months initially  and later every 6 months.( PET scan, Mammograms)
  5.  Extra screenings for some women, MRI or ultrasound screenings can add valuable  information to regular mammogram screening like those who have a family history of breast cancer

 Encourage your family members for check-ups, try to be proactive. There is no vaccine to stop the spread of breast cancer, the only way out is early detection.

Multi-Drug Resistant Tuberculosis

According to the national health authorities of PNG, TB infection in the country is a “national emergency” requiring to be tackled on a war footing. With one of the highest TB infection rates in the world, drug-resistant strains of tuberculosis are causing a disaster in PNG. Approximately 30,000 people in the country are newly infected with TB every year with increasing cases of drug-resistant strains.

These drug resistant strains are difficult to treat even with the most effective TB medication. Thus, patients are left with a more severe strain of infection and less effective treatment options. Understanding the urgency to curtail the spread of multi-drug resistant TB , government, public, private sectors and healthcare workers all should come together to combat the escalation of drug-resistant cases in PNG.

What is Multi-Drug Resistant–TB?

TB bacteria can grow resistance to many TB drugs used to cure the disease; they develop into a unique strain of multi-drug resistant tuberculosis or M-D-R-T-B as it’s known. These strains do not respond to isoniazid and rifampicin, the two most powerful anti-TB drugs, leaving the patient with an even severe strain of TB bacteria that is difficult to cure.

Causes of MDRTB

Not undergoing proper TB treatment, incorrect use of antibacterial drugs, use of ineffective formulations of drugs (e.g. use of single drugs, poor quality medicines or bad storage conditions), and discontinuing treatment can all be the reasons for drug resistance.

Solutions to control drug-resistant TB are:

  • TB screening tests for timely diagnosis
  • Curing the TB patient the first time
  • Ensure adequate infection control measures
  • Ensure the appropriate use of recommended second-line drugs
  • Educate public and raise awareness on prevention and treatment

TB treatment may require a daily regimen of injections, oral medication, and supervised medical care for anywhere between 6 and 24 months. To prevent MDRTB it is necessary for every TB patient to complete his or her treatment.

Prevalence of MDRTB in PNG

Multi-drug resistant cases in PNG have increased almost by 2% since 2013. The epicenters of drug resistant TB are the rural Western and Gulf Provinces. Daru Island is the centre of this epidemic and the rates of drug-resistant TB are among the highest documented globally. As per a study by the national TB control programme 2016, the levels of MDRTB found in PNG are higher than those reported by high MDRTB burden countries such as the Philippines and Vietnam.

The higher prevalence of drug resistance in this area is because of poor treatment, large number of patients not finishing the treatment course, poor quality diagnosis (with smear microscopy) and poor DOTs program execution.

Overcrowded settlements and extreme poverty also play a major role in escalating the spread of MDRTB infection.

MDRTB and HIV

In 2014, at least one-third of people living with HIV worldwide were infected with TB bacteria. People living with HIV are 20 to 30 times more likely to develop active TB disease than people without HIV (WHO 2015). In such immune compromised cases it becomes more difficult to treat drug resistant TB. In PNG with high prevalence of HIV and AIDS the transmission of MDRTB infection can be even more rampant.