The Causation and Prevention of Cancer

1. The Causation and Prevention of Cancer Personal observations, reflections and experience Gordon A. Read.

2. The significance of Observations • Ye see but you do not observe ‘Samuel Johnson’ • Relationship between cause and effect. • Causative, predisposing conditions, precipitatory factors. Co-factors • Genetic abberations. • Intrinsic and extrinsic. • Epidemiological Studiesand Statistics

3. Historical events • Sixth form lecture on the Evils of Smoking • Medical training and increasing awareness • Publicity in 60’s and 70’s of the growing conviction of the relationship between smoking and cancer. • Conventional v. reverse smoking : increased incidence of oral cancer in the latter • World Forum for the Control of Tobacco Korea 2007. Awesome prediction that by 2030 70% of disease amongst communities in the less developed parts of the world will be smoking related • All is not what it seems: contemporary and continuing debate about the value of mammography. • One in three of our generation will develop cancer.

4. Genetic contribution. • Primary genetic disorders. • Eg Trisomy 21 Down syndrome – treatment of patients with leukaemia and testicular tumours. • Patients with Neurofibromatosis – developing CNS and spinal tumour. • Damage to the innate genetic contribution by radiation , chemotherapy , chemical substances leading to subsequent malignancy. • New York dial painters, gold miners of Zimbabwe, uranium miners of the Ukraine, malignant melanomas of pilots and sun bed worshippers

5. Neurofibromatosis

6. Radiation induced skin cancer

7. Atomic bomb/accident sequelae

8. Solar radiation induced melanoma

10. The answer lies in the soil – an old Devonian expression • In MALAWI – in the highlands three times the incidence of oesophageal cancer as in the Shire valley rich in allevial soils rich in the rare earth elements of molybdenum and manganese, deficiencies of which are associated with the disease. • Similiarly deficiencies of iodine associatied with goitre / thyroid disorders and malignancy. • Conversely radioactive materials following Atomic bomb detonations over Japan, Marchelles Islands in the Pacific and more recently Chernobyl in Russia have led to an increase in bone marrow and thyroid carcinoma. • A Farmer living beneath a race track in Lincolnshire developed myeloma. High environmental content of volatile organic solvents. • Blood flukes of Africa, Asia and the Far East leading to high incidence of bladder cancer through schistosomiasishaematobium and rectal cancer through schistosomiasismansoni.

11. Schistosomal Blood Fluke

12. TRAUMATIC CAUSES • BREAST CANCER • BONE CANCER • BRAIN TUMOUR • MEDICAL STUDENT DEVELOPING A GLIOMA FOLLOWING A MOTOR BIKE ACCIDENT AND HEAD INJURY • MELANOMATA OF THE FEET • KAPOSI’S SARCOMA – FEET AND LOWER LEGS – TRAUMA FROM GRASS AND VEGETATION

13. Kaposi’s Sarcoma

14. MELANOMA OF THE SOLE OF THE FOOT

15. Myeloma cells

16. Myeloma pathological fractures

19. INFECTION • Lung cancer superimposed upon a pulmonary TB scar. • Squamous cell carcinoma of the skin in relation to osteomyelitis of the leg • Squamous cell carcinoma of the tongue following syphilis • Non-Hodgkin’s Lymphoma as a sequel to HIV

22. Squamous cell cancer of the tongue

23. Arsenical dermatosis

24. Chemical carcinogensis • Lincolnshire Farmer – house covered by a drying agent / insecticide follwing aeroplane spraying. • Subsequently developed bladder cancer • Medical legal case ensued

25. Cystoscopic appearance of a bladder cancer

26. ASBESTOS EXPOSURE AND MESOTHELIOMA • Blue asbestos fibres. • Long latent period. • Peak incidence by 2020 • Over 25,000 deaths per year by then • Chase Farm Family – Overhauls • Two Sister – both Teachers – clearing the loft • YMCA building near PAH – walk on the other side

28. THANK YOU FOR NOT SMOKING !