The origins of cancer

The origins of cancer
By Datuk Dr IBRAHIM WAHID
We’re introducing a new column on cancer called Living with Cancer. It’s a monthly columBy the Malaysian Oncological Society (MOS) in collaboration with sanofi-aventis Malaysia. This week, we take a general look at cancer.
THE word cancer originated from the Greek word “karkinos”. In English, this term translates into “carcinos” or “carcinoma”.
Hippocrates was the man that gave cancer its name. Also known as the Father of Medicine, he was the first person to clearly describe the differences between benign (non-cancerous) and malignant (cancerous) tumors1.

Hippocrates first noticed that blood vessels surrounding a malignant tumour looked like the claws of a crab and therefore proceeded to name his observation “karkinos”, or crab in English.
Cancer is not a disease of modern civilisations. The earliest recorded history describing cancer was found between 3000 BC to 1500 BC1. Details of medical conditions consistent with modern descriptions of cancer were found amongst the inscriptions of two papyrus scrolls of Egypt, known as the “Edwin Smith” and “George Ebers” papyri1.
The burden of cancer
Today, cancer remains one of mankind’s most feared diseases. Approximately 10.9 million people around the world are diagnosed with cancer every year, with almost half of these (45%) coming from Asia2.
Up to 24.5 million people worldwide were estimated to have received a diagnosis of cancer in the last five years2.
And each year, an estimated 6.7 million people die as a result of cancer, representing 12% of total deaths that occur annually2.
Cancer is one of the major health problems in Malaysia. It is now one of the leading causes of death among medically certified deaths, with lung cancer being the most common of all cancer related deaths3.
The National Cancer Registry received close to 43,000 notifications of cancer from Malaysian residents in 20034. Cancer occurs at all ages. The median age for cancer diagnosis was 59 years old among Malaysian men and 53 years old among Malaysian women4.
The most common cancers found in men over 50 years old are cancers of the lung, colon, rectum, nasopharynx, prostate and stomach. In women over 50 years old, cancers of the breast, cervix, colon, uterus, lung and rectum were most common4.
The evolution of modern treatment
The understanding of cancer and its treatments have undergone tremendous evolution since the times of the pharaohs to what it is today.
Back in ancient Egyptian civilisations, magic and religion were very much part of daily lives. Gods and demons were believed to be the cause for many ailments.
Treatment for cancer therefore, often involved supernatural elements, and the first recourse often involved making appeals to a deity. Priests and magicians played important roles, alongside with physicians.

Inscriptions in papyrus scrolls detailed the use of ointments, enemas, caster oil, suppositories and poultices in fighting various forms of cancer, often in addition to supernatural elements.
Following the decline of Egypt, medical and scientific development began to take place in Greece and Rome. Then, Hippocrates, together with another physician named Galen, began to revolutionise the practice of medicine through the use of reason and logic, slowly removing it from the grips of superstitions and magic1.
Hippocrates and Galen believed that human diseases are natural physical processes and hypothesised that cancer was the result of an excess of black bile1.
The Renaissance period saw voyages of discoveries that brought a surge in knowledge and new learning. Up till this time, a variety of remedies were used in the form of arsenic-containing creams and pastes.
The invention of the microscope in the late 17th century added much needed momentum in the quest to understand cancer, enabling closer observations on how cancerous cells behave.
The discovery of the lymphatic system in the late 17th century brought an end to Galen’s “black bile” theory. The understanding and treatment of cancer began to take on a new path, and new theory suggests that it was the result of abnormalities in the lymph and lymphatic system1.

It was not until the 18th century that a modern era in the science of cancer began to emerge. Two French physicians, Jean Astruc and Bernard Peyrilhe, took the very first steps and conducted research that give birth to modern experimental oncology1.
Systematic experiments on cancer were performed, leading to oncology as a medical specialty.
With the discovery of anaesthesia in 1844, surgical procedures flourished and classical cancer operations such as mastectomy (surgical removal of the breast) began to develop, changing the treatment paradigm for cancer.
The 19th, 20th and 21st centuries marked tremendous leaps in research, discoveries and developments in cancer treatment as well as improved understanding of its etiology. It is also during these times that the development and use of chemical compounds (chemotherapy) to treat cancer began to play a central role, alongside radiation and surgery.
Cancer as we know it today is much more complicated than what early scientists hypothesised. It is a class of diseases in which a group of cells display traits of uncontrolled growth, invasion into and destruction of nearby tissues, and sometimes metastasis (spread to other locations in the body via the lymphatic system or blood)5.
Nearly all cancers arise from abnormalities of genetic materials within cells. These abnormalities may be caused by carcinogens (cancer-causing agents) such as tobacco smoke, radiation, certain chemicals or infectious agents5.
Cancer therapy in the modern era
The discovery of various chemical agents during World War I and II kick-started the use of chemicals in fighting cancer.
During World War II, nitrogen mustard was used as ammunition for chemical warfare. Soldiers exposed to this gas were found to have abnormally low counts of white blood cells. Nitrogen mustard was then thought to have an effect on rapidly growing white blood cells.
Subsequent administration of it to a number of patients with lymphoma proved to be effective, albeit only temporarily.
This discovery spearheaded research into the use of chemical compounds for cancer treatment. Up to the 1980s, only a few chemical compounds were discovered and their use caused various toxicities.
However, since the 1990s, newer, more effective and safer chemotherapy compounds were discovered and have been in use for the treatment of cancer until this present day.
Stage IV colorectal cancer is one good example to illustrate how treatment advancements have extended the survival of patients.
Before the 1960s, a patient diagnosed with stage IV colorectal cancer can only hope to survive between four to six months without any use of chemotherapy6. With the discovery of 5-fluorouracil (a chemotherapy agent) in the 1960s, survival was extended to 12-15 months6, making it the only chemotherapy treatment for the next 30 years.
During the 1990s, the discovery of newer chemotherapy compounds such as oxaliplatin and irinotecan changed the treatment paradigm for colorectal cancer. The use of either of these two agents in combination with 5-fluorouracil further pushed up survival to around the range of 16-17 months6.
Therefore, combination therapy of oxaliplatin or irinotecan with 5-fluorouracil became the standard of care.
As we enter into this new millennium, advances in genetics and biochemistry have enabled greater understanding of how cancer cells behave at molecular levels.
This fuelled the research and development of drugs that target specific parts or mechanisms that cause cancer cells to grow. New agents known broadly as “molecular targeted therapy” began to play a role in cancer treatment.
The results achieved from a combination of chemotherapy and molecular targeted agents in fighting cancer have been greatly encouraging.
For the case of stage IV colorectal cancer, a combination of molecular targeted agents with chemotherapy has been shown in various clinical trials to extend survival by up to 30 months7.
Indeed in just a span of 40 years, research has enabled the survival of stage IV colorectal patients to improve from less than six months to more than two years.
Extension of survival through the use of combination treatment of chemotherapy and molecular targeted agents were also observed in other cancer types, such as cancers of the breasts, lungs and kidneys.
Cancer will continue to be a major health problem in the foreseeable future.
At least now in this age of modern science and technology, we can gather more comfort and confidence that continuous medical research is heading towards the right direction in our quest to improve survival for cancer patients.
References:
1. www.medicineworld.org. Accessed on 20th April 2008
2. Ferlay J, et al., GLOBOCAN 2002. Cancer Incidence, Mortality and Prevalence Worldwide. IARC CancerBase No.5, Version 2.0. IARCPress, Lyon, 2004
3. Lim GCC. Jpn J Clin Oncol 2002; 32 (Suppl. 1) S37-S42
4. 2nd Report of The National Cancer Registry. Cancer Incidence in Malaysia 2003
5. Cancer. Wikepedia. http://en.wikipedia.org/wiki/Cancer. Accessed on 26th May 2008
6. Venook A. The Oncologist 2005; 10:250-261
7. Tabernero J et al. J Clin Oncol 2007, 25:5225-32
Datuk Dr Ibrahim Wahid is a consultant oncologist and acting president of the Malaysian Oncological Society (MOS). MOS consists of doctors/specialist who have an interest in treating cancer patients. The society members include oncologists, physicians and surgeons.It started in 1976 as an academic society to enhance the knowledge of its members by organising talks, conferences and other academic activities related to cancer management.
For any questions related to this article, please email cancer@malaysiaoncology.org by June 22, 2008. All questions will be answered, but only selected questions will be published the following month. For other enquiries, please visit the MOS website at www.malaysiaoncology.org.
The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

kuasa Allah dan amerika

Air Sungai Mississippi mula melimpahi tebing
IOWA 19 Jun - Paras air di sungai Mississippi semalam melimpah dari 12 tambak yang dibina di sebalik kejadian banjir buruk yang telah menenggelamkan ladang-ladang mengakibatkan kerugian bernilai berbilion dolar.
Lebih membimbangkan lagi cuaca buruk itu dijangka akan meningkatkan kadar inflasi makanan dunia.
Setakat ini 22 tambak telah pecah dan 10 daripadanya berlaku dalam minggu ini mengakibatkan paras air sungai menyusut dan melimpah ke ladang-ladang berhampiran.
Pihak berkuasa tempatan dan sukarelawan kini sibuk menambak laluan air utama menggunakan beg pasir di kebanyakan kawasan di Amerika Syarikat (AS) bagi menahan tambak daripada pecah dan menyelamatkan ribuan ekar tanaman utama daripada ditenggelami air.
“Kami berasa sedikit lega kerana paras air sungai menurun sedikit tetapi dijangka keadaan ini tidak kekal lama.
“Namun kami masih terus menambak kawasan ini dan keadaan dijangka akan menjadi kritikal malam ini,” kata seorang pekerja dari Agensi Perkhidmatan Kecemasan Daerah Hancock, Kathy Dougherty.
Bencana ini merupakan yang paling buruk melanda Tengah Utara AS dalam tempoh 15 tahun yang turut memusnahkan sebahagian besar kawasan pertanian dan memaksa lebih 10,000 penduduk dipindahkan ke kawasan selamat.
Kerugian akibat bencana ini dijangka mencecah lebih AS$20 bilion (RM64 bilion) dan Iowa merupakan negeri paling teruk terjejas akibat banjir.
Kejadian ini turut mengakibatkan harga di pasaran komoditi, pengeluar makanan dan pengeksport melambung.
Lembaga Perdagangan Chicago melaporkan harga dagangan jagung telah mencatat rekod apabila diniagakan pada harga AS$8.07 untuk satu busyel.
AS menguasai eksport jagung dunia sebanyak 54 peratus, kacang soya 36 peratus dan gandum 23 peratus.- Reuters

sultan johor dan batu putih

Pulau itu bukan hak Singapura - Sultan Johor
“Saya akan berikhtiar mencari jalan mendapatkan semula hak kedaulatan Batu Putih yang kini dimiliki Singapura supaya kembali kepada kerajaan Malaysia. Suka saya ingatkan bahawa saya tidak lupa pada Batu Putih. Pulau itu bukan hak Singapura, tetapi hak Johor. Sampai bila pun saya akan cari ikhtiar dapatkan semula pulau milik Johor itu,” titah Sultan Johor, Sultan Iskandar. Titah itu ditegaskan oleh Sultan Iskandar semasa merasmikan pembukaan Persidangan Pertama Dewan Undangan Negeri (DUN) Johor hari Khamis. Pada 23 Mei lalu, Mahkamah Keadilan Antarabangsa (ICJ) di The Hague, Belanda memutuskan hak kedaulatan Batu Putih diberikan kepada Singapura, manakala Batuan Tengah kepada Malaysia sementara Tubir Selatan diberikan kepada negara yang berada di perairannya. Sementara itu, Menteri Besar Johor, Datuk Abdul Ghani Othman ketika diminta mengulas titah Sultan Johor itu berkata, pihaknya akan mengambil kira perkara yang dibangkitkan oleh baginda tetapi enggan mengulas lanjut mengenai perkara itu. - 19/6/2008

melogikkan pemikiran kita

"Untuk kenaikan harga minyak kali ini. Penstrukturan subsidi yg dibayar menggunakan wang pos. Tahukah anda, Pos Malaysia adalah milik ECM-LIBRA, dan ECM-Libra adalah milik Khairi Jamaluddin menantu Pak Lah. Perancang strategik Pak Lah dari tingkat 4. Bayangkan duit yg masuk ke dalam poket Khairy, setiap RM10 yg dibayar sbg subsidi.. 10 sen akan masuk ke poket sebagai komisen wang pos. Maknanya ada 6 juta kenderaan di malaysia dan setiap kenderaan akan dapat subsidi Rm 620, iaitu RM 6.20 komisen kepada Khairi. Untuk setiap kenderaan RM 6.20 X 6 Juta kenderaan = RM 37 200 000 setiap tahun. Itu tidak termasuk bayaran setiap bulan terhadap VESEL dan Nelayan, juga menggunakan wang pos." Bayaran tunai sebanyak RM200 setiap bulan bagi setiap pemilik dan pekerja vesel rakyat Malaysia yang berdaftar dengan Jabatan Perikanan. Bayaran insentif kepada pemilik vesel pada kadar 10 sen sekilogram hasil tangkapan ikan yang didaratkan oleh vesel perikanan berdaftar di pusat pendaratan ikan di dalam negara. "Pembayaran akan diuruskan oleh Lembaga Kemajuan Ikan Malaysia . Kabinet juga telah memutuskan pengusaha bot penumpang sungai akan diberi bayaran tunai sebanyak 10 sen seliter berdasarkan kuota yang diluluskan," kata Abdullah."Figure2 di atas tidak termasuk "Berapa bilion wang kerajaan akan menjadi simpanan tetap di Pos Malaysia dan berapa untung Pos Malaysia memperniagakan wang itu dengan keuntungan yang didepositkan ke tempat lain."-- Berjuang,berjuang, berjuang dan terus berjuang!!!

kerajaaan malaysia masih mewah

Data bukti kerajaan mewah, tetapi terus zalimi rakyat

Data daripada Bank Negara Malaysia dan Pembendaharaan Negara membuktikan bahawa Kerajaan sebenarnya selesa dan mewah akibat kesan kenaikan harga minyak mentah di pasaran dunia. -->
Data Pembedaharaan menunjukkan kenaikan pendapatan hasil kerajaan melonjak semenjak Abdullah Ahmad Badawi menerajui negara dan lonjakan ini adalah disebabkan kenaikan hasil yang diperolehi kerajaan menerusi
1. Cukai Langsung dari Cukai Pendapatan Syarikat Petroleum yang meningkat dari RM 11.5 B pada tahun 2004 kepada RM 20.7 B dalam tahun 2006.
2. Cukai Tak Langsung dari Duti Eksport Petroleum yang meningkat dari RM 1.5 B pada tahun 2004 kepada RM 2.3 B pada tahun 2006.
3.Hasil Bukan Cukai - Dividen Petronas daripada RM9.1 B dalam tahun kewangan 2004 yang melonjak 100% kepada RM18.0 B pada tahun berakhir 2006.
4. Hasil Bukan Cukai - Royalti Petroleum dan Gas yang meningkat dari RM2.5 B pada tahun 2004 kepada RM4.2 B pada tahun 2006.
(Data ini diperolehi dari sumber Perbendaharaan Negara dan boleh dilihat umum di treasury.gov.my).
Kenaikan pendapatan kerajaan ini adalah berkait rapat dengan keuntungan besar yang diperolehi oleh syarikat Petroleum terutamanya Petronas yang mengaut keuntungan terus daripada kenaikan harga pasaran minyak mentah dunia.
Bagaimanapun, Data daripada Bank Negara Malaysia menunjukkan perbelanjaan kerajaan untuk subsidi tidak melonjak dengan ketara akibat daripada kenaikan kenaikan harga minyak di pasaran dunia. Data Bank Negara menafikan hakikat yang cuba diutarakan oleh kerajaan bagi menaikan harga bahan bakar untuk kenderaan di Malaysia.
(Walaupun data berakhir pada tahun 2006, tetapi kita boleh bayangkan trend di antara kenaikan harga minyak dan peningkatan perolehan kerajaan apabila pasaran minyak mentah dunia terus melonjak pada tahun 2007 dan 2008.)
Data yang dikeluarkan oleh Bank Negara Malaysia menunjukkan pada tahun 2004, Kerajaan membelanjakan sebanyak RM5.8 B untuk segala subsidi iaitu termasuk subsidi bahan bakar, subsidi bahan makanan dan lain-lain.
Pada tahun 2005, perbelanjaan kerajaan bagi tujuan subsidi bagaimanapun meningkat hampir 3 kali ganda kepada RM13.4 B tetapi perbelanjaan untuk subsidi bagaimanapun menurun semula pada tahun 2006 kepada hanya RM10.1 B sedangkan mulai 2006 desas-desus dalam kerajaan untuk menamatkan pemberian subsidi bahan bakar mula timbul.
Walaupun kenaikan pendapatan hasil kerajaan dari sumber Petroleum meningkat dengan mendadak yang membuktikan hasil kerajaan turut meningkat setiap kali harga minyak mentah dunia meningkat, tetapi subsidi yang dikeluarkan oleh kerajaan tidak meningkat pada peratusan yang sama.
Kerajaan membiarkan rakyat menanggung beban kenaikan harga minyak mentah dunia sebaliknya kerajaan menikmati perolehan yang amat positif dari kenaikan itu.
Sebaliknya data-data dari kerajaan jelas menunjukkan kerajaan sebenarnya mampu dengan selesa menurunkan harga bahan bakar petrol dan diesel dengan meningkatkan subsidi setanding dengan peratusan kanaikan perolehan kerajaan.
Sebaliknya, kerajaan bertindak menaikan harga minyak. Rakyat dijanjikan dengan menanggung sendiri beban kenaikan harga minyak, kerajaan akan mempertingkatkan taraf hidup dan kualiti hidup penduduk menerusi pembiayaan projek-projek yang mampu meringankan beban rakyat.
Malangnya, walaupun terpaksa menanggung beban kenaikan harga minyak, rakyat tidak pula dapat menikmati janji-janji kerajaan itu. Projek-projek kerajaan yang diumumkan sering dibatalkan dan pembayar cukai dipaksa pula membayar ganti rugi akibat pembatalan kontrak-kontrak oleh kerajaan.
Apa yang jelas lagi bersuluh, beban rakyat bukanlah disebabkan kenaikan harga minyak tetapi disebabkan kebebalan dan sikap tidak bijak Kerajaan yang diterajui oleh Abdullah Haji Ahmad Badawi_

darah naik bila minyak naik

assalamualaikum wbt

terkesankah kita dengan kemarahan rakyat,mungkinkah cuitan gerak gempa ini akan mencetuskan rantaian letupan gunung berapi,walaupun ianya panas,asapnya beracun, debunya gelap tapi laharnya menyuburkan.