Riwayat Alamiah PenyakitRiwayat Alamiah Penyakit 11

PREVENTION PADA CANCER (Ca)

DR. Dr. Artha Budi Susila Duarsa, M.KesPUBLIC HEALTH DEPARTEMENT FACULTY OF MEDICINEYARSI UNIVERSITY

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Penyebab Utama Kematian di Amerika Serikat 1900

(abad pemunculan pandemik) vs 1967 (abad penyakit degeneratif)

Pneumonia & influenza

Tuberculosis Diarrhea & enteritis Penyakit jantung Nephritis Kecelakaan Kanker Diphtheria Meningitis

Penyakit jantung Kanker Cerebral hemorrhage Kecelakaan Pneumonia &

influenza Penyakit pada awal

bayi Arteriosklerosis 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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xisting

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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