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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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