40 doctors and nurses attend Continuing Medical Education (CME) programme on Cancer Prevention and Management

On January 24 & 25, the Directorate of Public Health, Rotary Club, Empower and Udhavum Ullangal jointly organised a CME programme in Tuticorin (Thootukudi) on the latest advancements in the treatment of cancer.

 A total of forty Doctors and an equal number of chief nurses from all the primary health centres of Tuticorin district participated.

The programme commenced with a short prayer at 11.00 A.M. A welcome address was given by Dr. Uma, Asst. Director of Public Health, Tuticorin District. An introductory speech was given by Mr. Rajan, president of the Rotary Club of Tuticorin. Thereafter the felicitation speech was made by Mr. Sankar, head of Empower, an NGO based at Tuticorin.

 Dr. Ilango, Director of Public Health, during his speech highlighted the growing incidence of cancer in the district and the need for proper awareness among the staff of primary health centres (PHCs), which were the primary node of contact for the rural patients.  He made a special mention of how this non-communicable disease was brought upon oneself largely, by improper living and habits.

 Dr. Sundaram gave a power point presentation under the theme “Cancer management – the window of opportunity”. He said whatever the stage of cancer, there was hope, and early detection could save a life. At the same time, patients in advanced stages could also not be ignored. He highlighted the fact that globally, there were 10.1 million new cases in the year 2000, of which 8 lac cases were in India. Cervical and breast cancers accounted for half of the cases in India and out of this, more than 50%  cases were in stage II and III.  Among men, oral cancer was very predominant.

 He stressed the role of a well informed family physician in early detection, as he is the nodal person whom the patient will contact for treatment first. He should be able to provide a basic standard of care, and should standardize a pattern of referral to specialists for further expert care.

 The highlight of his presentation was the “window of opportunity” which includes screening, early diagnosis, staging and appropriate treatment. The treated patients needed follow-up to check for recurrence, which can lead to meta-static disease.

The other two important aspects are prevention on the one hand, and palliative care – hospices – on the other.

 Snacks and tea were served to all after this presentation.

 The next detailed presentation was made by Dr. Selvi Radhakrishna on cancer of the breast. She stressed the importance of early diagnosis, which should be three pronged – analyzing the history of the patient as well as close blood relations, clinical examination and then investigations. She also emphasized that all women should be taught the technique of breast self examination (BSE) which should be carried out at least once a month, preferably a few days after each menstrual cycle. The next level of test after BSE should be the mammogram. Similarly the important investigations for cancer of the cervix are clinical examination, pap smear test and colposcopy.

 Thereafter Dr. Charles made a lucid presentation on oral cancer among the male populace. He said this form of cancer was brought upon oneself by mainly two factors – smoking, use of tobacco in any other form, and prolonged irritation caused inside the mouth either by broken/damaged teeth or ill fitting dentures. He touched upon the various options for prevention, treatment and management of this form of the disease. He mentioned it occurred in its most virulent form among the users of Gutkha – such as Pan Parag etc., which was also the most difficult to treat.

 Thereafter a vegetarian buffet lunch was served to all the participants. The post lunch session started off with a lively discussion between Dr. Selvi and Dr. Sundaram about the introduction of a vaccine in the market for cervical cancer and its efficacy. They mentioned the cancer was caused by the human papilloma virus (HPV) and vaccinating against the virus at an early stage can prevent cervical cancer. 

 A disturbing fact mentioned by Dr. Sundaram was that the virus can be introduced in the mouth of the cervix by only one means – sexual activity, where it typically takes many years to develop into cervical cancer.  The fact that often women even in their mid  twenties are seen with this form of cancer leads us to only one conclusion - that the act must have taken place during their very early teens or even earlier, most probably by someone very close to the family or in the family itself! The harsh truth is that child abuse exists in our society too, but tends to be swept under the carpet due to embarrassment and stigma.

 After this there was a lively interactive session between the guest speakers and the participants. Many doctors and nurses raised pertinent questions and had their doubts clarified by the panel of experts. Snacks and tea were served to all at this point. A certificate of participation was issued to all the doctors. A couple of nurses approached Udhavum Ullangal and expressed their desire to study and pursue oncological nursing as a career, and suitable help was promised to them.

The CME programme concluded at 2.45 P.M. with a vote of thanks by Mr. Santhanam of Udhavum Ullangal. The programme was well covered by the media.

 The next day (25.01.2010), a human chain for anti-tobacco awareness was formed in front of the VOC College of Education with the active participation of the students. Mr. Prakash, DRO, Tuticorin District, participated in the human chain along with Mr. Sankar Mahadevan and Mr. Santhanam of Udhavum Ullangal, Dr. Sundaram and Mr. Sankar of Empower, Tuticorin. The participation of the students of the college of education was apt, since they are all future teachers and will be crucial to carry the message to school children who will be the future citizens of our country.

 After the human chain, Dr. Sundaram made a presentation to the students about oral cancer and the ills of smoking / tobacco usage. There was an active interactive session with the students as well. Many of the students raised pertinent questions and their doubts were duly clarified by Dr. Sundaram.