World Malaria Day is commemorated on every 25 April. It recognises global efforts to control malaria. The theme for this year’s celebration is “Invest in the future, defeat malaria”, as it has been since 2013. Globally, about 3.3 billion people in 106 countries are at risk of malaria. In 2009, 781 000 people died from malaria, mainly women and children in Africa.

World Malaria Day was established in May 2007 by the 60th session of the World Health Assembly, the decision-making body of the World Health Organisation. The day was established to provide education and understanding of malaria and spread information on year-long intensified implementation of national malaria-control strategies, including community-based activities for malaria prevention and treatment in endemic areas.

The World Malaria Day theme provides a common platform for countries to showcase their successes in malaria control and unify diverse initiatives in the changing global context. Malaria-endemic countries have made incredible gains in malaria in the last decade, but sustaining them will take extra efforts until the job is finished and malaria is eliminated worldwide.

While efforts to prevent, diagnose and treat malaria have gained important momentum over the past years, an annual shortage of US$ 3.6 billion threatens to slow down progress, particularly across Africa where high-burden countries are facing critical funding gaps. Unless the world can find a way to bridge the funding gaps and endemic countries have the resources and technical support they need to implement sound malaria control plans, malaria resurgence will likely take many more lives.

In view of this reality, the National Agency for Food and Drug Administration and Control (NAFDAC) recently entered a partnership with the Cuban government, in order to employ the country’s biotechnology in eradicating malaria in Nigeria.

The Cuban Ambassador, Carlose Trejo Sosa, speaking on the development, said Cuba, as a country rich in biotechnology, could improve the health care of the Nigerian population, under the surveillance of NAFDAC.

“I think and I am sure Nigeria has many things to offer Cuba in the aspect of experience and investigation that have been made in this country, which could be of greatest interest to Cuban people”, Sosa said.

On his part, Dr Paul Orhii, NAFDAC DG, said: “Cuba has a very rich cultural heritage and has good ties with Nigeria; but more importantly, from a health perspective”.

Affirming the authenticity of the partnership, Orhii noted that Cuba is the global leader in biotechnology, developing new technologies to fight diseases, adding that most of the technologies Cuba would be bringing to fight diseases attack diseases in a more natural way.

“For example, the biolarvaesal programme on malaria that we are talking about is not just spreading chemicals that will broadly kill every other thing that will come its way; it specifically targets some disease-causing larvae, all sorts of malaria, and black flies that cause river blindness. As a leader in biotechnology in the whole world, I think we have a lot to gain and learn in this relationship. Even on eliminating malaria alone, you cannot put a naira sign. We are talking about eradicating malaria in Nigeria. We know that anti-malaria drugs are the most often used in high volumes in Nigeria because most people in Nigeria suffer from malaria”, Orhii said.

The partnership with Cuba is just one of several efforts to curb malaria in Nigeria. Hopefully, more initiatives will emerge in the course of the year. However, we shall endeavour to discuss the disease in detail below.

What is malaria?

Malaria is a mosquito-borne infectious disease of humans. It is widespread in tropical and subtropical regions, including much of Sub-Saharan Africa, Asia and the Americas. The disease results from the multiplication of malaria parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases progressing to coma, and death.

Malaria is not just a disease commonly associated with poverty but also a cause of poverty and a major hindrance to economic development. Tropical regions are affected the most; however, malaria’s furthest extent reaches into some temperate zones with extreme seasonal changes. The disease has been associated with major negative economic effects on regions where it is widespread. During the late 19th and early 20th centuries, it was a major factor in the slow economic development of the American southern states.

Globally, the World Health Organisation estimates that in 2013, 198 million clinical cases of malaria occurred, and 500,000 people died of malaria, most of them children in Africa. Because malaria causes so much illness and death, the disease is a great drain on many national economies. Since many countries with malaria are already among the poorer nations, the disease maintains a vicious cycle of disease and poverty.

There are four species of the Plasmodium parasite that can cause malaria in humans: P. falciparum, P. vivax, P. ovale, and P. malariae. The first two types are the most common. Plasmodium falciparum is the most dangerous of these parasites because the infection can kill rapidly (within several days), whereas the other species cause illness but not death. Falciparum malaria is particularly frequent in sub-Saharan Africa and Oceania.

Causes of malaria

You can only get malaria if you’re bitten by an infected mosquito, or if you receive infected blood from someone during a blood transfusion. Malaria can also be transmitted from mother to child during pregnancy.

The mosquitoes that carry Plasmodium parasite get it from biting a person or animal that’s already been infected. The parasite then goes through various changes that enable it to infect the next creature the mosquito bites. Once it’s in you, it multiplies in the liver and changes again, getting ready to infect the next mosquito that bites you. It then enters the bloodstream and invades red blood cells. Eventually, the infected red blood cells burst. This sends the parasites throughout the body and causes symptoms of malaria.

Malaria has been with us long enough to have changed our genes. The reason many people of African descent suffer from the blood disease, sickle cell anaemia, is because the gene that causes it also confers some immunity to malaria. In Africa, people with a sickle cell gene are more likely to survive and have children. The same is true of thalassemia, a hereditary disease found in people of Mediterranean, Asian, or African-American descent.

Symptoms and complications of malaria

Symptoms usually appear about 12 to 14 days after infection. People with malaria have the following symptoms:

• abdominal pain
• chills and sweats
• diarrhoea, nausea, and vomiting (these symptoms only appear sometimes)
• headache
• high fevers
• low blood pressure causing dizziness if moving from a lying or sitting position to a standing position (also called orthostatic hypotension)
• muscle aches
• poor appetite
• In people infected with P. falciparum, the following symptoms may also occur:
• anaemia caused by the destruction of infected red blood cells
• extreme tiredness, delirium, unconsciousness, convulsions, and coma
• kidney failure
• pulmonary oedema (a serious condition where fluid builds up in the lungs, which can lead to severe breathing problems)

1. vivax and P. ovale can lie inactive in the liver for up to a year before causing symptoms. They can then remain dormant in the liver again and cause later relapses. P. vivax is the most common type in North America.

In recent years, some human cases of malaria have also occurred with Plasmodium knowlesi – a species that causes malaria among monkeys and occurs in certain forested areas of South-East Asia.

Transmission of malaria

Malaria is transmitted exclusively through the bites of Anopheles mosquitoes. The intensity of transmission depends on factors related to the parasite, the vector, the human host, and the environment.

About 20 different Anopheles species are locally important around the world. All of the important vector species bite at night. Anopheles mosquitoes breed in water and each species has its own breeding preference; for example, some prefer shallow collections of fresh water, such as puddles, rice fields, and hoof prints. Transmission is more intense in places where the mosquito lifespan is longer (so that the parasite has time to complete its development inside the mosquito) and where it prefers to bite humans rather than other animals. For example, the long lifespan and strong human-biting habit of the African vector species is the main reason about 90 per cent of the world’s malaria deaths are in Africa.

Transmission also depends on climatic conditions that may affect the number and survival of mosquitoes, such as rainfall patterns, temperature and humidity. In many places, transmission is seasonal, with the peak during and just after the rainy season. Malaria epidemics can occur when climate and other conditions suddenly favour transmission in areas where people have little or no immunity to malaria. They can also occur when people with low immunity move into areas with intense malaria transmission, for instance to find work, or as refugees.

Human immunity is another important factor, especially among adults in areas of moderate or intense transmission conditions. Partial immunity is developed over years of exposure, and while it never provides complete protection, it does reduce the risk that malaria infection will cause severe disease. For this reason, most malaria deaths in Africa occur in young children, whereas in areas with less transmission and low immunity, all age groups are at risk.

When a mosquito bites an infected person, a small amount of blood is taken in, which contains microscopic malaria parasites. About a week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.

Because the malaria parasite is found in red blood cells of an infected person, malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. Malaria may also be transmitted from a mother to her unborn infant before or during delivery (“congenital” malaria).

Anyone can get malaria. Most cases occur in people who live in countries with malaria transmission. People from countries with no malaria can become infected when they travel to countries with malaria or through a blood transfusion (although this is very rare). Also, an infected mother can transmit malaria to her infant before or during delivery.

Malaria diagnosis

Malaria is diagnosed by seeing the parasite under the microscope. Blood taken from the patient is smeared on a slide for examination. Special stains are used to help highlight the parasite. Sometimes, it is possible to identify the species of Plasmodium by the shape of the parasite, especially if gametocytes are seen. Whenever possible, smears should be reviewed by someone with expertise in the diagnosis of malaria. If the smears are negative, they can be repeated every 12 hours. Smears that are repeatedly negative suggest another diagnosis should be considered.

Two types of other tests are available for diagnosis of malaria. Rapid tests can detect proteins called antigens that are present in Plasmodium. These tests take less than 30 minutes to perform. However, the reliability of rapid tests varies significantly from product to product. Thus, it is recommended that rapid tests be used in conjunction with microscopy. A second type of test is the polymerase chain reaction (PCR), which detects malaria DNA. Because this test is not widely available, it is important not to delay treatment while waiting for results.

Antimalarial drug resistance

Resistance to antimalarial medicines is a recurring problem. Resistance of P. falciparum to previous generations of medicines, such as chloroquine and sulfadoxine-pyrimethamine (SP), became widespread in the 1970s and 1980s, undermining malaria control efforts and reversing gains in child survival.

In recent years, there has been a massive reduction in malaria-related morbidity and mortality in regions of high endemicity in the last decade, which was in part due to the effectiveness of the ACT regimen. However, these successes are threatened by the emergence of artemisinin-resistant strains of Plasmodium falciparum from the Thai-Cambodian border and Thai-Myanmar border.

Indeed, artemisinin resistance is a major threat to global health, particularly in low- and middle-income countries (LMICs), in which the disease burden is highest. Substandard or counterfeit ACT compounds are widely available, and systems for the monitoring and containment of resistance are inadequate. There is little existing knowledge regarding ACT-resistant malaria in many SSA countries, including Nigeria, and the most recent reports of ACT treatment failures were in travellers who had recently visited African countries.

Additionally, there have been no reports of delayed parasite clearance in routine therapeutic efficacy studies conducted in Africa. Thus, arguments for the presence of artemisinin resistance in Africa have been based solely on in vitro and/or molecular analyses of parasites collected from autochthonous patients or returning travellers. However, standard in vitro tests are not reliable tools for monitoring artemisinin resistance. In addition, none of the putative molecular markers for antimalarial drug resistance has been correlated with delayed clearance after treatment with artemisinin.

Prevention

Vector control is the main way to reduce malaria transmission at the community level. It is the only intervention that can reduce malaria transmission from very high levels to close to zero. For individuals, personal protection against mosquito bites represents the first line of defence for malaria prevention.

Two forms of vector control are effective in a wide range of circumstances:

• Insecticide-treated mosquito nets (ITNs)

Long-lasting insecticidal nets (LLINs) are the preferred form of ITNs for public health distribution programmes. WHO recommends coverage for all at-risk persons, and in most settings. The most cost-effective way to achieve this is through provision of free LLINs, so that everyone sleeps under a LLIN every night.

• Indoor spraying with residual insecticides

Indoor residual spraying (IRS) with insecticides is a powerful way to rapidly reduce malaria transmission. Its full potential is realised when at least 80 per cent of houses in targeted areas are sprayed. Indoor spraying is effective for 3–6 months, depending on the insecticide used and the type of surface on which it is sprayed. DDT can be effective for 9–12 months in some cases. Longer-lasting forms of existing IRS insecticides, as well as new classes of insecticides for use in IRS programmes, are under development.

Antimalarial medicines can also be used to prevent malaria. For travellers, malaria can be prevented through chemoprophylaxis, which suppresses the blood stage of malaria infections, thereby preventing malaria disease. In addition, WHO recommends intermittent preventive treatment with sulfadoxine-pyrimethamine for pregnant women living in high transmission areas, at each scheduled antenatal visit after the first trimester. Similarly, for infants living in high-transmission areas of Africa, three doses of intermittent preventive treatment with sulfadoxine-pyrimethamine is recommended delivered alongside routine vaccinations.

Surveillance

Tracking progress is a major challenge in malaria control. In 2012, malaria surveillance systems detected only around 14 per cent of the estimated global number of cases. Stronger malaria surveillance systems are urgently needed to enable a timely and effective malaria response in endemic regions, to prevent outbreaks and resurgences, to track progress, and to hold governments and the global malaria community accountable.

Elimination

Malaria elimination is defined as interrupting local mosquito-borne malaria transmission in a defined geographical area, i.e. zero incidences of locally contracted cases. Malaria eradication is defined as the permanent reduction to zero of the worldwide incidence of malaria infection caused by a specific agent; i.e. applies to a particular malaria parasite species.

On the basis of reported cases for 2013, 55 countries are on track to reduce their malaria case incidence rates by 75 per cent, in line with World Health Assembly targets for 2015. Large-scale use of WHO-recommended strategies, currently available tools, strong national commitments, and coordinated efforts with partners, will enable more countries – particularly those where malaria transmission is low and unstable – to reduce their disease burden and progress towards elimination.

In recent years, four countries have been certified by the WHO Director-General as having eliminated malaria: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), and Armenia (2011).

Vaccines against malaria

There are currently no licensed vaccines against malaria or any other human parasite. One research vaccine against P. falciparum, known as RTS, S/AS01, is the most advanced. This vaccine has been evaluated in a large clinical trial in seven countries in Africa and has been submitted to the European Medicines Agency under art. 58 for regulatory review. A WHO recommendation for use will depend on the final results from the large clinical trial and a positive regulatory review. The recommendation as to whether or not this vaccine should be added to existing malaria control tools is expected in late 2015.

Treatment

The choice of drug depends on the species of Plasmodium and the risk of drug resistance in the area where the malaria was acquired. In sub-Saharan Africa, for example, older drugs like chloroquine are largely ineffective.

Most medications are available only as tablets or pills. Intravenous treatment with quinidine may be needed in severe malaria or when the patient cannot take oral medications. Malaria during pregnancy requires treatment by someone who is an expert in this area. Miscarriage and maternal death may occur, even in the best of hands.

Patients with P. vivax or P. ovale may not be completely cured by the above medications, even though the symptoms resolve. This is because the parasites can hide in the liver. A medication called primaquine is used to eradicate the liver form, but this drug cannot be given to people who are deficient in an enzyme called G6PD.

Treatment usually lasts for 3 to 7 days, depending on the medication type. To get rid of the parasite, it’s important to take the medication for the full length of time prescribed – don’t stop taking the medication even if you feel better. If you experience any side effects, your doctor can recommend ways to manage them or may choose to give you a different medication.

If you’re travelling to a malarial region, you should take a course of preventive treatment. Medications similar to those used to cure malaria can prevent it if taken before, during, and after your trip. It’s vital to take your medication as prescribed, even after you return home. Before travelling, check with your doctor or travel clinic about the region’s malaria status.

Reports compiled by Temitope Obayendo with additional information from: The World Health Organisation (WHO); National Agency for Food and Drug Administration and Control (NAFDAC); bodyandhealth.com; and cutecalendar.com

Skin infections or disorders constitute a significant proportion of consultations in Clinics. However, there is paucity of data on the prevalence of dermatological lesions in hospitalised children and adults in Nigeria.

According to the Nigerian Journal of Clinical Practice, skin diseases are one of the three common causes of morbidity in the developing countries of sub-Saharan Africa, along with malaria and diarrhoea. The development of acute glomerulonephritis, following skin infection with Group A b-hemolytic streptococcus, has been demonstrated to be a risk factor for albuminuria and hematuria in adult life.

Although skin diseases do not feature prominently in the paediatric morbidity and mortality trends reported from many hospitals in Nigeria, it is essential to pay attention to bacterial skin infections complicating scabies and insect bites.

Basically, skin infection is an infection of the skin. Infection of the skin is distinguished from dermatitis, which is inflammation of the skin, but a skin infection can result in skin inflammation. Skin inflammation due to skin infection is called infective dermatitis.

Bacterial infections

*    Impetigo is a highly contagious bacterial skin infection most common among pre-school children. It is primarily caused by Staphylococcus aureus, and sometimes by Streptococcus pyogenes.

*    Erysipelas is an acute streptococcus bacterial infection of the deep epidermis with lymphatic spread.

*    Cellulitis is a diffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin. Cellulitis can be caused by normal skin flora or by exogenous bacteria, and often occurs where the skin has previously been broken – cracks in the skin, cuts, blisters, burns, insect bites, surgical wounds, intravenous drug injection or sites of intravenous catheter insertion. Skin on the face or lower legs is most commonly affected by this infection, though cellulitis can occur on any part of the body.

Fungal infections

Fungal skin infections may present as either a superficial or deep infection of the skin, hair, and/or nails. They affect as of 2010 about one billion people globally.

Parasitic infestations, stings, and bites

Parasitic infestations, stings, and bites in humans are caused by several groups of organisms belonging to the following phyla: Annelida, Arthropoda, Bryozoa, Chordata, Cnidaria, Cyanobacteria, Echinodermata, Nemathelminthes, Platyhelminthes, and Protozoa.

Viral infections

Virus-related cutaneous conditions are caused by two main groups of viruses–DNA and RNA types–both of which are obligatory intracellular parasites.

Athlete’s foot

Athlete’s foot is a very common infection. The fungus grows best in a warm, moist environment such as shoes, socks, swimming pools, locker rooms, and the floors of public showers. It is most common in the summer and in warm, humid climates. It occurs more often in people who wear tight shoes and who use community baths and pools.

What causes athlete’s foot?

Athlete’s foot is caused by a microscopic fungus that lives on dead tissue of the hair, toenails, and outer skin layers. There are at least four kinds of fungus that can cause athlete’s foot. The most common of these fungi is trichophytonrubrum.

What are the symptoms of athlete’s foot?

Signs and symptoms of athlete’s foot vary from person to person. However, common symptoms include:

*    Peeling, cracking, and scaling of the feet

*    Redness, blisters, or softening and breaking down of the skin

*    Itching, burning, or both

Types of athlete’s foot

*    Interdigital: Also called toe web infection, this is the most common kind of athlete’s foot. It usually occurs between the two smallest toes. This form of athlete’s foot can cause itching, burning, and scaling and the infection can spread to the sole of the foot.

*    Moccasin: A moccasin-type infection of athlete’s foot can begin with a minor irritation, dryness, itching, or scaly skin. As it develops, the skin may thicken and crack. This infection can involve the entire sole of the foot and extend onto the sides of the foot.

*    Vesicular: This is the least common kind of athlete’s foot. The condition usually begins with a sudden outbreak of fluid-filled blisters under the skin. Most often, the blisters develop on the underside of the foot. However, they also can appear between the toes, on the heel, or on the top of the foot.

How is athlete’s foot diagnosed?

Not all itchy, scaly feet have athlete’s foot. The best way to diagnose the infection is to have your doctor scrape the skin and examine the scales under a microscope for evidence of fungus.

How is athlete’s foot treated?

Athlete’s foot is treated with topical antifungal medication (a drug placed directly on the skin) in most cases. Severe cases may require oral drugs (those taken by mouth). The feet must be kept clean and dry since the fungus thrives in moist environments.

How is athlete’s foot prevented?

Steps to prevent athlete’s foot include wearing shower sandals in public showering areas, wearing shoes that allow the feet to breathe, and daily washing of the feet with soap and water. Drying the feet thoroughly and using a quality foot powder can also help prevent athlete’s foot.

Jock itch

Jock itch, also called tineacruris, is a common skin infection that is caused by a type of fungus called tinea. The fungus thrives in warm, moist areas of the body and as a result, infection can affect the genitals, inner thighs, and buttocks. Infections occur more frequently in the summer or in warm, wet climates. Jock itch appears as a red, itchy rash that is often ring-shaped.

Is jock itch contagious?

Jock itch is only mildly contagious. The condition can be spread from person to person through direct contact or indirectly from objects carrying the fungus.

What are the symptoms of jock itch?

*    Itching, chafing, or burning in the groin or thigh

*    A circular, red, raised rash with elevated edges

*    Redness in the groin or thigh

*    Flaking, peeling, or cracking skin

How is jock itch diagnosed?

In most cases, jock itch can be diagnosed based on the appearance and location of the rash. If you are not certain that the condition is jock itch, contact your doctor. The doctor will ask about your symptoms and medical history, and will perform a physical exam. A microscopic exam of the scales of skin can confirm the diagnosis.

How is jock itch treated?

In most cases, treatment of jock itch involves keeping the affected area clean and dry and applying topical antifungal medications. Jock itch usually responds to over-the-counter antifungal creams and sprays. However, prescription antifungal creams are sometimes necessary. During treatment of jock itch, be sure to:

*    Wash and dry the affected area with a clean towel

*    Apply the antifungal cream, powder, or spray as directed

*    Change clothes – especially underwear – everyday.

Ringworm

Ringworm, also called tineacorporis, is not a worm, but a fungal infection of the skin. It can appear anywhere on the body and looks like a circular, red, flat sore. It is often accompanied by scaly skin. The outer part of the sore can be raised while the skin in the middle appears normal. Ringworm can be unsightly, but it is usually not a serious condition.

Is ringworm contagious?

Ringworm can spread by direct contact with infected people or animals. It also may be spread on clothing or furniture. Heat and humidity may help to spread the infection.

What are the symptoms of ringworm?

Ringworm appears as a red, circular, flat sore that is sometimes accompanied by scaly skin. There may be more than one patch of ringworm on the skin, and patches or red rings of rash may overlap. It is possible to have ringworm without having the common red ring of rash.

How is ringworm diagnosed?

A doctor can diagnose ringworm based on the appearance of the rash or reported symptoms. He or she will ask about possible exposure to people or animals with ringworm. The doctor may take skin scrapings or samples from the infected area and look at them under a microscope to confirm the diagnosis.

Boils

A boil is a skin infection that starts in a hair follicle or oil gland. At first, the skin turns red in the area of the infection, and a tender lump develops. After four to seven days, the lump starts turning white as pus collects under the skin.

The most common places for boils to appear are on the face, neck, armpits, shoulders, and buttocks. When one forms on the eyelid, it is called a sty.If several boils appear in a group, this is a more serious type of infection called a carbuncle.

Causes of boils

Most boils are caused by a germ (staphylococcal bacteria). This germ enters the body through tiny nicks or cuts in the skin or can travel down the hair to the follicle.

Symptoms of boils

A boil starts as a hard, red, painful lump usually about half an inch in size. Over the next few days, the lump becomes softer, larger, and more painful. Soon a pocket of pus forms on the top of the boil.

These are the signs of a severe infection:

*    The skin around the boil becomes infected. It turns red, painful, warm, and swollen.

*    More boils may appear around the original one.

*    A fever may develop.

*    Lymph nodes may become swollen.

When to seek medical care:

*    You start running a fever.

*    You have swollen lymph nodes.

*    The skin around the boil turns red or red streaks appear.

*    The pain becomes severe.

*    The boil does not drain.

*    A second boil appears.

*    You have a heart murmur, diabetes, any problem with your immune system, or use immune suppressing drugs (for example, corticosteroids or chemotherapy) and you develop a boil.

Boils usually do not need immediate emergency attention. If you are in poor health and you develop high fever and chills along with the infection, a trip to a hospital’s emergency room is needed.

Exams and tests

Your doctor can make the diagnosis with a physical exam. Many parts of the body may be affected by this skin infection; so some of the questions or exam may be about other parts of your body.

Boils treatment – home remedies

*    Apply warm compresses and soak the boil in warm water. This will decrease the pain and help draw the pus to the surface. Once the boil comes to a head, it will burst with repeated soakings. This usually occurs within 10 days of its appearance. You can make a warm compress by soaking a wash cloth in warm water and squeezing out the excess moisture.

*    When the boil starts draining, wash it with an antibacterial soap until all the pus is gone. Apply a medicated ointment and a bandage. Continue to wash the infected area two to three times a day and to use warm compresses until the wound heals.

*    Do not pop the boil with a needle. This could make the infection worse.

Leprosy

Leprosy is an infectious disease that causes severe, disfiguring skin sores and nerve damage in the arms and legs. The disease has been around since the beginning of time, often surrounded by terrifying, negative stigma and tales of leprosy patients being shunned as outcasts. At one time or another, outbreaks of leprosy have affected, and panicked, people on every continent. The oldest civilisations of China, Egypt, and India feared leprosy was an incurable, mutilating, and contagious disease.

However, leprosy is actually not highly contagious. You can catch it only if you come into close and repeated contact with nose and mouth droplets from someone with untreated, severe leprosy. Children are more likely to get leprosy than adults.

Today, more than 200,000 people worldwide are infected with leprosy, according to the World Health Organisation, most of them in Africa and Asia. About 100 people are diagnosed with leprosy in the U.S. every year, mostly in the South, California, Hawaii, and some U.S. territories.

What causes leprosy?

Leprosy is caused by a slow-growing type of bacteria called Mycobacteriumleprae (M. leprae).Leprosy is also known as Hansen’s disease, after the scientist who discovered M. leprae in 1873.

What are the symptoms of leprosy?

Leprosy primarily affects the skin and the nerves outside the brain and spinal cord, called the peripheral nerves. It may also strike the eyes and the thin tissue lining the inside of the nose.

The main symptom of leprosy is disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The skin sores are pale-coloured.Nerve damage can lead to:

*    Loss of feeling in the arms and legs

*    Muscle weakness

It takes a very long time for symptoms to appear after coming into contact with the leprosy-causing bacteria. Some people do not develop symptoms until 20 or more years later. The time between contact with the bacteria and the appearance of symptoms is called the incubation period. Leprosy’s long incubation period makes it very difficult for doctors to determine when and where a person with leprosy originally got sick.

Forms of leprosy

Leprosy is characterised according to the number and type of skin sores you have. Specific symptoms and your treatment depend on the type of leprosy you have. The types are:

*    Tuberculoid: A mild, less severe form of leprosy. People with this type have only one or a few patches of flat, pale-coloured skin (paucibacillary leprosy). The affected area of skin may feel numb because of nerve damage underneath. Tuberculoid leprosy is less contagious than other forms.

*    Lepromatous: A more severe form of the disease. It involves widespread skin bumps and rashes (multibacillary leprosy), numbness, and muscle weakness. The nose, kidneys, and male reproductive organs may also be affected. It is more contagious than tuberculoid leprosy.

*    Borderline: People with this type of leprosy have symptoms of both the tuberculoid and lepromatous forms.

How is leprosy diagnosed?

If you have a suspicious skin sore, your doctor will remove a small sample of the abnormal skin and send it to a lab to be examined. This is called a skin biopsy. A skin smear test may also be done. With paucibacillary leprosy, no bacteria will be detected. In contrast, bacteria are expected to be found on a skin smear test from a person with multibacillary leprosy.

How Is leprosy treated?

Leprosy can be cured. In the last two decades, more than 14 million people with leprosy have been cured. The World Health Organisation provides free treatment for all people with leprosy.

Treatment depends on the type of leprosy that you have. Antibiotics are used to treat the infection. Long-term treatment with two or more antibiotics is recommended, usually from six months to a year. People with severe leprosy may need to take antibiotics longer. However, antibiotics cannot reverse nerve damage.

Anti-inflammatory drugs are used to control swelling related to leprosy. This may include steroids, such as prednisone.Patients with leprosy may also be given thalidomide, a potent medication that suppresses the body’s immune system. It helps treat leprosy skin nodules. Thalidomide is known to cause severe, life-threatening birth defects and should never be taken by pregnant women.

Leprosy complications

Without treatment, leprosy can permanently damage your skin, nerves, arms, legs, feet, and eyes.

Complications of leprosy can include:

*    Blindness or glaucoma.

*    Disfiguration of the face (including permanent swelling, bumps, and lumps).

*    Erectile dysfunction and infertility in men.

*    Kidney failure.

*    Muscle weakness that leads to claw-like hands or an inability to flex the feet.

*    Permanent damage to the inside of the nose, which can lead to nosebleeds and a chronic, stuffy nose.

*    Permanent damage to the peripheral nerves, the nerves outside the brain and spinal cord, including those in your arms, legs, and feet.

Nerve damage can lead to a dangerous loss of feeling. A person with leprosy-related nerve damage may not feel pain when the hands, legs, or feet are cut, burned, or otherwise injured.Approximately 1 to 2 million people worldwide are permanently disabled because of leprosy.

Carbuncles

A carbuncle is a red, swollen, and painful cluster of boils that are connected to each other under the skin. A boil (or furuncle) is an infection of a hair follicle that has a small collection of pus (called an abscess) under the skin. Usually single, a carbuncle is most likely to occur on a hairy area of the body such as the back or nape of the neck. But a carbuncle also can develop in other areas of the body such as the buttocks, thighs, groin, and armpits.

Cause

Most carbuncles are caused by Staphylococcus aureus bacteria, which inhabit the skin surface, throat, and nasal passages. These bacteria can cause infection by entering the skin through a hair follicle, small scrape, or puncture, although sometimes there is no obvious point of entry.

Filled with pus – a mixture of old and white blood cells, bacteria, and dead skin cells — carbuncles must drain before they’re able to heal. Carbuncles are more likely than boils to leave scars.

An active boil or carbuncle is contagious: the infection can spread to other parts of the person’s body or to other people through skin-to-skin contact or the sharing of personal items. So it’s important to practice appropriate self-care measures, like keeping the area clean and covered, until the carbuncle drains and heals.

Carbuncles require medical treatment to prevent or manage complications, promote healing, and minimise scarring. Contact your doctor if you have a boil or boils that have persisted for more than a few days.

Risk factors for carbuncles

Older age, obesity, poor hygiene, and poor overall health are associated with carbuncles. Other risk factors for carbuncles include:

*    Chronic skin conditions, which damage the skin’s protective barrier

*    Diabetes

*    Kidney disease

*    Liver disease

*    Any condition or treatment that weakens the immune system

Carbuncles also can occur in otherwise healthy, fit, younger people, especially those who live together in group settings such as college dorms and share items such as bed linens, towels, or clothing. In addition, people of any age can develop carbuncles from irritations or abrasions to the skin surface caused by tight clothing, shaving, or insect bites, especially in body areas with heavy perspiration.

Symptoms of carbuncles

The boils that collect to form carbuncles usually start as red, painful bumps. The carbuncle fills with pus and develops white or yellow tips that weep, ooze, or crust. Over a period of several days, many untreated carbuncles rupture, discharging a creamy white or pink fluid.

Superficial carbuncles – which have multiple openings on the skin’s surface – are less likely to leave a deep scar. Deep carbuncles are more likely to cause significant scarring. Other carbuncle symptoms include fever, fatigue, and a feeling of general sickness. Swelling may occur in nearby tissue and lymph nodes, especially lymph nodes in the neck, armpit, or groin.

Complications of carbuncles

Sometimes, carbuncles are caused by methicillin-resistant Staphylococcus aureus (MRSA) bacteria, and require treatment with potent prescription antibiotics if the lesions are not drained properly.

In rare cases, bacteria from a carbuncle can escape into the bloodstream and cause serious complications, including sepsis and infections in other parts of the body such as the lung, bones, joints, heart, blood, and central nervous system.

Sepsis is an overwhelming infection of the body that is a medical emergency and can be fatal if left untreated. Symptoms include chills, a spiking fever, rapid heart rate, and a feeling of being extremely ill.

Home treatment for carbuncles

The cardinal rule is to avoid squeezing or irritating a carbuncle, which increases the risk of complications and severe scarring.

Warm compresses may promote the drainage and healing of carbuncles. Gently soak the carbuncle in warm water, or apply a clean, warm, moist washcloth for 20 minutes several times per day. Similar strategies include covering the carbuncle with a clean, dry cloth and gently applying a heating pad or hot water bottle for 20 minutes several times per day. After each use, washcloths or cloths should be washed in hot water and dried at a high temperature.

Washing the carbuncle and covering the area with a sterile bandage also may promote drainage and healing and help prevent the infection from spreading. Over-the-counter medications such as acetaminophen or ibuprofen can help relieve the pain of an inflamed carbuncle.

It is important to thoroughly wash your hands after touching a carbuncle. Launder any clothing, bedding, and towels that have touched a carbuncle and avoid sharing bedding, clothing, or other personal items.

Medical treatments for carbuncles

See your doctor if a boil or boils do not drain and heal after a few days of home treatment; or if you suspect you have a carbuncle. Also, seek medical evaluation for a carbuncle that develops on your face, near your eyes or nose, or on your spine. Also see a doctor for a carbuncle that becomes very large or painful.

Your doctor may cut and drain the carbuncle, and ensure that all the pus has been removed by washing the area with a sterile solution. Some of the pus can be collected and sent to a lab to identify the bacteria causing the infection and check for susceptibility to antibiotics.

If the carbuncle is completely drained, antibiotics are usually unnecessary. But treatment with antibiotics may be necessary in cases such as:

*    When MRSA is involved and drainage is incomplete

*    There is surrounding soft-tissue infection (cellulitis)

*    A person has a weakened immune system

*    An infection has spread to other parts of the body

Depending on severity, most carbuncles heal within two to three weeks after medical treatment.

Impetigo

Impetigo is a highly contagious bacterial skin infection. It can appear anywhere on the body but usually attacks exposed areas. Children tend to get it on the face, especially around the nose and mouth, and sometimes on the arms or legs. The infected areas appear in plaques, ranging from dime to quarter size, starting as tiny blisters that break and expose moist, red skin. After a few days the infected area is covered with a grainy, golden crust that gradually spreads at the edges.

In extreme cases, the infection invades a deeper layer of skin and develops into ecthyma, a deeper form of the disease. Ecthyma forms small, pus-filled bumps with a crust much darker and thicker than that of ordinary impetigo. Ecthyma can be very itchy, and scratching the irritated area spreads the infection quickly. Left untreated, the sores may cause permanent scars and pigment changes.

The gravest potential complication of impetigo is post-streptococcal glomerulonephritis, a severe kidney disease that occurs following a strep infection in less than 1 per cent of cases, mainly in children. The most common cause of impetigo is Staphylococcus aureus. However, another bacteria source is group A streptococcus. These bacteria lurk everywhere.

It is easier for a child with an open wound or fresh scratch to contract impetigo. Other skin-related problems, such as eczema, body lice, insect bites, fungal infections, and various other forms of dermatitis can make a person susceptible to impetigo.

Most people get this highly infectious disease through physical contact with someone who has it, or from sharing the same clothes, bedding, towels, or other objects. The very nature of childhood, which includes lots of physical contact and large-group activities, makes children the primary victims and carriers of impetigo.

Pilonidal cyst

A pilonidal cyst occurs at the bottom of the tailbone (coccyx) and can become infected and filled with pus. Once infected, the technical term is pilonidal abscess. Pilonidal abscesses look like a large pimple at the bottom of the tailbone, just above the crack of the buttocks. It is more common in men than in women. It usually happens in young people up into the fourth decade of life.

Causes

Most doctors think that ingrown hairs cause pilonidal cysts. Pilonidal means “nest of hair.” It is common to find hair follicles inside the cyst.Another theory is that pilonidal cysts appear after trauma to that region of the body. During World War II, more than 80,000 soldiers developed pilonidal cysts that required a hospital stay. People thought the cysts were due to irritation from riding in bumpy Jeeps. For a while, the condition was actually called “Jeep disease.”

Symptoms

The symptoms of a pilonidal cyst include:

*    Pain at the bottom of the spine

*    Swelling at the bottom of the                         spine

*    Redness at the bottom of the                         spine

*    Draining pus

*    Fever

When to seek medical care for a pilonidal cyst

A pilonidal cyst is an abscess or boil that needs to be drained or lanced, to improve. Like other boils, it does not improve with antibiotics. If any of the above symptoms occur, consult a doctor.

Exams and tests

A doctor can diagnose a pilonidal cyst by taking a history (asking about the patient’s history and symptoms regarding the cyst) and performing a physical exam. The doctor may find the following conditions:

*    Tenderness, redness, and swelling between the cheeks of the buttocks just above the anus

*    Fever

*    Increased white blood cells on a blood sample (not always taken)

*    Inflammation of the surrounding skin

Home remedies

Early in an infection of a pilonidal cyst, the redness, swelling, and pain may be minimal. Sitting in a warm tub may decrease the pain and may decrease the chance that the cyst will develop to the point of requiring incision and drainage.

Medical treatment for a pilonidal cyst

Antibiotics do not heal a pilonidal cyst. Doctors have any of a number of procedures available, including the following treatments.

*    The preferred technique for a first pilonidal cyst is incision and drainage of the cyst, removing the hair follicles and packing the cavity with gauze.

Advantage- Simple procedure done under local anaesthesia

Disadvantage – Frequent changing of gauze packing until the cyst heals, sometimes up to three weeks

*    Marsupialisation – This procedure involves incision and draining, removal of pus and hair, and sewing of the edges of the fibrous tract to the wound edges to make a pouch.

Advantages – Outpatient surgery under local anaesthesia, minimises the size and depth of the wound without the need to pack gauze in the wound

Disadvantages – Requires about six weeks to heal, needs a doctor trained in the technique

*    Another option is incision and drainage with immediate closing of the wound.

Advantages – Wound completely closed immediately following surgery without need for gauze

Disadvantages – High rate of recurrence (it is hard to remove the entire cyst, which might come back). Typically performed in an operating room, it requires a specially trained surgeon.

Skin and molluscum contagiosum

Molluscum contagiosum is a viral skin infection that causes either single or multiple raised, pearl-like bumps (papules) on the skin. It is a chronic infection and lesions may persist from a few months to a few years. However, most cases resolve in six to nine months.

Causes

Molluscum contagiosum is caused by a virus (the molluscumcontagiosum virus) that is part of the pox virus family. The virus is contagious through direct contact and is more common in children. However, the virus also can be spread by sexual contact and can occur in people with compromised immune systems. Molluscumcontagiosum can spread on a single individual through scratching and rubbing.

Symptoms

Common locations for the molluscumcontagiosum papules are on the face, trunk, and limbs of children and on the genitals, abdomens, and inner thighs of adults. The condition usually results in papules that:

*    Are generally painless, but can itch

*    Are small (2 to 5 millimetre diameter)

*    Have a dimple in the centre

*    Are initially firm, dome-shaped, and flesh-coloured

*    Become softer with time

*    May turn red and drain over time

*    Have a central core of white, waxy material

Molluscum contagiosum usually disappears spontaneously over a period of months to years in people who have normal immune systems. In people who have AIDS or other conditions that affect the immune system, the lesions associated with molluscumcontagiosum can be extensive and especially chronic.

Diagnosis

Diagnosis of molluscum contagiosum is based on the distinctive appearance of the lesion. If the diagnosis is in question, a doctor can confirm the diagnosis with a skin biopsy — the removal of a portion of skin for closer examination. If there is any concern about related health problems, a doctor can check for underlying disorders.

Treatment

Molluscum contagiosum is usually self-limited, so treatment is not always necessary. However, individual lesions may be removed by scraping or freezing. Topical medications, such as those used to remove warts, may also be helpful in lesion removal.

Note: The surgical removal of individual lesions may result in scarring.

Prevention

To prevent molluscum contagiosum, follow these tips:

*    Avoid direct contact with anyone who may have the condition.

*    Treat underlying eczema in children.

*    Remain sexually abstinent or have a monogamous sexual relationship with an uninfected individual. (Male and female condoms cannot offer full protection as the virus can be found on areas not covered by the condom.)

Shingles

Shingles (herpes zoster) results from a reactivation of the virus that also causes chickenpox. With shingles, the first thing you may notice is a tingling sensation or pain on one side of your body or face. Painful skin blisters then erupt on only one side of your face or body along the distribution of nerves on the skin. Typically, this occurs along your chest, abdomen, back, or face, but it may also affect your neck, limbs, or lower back. The area can be very painful, itchy, and tender. After one to two weeks, the blisters heal and form scabs, although the pain often continues.

The deep pain that follows after the infection has run its course is known as postherpetic neuralgia. It can continue for months or even years, especially in older people. The incidence of shingles and of postherpetic neuralgia rises with increasing age. More than 50 per cent of cases occur in people over 60. Shingles usually occurs only once, although it has been known to recur in some people.

What causes shingles?

Shingles arises from varicella-zoster, the same virus that causes chickenpox. Following a bout of chickenpox, the virus lies dormant in the spinal nerve cells. But it can be reactivated years later when the immune system is suppressed by:

*    Physical or emotional trauma

*    A serious illness

*    Certain medications

Medical science doesn’t understand why the virus becomes reactivated in some people and not in others.

Chickenpox

Chickenpox (varicella), a viral illness characterised by a very itchy red rash, is one of the most common infectious diseases of childhood. It is usually mild in children, but adults run the risk of serious complications, such as bacterial pneumonia.

People who have had chickenpox almost always develop lifetime immunity (meaning you can’t get it again). However, the virus remains dormant in the body, and it can reactivate later in life and cause shingles.

Because the chickenpox virus can pass from a pregnant woman to her unborn child, possibly causing birth defects, doctors often advise women considering pregnancy to confirm their immunity with a blood test.

What causes chickenpox?

Chickenpox is caused by the herpes zoster virus, also known as the varicella zoster virus. It is spread by droplets from a sneeze or cough, or by contact with the clothing, bed linens, or oozing blisters of an infected person. The onset of symptoms is seven to 21 days after exposure. The disease is most contagious a day before the rash appears and up to seven days after, or until the rash is completely dry and scabbed.

Reports compiled by Adebayo Folorunsho-Francis with addition information from webmd.com/skin-problems-and-treatments and wikipedia.org/wiki/Skin_infection

The annual World Cancer Day was marked on 4 February, 2015. The goal was to intensify awareness campaign on the disease, as well as discuss new methods of curbing it. This year’s theme, ‘Not beyond us’, gives hope to cancer patients and their relatives, as it implies the possibility of cancer remedies across the globe and within our reach.

According to a report on World Cancer Day 2015, the campaign will explore the implementation of existing preventive measures, early detection, treatment and care, and in turn, open up to the exciting prospect that can impact the global cancer burden – for the better. Four key areas will constitute the focal point of the campaign, which are: choosing healthy lives; delivering early detection; achieving treatment for all; and maximising quality of life.

If all stakeholders would give this crusade all it takes to be a success, the alarming rate of 100,000 new cases of cancer recorded annually in the country will be drastically reduced.

A professor of radiotherapy and Oncology with the College of Medicine, University of Lagos, Akoka, Aderemi Ajekigbe, had while leading a campaign against cancer in January, asserted that Nigeria records 100,000 new cases of cancer annually. He added that except a timely intervention of government occurs, through the provision of functioning radiotherapy machines across the country, more cases will be recorded.

Ajekigbe attributed the increasing rate of the disease in developing countries like Nigeria to the poor state of health facilities, poor funding of cancer care, late diagnosis and detection of the deadly disease in the country. He emphasised the need for government to play a major role in the crusade as there are many poor Nigerians groaning under the pain of cancer, who cannot afford the treatment option.

“We cannot afford to lose more Nigerians to cancer. Government should dedicate the proceeds from an oil block to the provision of cancer equipment and treatment. It is a need,” he said.

What is cancer?

Cancer is a class of diseases characterised by out-of-control cell growth. There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected.

Cancer harms the body when damaged cells divide uncontrollably to form lumps or masses of tissue called tumours (except in the case of leukaemia where cancer prohibits normal blood function by abnormal cell division in the blood stream). Tumours can grow and interfere with the digestive, nervous, and circulatory systems and they can release hormones that alter body function. Tumours that stay in one spot and demonstrate limited growth are generally considered to be benign.

More dangerous or malignant tumours form when two things occur:

1. a cancerous cell manages to move throughout the body using the blood or lymph systems, destroying healthy tissue in a process called invasion
2. that cell manages to divide and grow, making new blood vessels to feed itself in a process called angiogenesis.

When a tumour successfully spreads to other parts of the body and grows, invading and destroying other healthy tissues, it is said to have metastasized. This process itself is called metastasis, and the result is a serious condition that is very difficult to treat.

 Symptoms of cancer

1.  Persistent cough or hoarseness. While a cough here and there is nothing to worry about, a consistent cacophony or a cough accompanied by blood is definitely a cause for concern. “Most coughs are not cancer,” says Therese Bartholomew Bevers, M.D., professor of clinical cancer prevention and the medical director of the Cancer Prevention Centre at the MD Anderson Cancer Centre. “But certainly a persistent cough needs to be evaluated to see if it could be lung cancer.” Your physician should recommend a chest X-ray or CT scan to rule out cancer as a possibility.

2. Persistent change in bowel habits. When your bowel movements aren’t as easy as they once were or your stool appears larger than normal or somewhat deformed, this could be a sign of colon cancer, says Bartholomew Bevers. “It could be a sign that there is a mass impeding the transit of the stool from the bowel,” she says. “This is a symptom where a person should go to the doctor and schedule a colonoscopy to see if there indeed is a mass.”

3. Persistent change in bladder habits. “If there is blood in the urine, that could be indicative of bladder or kidney cancer—but more commonly this is a sign of a urinary tract infection,” says Bartholomew Bevers. Check for an infection first, then pursue other treatment options.

4. Persistent unexplained pain. “Most pain is not a sign of cancer, but persistent pain must be checked out,” says Bartholomew Bevers. “If you have persistent headaches, for example, you likely don’t have brain cancer—but it is still something that must be looked into. Persistent pain in the chest could be a sign of lung cancer. And pain in your abdomen could be ovarian cancer.”

5. Change in the appearance of a mole. While not all moles are indicative of melanoma, spotting a new mark or one that has changed is something you should bring up with a dermatologist who can screen for skin cancer, says Bartholomew Bevers.

6. A sore that does not heal. If you have a sore that’s hanging on past the three-week mark, you should bring it up with your doctor. “We would have expected our body to have healed itself by now,” says Bartholomew Bevers, “and you should absolutely get that checked out.” That kind of sore could be a sign of carcinoma.

7. Unexpected Bleeding. Vaginal bleeding—outside of your normal cycle—could be an early sign of cervical cancer, while bleeding from the rectum could indicate colon cancer, says Bartholomew Bevers.

8. Unexplained weight loss. “As adults, we try very hard to lose weight,” says Bartholomew Bevers. “But if weight is falling off of you without any effort on your part, that is a big concern and can be indicative of a serious medical problem.” One of those problems, she says, could be malignancy or a tumour.

9. An unexplained lump. “Any time you have a lump that is new or a lump that is changing, that is something you should absolutely have looked at by your doctor,” says Bartholomew Bevers. While it could be a benign cyst (and likely is), it could also be “a cancer that is in the subterranean tissue. A lump in the chest, of course, is a very common symptom of chest cancer.” See your physician to get more information.

 How is cancer classified?

There are five broad groups that are used to classify cancer.

1. Carcinomas are characterised by cells that cover internal and external parts of the body such as lung, breast, and colon cancer.
2. Sarcomas are characterised by cells that are located in bone, cartilage, fat, connective tissue, muscle, and other supportive tissues.
3. Lymphomas are cancers that begin in the lymph nodes and immune system tissues.
4. Leukaemias are cancers that begin in the bone marrow and often accumulate in the bloodstream.
5. Adenomas are cancers that arise in the thyroid, the pituitary gland, the adrenal gland, and other glandular tissues.

Cancers are often referred to by terms that contain a prefix related to the cell type in which the cancer originated and a suffix such as -sarcoma, -carcinoma, or just -oma. Common prefixes include:

*    Adeno- = gland

*    Chondro- = cartilage

*    Erythro- = red blood cell

*    Hemangio- = blood vessels

*    Hepato- = liver

*    Lipo- = fat

*    Lympho- = white blood cell

*    Melano- = pigment cell

*    Myelo- = bone marrow

*    Myo- = muscle

*    Osteo- = bone

*    Uro- = bladder

*    Retino- = eye

*    Neuro- = brain

 How fast does cancer spread?

Scientists reported in Nature Communications that they have discovered an important clue as to why cancer cells spread. It has something to do with their adhesion (stickiness) properties. Certain molecular interactions between cells and the scaffolding that holds them in place (extracellular matrix) cause them to become unstuck at the original tumour site, they become dislodged, move on and then reattach themselves at a new site.

The researchers say this discovery is important because cancer mortality is mainly due to metastatic tumours, those that grow from cells that have travelled from their original site to another part of the body. Only 10 per cent of cancer deaths are caused by the primary tumours.

The scientists, from the Massachusetts Institute of Technology, say that finding a way to stop cancer cells from sticking to new sites could interfere with metastatic disease, and halt the growth of secondary tumours.

In 2007, cancer claimed the lives of about 7.6 million people in the world. Physicians and researchers who specialise in the study, diagnosis, treatment, and prevention of cancer are called oncologists.

Malignant cells are more agile than non-malignant ones. Scientists from the Physical Sciences-Oncology Centers, USA, reported in the journal Scientific Reports (April 2013 issue) that malignant cells are much “nimbler” than non-malignant ones. Malignant cells can pass more easily through smaller gaps, as well as applying a much greater force on their environment compared to other cells.

Professor Robert Austin and team created a new catalogue of the physical and chemical features of cancerous cells with over 100 scientists from 20 different centres across the United States. The authors believe their catalogue will help oncologists detect cancerous cells in patients early on, thus preventing the spread of the disease to other parts of the body.

Prof. Austin said. “By bringing together different types of experimental expertise to systematically compare metastatic and non-metastatic cells, we have advanced our knowledge of how metastasis occurs.”

 How is cancer diagnosed and staged?

Early detection of cancer can greatly improve the odds of successful treatment and survival. Physicians use information from symptoms and several other procedures to diagnose cancer. Imaging techniques such as X-rays, CT scans, MRI scans, PET scans, and ultrasound scans are used regularly in order to detect where a tumour is located and what organs may be affected by it. Doctors may also conduct an endoscopy, which is a procedure that uses a thin tube with a camera and light at one end, to look for abnormalities inside the body.

Extracting cancer cells and looking at them under a microscope is the only absolute way to diagnose cancer. This procedure is called a biopsy. Other types of molecular diagnostic tests are frequently employed as well. Physicians will analyse your body’s sugars, fats, proteins, and DNA at the molecular level. For example, cancerous prostate cells release a higher level of a chemical called PSA (prostate-specific antigen) into the bloodstream that can be detected by a blood test. Molecular diagnostics, biopsies, and imaging techniques are all used together to diagnose cancer.

 How can cancer treated?

Cancer treatment depends on the type of cancer, the stage of the cancer (how much it has spread), age, health status, and additional personal characteristics. There is no single treatment for cancer, and patients often receive a combination of therapies and palliative care. Treatments usually fall into one of the following categories: surgery, radiation, chemotherapy, immunotherapy, hormone therapy, or gene therapy.

 Surgery

Surgery is the oldest known treatment for cancer. If a cancer has not metastasised, it is possible to completely cure a patient by surgically removing the cancer from the body. This is often seen in the removal of the prostate or a breast or testicle. After the disease has spread, however, it is nearly impossible to remove all of the cancer cells. Surgery may also be instrumental in helping to control symptoms such as bowel obstruction or spinal cord compression.

Innovations continue to be developed to aid the surgical process, such as the iKnife that “sniffs” out cancer. Currently, when a tumour is removed surgeons also take out a “margin” of healthy tissue to make sure no malignant cells are left behind. This usually means keeping the patients under general anaesthetic for an extra 30 minutes while tissue samples are tested in the lab for “clear margins”. If there are no clear margins, the surgeon has to go back in and remove more tissue (if possible). Scientists from Imperial College London say the iKnife may remove the need for sending samples to the lab.

 Radiation

Radiation treatment, also known as radiotherapy, destroys cancer by focusing high-energy rays on the cancer cells. This causes damage to the molecules that make up the cancer cells and leads them to commit suicide. Radiotherapy utilises high-energy gamma-rays that are emitted from metals such as radium or high-energy x-rays that are created in a special machine. Early radiation treatments caused severe side-effects because the energy beams would damage normal, healthy tissue, but technologies have improved so that beams can be more accurately targeted. Radiotherapy is used as a standalone treatment to shrink a tumour or destroy cancer cells (including those associated with leukaemia and lymphoma), and it is also used in combination with other cancer treatments.

 Chemotherapy

Chemotherapy utilises chemicals that interfere with the cell division process – damaging proteins or DNA – so that cancer cells will commit suicide. These treatments target any rapidly dividing cells (not necessarily just cancer cells), but normal cells usually can recover from any chemical-induced damage while cancer cells cannot. Chemotherapy is generally used to treat cancer that has spread or metastasised because the medicines travel throughout the entire body. It is a necessary treatment for some forms of leukaemia and lymphoma. Chemotherapy treatment occurs in cycles so the body has time to heal between doses. However, there are still common side effects such as hair loss, nausea, fatigue, and vomiting. Combination therapies often include multiple types of chemotherapy or chemotherapy combined with other treatment options.

 Immunotherapy

Immunotherapy aims to get the body’s immune system to fight the tumour. Local immunotherapy injects a treatment into an affected area, for example, to cause inflammation that causes a tumour to shrink. Systemic immunotherapy treats the whole body by administering an agent such as the protein interferon alpha that can shrink tumours. Immunotherapy can also be considered non-specific if it improves cancer-fighting abilities by stimulating the entire immune system, and it can be considered targeted if the treatment specifically tells the immune system to destroy cancer cells. These therapies are relatively young, but researchers have had success with treatments that introduce antibodies to the body that inhibit the growth of breast cancer cells. Bone marrow transplantation (hematopoietic stem cell transplantation) can also be considered immunotherapy because the donor’s immune cells will often attack the tumour or cancer cells that are present in the host.

 Hormone therapy

Several cancers have been linked to some types of hormones, most notably breast and prostate cancer. Hormone therapy is designed to alter hormone production in the body so that cancer cells stop growing or are killed completely. Breast cancer hormone therapies often focus on reducing estrogenic levels (a common drug for this is tamoxifen) and prostate cancer hormone therapies often focus on reducing testosterone levels. In addition, some leukaemia and lymphoma cases can be treated with the hormone cortisone.

 Gene therapy

The goal of gene therapy is to replace damaged genes with ones that work to address a root cause of cancer: damage to DNA. For example, researchers are trying to replace the damaged gene that signals cells to stop dividing (the p53 gene) with a copy of a working gene. Other gene-based therapies focus on further damaging cancer cell DNA to the point where the cell commits suicide. Gene therapy is a very young field and has not yet resulted in any successful treatments.

 Using cancer-specific immune system cells to treat cancer

Scientists from the RIKEN Research Centre for Allergy and Immunology in Yokohama, Japan, explained in the journal Cell Stem Cell (January 2013 issue) how they managed to make cancer-specific immune system cells from iPSCs (induced pluripotent stem cells) to destroy cancer cells.

The authors added that their study has shown that it is possible to clone versions of the patients’ own cells to enhance their immune system so that cancer cells could be destroyed naturally.

Hiroshi Kawamoto and team created cancer-specific killer T-lymphocytes from iPSCs. They started off with mature T-lymphocytes which were specific for a type of skin cancer and reprogrammed them into iPSCs with the help of “Yamanaka factors”. The iPSCs eventually turned into fully active, cancer-specific T-lymphocytes – in other words, cells that target and destroy cancer cells.

 How can cancer be prevented?

Cancers that are closely linked to certain behaviours are the easiest to prevent. For example, choosing not to smoke tobacco or drink alcohol significantly lowers the risk of several types of cancer – most notably lung, throat, mouth, and liver cancer. Even if you are a current tobacco user, quitting can still greatly reduce your chances of getting cancer.

Skin cancer can be prevented by staying in the shade, protecting yourself with a hat and shirt when in the sun, and using sunscreen. Diet is also an important part of cancer prevention since what we eat has been linked to the disease. Physicians recommend diets that are low in fat and rich in fresh fruits and vegetables and whole grains.

Certain vaccinations have been associated with the prevention of some cancers. For example, many women receive a vaccination for the human papillomavirus because of the virus’s relationship with cervical cancer. Hepatitis B vaccines prevent the hepatitis B virus, which can cause liver cancer.

Some cancer prevention is based on systematic screening in order to detect small irregularities or tumours as early as possible even if there are no clear symptoms present. Breast self-examination, mammograms, testicular self-examination, and Pap smears are common screening methods for various cancers.

Researchers from Northwestern University Feinberg School of Medicine in Chicago reported in the journal Circulation that the 7 steps recommended for protection against heart disease can also reduce the risk of developing cancer,. They include being physically active, eating a healthy diet, controlling cholesterol, managing blood pressure, reducing blood sugar and not smoking.

Other means of combating cancer

 Exercise and cancer

Exercise can help control fatigue, muscle tension, and anxiety in those with cancer. Patients tend to feel better if they do exercises such as walking or swimming. Exercise has also been shown to improve the outcomes associated with cancer treatment.

 Mind/body medicine for cancer

Some mind/body therapies improve quality of life for cancer patients through behaviour modification; others encourage expression of emotions. Behaviour therapies such as guided imagery, progressive muscle relaxation, hypnotherapy, and biofeedback are used to alleviate pain, nausea, vomiting, and the anxiety that may occur in anticipation of, or after, cancer treatment. Individual or group counselling allows patients to confront problems and emotions caused by cancer and receive support from fellow patients in a group setting. Patients who pursue these types of therapies tend to feel less lonely, less anxious about the future, and more optimistic about recovery.

 Nutrition, diet, and cancer

Scientific evidence suggests that nutrition may play a role in cancer prevention. Observational studies have shown that cancer is more common in some people with certain dietary habits — such as colorectal cancer in people who have diets rich in meat products. So far, data has not supported the use of any vitamins or supplements to decrease the risk of cancer. In fact, studies show some supplements may increase cancer risk, such as lung cancer risk in smokers taking beta carotene and prostate cancer risk in men taking high doses of vitamin E.

Also, experts don’t recommend stopping standard treatment in place of complementary medicine, but many therapies can help people with cancer feel better.

 Acupuncture and acupressure

Acupuncture and acupressure are examples of “complementary” medicine for cancer. While neither claims to cure the disease, some evidence shows that they help reduce symptoms and side effects of the illness and its treatment.

Other tips:

*    Join a cancer support group.

* Get plenty of rest, balanced with light exercise.

*    Rather than feeling compelled to maintain a “positive attitude,” express your emotions honestly. Don’t worry if you sometimes feel depressed or afraid: These are normal feelings and legitimate reactions that will not affect your cancer.

*    Fill your days with activities you enjoy. Reading a good book, listening to music, and talking with friends are surprisingly therapeutic.

Report compiled by Temitope Obayendo with additional information from:

WebMD Medical Reference; World Cancer Day 2015; womenshealthmag.com