2018 National Cancer Prevention Workshop
HIV and AIDS and Increased Cancer Risk
Deputy Head of Global Oncology, Fred Hutchinson Cancer Research Center

Digital Transciption:
Yeah I'll tell her my story it's really an honor to be here today on cancer prevention day thank you to everyone who is joining I'm passionate about which is prevention of cancer in people with HIV and also give a global Health perspective on cancer prevention so really one of the great biomedical the trees at the past 20 plus years it's been the development of effective drugs to treat HIV and with increasingly effective and less toxic drugs patients living with HIV now have a life span life expectancy comprable to that of the general population with these victories cancer has become the leading cause of morbidity and mortality in this patient population I'm in for the more than 1.2 people million people with HIV living in the United States and 37 million people living with HIV cancer is an important issue that will need to address moving forward so in terms of cancer prevention there are actually very effective methods to prevent cancer in this patient population we've known for many years that lymphoma kaposi sarcoma lung cancer liver cancer are all occurring it increase rates substantially increase rates compared to the general population and people with HIV additionally cervical cancer and anal cancer and Cancers caused by HPV are a priest in this patient population but fortunately there are effective ways to prevent these Cancers and that's what I want to talk to you about a little bit today so first and foremost the most important thing you can do to prevent cancer some people with HIV is starting them on antiretroviral therapy early this is a proven a way to prevent lymphoma and kaposi sarcoma we know that Byerly's antiretroviral therapy we can decrease cancer incidence by more than 50% and so roll out of antiretroviral therapy access of antiretroviral therapy to the more than 37 million people around the globe in the tremendous efforts to do this needs to continue the goals of reaching 90% of people with HIV providing them with f active antiretroviral therapy will not only curved the HIV epidemic but for the people living with HIV is an effective in preventing cancer prevention strategy and we need to keep pushing forward with these efforts in the United States and globally the second area where cancer prevention is proven to be effective is in the area of hpv-associated cancers and we heard a little bit about this during the lunch session I just want to expand on it a little bit more difficult cancer and anal cancer as well as some head and neck cancers are caused by a virus called human papillomavirus since we know that vaccines can help prevent HPV in for Young Generation abroad use of HPV vaccine HPV vaccine holds the promise of perhaps a generation free of hpv-associated tumors for more than the more than 37 million people living with HIV cervical cancer screening and anal cancer screening are proven ineffective programs that we need to continue Decades of cervical cancer screening in hiv-infected women is actually been a major success story and cancer prevention and has prevented a large number of cervical cancer cases in the United States for the more than 37 million people globally we really need to look at novel cervical cancer screening methods and we again heard a little bit about this from Victor in the lungs session of how to incorporate things like HPV viral testing into cervical cancer screening programs in this will be very important globally additionally anal cancer is an important cancer in both women and men who are infected with HIV the rates in the United States are similar to cervical cancer rates and low and middle-income countries globally and there are efforts to try to develop screening programs for people with HIV that are based on the very effective methods that are used for cervical cancer screening the National Cancer Institute is sponsoring a large randomized control study called The Anchor study which will look at anal cancer screening and see whether or not anal cancer screening definitively decreases the incidence of invasive anal cancer and this is a very debilitating disease in data from this study will be very important in defining prevention of anal cancer moving forward so the next thing I wanted to put this talk about a little bit has to put this in the global Health perspective so we are followed been touched by some cancel I think very moved by some of the stories I've heard today, but it's important to recognize that 70% of the cancers in the world today are seen in low and middle-income countries their 17.5 million cancers per year now and expected to grow by 70% over the next two decades about a quarter of these are in low and middle-income countries are caused by viruses I'm working now with the Fred Hutch Cancer Research Center Global oncology to conduct ...

Abstract - Recently published informed debate affords strong indication that in patients with the Acquired Immune Deficiency Syndrome, HIV cannot, directly or indirectly, be the cause of Kaposi's sarcoma. This paper provides reasons for disallowing a current alternative theory that Kaposi's sarcoma is due to an unidentified sexually transmitted infectious agent and proposes instead that Kaposi's sarcoma is the result of prolonged and repeated exposure to nitrites and/or semen. If this alternative hypothesis is strengthened by confirmation of its predictions then the relationship of HIV to Kaposi's sarcoma, one of the principal AIDS-associated diseases, becomes somewhat remote. This may facilitate a shift of emphasis and encourage the development of alternative therapies.

সারকোমা অন্যান্য সকল ক্যান্সারের মতনই, কিন্তু প্রাথমিকভাবে এটি সনাক্ত করা গেলে এর চিকিৎসা খুবই ফলপ্রসূ হতে পারে। অন্য দিকে, এটি যদি মেটাস্ট্যাটিক স্টেজে সনাক্ত করা হয়ে থাকে তাহলে সেক্ষেত্রে বেঁচে থাকার সম্ভাবনা খুবই ক্ষীণ।’’


আপনি হয়তো কখনোই সারকোমার ব্যাপারে শোনেননি, কেননা এটি সচরাচর কারো হয় না। কিন্তু, এতে আক্রান্ত হয়ে মৃত্যুর হার আশঙ্কাজনকভাবে অনেক বেশি। পরিসংখ্যানে দেখা যায় যে, এতে আক্রান্ত হয়ে প্রতি বছর 5,270 জন মানুষ মৃত্যু বরণ করে এবং 1.5 মিলিয়ন মানুষের মধ্যে কেবলমাত্র 12,750 জনের ক্ষেত্রে এটি সনাক্ত করা সম্ভব হয়েছে। এধরণের ক্যান্সারের ব্যাপারে সবার মধ্যে সচেতনতা সৃষ্টির লক্ষ্যে জুলাই মাসটিকে সারকোমা মাস হিসেবে আখ্যায়িত করা হয়েছে।


কানেক্টিভ টিস্যু বা সংযোজক টিস্যুর ক্যান্সারকে সাধারণ অর্থে সারকোমা বলা হয়। মূলত সারকোমা বিভিন্ন ধরণের হয়ে থাকে যা ভিন্ন ভিন্ন স্থানে বিস্তার লাভ করতে পারে, যেমন- হাড়ের কোষ, কারটিলেজ, রক্তনালী এবং স্টেম কোষ। এই ক্যান্সারটিকে প্রধানত 2 ভাগে ভাগ করা যায়, যা হল- বোন বা হাড়ের সারকোমা এবং সফট টিস্যু সারকোমা।

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