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Head and Neck Cancer Prevention
- 1. Head and Neck Cancers Prevention and Early Detection Dr. Ahmed A. Shamlan Clinical Oncologist National Oncology Center Sana’a, Yemen
- 2. ﺳﺮﻃﺎن اﻟﺮأس واﻟﻌﻨﻖ اﻟﻮﻗﺎﯾﺔ واﻻﻛﺘﺸﺎف اﻟﻤﺒﻜﺮ د. أﺣﻤﺪ أﺣﻤﺪ ﺷﻤﻼن اﺳﺘﺸﺎري ﻋﻼج اﻷورام
- 3. ﺣﺠﻢ ﻣﺸﻜﻠﺔ ﺳﺮﻃﺎن اﻟﺮأس واﻟﻌﻨﻖ ﻓﻲ اﻟﻌﺎﻟﻢ وﻓﻲ اﻟﯿﻤﻦ • ﻣﺎ ھﻲ ﻣﻨﻄﻘﺔ اﻟﺮأس واﻟﻌﻨﻖ وﻣﺎ أﺟﺰاءھﺎ • اﻷﻋﺮاض واﻟﻌﻼﻣﺎت اﻟﻤﺒﻜﺮة ﻟﻤﻨﺎﻃﻖ اﻟﺮأس واﻟﻌﻨﻖ اﻟﻤﺨﺘﻠﻔﺔ • ﻛﯿﻒ ﯾﻤﻜﻦ اﻟﻮﻗﺎﯾﺔ ﻣﻦ ﺳﺮﻃﺎن اﻟﺮأس واﻟﻌﻨﻖ • اﻟﺼﻌﻮﺑﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻟﺠﻤﮭﻮرﯾﺔ اﻟﯿﻤﻨﯿﺔ • اﻟﺼﻌﻮﺑﺎت اﻟﺨﺎﺻﺔ ﺑﺎﻟﺠﻤﮭﻮرﯾﺔ اﻟﯿﻤﻨﯿﺔ اﻟﺨﺎﺻﺔ ﺑﺴﺮﻃﺎن اﻟﺮأس • واﻟﻌﻨﻖ اﻟﻄﺮق اﻟﻌﻼﺟﯿﺔ ﻟﺴﺮﻃﺎن اﻟﺮأس واﻟﻌﻨﻖ • • Size of the problem globally and in Yemen • What is the head and neck regions • The early symptoms and signs of the head and neck regions • Education, Prevention and Early detection • Difficulties in Yemen • Treatment lines and mistakes noted from the medical staff
- 5. أوﻻ ﻋﻮاﻣﻞ ﺗﺴﺎﻋﺪ ﻋﻠﻰ ارﺗﻔﺎع ﻧﺴﺒﺔ اﻹﺻﺎﺑﺔ ﺑﺎﻟﺴﺮﻃﺎن ﻗﻠﺔ اﻟﻮﻋﻲ اﻟﻤﺠﺘﻤﻌﻲ ﺑﺎﻟﻮﻗﺎﯾﺔ اﻷوﻟﯿﺔ واﻟﺜﻨﺎﺋﯿﺔ ﻣﻦ اﻟﺴﺮﻃﺎن ﻋﻮاﻣﻞ ﻣﺴﺮﻃﻨﺔ ﻟﯿﺴﺖ ﻣﻮﺟﻮدة ﺑﺎﻟﻌﺎﻟﻢ )اﻟﺸﻤﺔ ، اﻟﻘﺎت، زواج اﻷﻗﺎرب؟؟( زﯾﺎدة ﻧﺴﺒﺔ اﻟﻤﺪﺧﻨﯿﻦ وﻟﻸﺳﻒ ﺑﯿﻦ اﻟﺠﻨﺴﯿﻦ وﺣﺎﻟﯿﺎ زﯾﺎدة اﺳﺘﺨﺪام اﻟﺸﯿﺸﺔ اﻧﻌﺪام اﻷﺑﺤﺎث اﻟﻌﻠﻤﯿﺔ ﻓﻲ ھﺬا اﻟﺠﺎﻧﺐ ﻋﺪم ﻓﻌﺎﻟﯿﺔ اﻟﻤﺸﺮوع اﻟﻮﻃﻨﻲ ﻟﻠﻮﻗﺎﯾﺔ اﻷوﻟﯿﺔ واﻟﺜﻨﺎﺋﯿﺔ ﻋﺪم اﺳﺘﻜﻤﺎل اﻟﻤﺸﺮوع اﻟﻮﻃﻨﻲ ﻟﺘﺴﺠﯿﻞ اﻟﺴﺮﻃﺎن
- 6. ﻋﻮاﻣﻞ اﻟﺨﻄﻮرة ﻟﺤﺪوث ﺳﺮﻃﺎن اﻟﺮأس واﻟﻌﻨﻖ وﺧﺼﻮﺻﯿﺎت ﺑﺎﻟﺠﻤﮭﻮرﯾﺔ اﻟﯿﻤﻨﯿﺔ • اﻟﺘﺒﻎ ﺑﺄﺷﻜﺎﻟﮫ اﻟﻤﺨﺘﻠﻔﺔ ھﻮ أﻛﺜﺮ اﻟﻌﻮاﻣﻞ اﻟﺘﻲ ﯾﻤﻜﻦ ﻣﻜﺎﻓﺤﺘﮭﺎ وھﻲ: اﻟﺘﺪﺧﯿﻦ وﺧﺎﺻﺔ ﻓﻲ اﻟﻤﺠﺎﻟﺲ وﻟﺪى اﻷﻃﻔﺎل واﻟﺸﺒﺎب. – اﻟﺸﯿﺸﺔ واﻟﺘﻲ ﺗﺰﯾﺪ ﺣﺎﻟﯿﺎ ﻟﺪى اﻟﺸﺒﺎب اﻟﺬﻛﻮر واﻹﻧﺎث وﻣﺤﺎوﻟﺔ ﻋﺮﺿﮭﺎ وﺗﺴﻮﯾﻘﮭﺎ أﻧﮭﺎ – أﻗﻞ ﺿﺮرا ﻣﻦ اﻟﺘﺪﺧﯿﻦ. اﻟﻤﺪاﻋﺔ – اﻟﺸﻤﺔ ﺑﺄﺷﻜﺎﻟﮭﺎ اﻟﻤﺨﺘﻠﻔﺔ: – • اﻟﻤﻀﻎ • اﻟﺘﺨﺰﯾﻦ • اﻟﻨﺸﻮق • اﻟﺘﻨﺒﻞ وﻣﻦ أﻛﺒﺮ ﻣﺸﺎﻛﻠﮭﺎ أﻧﮭﺎ ﺗﺴﺘﺨﺪم ﺑﻮاﺳﻄﺔ ﻛﻞ اﻷﻋﻤﺎر ذﻛﻮرا وإﻧﺎﺛﺎ )ﺗﺄﺗﻲ ﺣﺎﻻت ﻛﺜﯿﺮة ﺑﺴﺒﺒﮭﺎ(. – ;Spit tobacco or smokeless tobacco – ;Cigars, cigarillos, and pipe tobacco – Bidis; and – .Kreteks or clove and other herbal cigarettes • اﻟﻘﺎت وﺑﺪاﯾﺔ اﻷﻃﻔﺎل ﻻﺳﺘﺨﺪاﻣﮫ ﻓﻲ أﻋﻤﺎر ﺻﻐﯿﺮة.
- 7. • اﻟﻘﺎت وﺑﺪاﯾﺔ اﻷﻃﻔﺎل ﻻﺳﺘﺨﺪاﻣﮫ ﻓﻲ أﻋﻤﺎر ﺻﻐﯿﺮة. • زراﻋﺔ اﻟﻘﺎت
- 8. • Spit tobacco Spit tobacco, also known as smokeless tobacco, • is tobacco that is placed inside the mouth. It is sold as: • • Chew – This is a leafy form of tobacco sold in pouches. A person keeps the chew between the cheek and gums for several hours at a time. It is also known as ‘a wad’. • • Plug – This is chew tobacco that has been pressed into a hard block and placed between the cheek and gum. • • Snuff – This is ground-up moist tobacco sold in cans. It is usually placed between the bottom lip and gum. It is also known as ‘dipping’. • Spit tobacco can be as addictive as smoking cigarettes. A person who uses 8 to 10 dips or chews a day gets the same amount of nico ne as a person who smokes 30 to 40 cigare es a day. Spit tobacco is flavoured with licorice, mint or cherry and sweetened with sugar. However, spit tobacco has over 3000 chemicals including 28 known cancer-causing chemicals, such as formaldehyde and cadmium. • Cancers of the mouth can develop within five years of regular tobacco product use. Only 56 per cent of people with mouth or throat cancer live more than five years after the time of diagnosis. Tobacco Prevention Series - Number 30d August 2005 www.bchealthguide.org
- 9. • People who smoke cigars and pipes face a higher risk of cancers of the mouth, throat, oesophagus, as well as lung cancer. • Bidis Bidis, or beadies, are thin cigarettes of tobacco • wrapped in leaves and tied with colourful strings. Bidis are popular with youth because they are cheaper than regular cigarettes and are sold in a variety of candy-like flavours such as chocolate, cherry and mango. Because bidis are wrapped in a leaf rather than paper, youth may believe they are a safe, "natural" option to cigarettes. • While bidis have less tobacco than regular cigarettes, they are unfiltered and can have higher levels of nicotine, tar and carbon monoxide. Bidis do not stay lit easily, so people who smoke them need to puff harder and inhale deeper into their lungs to keep them lit. • People who smoke bidis are at higher risk of heart disease and cancers of the mouth, lung, stomach and throat. They are also four times more likely to suffer from chronic lung infections. Tobacco Prevention Series - Number 30d August 2005 www.bchealthguide.org
- 10. • Kreteks Kreteks are Indonesian cigarettes made up of tobacco, ground cloves and other additives. Teens believe that Kreteks are safer than regular cigarettes because they are often marketed as “natural tobacco”. This is misleading because “natural tobacco” can be as dangerous as regular cigarettes. • Kreteks have the same health risks as regular cigarettes, but they have more nicotine, tar and carbon monoxide. People who smoke Kreteks are at higher risk of acute lung injury and have up to 20 times the risk of problems with lung function. Tobacco Prevention Series - Number 30d August 2005 www.bchealthguide.org
- 11. • اﻟﻤﮭﻦ اﻟﺨﺎﺻﺔ واﻟﺘﻲ ﯾﻜﻮن ﻓﯿﮫ اﻟﻌﺎﻣﻠﯿﻦ ﻋﺮﺿﺔ ﻟﺤﺪوث ﺳﺮﻃﺎن اﻟﺮأس واﻟﻌﻨﻖ • اﻟﻤﮭﻦ اﻟﺘﻲ ﺑﮭﺎ ﺗﻠﻮث ﻟﻠﺒﯿﺌﺔ اﻟﻤﮭﻨﯿﺔ: – اﻟﻤﻨﺎﺟﻢ وﻣﻜﺎﺳﺮ )ﻣﻘﺎﻃﻊ( اﻷﺣﺠﺎر – اﻟﺤﺪادﯾﻦ اﻟﻠﺤﺎﻣﯿﻦ – اﻟﺨﺒﺎزﯾﻦ – اﻟﻤﮭﻨﺪﺳﯿﻦ واﻟﻨﺠﺎرﯾﻦ – اﻟﻤﺰارﻋﯿﻦ – وﻏﯿﺮھﺎ
- 12. ﻣﺎ ھﻲ أھﻢ أﺳﺒﺎب ﺳﺮﻃﺎن اﻟﻔﻢ؟ • اﻟﺘﺒﻎ ﺑﻤﺨﺘﻠﻒ أﺷﻜﺎﻟﮫ وﺧﺎﺻﺔ ﻣﺎ ﯾﺘﻢ وﺿﻌﺔ ﻣﺒﺎﺷﺮة ﻋﻠﻰ اﻷﻏﺸﯿﺔ اﻟﻤﺨﺎﻃﯿﺔ ﻟﻠﻔﻢ ﻛﺎﻟﺸﻤﺔ ﻟﺪﯾﻨﺎ ﺑﺎﻟﯿﻤﻦ وﻟﮭﺎ ﺗﺴﻤﯿﺎت ﻣﺨﺘﻠﻔﺔ ﻓﻲ اﻟﺪول اﻟﺘﻲ ﯾﺘﻢ اﺳﺘﺨﺪاﻣﮭﺎ ﺑﮭﺎ. – ﺗﻌﺘﺒﺮ اﻟﻌﺎﻣﻞ اﻟﺮﺋﯿﺴﻲ ﻓﻲ أﻛﺜﺮ ﻣﻦ ٠٩% ﻣﻦ ﺳﺮﻃﺎن اﻟﻔﻢ. – اﻟﺘﺄﺛﯿﺮ اﻟﻤﺒﺎﺷﺮ واﻟﺘﮭﯿﯿﺞ ﻟﻸﻏﺸﯿﺔ اﻟﻤﺨﺎﻃﯿﺔ واﻷﻧﺴﺠﺔ ﻟﻠﻔﻢ ﺗﺴﺒﺐ ﺗﻐﯿﺮ اﻟﺨﻼﯾﺎ واﻟﺘﺤﻮل ﻟﻠﺴﺮﻃﺎن – اﻷﻓﻜﺎر اﻟﺨﺎﻃﺌﺔ ﻓﻲ أﻧﮭﺎ ﺗﻨﻔﻊ ﻓﻲ اﻵﻻم واﻟﺘﮭﺎب اﻷﺳﻨﺎن ﻛﻼم ﻛﺬب وﯾﺤﺘﺎج ﻹزاﻟﺘﮫ ﻣﻦ اﻷﻓﻜﺎر وﺧﺎﺻﺔ ﻟﺪى اﻷﺟﯿﺎل اﻟﺤﺪﯾﺜﺔ. اﻟﻘﺎت وﻣﺎ ﯾﺤﺘﻮﯾﮫ ﻣﻦ ﻣﺒﯿﺪات ﺗﺴﺘﺨﺪم ﺣﺎﻟﯿﺎ ﯾﺘﻮﻗﻊ ﻟﮭﺎ دور ﻛﺒﯿﺮ ﻓﻲ ذﻟﻚ. • اﻟﻜﺤﻮل ﻋﺎﻣﻞ ھﺎم ﻓﻲ ﺳﺮﻃﺎن اﻟﻔﻢ ﻋﺎﻣﻞ وﺗﺰﯾﺪ ﺧﻄﻮرﺗﮫ ﻓﻲ وﺟﻮد • اﻟﺘﺒﻎ. أﻣﺮاض ﻣﺰﻣﻨﺔ واﻟﺘﮭﺎﺑﺎت ﺑﺎﻷﺳﻨﺎن واﻟﻠﺜﺔ وﻋﺪم اﻹھﺘﻤﺎم ﺑﮭﺎ وﺑﻨﻈﺎﻓﺔ • اﻟﻔﻢ. أﺳﺒﺎب أﺧﺮى ﻣﺜﻞ ﺑﻌﺾ اﻟﻔﯿﺮوﺳﺎت وﻏﯿﺮھﺎ. •
- 13. • اﺳﺘﺨﺪام اﻟﻤﺒﯿﺪات اﻟﺤﺸﺮﯾﺔ ﺑﺎﻟﻄﺮق اﻟﻌﺸﻮاﺋﯿﺔ وﺑﺪون ﻣﺮاﻋﺎة: – اﻷﻧﻮاع اﻟﻤﺴﻤﻮح ﺑﮭﺎ ﻟﻼﺳﺘﺨﺪام اﻟﺒﺸﺮي. – اﻷﻧﻮاع اﻟﻤﻨﺎﺳﺒﺔ ﻟﻜﻞ ﻣﻨﺘﺞ زراﻋﻲ. – اﻟﺘﺮﻛﯿﺰ اﻟﻤﺴﻤﻮح ﺑﮫ. – ﻃﺮق اﻟﺮش. – اﺳﺘﺨﺪام أﺳﺎﻟﯿﺐ اﻟﻮﻗﺎﯾﺔ اﻟﺸﺨﺼﯿﺔ. – ﻣﻮاﻋﯿﺪ اﻟﺤﺼﺎد ﻣﻦ ﯾﻮم اﻟﺮش.
- 14. • ﺳﻮء اﻟﺘﻐﺬﯾﺔ ﻋﻨﺪ اﻟﻜﺜﯿﺮ ﻣﻦ اﻟﻨﺎس وﻋﺪم ﺗﻨﺎول اﻟﻮﺟﺒﺎت اﻟﻤﺘﺰﻧﺔ وﻋﺪم ﺗﻨﺎول اﻟﺨﻀﺎر واﻟﻔﻮاﻛﮫ. • أﻣﺮاض ﻣﻌﺪﯾﺔ: – ﻓﯿﺮوس إﺑﺸﺘﺎﯾﻦ - ﺑﺎر EBV – ﻓﯿﺮوس اﻟﺤﻠﻤﻲ اﻟﺒﺸﺮي HPV
- 15. اﻟﻤﺸﻜﻠﺔ ﻓﻲ اﻟﺤﺪﯾﺪة أﻛﺜﺮ ﻣﻦ ﻏﯿﺮھﺎ ﻟﻤﺎذا؟ و ﻣﺎ ھﻮ دور اﻟﻜﺎدر اﻟﻄﺒﻲ؟ • أوﻻ: ﻟﻤﺎذا أﻏﻠﺐ اﻟﺤﺎﻻت ﺗﺤﻀﺮ ﻓﻲ ﻣﺮاﺣﻞ ﻣﺘﺄﺧﺮة؟ • اﻟﺘﺄﺧﺮ ﻗﻲ اﻟﺘﺸﺨﯿﺺ ﻟﮫ ﻋﺪة أﺳﺒﺎب: – أﺳﺒﺎب ﺗﺘﻌﻠﻖ ﺑﺎﻟﻤﺮﯾﺾ: • اﻟﻔﻘﺮ واﻟﺬي ﯾﺆدي إﻟﻰ ﻋﺪة ﻣﺸﺎﻛﻞ أھﮭﺎ: – )ﻟﻠﺬھﺎب ﻟﻠﻤﻌﺎﻟﺠﺔ واﻷدوﯾﺔ، واﻟﺼﺒﺮ ﻋﻠﻰ اﻟﻤﺮض ﺣﺘﻰ ﻣﺮاﺣﻞ ﻣﺘﺄﺧﺮة( – ﺴﻭﺀ ﺍﻟﺘﻐﺫﻴﺔ • اﻟﺠﮭﻞ )اﻟﻌﺎم واﻟﺜﻘﺎﻓﺔ اﻟﺼﺤﯿﺔ( • ﺑﻌﺪ اﻟﻤﺴﺎﻓﺎت ﻣﻦ اﻟﺴﻜﻦ إﻟﻰ اﻟﻤﺴﺘﺸﻔﯿﺎت وﺻﻌﻮﺑﺔ اﻟﻤﻮاﺻﻼت • اﻟﻌﺎدات اﻟﺴﯿﺌﺔ اﻟﻤﻨﺘﺸﺮة ﻟﺪى ﻛﻞ اﻟﻔﺌﺎت اﻟﻌﻤﺮﯾﺔ ذﻛﻮرا وإﻧﺎﺛﺎ – أﺳﺒﺎب ﺗﺘﻌﻠﻖ ﺑﺎﻟﻄﺒﯿﺐ • ﻋﺪم اﻟﺘﻔﻜﯿﺮ ﺑﺎﻟﺴﺮﻃﺎن رﻏﻢ ﻣﺮور اﻟﻤﺮﯾﺾ ﻋﻠﻰ اﻟﻌﺪﯾﺪ ﻣﻨﮭﻢ )ﻗﺼﻮر ﻓﻲ اﻟﻜﻔﺎءة أو ﻋﺪم اﻟﺘﺪرﯾﺐ( – أﺳﺒﺎب ﺗﺘﻌﻠﻖ ﺑﺎﻟﺠﺎﻧﺐ اﻟﺮﺳﻤﻲ • ﻣﺤﺪودﯾﺔ اﻟﺘﻮﻋﯿﺔ واﻟﺘﺜﻘﯿﻒ ﺑﻤﺎ ﯾﺨﺺ اﻟﺴﺮﻃﺎن ﻋﺎﻣﺔ واﻟﺸﻤﺔ ﺧﺎﺻﺔ. • ﻋﺪم ﺗﻮﻓﺮ اﻟﻤﺮاﻛﺰ اﻟﻤﺘﺨﺼﺼﺔ واﻹﻣﻜﺎﻧﺎت • ﻗﻠﺔ اﻟﻜﻮادر اﻟﻤﺘﺨﺼﺼﺔ
- 16. ﻛﻠﻤﺎ ﺗﻢ ﺍﻛﺘﺸﺎﻑ ﺍﻟﺪﺍﺀ ﻭﺗﺸﺨﻴﺺ ﻣﺮﺣﻠﺘﻪ ﻣﺒﻜﺮﺍ ، ﻛﻠﻤﺎ ﻛﺎﻧﺖ ﺍﻟﻔﺮﺻﺔ ﺃﻛﺒﺮ ﻓﻲ ﻧﺠﺎﺡ ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ ﻋﻠﻰ رﻏﻢ ان اﻟﻌﺪﯾﺪ ﻣﻦ اﻟﺴﺮﻃﺎﻧﺎت ﻻ ﯾﻤﻜﻦ ﻣﻨﻌﮭﺎ :ﻣﻦ اﻟﻤﻤﻜﻦ ﻣﻨﻊ اﻟﻌﺪﯾﺪ ﻣﻦ اﻟﻮﻓﯿﺎت ﺑﺎﻛﺘﺸﺎف اﻟﺪاء وﺗﺸﺨﯿﺺ ﻣﺮﺣﻠﺘﮫ ﻣﺒﻜﺮ *** اﻟﻮﻋﻲ ﺑﺎﻟﻌﻼﻣﺎت اﻟﺘﺤﺬﯾﺮﯾﺔ *** ﻋﻤﻠﯿﺔ اﻟﺘﻘﺼﻲ ) اﻟﻔﺤﺺ ( ﻟﻠﻜﺸﻒ اﻟﻤﺒﻜﺮ ﻋﻦ اﻟﺴﺮﻃﺎن
- 17. ﻟﺪﯾﻨﺎ ﺑﺎﻟﺠﻤﮭﻮرﯾﺔ اﻟﯿﻤﻨﯿﺔ ﻋﻮاﻣﻞ ﺗﺘﺴﺒﺐ ﻓﻲ زﯾﺎدة ﺣﺪوث ﺑﻌﺾ اﻷورام اﻟﺴﺮﻃﺎﻧﯿﺔ • اﻟﺘﺒﻎ ﺑﺄﺷﻜﺎﻟﮫ اﻟﻤﺨﺘﻠﻔﺔ ھﻮ أﻛﺜﺮ اﻟﻌﻮاﻣﻞ اﻟﺘﻲ ﯾﻤﻜﻦ ﻣﻜﺎﻓﺤﺘﮭﺎ وھﻲ: – اﻟﺘﺪﺧﯿﻦ وﺧﺎﺻﺔ ﻓﻲ اﻟﻤﺠﺎﻟﺲ وﻟﺪى اﻷﻃﻔﺎل واﻟﺸﺒﺎب. – اﻟﺸﯿﺸﺔ واﻟﺘﻲ ﺗﺰﯾﺪ ﺣﺎﻟﯿﺎ ﻟﺪى اﻟﺸﺒﺎب اﻟﺬﻛﻮر واﻹﻧﺎث. – اﻟﺸﻤﺔ ﻟﺪى ﻛﻞ اﻷﻋﻤﺎر ذﻛﻮرا وإﻧﺎﺛﺎ )ﺗﺄﺗﻲ ﺣﺎﻻت ﻛﺜﯿﺮة ﺑﺴﺴﺒﮭﺎ(. • اﻟﻘﺎت وﺑﺪاﯾﺔ اﻷﻃﻔﺎل ﻹﺳﺘﺨﺪاﻣﮫ ﻓﻲ أﻋﻤﺎر ﺻﻐﯿﺮة.
- 18. • اﺳﺘﺨﺪام اﻟﻤﺒﯿﺪات اﻟﺤﺸﺮﯾﺔ ﺑﺎﻟﻄﺮق اﻟﻌﺸﻮاﺋﯿﺔ وﺑﺪون ﻣﺮاﻋﺎة: – اﻷﻧﻮاع اﻟﻤﺴﻤﻮح ﺑﮭﺎ ﻟﻼﺳﺘﺨﺪام اﻟﺒﺸﺮي. – اﻷﻧﻮاع اﻟﻤﻨﺎﺳﺒﺔ ﻟﻜﻞ ﻣﻨﺘﺞ زراﻋﻲ. – اﻟﺘﺮﻛﯿﺰ اﻟﻤﺴﻤﻮح ﺑﮫ. – ﻃﺮق اﻟﺮش. – واﺳﺘﺨﺪام أﺳﺎﻟﯿﺐ اﻟﻮﻗﺎﯾﺔ اﻟﺸﺨﺼﯿﺔ. – ﻣﻮاﻋﯿﺪ اﻟﺤﺼﺎد ﻣﻦ ﯾﻮم اﻟﺮش.
- 19. • ﺑﻌﺾ اﻷﻣﺮاض اﻟﻤﻌﺪﯾﺔ اﻟﺘﻲ ﻣﺎﺗﺰال ﻣﻮﺟﻮدة ﺑﺎﻟﯿﻤﻦ ﻣﻘﺎرﻧﺔ ﺑﺎﻟﺪول اﻷﺧﺮى ﻣﺜﻞ: – اﻟﺒﻠﮭﺎرﺳﯿﺎ. – اﻟﻔﯿﺮوس اﻟﻜﺒﺪي اﻟﺒﺎﺋﻲ واﻟﺴﯿﻨﻲ. – ﺑﺎﻛﺘﯿﺮﯾﺎ ھﻠﯿﻜﻮﺑﺎﻛﺘﺮ ﻓﻲ اﻟﻤﻌﺪة. • ﺳﻮء اﻟﺘﻐﺬﯾﺔ ﻋﻨﺪ اﻟﻜﺜﯿﺮ ﻣﻦ اﻟﻨﺎس وﻋﺪم ﺗﻨﺎول اﻟﻮﺟﺒﺎت اﻟﻤﺘﺰﻧﺔ وﻋﺪم ﺗﻨﺎول اﻟﺨﻀﺎر واﻟﻔﻮاﻛﮫ.
- 20. ﻣﻨﺎﻃﻖ وأﻋﻀﺎء ﻣﻨﻄﻘﺔ اﻟﺮأس واﻟﻌﻨﻖ – اﻟﺘﺠﻮﯾﻒ اﻟﻔﻤﻲ اﻟﻠﺴﺎن )اﻟﺜﻠﺜﯿﻦ اﻷﻣﺎﻣﯿﺔ( • ﻗﺎع اﻟﻔﻢ • اﻟﻐﺸﺎء اﻟﺨﻄﻲ اﻟﻤﺒﻄﻦ ﻟﻠﺨﺪﯾﻦ ﻣﻦ اﻟﺪاﺧﻞ • اﻟﻔﻚ واﻷﺳﻨﺎن • اﻟﻠﺜﺔ • اﻟﺠﺰء اﻷﻣﺎﻣﻲ ﻣﻦ اﻟﺤﻨﻚ )اﻟﺠﺎﻣﺪ( • – اﻟﺒﻠﻌﻮم • اﻟﺒﻠﻌﻮم اﻟﻔﻤﻲ )ﺧﻠﻒ اﻟﺘﺠﻮﯾﻒ اﻟﻔﻤﻲ( • اﻟﺒﻠﻌﻮم اﻷﻧﻔﻲ )ﺧﻠﻒ اﻷﻧﻒ( • اﻟﺒﻠﻌﻮم اﻟﺴﻔﻠﻲ )ﺧﻠﻒ اﻟﺤﻨﺠﺮة( – اﻟﺤﻨﺠﺮة – اﻷﻧﻒ واﻟﺠﯿﻮب اﻷﻧﻔﯿﺔ – اﻟﻐﺪد اﻟﻠﻌﺎﺑﯿﺔ • اﻟﻐﺪد اﻟﻠﻌﺎﺑﯿﺔ اﻟﻜﺒﺮى • اﻟﻐﺪد اﻟﻠﻌﺎﺑﯿﺔ اﻟﺼﻐﺮى – اﻟﻐﺪة اﻟﺪرﻗﯿﺔ – اﻟﻐﺪد اﻟﻠﯿﻤﻔﺎوﯾﺔ ﺑﺎﻟﺮﻗﺒﺔ
- 21. Head and neck regions Pharynx (Nasopharynx, Oropharynx, Hypopharynx) • Nose and nasal air sinuses • Oral cavity • Larynx • Salivary glands •
- 22. اﻷﻋﺮاض اﻟﻤﺒﻜﺮة ﻷورام اﻟﺴﺮﻃﺎن ﻟﻤﻨﻄﻘﺔ اﻟﺮأس واﻟﻌﻨﻖ
- 23. اﻟﺘﺠﻮﯾﻒ اﻟﻔﻤﻲ ﺗﻐﯿﺮ ﻓﻲ ﻟﻮن وﺷﻜﻞ اﻟﻠﺴﺎن واﻷﻏﺸﯿﺔ اﻟﻤﺨﺎﻃﯿﺔ وﻗﺪ ﺗﻜﻮن ﺑﺪاﯾﺔ • اﺑﯿﻀﺎض ﺛﻢ اﺣﻤﺮار ﻣﺨﻤﻠﻲ وﻃﺒﻘﺔ ﺑﯿﻀﺎء ﺗﻌﻄﻲ اﻟﻐﺸﺎء اﻟﻤﺨﺎﻃﻲ وﻗﺪ ﺗﻜﻮ ﻏﯿﺮ ﻣﺆﻟﻤﺔ أو ﻣﺆﻟﻤﺔ. ﻗﺮﺣﺔ ﻣﺰﻣﻨﺔ )ﺑﺎﻟﻠﺴﺎن أو ﻗﺎع اﻟﻔﻢ أو ﺑﺎﻟﻠﺜﺔ أو أي ﻣﻜﺎن( ﻟﻢ ﺗﺴﺘﺠﺐ • ﻟﻠﻌﻼج ﻟﻔﺘﺮة أﻛﺜﺮ ﻣﻦ ﺷﮭﺮ. ورم أو ﻛﺘﻠﺔ ﺑﺎﻟﻠﺴﺎن وﺑﺪاﯾﺔ ﻗﺪ ﺗﻜﻮن ﻻ ﺗﺆﻟﻢ وﺗﻜﺒﺮ ﺗﺪرﯾﺠﯿﺎ • ﻣﺘﺄﺧﺮا ﻋﺪم اﻟﻤﻘﺪرة ﻋﻠﻰ ﺣﺮﻛﺔ اﻟﻠﺴﺎن ﺑﺴﮭﻮﻟﺔ ﺗﺆﺛﺮ ﻋﻠﻰ اﻟﻜﻼم • واﻷﻛﻞ واﻟﺘﺬوق ﻗﺮﺣﺔ ﺑﺠﺎﻧﺐ أو ﺗﺤﺖ أﺣﺪ اﻷﺳﻨﺎن واﻟﺘﻲ ﻻ ﺗﺴﺘﺠﯿﺐ ﻟﻠﻌﻼج وﻗﺪ ﺗﻮدي • إﻟﻰ إھﺘﺰاز اﻟﺴﻦ وأﺧﯿﺮا ﺗﺆدي إﻟﻰ ﺧﻠﻌﺔ وﺑﻌﺪھﺎ ﺗﻈﮭﺮ اﻟﻘﺮﺣﺔ ﻧﺰﯾﻒ ﻣﻦ اﻟﻔﻢ ﺑﺴﮭﻮﻟﺔ •
- 24. ﻗﺮﺣﺔ وﻛﺘﻠﺔ ﻣﺮﺣﻠﺔ ﻣﺘﺄﺧﺮة
- 25. اﻟﺒﻠﻌﻮم ١- اﻟﺒﻠﻌﻮم اﻟﻔﻤﻲ أﻟﻢ ﻋﻨﺪ اﻟﺒﻠﻊ ﻓﻲ اﻟﺠﺰء اﻟﺨﻠﻔﻲ ﻣﻦ اﻟﻔﻢ أو اﻟﻠﺴﺎن • ﻗﺮﺣﺔ ﺑﻤﻨﻄﻘﺔ اﻟﺒﻠﻌﻮم اﻟﻔﻤﻲ وﻣﻨﻄﻘﺔ اﻟﻠﻮزﺗﯿﻦ ﻟﻢ ﺗﺴﺘﺠﺐ • ﻟﻠﻌﻼج اﻟﻌﺎدي ﻷﻛﺜﺮ ﻣﻦ ﺷﮭﺮ ﻛﺘﻠﺔ أو ورم ﺑﺎﻟﺒﻠﻌﻮم ﯾﺴﺒﺐ ﺻﻌﻮﺑﺔ ﻓﻲ اﻟﺒﻠﻊ • ﺗﻐﯿﺮ ﻓﻲ ﻟﻮن وﻃﺒﻘﺔ اﻷﻏﺸﯿﺔ اﻟﻤﺨﺎﻃﯿﺔ ﻟﻠﺜﻠﺚ اﻟﺨﻠﻔﻲ ﻣﻦ • اﻟﻠﺴﺎن ورم ﺑﺎﻟﺜﻠﺚ اﻟﺨﻠﻔﻲ ﻣﻦ اﻟﻠﺴﺎن ﯾﺆﺛﺮ ﻋﻠﻰ ﺣﺮﻛﺔ اﻟﻠﺴﺎن ﻓﯿﺆﺛﺮ • ﻋﻠﻰ اﻟﻜﻼم واﻟﺒﻠﻊ وﻗﺪ ﯾﻜﻮن ﺑﺪاﯾﺔ ﻻﯾﺆﻟﻢ
- 26. اﻟﺒﻠﻌﻮم ٢- اﻟﺒﻠﻌﻮم اﻷﻧﻔﻲ اﻧﺴﺪاد ﻓﻲ اﻷﻧﻒ وﻗﺪ ﯾﻜﻮن ﻓﻲ ﺟﮭﺔ واﺣﺪة وﻟﻤﺪة ﻃﻮﯾﻠﺔ دون ﻣﻼﺣﻈﺔ • أھﻤﯿﺘﮫ وﻗﺪ ﯾﻤﺘﺪ ﻣﺆﺧﺮا ﻟﻠﺠﮭﺘﯿﻦ ﻧﺨﻤﺔ أو ﺗﺨﯿﺮ ﻓﻲ اﻟﺼﻮت • رﻋﺎف أو ﻧﺰﯾﻒ ﻣﻦ اﻷﻧﻒ وﺑﺴﮭﻮﻟﺔ وﻗﺪ ﯾﻜﻮن ﺗﻠﻘﺎﺋﯿﺎ ﻣﻦ دون ﺳﺒﺐ • ﺻﻌﻮﺑﺔ ﻓﻲ اﻟﺒﻠﻊ أو اﻹﺣﺴﺎس ﺑﻮﺟﻮد ﺟﺴﻢ ﻏﺮﯾﺐ ﺧﻠﻒ اﻷﻧﻒ أو ﻓﻲ • اﻟﺤﻠﻖ أﻟﻢ ﻓﻲ اﻷذن أو اﻟﺴﻤﻊ ﺑﺎﻟﺠﮭﺔ اﻟﺘﻲ ﺑﮭﺎ اﻟﻮرم • ﺗﻐﯿﺮ ﻓﻲ اﻟﺸﻢ أو ﻓﻘﺪاﻧﮫ • اﻟﺼﺪاع اﻟﺸﺪﯾﺪ ﻓﻲ اﻟﻤﺮﺣﻠﺔ اﻟﻤﺘﺄﺧﺮة ﻻﻣﺘﺪاد اﻟﻮرم ﻟﻌﻈﺎم ﻗﺎع اﻟﺠﻤﺠﻤﺔ • ﺗﻐﯿﺮات ﻋﺼﺒﯿﺔ ﻣﺜﻞ ﺣﺮﻛﺔ اﻟﻌﯿﻦ أو اﻟﺤﻮل ﺑﻌﺪ اﻣﺘﺪاد اﻟﻮرم ﻟﻠﺠﺰء • اﻟﺴﻔﻠﻲ ﻣﻦ اﻟﺪﻣﺎغ واذا اﻣﺘﺪ أﻛﺜﺮ ﻗﺪ ﯾﺆدي إﻟﻰ ﻣﺸﺎﻛﻞ ﻋﺼﺒﯿﺔ اﺧﺮى
- 27. اﻟﺒﻠﻌﻮم ٣- اﻟﺒﻠﻌﻮم اﻟﺴﻔﻠﻲ )ﺧﻠﻒ اﻟﺤﻨﺠﺮة( ﺻﻌﻮﺑﺔ ﻓﻲ اﻟﺒﻠﻊ واﻟﺸﻌﻮر ﺑﺘﻮﻗﻒ اﻷﻛﻞ ﺧﻠﻒ اﻟﺤﻨﺠﺮة • أﻟﻢ ﻋﻨﺪ اﻟﺒﻠﻊ ﺧﻠﻒ اﻟﺤﻨﺠﺮة • ﺗﻐﯿﺮ ﻓﻲ اﻟﺼﻮت أو اﻟﺸﺤﺐ ﻋﻨﺪ اﻣﺘﺪاد اﻟﻮرم ﻟﻠﺤﻨﺠﺮة • اﻟﺸﻌﻮر ﺑﺠﺴﻢ ﻏﺮﯾﺐ ﺑﺎﻟﺒﻠﻌﻮم ﻋﻨﺪ اﻟﺒﻠﻊ ﻻ ﯾﺴﺘﻄﯿﻊ إﺧﺮاﺟﺔ •
- 28. اﻟﺤﻨﺠﺮة • ﺗﻐﯿﺮ ﻓﻲ اﻟﺼﻮت )اﻟﺸﺤﺐ( أول ﻋﻼﻣﺔ ﻣﺒﻜﺮة ﻟﺴﺮﻃﺎن اﻷﺣﺒﺎل اﻟﺼﻮﺗﯿﺔ • ﺻﻌﻮﺑﺔ ﻋﻨﺪ اﻟﺒﻠﻊ او أﻟﻢ ﻓﻲ اﻟﺒﻠﻊ • اﻹﺣﺴﺎس ﺑﺘﻮﻗﻒ اﻷﻛﻞ ﻓﻲ ﻣﻨﻄﻘﺔ اﻟﺤﻨﺠﺮة ﻋﻨﺪ اﻣﺘﺪاد اﻟﻮرم ﻟﻠﺒﻠﻌﻮم
- 29. اﻷﻧﻒ واﻟﺠﯿﻮب اﻷﻧﻔﯿﺔ اﻧﺴﺪاد اﻷﻧﻒ • اﻟﺮﻋﺎف أو اﻟﻨﺰﯾﻒ اﻟﻤﺘﻜﺮر ﺑﺪون ﺳﺒﺐ • إﺣﺴﺎس ﺟﺴﻢ ﻏﺮﯾﺐ أو ﻛﺘﻠﺔ ﻓﻲ اﻷﻧﻒ • اﻹﺣﺴﺎس ﺑﺜﻘﻞ ﺑﺎﻟﺮأس وﻣﻨﻄﻘﺔ اﻟﺠﯿﺐ اﻟﻨﻔﻲ اﻟﻤﺘﻀﺮر • اﻟﺼﺪاع اﻟﻤﺰﻣﻦ اﻟﺬي ﻟﻢ ﯾﺴﺘﺠﺐ ﻟﻠﻌﻼج اﻟﻌﺎدي • ﺗﻐﯿﺮ راﺋﺤﺔ اﻟﻨﻔﺲ ﻟﻠﺸﺨﺺ واﻟﺬي ﻗﺪ ﯾﻀﺎﯾﻖ ﻏﯿﺮه اﻟﻤﺠﺎورﯾﻦ ﻟﮫ • ﻇﮭﻮر ﻛﺘﻠﺔ ﻓﻲ اﻟﺠﺰء اﻟﻌﻠﻮي ﻣﻦ اﻟﻔﻢ ﻣﺜﻼ ﺟﻮار اﻷﺿﺮاس • اﻟﻌﻠﻮﯾﺔ أو ﻣﻦ اﻟﺤﻨﻚ ﺗﻐﯿﺮ ﻓﻲ ﻧﻐﻤﺔ اﻟﺼﻮت •
- 30. اﻟﻐﺪد اﻟﻠﻌﺎﺑﯿﺔ ﻛﺘﻠﺔ ﺣﻮل أو ﺗﺤﺖ اﻷذن )ﺗﻌﺎﻟﺞ ﻟﻔﺘﺮة ﻃﻮﯾﻠﺔ ﻋﻠﻰ أﻧﮭﺎ • اﻟﻨﻜﺎف ) ((Mumps أﻟﻢ ﻋﻨﺪ اﻟﻤﻀﻎ ﻟﻸﻛﻞ ﺣﻮل أو ﺗﺤﺖ اﻷذن • ﺗﻐﯿﺮ ﻓﻲ ﺷﻜﻞ اﻟﻮﺟﮫ ون اﻟﺠﮭﺔ اﻟﺠﺎﻧﺒﯿﺔ ﺗﻼﺣﻆ ﻣﻦ اﻵﺧﺮﯾﻦ • ﻛﺘﻠﺔ ﻓﻲ اﻟﻔﻢ أو ﺑﺎﻟﻐﺸﺎء اﻟﻤﺤﺎﻃﻲ ﺑﺎﻟﻔﻢ واﻟﺒﻠﻌﻮم وﻏﯿﺮه • ورم اﻟﻐﺪة اﻟﻨﻜﻔﯿﺔ ﻣﺘﺄﺧﺮا ﻗﺪ ﯾﺴﺒﺐ ﺷﻠﻞ ﻓﻲ اﻟﻌﺼﺐ اﻟﺴﺎﺑﻊ • ﻣﺴﺒﺒﺎ ﻟﻮﻗﺎن أو اﻧﺤﺮاف اﻟﻔﻢ ﻟﺠﮭﺔ واﺣﺪة وﺻﻌﻮﺑﺔ ﻓﻲ ﻋﻤﻠﯿﺔ اﻟﻤﻀﻎ وﺗﺮاﻛﻢ اﻷﻛﻞ ﺧﻠﻒ اﻟﺨﺪ وﺗﺴﺮب اﻟﻤﺎء ﻣﻦ أﺣﺪ ﺟﮭﺎت اﻟﻔﻢ
- 31. اﻟﻐﺪة اﻟﺪرﻗﯿﺔ ﻛﺘﻠﺔ أو ورم أﺳﻔﻞ اﻟﺮﻗﺒﺔ ﺑﻤﻨﻄﻘﺔ اﻟﻐﺪة و ﺗﻜﻮن ﻋﺎدة ﻻﺗﺆﻟﻢ • ﺻﻌﻮﺑﺔ ﻓﻲ اﻟﻨﻔﺲ ﻓﻲ ﻣﺮﺣﻠﺔ ﻣﺎ ﻛﺎن اﻟﻮرم ﻗﺪ أﺻﺒﺢ ﻛﺒﯿﺮا ﯾﻀﻐﻂ ﻋﻠﻰ • اﻟﺤﻨﺠﺮة أو اﻟﻘﺼﺒﺔ اﻟﮭﻮاﺋﯿﺔ ﺻﻌﻮﺑﺔ ﻓﻲ اﻟﺒﻠﻊ ﻓﻲ ﻣﺮﺣﻠﺔ ﻣﺎ ﻛﺎن اﻟﻮرم ﻗﺪ أﺻﺒﺢ ﻛﺒﯿﺮا ﯾﻀﻐﻂ ﻋﻠﻰ • اﻟﺒﻠﻌﻮم واﻟﺠﺰء اﻟﻌﻠﻮي ﻣﻦ اﻟﻤﺮيء ﻋﻨﺪﻣﺎ ﯾﻜﻮن اﻟﻮرم ﻧﺸﯿﻄﺎ ھﺮﻣﻮﻧﯿﺎ ﻗﺪ ﯾﺴﺒﺐ أﻋﺮاض زﯾﺎدة ھﺮﻣﻮن • اﻟﺜﯿﺮوﻛﺴﯿﻦ ﻓﻲ اﻟﺪم وﻣﻨﮭﺎ: رﺟﻔﺎن ﺑﺎﻟﻘﻠﺐ – اﻟﻘﻠﻖ – اﻟﺘﻌﺐ ﺑﺴﺮﻋﺔ – ﻧﻘﺺ اﻟﻮزن – اﻟﺼﺪاع اﻟﻤﺰﻣﻦ – ارﺗﻔﺎع اﻟﻀﻐﻂ وأﻋﺮاﺿﮫ وﻋﻼﻣﺎﺗﮫ –
- 32. اﻟﻄﺮق اﻟﺘﺸﺨﯿﺼﯿﺔ • أﺧﺬ ﻗﺼﺔ ﻣﺮﺿﯿﺔ ﻛﺎﻣﻠﺔ ھﻲ أول واھﻢ ﺧﻄﻮة ﻟﻠﻮﺻﻮل ﻟﻠﺘﺸﺨﯿﺺ • اﻟﻔﺤﺺ اﻟﺴﺮﯾﺮي اﻟﻜﺎﻣﻞ • اﻟﻔﺤﻮﺻﺎت ﺑﺎﻹﺷﻌﺔ اﻟﻤﺨﺘﻠﻔﺔ أﺷﻌﺔ X – اﻷﺷﻌﺔ اﻟﺘﻠﻔﺰﯾﻮﻧﯿﺔ – اﻷﺷﻌﺔ اﻟﻤﻘﻄﻌﯿﺔ – اﻟﺮﻧﯿﻦ اﻟﻤﻐﻨﺎﻃﯿﺴﻲ – اﻟﻤﺴﺢ اﻟﺬري اﻟﻤﺨﺘﻠﻔﺔ – • أﺧﺬ اﻟﻌﯿﻨﺔ ﻣﻦ اﻟﻤﻜﺎن اﻟﺼﺤﯿﺢ واﻟﺬي داﺋﻤﺎ ﯾﻔﻀﻞ أن ﯾﻜﻮن ﻣﻦ اﻟﻤﻮﻗﻊ اﻷوﻟﻲ وﻟﻠﻮرم واﻟﺬي ﯾﺠﺐ اﻟﺒﺤﺚ ﻋﻨﮫ ﺑﻜﻞ ﻣﺎﯾﻤﻜﻦ وﯾﺘﻢ أﺧﺬ ﻋﯿﻨﺔ ﻛﺎﻓﯿﺔ ﻟﻠﻔﺤﺺ اﻟﻨﺴﯿﺠﻲ • ﯾﺘﻢ ﺗﺤﺪﯾﺪ اﻟﻤﺮﺣﻠﺔ ﻟﻠﻤﺮض ﺣﺴﺐ اﻟﻘﺼﺔ اﻟﻤﺮﺿﯿﺔ واﻟﻔﺤﺺ اﻟﺴﺮﯾﺮي واﻟﻔﺤﻮﺻﺎت اﻹﺷﻌﺎﻋﯿﺔ ﻟﯿﺘﻢ ﺗﺤﺪﯾﺪ ﻧﻮع اﻟﻌﻼج اﻷﺳﻠﻢ ﺣﺴﺐ اﻟﻤﺮﺣﺔ.
- 33. اﻟﻄﺮق اﻟﺘﺸﺨﯿﺼﯿﺔ )ﺗﻜﻤﻠﺔ( • ﻗﺪ ﯾﺤﺘﺎج اﻟﻔﺤﺺ اﻟﻨﺴﯿﺠﻲ ﻓﺤﻮﺻﺎت إﺿﺎﻓﯿﺔ ﻟﺘﺤﺪﯾﺪ ﻧﻮع اﻟﻤﺮض وﻧﻮع اﻟﺨﻼﯾﺎ ﻣﺜﻞ ).(ImmunoHistoChemistry
- 34. Staging • TNM staging • T: Tumor size and its extention to the surrounding structures • N: Lymph node metastasis, their number, levels and characters. • M: Metastasis to the other organs awy from the primary cancer.
- 35. اﻟﻮﻗﺎﯾﺔ واﻹﻛﺘﺸﺎف اﻟﻤﺒﻜﺮ • ﺗﻜﻮن اﻟﻮﻗﺎﯾﺔ ﺑﺘﺠﻨﺐ ﻛﻞ اﻟﻌﻮاﻣﻞ ﻟﻠﺨﻄﻮرة اﻟﻤﺴﺒﺒﺔ ﻟﻠﺴﺮﻃﺎن. • ﻻﯾﻮﺟﺪ ﻓﺤﺺ أو أﺳﻠﻮب ﻣﺴﺢ ﻋﺎم ﻋﺎﻟﻤﻲ ﻟﮭﺬه اﻷﻣﺮاض ﻟﻐﺮض اﻟﻜﺸﻒ اﻟﻤﺒﻜﺮ • ﻓﻲ اﻟﺪول اﻷﻛﺜﺮ ﺗﺄﺛﺮا ﻣﻦ ھﺬه اﻷﻣﺮاض ﻋﯿﺎدات ﺧﺎﺻﺔ ﻟﻠﺘﻮﻋﯿﺔ واﻟﻮﻗﺎﯾﺔ واﻟﻜﺸﻒ اﻟﻤﺒﻜﺮ
- 36. @ ﺍﻟﺘﺭﻜﻴﺯ ﻋﻠﻰ ﻤﺠﺎل ﺍﻟﻭﻗﺎﻴﺔ ) (Preventionﻤﻥ ﺨﻼل ﺘﻔﺼﻴل ﺩﻭﺭ ﺍﻟﻤﺅﺴﺴﺎﺕ ﺍﻹﻋﻼﻤﻴﺔ ﺒﺎﺴﺘﺨﺩﺍﻡ ﺍﻟﻤﺫﻴﺎﻉ ﻭﺍﻟﺘﻠﻔﺎﺯ ﻓﻲ ﺍﻟﺘﺤﺩﺙ ﻋﻥ ﺍﻟﻌﻭﺍﻤل ﺍﻟﻤﺴﺎﻋﺩﺓ ﻟﻺﺼﺎﺒﺔ ﺒﺎﻟﺴﺭﻁﺎﻥ ﻭﻁﺭﻕ ﺍﻟﻭﻗﺎﻴﺔ. @ ﺇﺴﺘﻌﻤﺎل ﺍﻟﻤﺩﺍﺭﺱ ﻭﺍﻟﻤﻌﺎﻫﺩ ﻭﺍﻟﺠﺎﻤﻌﺎﺕ ﻭﺇﻗﺎﻤﺔ ﻤﺤﺎﻀﺭﺍﺕ ﻭﻨﺩﻭﺍﺕ ﺨﺎﺼﺔ ﻟﻠﺘﻌﺭﻴﻑ ﺒﺎﻟﺴﺭﻁﺎﻥ ﻭﺃﻫﻤﻴﺔ ﺍﻟﻭﻗﺎﻴﺔ. @ اﻟﺒﺪء ﺑﺎﻟﺘﻮﻋﯿﺔ ﻟﺨﻄﻮرة اﺳﺘﺨﺪام اﻟﺸﻤﺔ واﺳﺘﻤﺮار ﺑﺮﻧﺎﻣﺞ ﺗﻮﻋﯿﺔ ﯾﺸﻤﻞ اﻟﻤﺤﺎﻓﻈﺔ واﻟﻤﺤﺎﻓﻈﺎت اﻟﻤﺴﺘﮭﺪﻓﺔ اﻟﻤﺠﺎورة. @ ﻣﻨﻊ ﺑﯿﻌﮭﺎ وﺻﻨﺎﻋﺘﮭﺎ ﻣﻦ اﻷھﺪاف اﻟﻤﺮﺟﻮة ﻣﺴﺘﻘﺒﻼ ﺗﻔﮭﻤﮭﺎ
- 37. ﺣﺎﻻت ﻟﻠﻨﻘﺎش