IN THE NAME OF GOD THE MERCIFUL

1
IN THE NAME OF GODTHE MERCIFUL
COMPASSIONATETHE
RESPONSIBILITY OF THE INDIVIDUAL IN THE FIGHT
AGAINST CANCERBYPR. DR. Mahmoud M.
MAHFOUZINCTR MEETING. CAIRO 2004
2
My dear Friends Colleagues,"The fighters of
disease and the lovers of peace On this
special occasion, I am thankful and grateful
to the Almighty for all what I achieved during
my lifetime.
3
I am deeply grateful to theINCTR,Board
Members for their kind nomination of the
Nazly Gad el-Mawla award
4
I am also indebted to my wife,my family, my
colleagues, all my friends, assistants and to
all those who were involved, associated or
connected with my professional, social or
political careers
5
I am also profoundlygrateful to my patients and
their families who gave me their confidence,
as well as, their helpful understanding.
6
To my TeachersI am deeply indebted, not only
to their educational and professional
directives but also, to their advices, which
were helpful and constructive.
7
L G This meeting, earmarks a mixture
ofthe humane and social responsibility, of
thoseWHO HAVE towards those WHO HAVE NOT.
8
L G.

• In the course of my addressI will be touching
  on a broad range of
• FIVE
• different topics

9
1- The Milestones of Egypts Historyof the
fight against disease.2- The role of Biology
in Civilization development.
10
3-The importance of the Safe Development of the
Central Nervous system in Health Promotion
Strategies.
11
4- Knowledge relationshipsto theEvolution of
civilization.5- Relationship of Health
Behavior to Cancer Control Strategies.
12
L G

• 350 years BC,
• the Greeks,
• named my country EGYPTOS
• Which means "the country of the black soil".

13
In the Arabic language, its name isMisr (The
inhabited Land) the word Copt means
dwellers of Egypt (derived from Gyptos).S

14
Therefore, all inhabitants of that land whether
Jews, Christians or Moslems are
Egyptians. Indeed, at this juncture, an
anthropological and genetic outlook of the
Egyptian Genome is required.
15
L G I am an Egyptian borne 1923 in
Assuit, one of the ancient and major cities of
Upper Egypt, 375 km south of Cairo. This city is
the last stop of the 40 days Desert Road that
links Egypt to Sudan And Chad. It was the only
surface road that Links the great desert of
Africa with the Nile Valley,
Red line, 40 days desert Road
16
Historically, I can identify in the Egyptian
Genome 8 out of 10 races that exist in the
world. The original race is
1-Hamites,which mixed with 2-Semites,3-Greeks,
4-Romans, 5-Persians,

17
6-Euroasians ,10th century who lived
around the Caspian Sea (Seljuks Turks).
7-Mongols ,11th century as well as, all
East Asian races. 8-All European Races, 13th
century during the Crusade wars.
18
However,9-The Mayas and Aztecs of the Americas,
are thought to be of Egyptian Origin.10-The
Aborigines of Australia who did not migrate
out, of their continent.
19
Accordingly, the Egyptian Genetic Map has
inherited a mixture of almost all the
charactersof the Human Genome.Such a genetic
mixture made the Egyptian civilization one of
the earliest and basic platforms of Human
development.

20
Taking into consideration that Egypt, has known
the Monotheistic belief before Judaism,
Christianity and Islam, it thus became the
cradle of human culture and knowledge, which
maintained the build-up of Human Civilization
and the System of Human Values.

21
LG

• At this juncture, I shall give a brief review
  of the history of the fight of disease and
  cancer in Egypt.
• 
  

22
THE ANCIENT HISTORICAL EPOCHS

• gt7000 years, Ancient Egyptian civilization.
• gt5500 BC ,The OON School of medicine
• and
• the description of disease
• and
• their treatment.

23
330 BC-650 AC, The Greco-Roman period and The
Alexandria Cradle of culture. 650-1300 AC,
The Medieval Arab epoch, Ibn Radwan, Ibn Elnafis,
EL Basry and many others.
24
MODERN HISTORICAL EPOCHS1798 AC, The
French Expedition to Egypt, Napoleon
Bonaparte.1805, Mohamed Aly Founder of
Modern Egypt.
25
1827 The Abozabal hospital, Dr Clott. 1832
Missions of young Egyptian scholars to France.
1838 The school of medicine and nursing of Kasr
El Einy (KEE)- Dr Clott.
26
1882 British occupation of Egypt.1908
The National University-
School of Medicine of Kasr El
Einy (KEE).1920 The Egyptian Medical
Association E M A

27
1923 The installation of the 1stradio
diagnostic equipment in the KEE hospital.1925
The change of the National University to
Fouad 1st University Kasr El Einy Faculty of
Medicine.

28
1927 Installation of the Radium
Bomband introduction Brachytherapyin the
Radiology Dept. of KEE Hospital1935 The
Institute of Radiology Kasr El Einy Faculty of
MedicineFouad 1st University.
29
1937 Departments of Radiodiagnosis,
Radiotherapy and Radium therapy (46 beds),
Electrotherapy and Physical Medicine, DMRE.1948
The Egyptian Society of Radiology, Affiliate of
the Egyptian Medical Association E M A.
30
1955 Ministry of Health established a Cancer
Hospital, which was affiliated to Cairo
University and was changed to a Cancer
Institute 1960.
31
1955 Establishment of the Atomic Energy
Committee EAEC. The start of the use of open
radionuclides in the diagnosis and treatment of
benign and malignant disease, in Ein Shams
University
32
1962 Separate postgraduate qualifications
in Radiodiagnosis, Radiation therapy and Nuclear
Medicine, Master (MS) and Doctorate (MD)
degrees.1963 Installation of
the 1st Cobalt 60 teletherapy unit, In the
Radiotherapy Dept. Faculty of Medicine Cairo
University.
33
1968 kasr El Einy Comprehensive Cancer Center.
Faculty OF Medicine (NEMROCK) Cairo Univ. 1968
Introduction of the first Cesium 137 Teletherapy
unit in (NEMROCK) KEE.
34
1970 The Egyptian Cancer Society, Affiliate
of the Egyptian Med. Association EMA 1974 The
Egyptian Welfare society for Cancer Patients and
Their Families.
35
1993 The Ministry of Health establishes 7
centers for cancer treatment.1994 The Egyptian
Society of 0ncology and Nuclear Medicine
Affiliate of the Egyptian Medical Association.
36
2001 The Pediatric Oncology Hospital of Cairo
University Faculty of Medicine.2003 Start of
the National Cancer Registry Ministry of Health.
37

• These milestones
• of the history of the fight against disease in
  Egypt, during the last 7000 years,
• shall promote and urge
• all of us to ear mark some of,
• the forthcoming
• health promotion problems of the
• 3rd Millennium,
• 
  

38
especially those which challenge the 3rd
world countries. Among such problems, is
how the LDCs would meet the challenge of using
Molecular Biology knowledge, in their Cancer
Control Strategies?.
39
Furthermore, the consideration of the
interrelations between The increase of cancer
incidenceand life style, human migrations,
wars, invasions, habits,as well as environment,
chemical biological pollutants.
40
L G

• Needless to mention that, socio-economic life
  stress factors,
• induce
• psychological tress, that is directly related to
  the
• imbalances of hormone release. Such
  imbalances, are known to be risk factors
  related to the high incidence of certain
  neoplasms.

41
L G,

• In spite that, GOD the Almighty
• has offered the
• Right to Live
• to all the biosystems (unicellular and
  multicellular),
• Yet, the duration of life is variable.
• Furthermore, Life is dependant
• on the balance
• between the following four factors
• 
  
  

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1- Environment
2- Natural Resources, 3-
Biological Instincts 4- Social
ValuesTherefore, while the Almighty offers the
Right to Liveto all biosystems, it is their
responsibility to maintain such a gift through
the optimal utilization of KNOWLEDGE INSTINCTS
43
L GMans responsibility of maintaining life
has been, performed through the use of
KNOWLEDGE, via
Acquisition Formulation Accumulation
Observation Environment Brain memory
Storage Climate Informatics
Retrieval Civilization Learning
Imitation Culture Education
44
It is known, that faculties of Observation and
Imitation lead to development of technology,
which eventually invites analysis comparison
of results that initiates science development .
45
L G

• Man achieves
• Promotion of his Health
• through the interaction
• Between
• Knowledge
• Culture
• Environment
• and
• Resources

46
Such interactions enabled Man to sustain and
maintain his life through his Physical
andMental powers.
47
Furthermore, many anthropological studies have
shown the correlation between , Civilization
development and theHuman Brain Size
development.
48
There are Four parameters to illustrate such
relationship, Life Scale, Time, Civilization
Skills and the Brain Size,are shown in the
following table
49
Life Epoch Time Range Civilization Skills Brain Size/ volume(g)
First creation Billion of years BC use of instincts lack of anthropological evidence
Human life 11 million years BC Fire use hunting 450
Australopithecus Hominid Up to 5-1 million years BC Migration, hunting agriculture 450
Homohabilis 1.9-1.2 million years BC Agriculture migrations 450-900
Homosapiens 0.3 million-7, 000 years BC, Egypt other civilizations Knowledge accumulation integration writing 1500
50
Such Anthropological finding that the
Homosapiens, have the biggest brain size among
all biosystems affirms the importance of the
CNS in the development of our civilization
51
We should also recall that Mans life passes
through the following biological phases1-The
embryological phase which begins on the 7th
intrauterine day and ends by child birth.
52
2- The Nervous System development phase which
incorporates theHuman Central Control System
(HCCS)
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2- The Nervous System development phase which
incorporates theHuman Central Control System
(HCCS)
54
3- The Genetic mixing phase that resulted from
Human migrations and invasions eventually led
to technology transfer,
Knowledge accumulation, technology and
science development which led to the
contemporary 3rd millennium civilization
55
4-The Knowledge accumulationphase which
involves 1-Technology revolution
2-Science revolution 3-Industrial,
electronic, atomic, and biological
revolutions
56
5- The 3rd millennium civilization phasewhich
includes four main fields Biological
biophotonic, genetic,
bioelectric Renewable energy
Information and Informatics
New materials
57
It is worth noting that the expected challenges,
of the forthcoming ECONOMIC GROWTH WAVE,
Kondratieff 5th cycle, THE MEGA-MARKET
WAVE,WHICH Shall involve Psychosocial Health
Biotechnology health challenges
58
Economic Growth waves Kondratieff-cycles
1825
1875
1913
2003
1966
2045 ??
II
III
VI
I
V
IV
Steam,Engine, Textile Industry
Electric Chemical Industry
Information Communication Tech.
MEGA-MARKET Psychosocial Health Biotechnology
Rail road cycle
Electronic,automobile Crude oil,Polymers
59
L G,We should also recall that Mans life
passes through the following four
EPISODES1-The embryological phase which
starts on the 7th intrauterine day after
fertilization of the ovum and ends by child
birth.
60
Days 7-10 Gastrulation major cellular
reorganization into 2 or 3 tissue (germ) layers
-Ectoderm skin, nervous system-Endoderm lining
of gut and internal organs -Mesoderm muscles,
bones, heart   Gastrula Early embryo with 3
tissue layers. All cells have the same DNA
however, different cells now begin to "turn on"
(or "express") different genes to become
different organs.
b
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2- The neuron development phase the
duration of which is 0-24 months,(the end of
the lactation phase) This phase earmarks the
Future capabilities of the CNS to store, to
retrieve to imitate and to integrate
observations
62
3-The pre-school age phase, 2-6 years, during
whichthe system of human values is formulated,
under the CARE DIRECTION OF THE mother,
family, preacher and kindergarten teacher.
63
4- At the end of the 2nd year of life, the
development of the CNS is almost complete
(lactation period). As the Future capabilities
of the CNS to store, retrieve and imitate as
well as,to integrate observations and
sensations, depend on its safe optimal
development.
64
Thus,the active and continuous participation
of the individual, in Health Promotion
practice Becomes attainable.
65
5-The longest human life development phase,
starts at the age of 6 years. (the school
age), passing to adolescence adulthood
until the end of life.
66
This particular phase, involves knowledge
accumulation (learning education), as well
as, Productivity, Innovation
and Creativity
67
Therefore, any health strategy (including the
fight against cancer), should take into
consideration that, the CNS is the first system
to develop in the body as well as, that its Safe
Development dominates the future HEALTH
BEHAVIOR of the individual.
68
Furthermore, due consideration has to be given
to the mutual relationships between the
autonomic Nervous S. , the
reticular brain formation,the pituitary gland
and, the other endocrine glands as well
as, to The Immune System.
69
Therefore, in order that man acquires Health
Promotion Capability, the following parameters
should be considered
70
1-The eradication of illiteracy and education
of females especially women in child bearing
age (15-45 years).
71
2- Preventive health programs should
give a high priority to early
detection of endemic, pandemic,
malnutrition neoplastic
diseases. In that respect,emphasis should be
given to the contribution and role of Religion
and Media systems.
72
3-The relationship between the psychological
status of the individual and the immune
system as well as the latters role in Cancer
Treatment Rehabilitation.
73
4-The efficacy of the roles of the Environmental
Infrastructure policies in the control of
Endemic, pandemic diseases and
vector control services Zonotic
diseases Veterinary health Waste
disposal Potable water
74
5-To incorporate the growing knowledge of
molecular biology intoMedical, Paramedical
Education of neoplastic disorders.
75
L G, Health Behavior represents
an interaction between biological
instincts, social and cultural values as well
as,
76
Success of this approach is dependent on the
safe development of the CNS, as well as, on
the Synergism between the following systems 1-
Cultural, 2- Learning 3- Education, 4-
Legislative 5- Maternal Fetal health care
services
77
L GAs most Developing Countries suffer from
of over population associated with a slow
developing economy as well as,
78
which cannot meet and cope with the the soaring
rise of medical care cost.The only way to solve
this riddle is to give a high priority to
Early Disease Preventive Health Strategies.
79
Needless to mention,that the role of the
individual in pollution control and the fight of
disease, is achievable when emphasis is put on
eradication of illiteracy and on promotion of
Health Awareness among the people.
80
However,such policies are scarcely politically
attractive because, they are of long term
nature. Furthermore, such policies often
receive a second degree of priority in health
policy decision makers.
81
L GWrapping up my speech, I shall end
with few questions suggestions, which I
hope,would call for,
82
your interactions, Your further studies and
Support in the following issues1- How can we
promote and urge the individual to participate
in Health Promotion strategies?
83
2-How to involve the Media and Clergy
institutions in such objectives?
84
3-Can Scientists select bundles of
information to be utilized by the education,
clergy and media experts, in order
that Health Public Education would be an
integral part of the National Culture?
85
4- Are there new approaches to help the LDCs to
overcome the financial burden of the soaring
prices of the anti-cancer drugs, without
disturbing the economy of the drug industry?
86
We must recall that the drug industries are
not charity organizations. They are profit
makers and promoters of research.
87
Therefore, the establishmentof an
international fund is required,under the
auspices of the WHO.
88
Such an international fundcould help toreduce
the cost of anticancer drugs for cancer
patients in countries of low per capita GNP.
89
Funding can be provided by allocating a very
small of the profits of the drug industry of
all countries of the world as well as, to
charity donations. all such resources are
eventually tax exempted.
90
Firm restriction of the use of that fund should
be applied under the umbrella of the WHO based
on incidence rates of neoplasia in the LDCs.
91
Therefore,the establishment of the National
Health Registry becomes a necessity in all
countries that seek the benefits of that fund.
As national health and cancer registries are not
efficient or/and complete, in most LDCs.,
92
5- Is Cancer a preventable disease? if so,
what strategies should be followed in order to
reduce cancer incidence?
93
L G,6-What are the new scopes of Technical
assistance,which can be offered to those
countries? Can the INCRT provide training
programs in Health Registration for these
countries?.
94
Furthermore,The INCRT is invited to draw the
attention to 1-The role of the NGOs in the
fight against cancer
95
2-In the programs of Pollution control
Adoption of health behavior compatible
withHealth Promotion andCancer Control.
96
3- How can wedivert and change CANCER PHOBIA
into an Urge or Desire to fight against that
disease?
97
Such thoughts ,are meant to invite for the
generation of ideas and discussions, which
would consolidate efforts of cancer control in
the less developed countries.
98
L GThank you again for your kind nomination
of the Nazly Gad El Moula prize, and let us
work together so that, our efforts will allow
Those WHO HAVE to help those WHO HAVE NOT