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Cancer. Chapter 16. Introduction. Causes about 565,000 deaths in the U.S. each year 1500 per day Leading cause of disease related death among people under age 65. Second most common cause of death Evidence supports that most cancers could be prevented by simple lifestyle changes.

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Cancer

Cancer

Chapter 16


Introduction
Introduction

  • Causes about 565,000 deaths in the U.S. each year

    • 1500 per day

  • Leading cause of disease related death among people under age 65.

  • Second most common cause of death

  • Evidence supports that most cancers could be prevented by simple lifestyle changes.

  • Tobacco is responsible for about 30% of all cancer deaths.

  • Poor diet and exercise habits account for another 30% of cancer deaths



What is cancer
What is Cancer? factors

  • Definition: an abnormal and uncontrollable multiplication of cells or tissue that can lead to death.

    • Tumor: a mass of tissue that serves no purpose.

  • Benign versus malignant tumors

    • Benign tumor: mass of cells enclosed in a membrane that prevents their penetration of other tissues.

    • Malignant tumor: (Neoplasm) cancerous, can invade surrounding tissues.

    • Every case of cancer begins as a change in a cell that allows it to grow and divide when it should not.


Metastasis
Metastasis factors

  • Primary tumor

    • Definition: the spreading of cancer cells from one part of the body to another, occurs because cancer cells do not stick to each other as strongly as normal cells.

      • Metastasizing – the traveling and seeding process of cancerous cells

        • Cells break away from primary tumor and invade surrounding tissues or travel through the blood and lymphatic system.

      • New tumors are called

        • Secondary tumor or metastases


Types of cancer
Types of Cancer factors

  • Malignant Tumors

    • The behavior of tumors arising in different body organs is characteristic of the tissue of origin

    • Classified according to the types of cells.

      • Initially retain some of the original properties of the host cell.

      • Carcinomas - most common - arises from the epithelial tissue that cover body surfaces. Linings, tubes, cavities and secretion glands.


Types of cancer1
Types of Cancer factors

  • Malignant Tumors

    • Sarcomas: arise in connective and fibrous tissues. Bone, muscle, cartilage and membranes covering muscle or fat.

    • Lymphomas: Cancers of the lymph nodes.

    • Leukemia: cancer of the blood-forming cells in bone marrow.



The incidence of cancer
The Incidence of Cancer factors

  • 1.4 million Americans are diagnosed yearly

  • American Cancer Society

    • Estimates that the 5-year survival rate for all cancers diagnosed between 1996 and 2003 is 66%

  • 1 in 2 men and 1 in 3 women will be develop cancer during their lifetime.


The incidence of cancer1
The Incidence of Cancer factors

  • Since 1991 the death rate has dropped 18% in men and 10% in women

    • Prevention

    • Early detection

    • Improved therapy

  • American Cancer Society estimates

    • 90% of skin cancer could have be prevented

    • 87% of lung cancer could have be prevented

  • Regular screening and self-examinations could save an additional 100,000 lives per year.

  • About 10.8 million living Americans have a history of cancer.


Lung cancer
Lung Cancer factors

  • Most common cause of cancer death in the U.S.

    • 162,000 deaths per year

    • Risk Factors

      • Tobacco smoking contributes to 87%.

        • Combined with environmental carcinogens multiply by a factor of 10.

    • Detection and Treatment (Difficult to detect)

      • Symptoms are not detected until cancer has reached the invasive stage.

      • Persistent cough, chest pain, or recurring bronchitis.

      • Diagnosis - chest x-ray or sputum examination - fiber-optic bronchosectomy.


Lung cancer1
Lung Cancer factors

  • Treatment:

    • Difficult to treat.

    • Caught early treated by surgery

      • Only 16% are detected prior to spreading

      • Radiation and chemotherapy are used in addition

    • Detected early 49% of patients are alive 5 years post.

    • Overall the survival rate is only 15%

    • Phototherapy, gene therapy, and immunotherapy are being studied.


Colon and rectal
Colon and Rectal factors

  • Second leading cancer causing death.

    • Risk Factors

      • Directly linked to diet and genetic predisposition.

      • 90% occurs after 50 yr. of age.

      • Heredity

      • Lifestyle

      • Up to 1/3 of the population is genetically prone.

    • Detection and Treatment

      • Diet low in fat and High in fiber

      • Screening

      • Sigmoidoscopy or colonoscopy

        • Examine for polyps

      • Surgery is primary treatment

      • Radiation and chemotherapy used prior to surgery


Breast cancer
Breast Cancer factors

  • Most common cancer in women

  • Causes almost as many deaths in women as lung cancer

  • 1:7 American women will develop it during her lifetime (182,000).

  • 1:30 Will die from the disease (41,000 deaths).

    • Risk Factors

      • Most common in women over 50

      • “Disease of Civilization”

      • Common causes: Genetic predisposition, High fat, High calorie diet and Sedentary lifestyle, Alcohol use, early onset of menstruation, First child after 30 and obesity

      • Current use of Hormone Replacement Therapy (HRT)

      • Estrogen -cancer in estrogen-responsive sites


Breast cancer1
Breast Cancer factors

  • Detection and Treatment

    • Early detection.

      • Monthly breast self-exam for all women over 20.

      • Clinical breast exam by a physician every 3 yr.

      • Mammography- Every 1-2 years 40-50 yr. old.

        • Over 50 every year.

      • DigitalMammography

      • Ultrasonography

    • Treatment

      • Biopsied

    • Survival rate

      • 98% if the cells did not metastasized

      • 89% for all stages at 5 years

      • 80% at 10 years

    • New strategies for treatment and prevention


Prostate cancer
Prostate Cancer factors

  • Most common cancer in men.

  • Second leading cancer death in men

  • 186,000 new cases per year

  • More than 28,000 deaths per year

    • Risk Factors

      • Age

      • Diet

      • Lifestyle

      • Genetic predisposition

    • Early detection is key.

      • Prostate-specific antigen (PSA) blood test

      • Digital rectal exam

      • Ultrasound

    • Treatment

      • surgical removal of the prostate and radiation

    • Survival

      • All stages near 100% after 5 years


Cancers of the female reproductive tract
Cancers of the Female Reproductive Tract factors

  • Cervical cancer - sexually transmitted.

    • Most cases stem from infection by the human papillomavirus (HPV)- transmitted by unprotected sex.

      • Group of about 100 related viruses

      • Women high in HPV 16 are at a high risk

    • Smoking

    • Infection by genital herpes

  • Cervical cancer most common in women in their 20’s and 30’s.

    • Factors: sexual intercourse before 18, multiple sex partners, cigarette smoking and low socioeconomic status.

  • Screening:

    • PAP Test

      • Cervical dysplasia

      • All sexually active women ages 18-65 should be tested

  • Treatment

    • Surgery

    • Cryoscopic probe

    • Localized laser

    • Vaccination of girls as young as 9 and women through age 26


Cancers of the female reproductive tract1
Cancers of the Female Reproductive Tract factors

  • Uterine, or Endometrial:

    • Occurs after 55

    • Risk factors similar to breast cancer

    • Determined by Pelvic Exam

    • Treatment is surgery

    • 95% survivability after 5 years

  • Ovarian Cancer:

    • Difficult to detect and diagnosis, No warning signs

    • Family history or genetic factors

    • Determined

      • Pelvic Exam

      • Ultrasound of ovaries

    • Treatment is surgical removal of the ovaries, the fallopian tubes, and the uterus.

    • Radiation and Chemotherapy are sometimes used.

    • Survival rate after 5 years is 92% for localized tumor

    • Survival rate after 5 years for all stages is 45%


Skin cancer
Skin Cancer factors

  • Most common form

    • 1 million cases per year

    • 62,500 are melanoma

      • Most serious

    • Easily detected and highly curable

  • Risk Factors

    • Exposure to ultraviolet rays during childhood

    • Common cause - sunburns and suntans

    • Caucasians are 10X more likely than African Americans to develop melanoma

  • Types:

    • Basal and Squamous

    • Melanoma - more dangerous form

  • Prevention

    • Avoid long term overexposure to sunlight

      • Blistering and peeling sunburns

  • Detection and Treatment

    • ABCD screen test


  • Other cancers
    Other Cancers factors

    • Oral Cancer

      • Lip, tongue, mouth, and throat

      • Smoking and tobacco use

    • Testicular Cancer

      • Rare

      • Most common n men age 20-35

    • Pancreatic Cancer

      • 3 out of 10 are linked to smoking

    • Stomach Cancer

      • Twice as common in males

      • Infected by Helicobacter pylori

    • Bladder Cancer

      • Three times more likely in males

      • Smoking is the key risk factor

    • Kidney Cancer

      • Smoking and obesity are mild risk factors

    • Brain Cancer

      • Develops for no apparent reason


    Leukemia
    Leukemia factors

    • Cancers of the white blood cells.

      • Starts in the bone marrow but spread to the lymph nodes, spleen, liver, other organs and CNS.

      • Abnormal production of immature white blood cells; rapidly growing cells displace red blood cell precursors

      • Immature WBC’s cannot fight off infections

      • Risk factors are unknown

      • 20% of cases of adult leukemia are related to smoking

      • About 44,000 new cases and 22,ooo deaths each year.


    Common cancers
    Common Cancers factors

    • Lymphoma

      • Arising from the lymph cells

        • Hodgkin’s disease

        • Non-Hodgkin’s disease (NHL)

          • More common

          • More deadly (6th most common cancer)

          • Risk factors are not well understood

            • Compromised immune system are at a greater risk

    • Multiple Myeloma

      • Malignant plasma cells produce tumors in the bone marrow.

        • Leads to anemia, excessive bleeding and decreased resistance to infection

        • Age is most significant risk factor – average age is 70


    The cause of cancer
    The Cause of Cancer factors

    • The Role of DNA (Deoxyribonucleic acid)

      • Each cells has 23 pairs of chromosomes

        • Each controls the way a cell will work

        • Each rung is made up of four different nucleotide bases:

          • Adenine, thymine, cytosine and guanine

        • A gene – smaller unit of DNA

    • DNA Mutations and Cancer

      • Changes the way the cells function

      • Mutagens – radiation, certain viruses and chemical substances

      • Oncogenes – a gene involved in the transformation of a normal cell into cancer

      • Tumor suppressor genes – type of oncogene that restrains cellular growth

    • Hereditary Cancer Risks


    Promoters
    Promoters factors

    • Cancer promoters

      • Do not directly produce mutations, they accelerate the growth of cells without damaging of permanently altering the DNA.

      • Estrogen

    • Cancer initiators:

      • Carcinogenic agents

        • UV radiation

    • Cigarette smoking is a complete carcinogen because it is a cancer initiator and promoter.


    Dietary factors
    Dietary Factors factors

    • Your food choices affect your cancer risk by exposing you to potential dangerous compounds and depriving you protective ones.

    • Dietary Fat and Meat

      • American Cancer Society encourages everyone to limit their consumption of processed and red meats.

        • Contributes to certain cancers:

          • Colon, stomach, and prostate

    • Alcohol

    • Fried Foods

    • Dietary Fiber

    • Fruits and Vegetables

      • Anticarcinogens

      • Carotenoids

      • Antioxidants versus Free radicals

      • Phytochemicals

      • Sulforaphane



    Inactivity and obesity
    Inactivity and Obesity factors

    • Linked to breast and colon cancer.

    • Benefits of Physical Activity

      • Speeding the movement of food through the digestive system

      • Strengthen the immune system

      • Decreasing blood fat levels

      • Prevention of obesity


    Microbes
    Microbes factors

    • About 15% of the world’s cancers are caused by microbes

      • Viruses

        • Human papillomavirus – cervical cancer

      • Bacteria

        • Helicobacter pylori – stomach cancer

        • Epstein-Barr virus (mononucleosis) – Hodgkin’s disease, cancer of the pharynx and some stomach cancers

        • Human herpesvirus 8 – Kaposi’s sarcoma and certain types of lymphomia

        • Hepatitis B and C – cause as many as 80% of the world’s liver cancers.

      • Parasites


    Carcinogens in the environment
    Carcinogens in the Environment factors

    • Ingested Chemicals

      • Nitrosamines – Nitrates and nitrites combining with dietary substances - highly potent carcinogen

    • Environmental and Industrial pollution

    • Radiation - UV rays or man made


    Detecting diagnosing and treating cancer
    Detecting,Diagnosing, and Treating Cancer factors

    • Detecting:

      • Self-monitoring

      • CAUTION acronym

    • Diagnosing:

      • Biopsy

      • Magnetic resonance imaging (MRI)

      • Computed tomography (CT)

      • Ultrasonography

    • Treatment:

      • Surgery

      • Chemotherapy

      • Radiation Therapy

    • New and Experimental:

      • Gene therapy

      • Bone marrow and Stem Cell transplants

      • Biological therapies

      • Proteasomeinhibitors

      • Anti-angiogenesis drugs

      • Enzyme activators/blockers


    Living with cancer
    Living with Cancer factors

    • More than 10 million cancer survivors in the U.S.

    • Economic prejudice

      • Face prejudice from health insurers

        • Refuse to issue

        • renewal

    • Financial impact

    • Psychological support is important


    Preventing cancer
    Preventing Cancer factors

    • Lifestyle choices

      • Avoid tobacco

      • Controlling diet and weight

      • Regular exercise

      • Protecting skin from the sun

      • Avoiding environmental and occupational carcinogensRecommended screening tests

    • Follow the American Cancer Society’s recommendations.

      • Appropriate timing and methods for screenings

      • Be aware of the early signs and symptoms


    Cancer1

    Cancer factors

    Chapter 16


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