Cancer Prevention and Early Detection

1. Cancer Prevention and Early Detection Christina Laukaitis, MD, PhD, FACP 6/21/12

2. What Is Cancer? • The term “cancer” refers to more than 100 different diseases that begin in the cells, the body’s basic unit of life.

3. What Is Cancer? • Cancer develops when cells grow and form more cells without order or control • Under normal circumstances, new cell growth and old cell death are kept in balance • In cancer, this balance is disrupted

4. Normal Tissue

5. Beginning of Cancerous Growth

6. Cancerous Tumor

7. What Is Cancer? • Cancer develops when cells grow and form more cells without order or control • Under normal circumstances, new cell growth and old cell death are kept in balance • In cancer, this balance is disrupted

8. Why is cell overgrowth a problem? • Non-functional cells crowd out original ones • Tissue no longer works right • For example, can’t swallow food, can’t make urine • Energy is going into making cancer cells • Rest of body can’t maintain itself • Person is tired, loses weight • Cancer spreads to other organs • Metastasis • These get crowded with cancer and don’t work

9. Types of Cancer • There are over 100 different types of cancer • Start in different tissues, involve different cell types • Treatment depends on the type of cancer

10. The body protects itself from cancer • Cells are instructed to destroy themselves when they malfunction or aren’t needed • Mutations can mess up this instruction • Some people are born with these mutations • The immune cells destroy malfunctioning cells • Diabetes and some medications make the immune system less effective • HIV affects the immune system

11. Cancers are named by where they start 1. Carcinomas begin in skin or tissues that line the internal organs 2. Sarcomas start in bone, fat, muscle, joint, nerve, blood vessel or deep skin tissues 3. Lymphomas start in lymph nodes or lymphoid tissues (tissues of the body’s immune system) 4. Leukemia is cancer of the white blood cells 5. Myelomas start in plasma cells found in bone marrow A tumor that has metastasized (spread) keeps its original name “Breast cancer metastatic to the bone”

12. In Summary • Cancer comes from cells that grow out of control • As cells become more out of control, they can spread to other parts of the body • Cancer is named based on the location where it started

13. What increases the risk of cancer? • Age • Exposures & infections • Family history

14. New AZ cancer cases for AI by age

15. Exposures that increase cancer risk • Radiation (Uranium, X-rays) • Leukemia • Sun • Skin cancer • Tobacco smoke • Lung and bladder cancers • Arsenic • Liver, lung, kidney, bladder cancer • Alcohol • Liver and pancreas cancer • Other chemicals & hormones

16. Infections that increase cancer risk • Hepatitis B & C • Liver cancer • Human Papilloma Virus (HPV) • Cervical and penis cancers • There is now a vaccination for teenagers! • Human Immunodeficiency Virus (HIV) • Certain skin cancers (Kaposi’s Sarcoma) • Lymphoma • Cervical cancer

17. Cancer in the family? If a parent, brother or sister had a certain kind of cancer, a person’s risk of getting that cancer is doubled • Average risk of colon cancer: 5%  • Risk if a parent or sibling had colon cancer: 10% 

18. Screening for cancer in family Start screening for specific cancers 10 years before it happened in a relative • If a mother had breast cancer at age 49, her daughters should start mammograms by 39

19. Cancers that often run in families • Breast • Ovarian • Colon • Kidney • Endocrine • Pheochromocytoma • Medullary thyroid cancer • Skin • Prostate • Pancreatic

20. Summary • Cancer becomes more likely as a person gets older • Exposures and infections can increase cancer risk • Some families are more affected by cancer than others

21. Cancer Screening and Prevention • Checking for cancer in a person who does not have any symptoms of the disease is called screening.

22. Cancer Screening and Prevention • The goal of cancer screening is to discover and stop a cancerous tumor before it grows and spreads (metastasizes) • This is called early detection

23. Cancer Screening and Prevention • Medical screening tests are effective tools for early detection of cancer • A few types of cancer can be detected early by specific tests

24. Early detection = more survivors

25. Most common cancers (2011) • Breast • Kidney • Prostate • Colorectal • Top 4 cancers for AI

26. Screening tests for common types of cancer • Breast - screening mammogram • Cervix - Pap test • Colon - fecal occult blood test or fecal immunotest, colonoscopy, sigmoidoscopy • Prostate - digital rectal exam, PSA • Skin – checking skin for unusual growths

27. Screening recommendations Women Men • Colon cancer screening from age 50-85 • Mammogram every 1-2 years from 40 or 50 • Pap smear every 3 years from 21-30; every 3-5 years from 30-65 • Colon cancer screening from 50-85 • Discuss prostate cancer screening with physician from 50

28. Challenges to Cancer Screening and Early Detection • Difficulty getting to clinic • Fear of cancer • Lack of knowledge • Modesty • Communication • Illness beliefs

29. Possible Symptoms of Cancer • There are many different symptoms known to be associated with certain types of cancers. • A symptom is a sign that something is not right in the body but does NOT always indicate cancer.

30. Pay attention to your body if there is. . . • Change in bowel or bladder habits • A sore that does not heal • Unusual bleeding or discharge • Thickening, lump, or swelling in the breast or any other part of the body • Indigestion or difficulty swallowing • Change in wart or mole • Nagging cough or hoarseness • Blood in urine

31. Pay attention to unexplained symptoms such as… • Continuing weight loss • Fever • Fatigue • Pain

32. Symptoms of specific cancers • Breast—lump in breast, skin change, nipple discharge • Ovarian—bloating, change in bowel habits, abdominal size growth, abdominal or pelvic pain • Colon—constipation & diarrhea, low blood counts • Thyroid—neck lump • Kidney—back pain, blood in urine • Uterine—postmenopausal vaginal bleeding • Prostate—problems urinating, back pain • Skin—non-healing sores, moles that change colors • Lung—cough, multiple pneumonias

34. How can you prevent cancer? • Don’t get old? • Choose good parents? • Live a healthy life!

35. Maintain a healthy weight • Be active • 30+ minutes of moderate exercise • 5 days per week

36. Eat a healthy diet • 5 or more servings of vegetables and fruits each day • Choose whole grains over processed (refined) grains • Limit processed and red meats

37. Choose other healthy habits • Don’t drink alcohol, or do so only in moderation • <1 drink per day for a woman • <2 drinks per day for a man • Don’t smoke!

38. Get recommended screening • Pap smear every 3 years from age 20-65 • Mammograms every 1-2 years starting between 40-50 • Colonoscopy every 10 years from age 50-85 • Discuss PSA and rectal exam after age 50

39. Summary • Pursue a healthy lifestyle • Get recommended screening • Know your family history • Be aware of your body • Get suspicious changes checked quickly • If something doesn’t seem right, keep pushing until you understand what is wrong

40. claukaitis@azcc.arizona.edu