THE

BASI CS

Chapter 13
Cancer: Reducing Your Risk

Agenda for Cancer Lecture

Introduction (Etiology, Epidemiology, Oncologist) Basic Understanding of Biology (cells) Define Cancer (Autoimmune Disease) Risk Factors (profile of our exposures) Classifications of Cancer Location of Cancer Prevention, Detection and Treatment

Introduction

The last 50 years has seen a better understanding of the causes and treatments of cancer. Hence, the stigma, early detection and technology has improved the prognosis of cancer patients to an unprecedented level.

Cancer Statistics

553,400 Americans died of cancer 2001 1.3 million new cases diagnosed 1 in 4 deaths from cancer Early detection/improvements in technology have improved prognosis for many

What do you think are the contributing factors to the incidence of cancer in the U.S. today?

Healthy Cells

Cells represent the smallest, functional unit of our existence which contains cytoplasm and a nucleus (i.e. metabolism, reproduction, day to day functions) Cells have a specialized function depending on their location in the body.

Cells grow, replicate and repair body organs. The genetic material (DNA/RNA) and your immune system regulate this process.

Different Types of Cells

Blood cells Muscle cells (smooth, striated, cardiac) Nerve cells Bone cells Cartilage cells Liver (hepa) cells

Define Cancer

Cancer is a term used to describe a large group of diseases that are characterized by a cellular malfunction. Healthy cells are programmed to know what to do and when to do it. Cancerous cells do not have this programming and therefore grow and replicate out of control. They also serve no physiological function. These cells are now termed a neoplasm.

This neoplasmic mass often forms a clumping of cells known as a tumor.

Tumors

Benign Tumors (noncancerous) Enclosed in a fibrous shell or capsule. Take up space Concerned if they interfere with surrounding tissues or vessels or impede the function of the body.

Malignant Tumors (cancerous) Not usually contained metastasis Invade and emit clawlike protrusions that disrupt the RNA and DNA of normal cells (these cancerous cells act like a virus).

Risk Factors (multi-factorial)

Exposure to Cancer-causing agents Cellular Mutations (what agents cause this? Environment & Lifestyle agents) Genetics & Hormone exposure (i.e. breast cancer) Occupation and Environment Factors Social and Psychological Factors Chemicals in Food Viral (i.e. herpes, HPV, mononucleosis) create an opportunistic environment Medical Factors

Classifications of Cancer

Types of Cancer

Carcinomas Sarcomas Lymphomas Leukemias

Lung Cancer

Killed 164,000 in 2000 Prevention-researchers theorize: 90% of all lung cancers could be avoided by not smoking

Gas Exchange in Your Lungs

Lung and Bronchus Cancer (Invasive), 1975-2002 (CDC)

Lung and Bronchus Cancer for U.S. Males, 1992-2002

Lung and Bronchus Cancer for U.S. Females, 1992-2002

Ten Leading Causes of Death for Males, 2002 (CDC)

Ten Leading Causes of Death for Females, 2002 (CDC)

An Overview of Cancer

Variations in Rates

Rates have large variations among populations 444.6 per 100,000 African Americans 402.1 per 100,000 Whites 272.4 per 100,000 Hispanics 279.3 per 100,000 Asian Pacific Islanders 152.8 per 100,000 Native Americans

An Overview of Cancer

What is Cancer?

Uncontrolled growth and spread of abnormal cells Neoplasms Malignant tumors Benign tumors

An Overview of Cancer

Cellular Change/Mutation Theories

Spontaneous errors External agents Oncogenes

Risks for Cancer-Lifestyle

Smoking among greatest Nutrition/exercise

Factors Believed to Contribute to Global Causes of Cancer

Figure 13.1

What Causes Cancer?

Biological Factors

Genetic predisposition Reproductive and hormonal risks

What Causes Cancer?

Occupational and Environmental Factors

Asbestos, nickel, chromate Radioactive substances

Social and Psychological Factors

Stress Decrease negative emotions

Chemicals in Food

What Causes Cancer?

Sodium nitrate Clostridium botulism

Viral Factors

Herpes-related virus and human papillomavirus

Medical Factors

Diethylstibestrol (DES) Chemotherapy

Table 13.1

Types of Cancer

Breast Cancer

One in 8 women Risk increases with age Risk factors supported by research Prevention (self-exam and mammography) See figure 13.3 for self-examination procedure Treatment

Breast Self-Examination

Figure 13.3

Colon and Rectum Cancer

Types of Cancer

3rd most common in men and women 135,400 in 2001 diagnosed Warning signals, e.g. blood in the stool, rectal bleeding

Prostate Cancer

Most common in males today 189,000 new cases will be diagnosed in 2002 Estimated 30,200 men will die

Types of Cancer

Skin Cancer: Sun Bathers Beware

1.3 million cases of skin cancer Treatable: basal or squamous Virulent: malignant melanoma ABCD rule about melanoma

What are some ideas about the use of sunscreen?

Types of Cancer

Testicular Cancer

Ages 17-34 at greatest risk Cause is unknown Undescended testicles present a great risk How and when should men examine their testicles? (see Figure 13.4)

Ovarian Cancer

Types of Cancer

4th leading cause of death in young women Enlargement of abdomen common sign Prevention: annual pelvic exams

Endometrium (Uterine) Cancer

Pap test for early detection Risk: early onset of intercourse Warning: abnormal bleeding

Types of Cancer

Cancer of the Pancreas

Silent disease 29,700 cases in 2002 Only 4% survive Contributors: inflammation, diabetes, high-fat diet

Types of Cancer

Leukemia

Cancer of blood-forming tissues Leads to the creation of immature white blood cells Symptoms: fatigue / paleness / weight loss Can be acute or chronic

Facing Cancer

Detecting Cancer

Magnetic Resonance Imaging (MRI) Computerized Axial Tomography scanning (CAT scan) Prostatic ultrasound (rectal probe) Self-exam and check-ups

Table 13.3

Facing Cancer

New Hope in Cancer Treatments

Surgery to remove tumor Chemotherapy Researching genes and cell mutations

Facing Cancer

Talking with Your Doctor about Cancer

Ask questions about type, treatment, clinical trials Ask about surgery Ask why one treatment is preferred Get all your options

Facing Cancer

Life After Cancer

Laws reduce insurance discrimination Less isolation Assistance is available Support groups