T H E B A S I C S

Cancer: Reducing Your RiskCancer: Reducing Your RiskChapter 13Chapter 13

Agenda for Cancer LectureAgenda for Cancer Lecture Introduction (Etiology, Epidemiology, Introduction (Etiology, Epidemiology,

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

IntroductionIntroduction

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

Cancer StatisticsCancer Statistics 553,400 Americans died of cancer 2001553,400 Americans died of cancer 2001 1.3 million new cases diagnosed1.3 million new cases diagnosed 1 in 4 deaths from cancer1 in 4 deaths from cancer Early detection/improvements in technology Early detection/improvements in technology

have improved prognosis for manyhave improved prognosis for many

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

Healthy CellsHealthy Cells Cells represent the Cells represent the

smallest, functional unit of smallest, functional unit of our existence which our existence which contains cytoplasm and a contains cytoplasm and a nucleus (i.e. metabolism, nucleus (i.e. metabolism, reproduction, day to day reproduction, day to day functions)functions)

Cells have a specialized Cells have a specialized function depending on function depending on their location in the body.their location in the body.

Cells grow, replicate and Cells grow, replicate and repair body organs.repair body organs.

The genetic material The genetic material (DNA/RNA) and your (DNA/RNA) and your immune system regulate immune system regulate this process.this process.

Different Types of CellsDifferent Types of Cells Blood cellsBlood cells Muscle cells Muscle cells

(smooth, striated, (smooth, striated, cardiac)cardiac)

Nerve cellsNerve cells Bone cellsBone cells Cartilage cellsCartilage cells Liver (hepa) cellsLiver (hepa) cells

Define CancerDefine Cancer Cancer is a term used to describe a large Cancer is a term used to describe a large

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

This neoplasmic mass often This neoplasmic mass often forms a clumping of cells forms a clumping of cells

known as a tumor.known as a tumor.

TumorsTumors Benign Tumors Benign Tumors

(noncancerous)(noncancerous) Enclosed in a fibrous Enclosed in a fibrous

shell or capsule.shell or capsule. Take up spaceTake up space Concerned if they Concerned if they

interfere with interfere with surrounding tissues surrounding tissues or vessels or impede or vessels or impede the function of the the function of the body.body.

Malignant Tumors Malignant Tumors (cancerous)(cancerous)

Not usually contained Not usually contained – metastasis– metastasis

Invade and emit Invade and emit clawlike protrusions clawlike protrusions that disrupt the RNA that disrupt the RNA and DNA of normal and DNA of normal cells (these cells (these cancerous cells act cancerous cells act like a virus).like a virus).

Risk Factors (multi-factorial)Risk Factors (multi-factorial) Exposure to Cancer-causing agentsExposure to Cancer-causing agents Cellular Mutations (what agents cause Cellular Mutations (what agents cause

this? Environment & Lifestyle agents)this? Environment & Lifestyle agents) Genetics & Hormone exposure (i.e. breast Genetics & Hormone exposure (i.e. breast

cancer)cancer) Occupation and Environment FactorsOccupation and Environment Factors Social and Psychological FactorsSocial and Psychological Factors Chemicals in FoodChemicals in Food Viral (i.e. herpes, HPV, mononucleosis) Viral (i.e. herpes, HPV, mononucleosis)

create an opportunistic environmentcreate an opportunistic environment Medical FactorsMedical Factors

Types of CancerTypes of Cancer Classifications of CancerClassifications of Cancer

CarcinomasCarcinomas SarcomasSarcomas LymphomasLymphomas LeukemiasLeukemias

Lung CancerLung Cancer Killed 164,000 in 2000Killed 164,000 in 2000 Prevention-researchers theorize: 90% of all Prevention-researchers theorize: 90% of all

lung cancers could be avoided by not smokinglung cancers could be avoided by not smoking

Gas Exchange in Your LungsGas Exchange in Your Lungs

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

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

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

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

Ten Leading Causes of Ten Leading Causes of Death for Females, 2002 Death for Females, 2002

(CDC)(CDC)

An Overview of CancerAn Overview of Cancer Variations in RatesVariations in Rates

Rates have large variations among populationsRates have large variations among populations 444.6 per 100,000 African Americans444.6 per 100,000 African Americans 402.1 per 100,000 Whites402.1 per 100,000 Whites 272.4 per 100,000 Hispanics272.4 per 100,000 Hispanics 279.3 per 100,000 Asian Pacific Islanders279.3 per 100,000 Asian Pacific Islanders 152.8 per 100,000 Native Americans152.8 per 100,000 Native Americans

An Overview of CancerAn Overview of Cancer

What is Cancer?What is Cancer? Uncontrolled growth and spread of abnormal cellsUncontrolled growth and spread of abnormal cells NeoplasmsNeoplasms Malignant tumorsMalignant tumors Benign tumorsBenign tumors

An Overview of CancerAn Overview of Cancer Cellular Change/Mutation TheoriesCellular Change/Mutation Theories

Spontaneous errorsSpontaneous errors External agentsExternal agents OncogenesOncogenes

Risks for Cancer-LifestyleRisks for Cancer-Lifestyle Smoking among greatestSmoking among greatest Nutrition/exerciseNutrition/exercise

Factors Believed to Factors Believed to Contribute to Global Causes Contribute to Global Causes

of Cancerof Cancer

Figure 13.1

What Causes Cancer?What Causes Cancer?

Biological FactorsBiological Factors Genetic predispositionGenetic predisposition Reproductive and hormonal risksReproductive and hormonal risks

What Causes Cancer?What Causes Cancer? Occupational and Environmental FactorsOccupational and Environmental Factors

Asbestos, nickel, chromateAsbestos, nickel, chromate Radioactive substancesRadioactive substances

Social and Psychological FactorsSocial and Psychological Factors StressStress Decrease negative emotionsDecrease negative emotions

What Causes Cancer?What Causes Cancer? Chemicals in FoodChemicals in Food

Sodium nitrateSodium nitrate Clostridium botulismClostridium botulism

Viral FactorsViral Factors Herpes-related virus and human papillomavirusHerpes-related virus and human papillomavirus

Medical FactorsMedical Factors Diethylstibestrol (DES)Diethylstibestrol (DES) ChemotherapyChemotherapy

Table 13.1

Types of CancerTypes of Cancer Breast CancerBreast Cancer

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

Breast Self-ExaminationBreast Self-Examination

Figure 13.3

Types of CancerTypes of Cancer Colon and Rectum CancerColon and Rectum Cancer

33rdrd most common in men and women most common in men and women 135,400 in 2001 diagnosed135,400 in 2001 diagnosed Warning signals, e.g. blood in the stool, rectal Warning signals, e.g. blood in the stool, rectal

bleedingbleeding

Prostate CancerProstate Cancer Most common in males todayMost common in males today 189,000 new cases will be diagnosed in 2002189,000 new cases will be diagnosed in 2002 Estimated 30,200 men will dieEstimated 30,200 men will die

Types of CancerTypes of Cancer Skin Cancer: Sun Bathers BewareSkin Cancer: Sun Bathers Beware

1.3 million cases of skin cancer1.3 million cases of skin cancer Treatable: basal or squamousTreatable: basal or squamous Virulent: malignant melanomaVirulent: malignant melanoma ABCD rule about melanomaABCD rule about melanoma

What are some ideas about the use of What are some ideas about the use of sunscreen?sunscreen?

Types of CancerTypes of Cancer Testicular CancerTesticular Cancer

Ages 17-34 at greatest riskAges 17-34 at greatest risk Cause is unknownCause is unknown Undescended testicles present a great riskUndescended testicles present a great risk How and when should men examine their testicles?How and when should men examine their testicles?

(see Figure 13.4)(see Figure 13.4)

Testicular Self-ExaminationTesticular Self-Examination

Figure 13.4

Types of CancerTypes of Cancer Ovarian CancerOvarian Cancer

44thth leading cause of death in young women leading cause of death in young women Enlargement of abdomen common signEnlargement of abdomen common sign Prevention: annual pelvic examsPrevention: annual pelvic exams

Endometrium (Uterine) CancerEndometrium (Uterine) Cancer Pap test for early detectionPap test for early detection Risk: early onset of intercourseRisk: early onset of intercourse Warning: abnormal bleedingWarning: abnormal bleeding

Types of CancerTypes of Cancer

Cancer of the PancreasCancer of the Pancreas ““Silent” diseaseSilent” disease 29,700 cases in 200229,700 cases in 2002 Only 4% surviveOnly 4% survive Contributors: inflammation, diabetes, high-fat dietContributors: inflammation, diabetes, high-fat diet

Types of CancerTypes of Cancer

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

Facing CancerFacing Cancer

Detecting CancerDetecting Cancer Magnetic Resonance Imaging (MRI)Magnetic Resonance Imaging (MRI) Computerized Axial Tomography scanning (CAT Computerized Axial Tomography scanning (CAT

scan)scan) Prostatic ultrasound (rectal probe)Prostatic ultrasound (rectal probe) Self-exam and check-upsSelf-exam and check-ups

Table 13.3

Facing CancerFacing Cancer

New Hope in Cancer TreatmentsNew Hope in Cancer Treatments Surgery to remove tumorSurgery to remove tumor ChemotherapyChemotherapy Researching genes and cell mutationsResearching genes and cell mutations

Facing CancerFacing Cancer

Talking with Your Doctor about CancerTalking with Your Doctor about Cancer Ask questions about type, treatment, clinical trialsAsk questions about type, treatment, clinical trials Ask about surgeryAsk about surgery Ask why one treatment is preferredAsk why one treatment is preferred Get all your optionsGet all your options

Facing CancerFacing Cancer

Life After CancerLife After Cancer Laws reduce insurance discriminationLaws reduce insurance discrimination Less isolationLess isolation Assistance is availableAssistance is available Support groupsSupport groups