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breast cancer incidence is increasing: overall risk in America has ... appears to be the first suppressor of metastasis identified for breast cancer ...
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Slide 1:Women and Cancer
Slide 2:Causes
cancer cells arise due to progressive mutations of DNA causes: inherited mutations viruses, chemicals, radiation mutations involve 2 types of genes: proto-oncogenes > dormant forms of cancer-causing genes tumor-suppressor genes > required for differentiation into mature cell types
Slide 3:Cancerous vs. Normal Cells
Not specialized; don’t contribute to normal functioning of body part Enter cycle repeatedly; are immortal Abnormal nuclei with deletions / amplif. of genes; abnormal chrom. # No restraint; will pile on top of one another Reduced need for growth factors Specialized with specific form and function Enter the cell cycle about 50x, then die Normal nuclei with 46 chromosomes Adhere to neighbor cells; exhibit contact inhibition Require growth factors for survival
Slide 4:Known carcinogens
90% of cancers are environmentally induced avoid these factors > reduce your risk Known carcinogens Target tissue high energy radiation tissue exposed UV radiation skin hormones breast, endometrium, ovary, prostate fat colon, breast, prostate nitrites stomach, esophagus smoking lungs, many others xenoestrogens? reproductive tissues?
Slide 5:Breast cancer
50,000 US women die per year from breast cancer 5-10% due to inherited mutations risk increases with age: ages 20-30, 1 in 2500 chance of developing b.c. ages 30-40, 1 in 63 ages 40-60, 1 in 28 by age 85, 1 in 9 by age 100, 1 in 8 breast cancer incidence is increasing: overall risk in America has increased from 1 in 11 in 1980s to 1 in 9 in late 1990s not a gender-specific disease! 1400 cases of male breast cancer reported / year
Slide 6:Inherited breast cancer
5-10% of cases due to inherited mutation risk is ~2x greater than general population if mother or sister developed disease two genes implicated in breast cancer: BRCA1 gene (chromosome 17) > encodes tumor suppressor protects against breast and ovarian cancer BRCA2 gene (chromosome 13) > encodes tumor suppressor protects against breast cancer in both sexes Inherit abnormal BRCA gene > 80% chance of developing breast cancer
Slide 7:BRCA genes
mutated BRCA genes can be inherited from mother or father normal BRCA genes can be mutated by environmental factors BRCA mutations probably account for 38% of all cases removal of both breasts lowers the risk of getting the disease by 91 percent!
Slide 8:Noninherited breast cancer
includes 90% of cases factors that appear to influence risk: sum of lifetime exposure to estrogens (depends on age of menarche, menopause, pregnancies, lactation; possibly xenoestrogens? birthweight?) obesity diet (vitamin A, I3C, low fat) exercise! others - smoking, place of residence
Slide 9:Other breast cancer genes…
breast cancer metastasis suppressor-1 (BRMS1) located on chromosome 11 appears to be the first suppressor of metastasis identified for breast cancer BRMS1 was expressed less as a cell's malignancy increased researchers then introduced chromosome 11 into a metastatic breast cell line While the cells still had the ability to form tumors, their ability to metastasize was greatly reduced between half and two-thirds of patients with late-stage breast cancer lose copies of chromosome 11
Slide 10:CHEK 2
CHEK2 may account for 1% of all breast cancers in women, and 9% of those in men gene is thought to be involved in repairing damaged DNA a mutation in it doubles a woman's risk of developing breast cancer (10-fold increase for men)
Slide 11:HER2
Human epidermal growth factor receptor type 2 Proto-oncogene https://www.her2status.com/public/public_home.htm # of copies amplified in some cases of breast cancer 30% of breast cancer patients have excess HER2 > more aggressive cancer Drug Herceptin blocks actions of HER2 > slows metastasis
Slide 12:Cervical Cancer
incidence decreases after menopause annual cervical (pap) smears can detect in older women, not a fast spreading cancer (opposite is true in young women with human papilloma virus) prognosis good (5 yr. survival = 100%) risk factors: greater number of sexual partners venereal diseases smoking
Slide 13:HPV
causes “venereal warts” -moist, soft, cauliflower-like bumps (within 3 weeks - 8 months) appear on cervix, labia, vulva, perineum in females treated topically with dry ice, liquid nitrogen > warts dry up and fall off in a few days sometimes surgery is necessary to remove warts may recur major cause of cervical cancer (95% of cases associated with HPV) also associated with cancer of the penis, vagina, anus
Slide 14:Endometrial Cancer
80% of cases occur after menopause increased risk associated with obesity, diabetes, hypertension, infertility most common symptom: vaginal bleeding sometimes discovered due to uterine enlargement rarely detected by pap smear pelvic exam required for diagnosis typically slow to metastasize treatment: hysterectomy; possible chemotherapy 5 yr survival rate = 85%
Slide 15:Ovarian Cancer
can occur anytime after puberty, but most often after menopause Previously difficult to detect > no symptoms until advanced stages before detection, often spreads to ovarian, uterine, peritoneal cavity new diagnostic measure: test for levels of lysophosphatidic acid (LPA) risk factors: BRAC 1 gene; smoking combination pills, bearing children seems to lower risk Previous blood test: CA-125
Slide 16:Smoking
THE major cause of cancer Quitting smoking reduces risk more than all other methods combined Lung cancer is most common cancer in women Female smokers 2x more likely to get lung cancer (smaller lungs) Women may be more genetically vulnerable to tobacco smoke Smokers at increased risk for all gynecologic cancers Nonsmoking women with husbands who smoke have higher cancer rates
Slide 17:Prevention
Increase consumption of plant foods Decrease consumption of fats Exercise! Minimize time in sun Reduce alcohol consumption
Slide 18:Endometrial cancer
rarely detected by pap smear pelvic exam required for diagnosis typically slow to metastasize treatment: hysterectomy; possible chemotherapy 5 yr survival rate = 85%
Slide 19:Endometrial cancer
rarely detected by pap smear pelvic exam required for diagnosis typically slow to metastasize treatment: hysterectomy; possible chemotherapy 5 yr survival rate = 85%
Slide 20:Ovarian Cancer
can occur anytime after puberty, but most often after menopause Previously difficult to detect > no symptoms until advanced stages before detection, often spreads to ovarian, uterine, peritoneal cavity
Slide 21:Ovarian cancer
risk factors: BRAC 1 gene; smoking combination pills, bearing children seems to lower risk blood test: CA-125 new diagnostic measure: test for levels of lysophosphatidic acid (LPA)
Slide 22:Smoking
THE major cause of cancer Quitting smoking reduces risk more than all other methods combined Lung cancer is most common cancer in women Female smokers 2x more likely to get lung cancer (smaller lungs)
Slide 23:Smoking
Women may be more genetically vulnerable to tobacco smoke Smokers at increased risk for all gynecologic cancers Nonsmoking women with husbands who smoke have higher cancer rates