CH. 9 PREVENTING MAJOR DISEASE

1. CH. 9 PREVENTING MAJOR DISEASE CANCER is now No. 1 killer of Americans! UNDERSTANDING CANCER • 1/3 smoking, 1/3 obesity, poor diet, inactivity. • 1 in 2 American men risk of developing cancer. • 1 in 3 American women risk of developing cancer. • African Americans more likely to develop and die from cancer than any other racial or ethnic group • AA women have the highest incidence of colorectal and lung cancers of any ethnic group. • Breast cancer highest among white women.

2. AA men have highest rates of prostate, colorectal, and lung. • Lung cancer no. 1 cause of death in men and women • Breast cancer no. 2 cause of death for women (highest in white and lowest Native Americans) • Prostate cancer no. 2 cause of death for men • Colon cancer is no. 3 cause of death for men and women • Skin cancers affects 1 in 5 Americans • Denial is first reaction to diagnosis to cancer.

3. CANCER - Abnormal, uncontrolled cellular growth Tumor - Abnormal cells grouped together • benign - non-cancerous • malignant – cancerous METASTASIZE – spread the cancer to other parts of the body via the bloodstream or the lymphatic system.

4. Primary Risk Factors for Cancer • Diet – reducing fats • Inactivity • Obesity – lose fat and excess weight • Heredity – racial and ethnic groups p. 255 • Environmental factors(80-90% of cancers) • Tobacco = lung cancer • Sunlight = skin cancer • Physical activity reduces the risk of breast cancer by 20-40%.

5. CLASSIFICATION OF CANCERS • Carcinoma – most common kind, skin, or line internal organs and glands. • Sarcoma – supporting or connective tissues, bones, muscles, blood vessels. • Leukemia – blood-forming tissues (bone-marrow, lymph nodes, spleen) • Lymphoma – lymph system (the network that filters out impurities)

6. Who Is at Risk for Developing Cancer? Insert Table 10-3 here

7. COMMON TYPES OF CANCERS • Skin Cancer – p 256 • basal-cell – most common, epidermis (top layer of skin) • squamous-cell – also common, involving cells in the epidermis • melanoma – deadliest type of skin cancer, 1-2% of all cancer deaths. (UV radiation) 1 in 75. Appears on scalp and neck.

8. Asymmetry: One half doesn’t match the other half Border irregularity: The edges are ragged, notched, or blurred Color: Rather than uniform pigmentation, there are shades of tan, brown, and black, with possible dashes of red, white, and blue. Diameter: The mole is larger than 6 mm (about the size of a pencil eraser). (The melanoma shown here is magnified about 20 times its actual size.) Fig. 10-6, p. 286

9. Warning signs of Melanoma p. 257 A – asymmetry, one half doesn’t match the other half B – border, the edges are ragged, notched, or blurred C – color, not uniform in color, shades of tan, brown, & black w/ possible dashed of red, white and blue. D – diameter, the mole is larger than 6mm (head of eraser on pencil) E – elevation, mole is raised

10. BREAST CANCER – every 3 minutes a woman in U.S. learns she has breast cancer. Every 12 minutes a woman dies of breast cancer. Best tool = mammography at age 40. BSE 259 • Age, p. 258, read risk of developing breast cancer. • Family history • Long menstrual history, before age 12, childless women • Age at birth of first child – first child in 40’s • Breast biopsies – if required more likely to develop cancer • Fibrocystic disease “lumpy breasts” is not a risk factor • Race – higher risk in white women over 40, but AA women greater chance of dying. • Occupation – p. 258 read • Alcohol – 2 or more drinks/day 40% risk of cancer • Hormone Therapy – higher risk 5 yrs. or longer • Obesity – excess weight after menopause, higher risk • Sedentary lifestyle – physical activity reduces risk

11. CERVICAL CANCER – highest incidence Vietnamese, Alaskan Native, Korean, Hispanic. The mortality rate for AA is twice that of whites because of high death rate among older black women. • primary risk factor infection with HPV • other risk factors – early age of first intercourse, multiple sex partners, genital herpes, smoking or exposure to passive smoke. Warning Signs - irregular bleeding or unusual vaginal discharge.

12. OVARIAN CANCER – leading cause of death from gynecological cancers. >Risk Factors: family history, personal history of breast cancer, obesity, infertility, and low levels of transferase (an enzyme involved in the metabolism of dairy foods). >No obvious symptoms until advanced stages.

13. COLON AND RECTAL CANCER >3rd most common cancer and accounts for 10% of cancer deaths. >Risks: over age 50, male, high fat or low fiber diet, inadequate intake of fruits and veggies, family history, smoking, alcohol consumption, prolonged high consumption of red and processed meat. >Early signs are bleeding from rectum, blood in the stool, change in bowel habits.

14. PROSTATE CANCER • After skin cancer, most common cancer in men. Risk is 1 in 6. If the cancer has spread the risk of death is 1 in 30. AA men more often than white. Asian and American Indian less often. Screening at age 50. Risks: high no. of sex partners, STD’s, age, and family history.

15. TESTICULAR CANCER • Last 20 yrs. has risen 51% in the U.S. Between 18-35 yrs. Slight enlargement of one testicle, lower abdominal pain, lumps on the testicles. Change in the way it feels • P. 260 self exam. LEUKEMIA (not in book) • Cancer of the blood. LUNG CANCER (not in book) • Leading cause of cancer deaths. WHY?

16. OTHER MAJOR DISEASES DIABETES MELLITUS – a disease in which the body doesn’t produce or respond properly to insulin. P. 240 • Type 1 – insulin dependent, or juvenile-onset • Type 2 - non-insulin dependent, or adult-onset Risk factors • Family history, inactivity, excessive weight, obesity, unhealthy food choices, depression. Early signs • Frequent urination, increased thirst, wt loss or gain, blurred vision, slow-healing sores, tender gums, flu-like symptoms • AA, Native Americans, and Mexican A. are at high risk of developing diabetes. Treatment: type 1, injections, infusion pump, oral medication. Type 2, balanced diet, exercise, and weight management.

17. ASTHMA (not in book) • Constriction of the breathing passages. 14 deaths in the U.S. each day. • More common among blacks and inner-city residents. ANEMIAS (not in book) • Diseases affecting the oxygen-carrying capacity of the blood. • Anemia caused by nutritional inadequacies, loss of blood, heavy menstrual bleeding, deficiencies in red-cell production or genetic disorders. • Iron-deficiency anemia is a form of anemia caused by lack of dietary iron. Most common and goes undiagnosed. • Sickle-cell anemia – genetic blood disorder, hemoglobin in red blood cells is abnormal. Blood cells become, crescent or sickle-shaped and unable to supply oxygen. Causes crippling, severe pain, and premature death. About 8-10% of AA carry the gene.

18. (not in book) ARTHRITIS – inflammatory disease of the joints. • Rheumatoid arthritis is an autoimmune disease in which the body attacks its own connective tissue, common among younger people. • Osteoarthritis, primarily at the joints, normal wear and tear, mostly older adults. Women 3x more often than men. HERNIAS – a bulge of soft tissue that forces its way through or between strained or weakened muscles. Most common in abdomen.