Chapter 16 Lecture Presentation

1. Chapter 16Lecture Presentation Reducing Your Cancer Risk

2. An Overview of Cancer • Cancer mortality rates are declining by an average of 2% per year. • In 2010, approximately 569,490 Americans died of cancer. • Each year, 1.5 million new cases are diagnosed; 68% of these people will be alive in 5 more years. • One-third of cancers are related to poor nutrition, physical inactivity, and obesity—all preventable causes.

4. What Is Cancer? • Cancer is a large group of diseases characterized by the uncontrolled growth and spread of abnormal cells. • A neoplasm is new growth of tissue that serves no physiological function. • A tumor is a clumping of neoplasmic cells. • Malignant means “cancerous.” • Benign means “noncancerous.” • A biopsy is a microscopic examination of cell development.

5. Metastasis

6. What Is Cancer? • Metastasis is the process by which malignant tumors that are not enclosed in a protective capsule spread to other organs. • Mutant cells form after a disruption of RNA and DNA within normal cells, which may produce cells that differ in form, quality, and function from the normal cell.

7. What Causes Cancer? • Risk for cancer can be classified in two ways: • Heredity risk • Factors that cannot be modified • Environmental risk • Factors that are potentially modifiable

8. Lifestyle Risks for Cancer • Lifetime risk is the probability that an individual, over the course of a lifetime, will develop cancer or die from it. • Relative risk is the measure of the strength of the relationship between risk factors and a particular cancer. • Men have almost a 1 in 2 chance of developing cancer in their lifetimes, while for women the chance is 1 in 3.

10. Lifestyle Risks for Cancer • Tobacco use • Tobacco is responsible for 1 in 5 deaths in America annually. It accounts for at least 30% of all cancers and 87% of lung cancer deaths. • Alcohol and cancer • The more alcohol that is consumed, the higher the risk is for cancer. • Poor nutrition, physical activity, and obesity • These factors cause about one-third of cancer deaths each year.

11. Genetic and Physiological Risks • Five percent of all cancers are strongly hereditary. • Cancer-causing genes are called oncogenes. • Cancers of the breast, stomach, colon, prostate, uterus, ovaries, and lungs appear to run in families.

12. Reproductive and Hormonal Factors • Early menarche and late menopause, not having children or having them later in life, recent use of birth control pills or hormone replacement therapy, and not breast-feeding all increase breast cancer risk. • This influence is seen in non-Hispanic white women but does not have as strong an influence on Hispanic women.

13. Occupational and Environment Risks • Asbestos • Nickel • Chromate • Chemicals such as benzene, arsenic, and vinyl chloride • Working with dyes, coal tar, and radioactive substances • Radiation

14. Chemicals in Foods • Sodium nitrate, when ingested, forms a potential carcinogen called nitrosamine. • Sodium nitrate is still used because it is effective in preventing botulism. • Pesticide and herbicide residues in high doses are known to cause cancer.

15. Infectious Disease Risks • Chronic hepatitis B, hepatitis C, and liver cancer: These viruses are believed to stimulate the growth of cancer cells in the liver. • Human papillomavirus and cervical cancer: Nearly 100% of women with cervical cancer have evidence of human papillomavirus (HPV) infection. A vaccine is now available to help protect against HPV. • Helicobacter pylori: Causes ulcers, which are a major factor in the development of stomach cancer.

16. Medical Factors • Some medical treatments actually increase a person’s risk for cancer. • Estrogen and progesterone supplementation, which are used to treat menopausal symptoms, contribute to multiple cancer risks. • Chemotherapy used to treat one form of cancer may increase the risk for another type of cancer.

17. Types of Cancers • Classification of cancers • Carcinomas • Sarcomas • Lymphomas • Leukemias

18. Leading Sites of New Cancer Cases and Deaths, 2010 Estimates

19. Lung Cancer • In 2010, nearly 220,000 new cases of lung cancer were diagnosed. • Since 1987, more women have died from lung cancer than from breast cancer. • Symptoms include a persistent cough, blood-streaked sputum, and chest pain. • Treatment includes surgery, radiation therapy, and chemotherapy. • Prevention involves the avoidance of smoking and environmental tobacco smoke.

20. Breast Cancer • 207,090 new cases of breast cancer were diagnosed in women in 2010, and 1,970 cases were diagnosed in men. • Detection involves mammograms and regular breast self-exams. • Symptoms include a lump in the breast, thickening, dimpling, skin irritation, distortion, and tenderness. • Risk factors include family history, hyperplasia, menstrual periods that started early in life and ended late in life, obesity after menopause, and oral contraceptives. • Treatment involves lumpectomy, radical mastectomy, radiation, and or chemotherapy. • A form of prevention is exercise.

21. Breast Self-Exam It is important to practice regular breast self-exams. Please see page 538 for more information about how to examine your breasts.

22. Points of View—Mammography for Women Under Age 50: To Screen or Not to Screen?

23. Mammogram Controversy • What is the controversy over when women should start getting mammograms? What dangers are posed for women on both sides of the debate? • What stances do breast cancer experts Susan Love and Marisa Weiss take in regard to new mammogram regulations? What pros and cons can you find on either side of the debate?

24. Colon and Rectal Cancers • Colon and rectal cancers are the third most common cancers in men and women, with over 142,570 new cases diagnosed in 2010. • Risk factors include being over 50 years old, obesity , family history of colon or rectal cancer or polyps, diets high in fats and low in fiber, smoking, high alcohol consumption, and lack of exercise. • Ninety percent of colorectal cancers are preventable. • Treatment includes radiation, surgery, and possibly chemotherapy. • Prevention involves regular exercise, a diet heavy in fruits and plant-origin foods, milk and calcium, a healthy weight, and moderation in alcohol consumption.

25. Skin Cancer • In 2010, about 11,790 people died from skin cancer. • Long-term sun exposure can result in skin cancer. • Malignant melanoma is the deadliest form of skin cancer. • The sun emits three types of harmful ultraviolet rays: • UVA • UVB • UVC

26. Skin Cancer • Use the ABCD rule to detect melanoma. • Asymmetry: half of a mole does not look like the other half. • Border irregularity: the edges are uneven. • Color: pigmentation is not uniform. • Diameter: larger than a pea.

27. Types of Skin Cancers

28. Risk Factors and Prevention • Being exposed to ultraviolet radiation without adequate skin protection • Having fair skin; blonde, red, or light brown hair; blue, green, or gray eyes • Having skin that burns before tanning or burns easily and peels readily • Having skin that doesn’t tan easily but still spending a lot of time outdoors

29. Risk Factors and Prevention • The use of no or low-sun-protection sunscreens or expired suntan lotions • Having had skin cancer in the past or having a family history of skin cancer • Having experienced severe sunburns during childhood

30. Tanning Beds • Why do you think some people become fixated on having a tan? In what ways do you think the media influence our society in terms of why many people feel the need to be tanned? • Were you surprised by the answers the tanning salon clerks gave when asked about the risk of tanning beds and cancer? Why or why not? In what ways do tanning beds increase your risk of skin cancer? • What do you know about vitamin D? Discuss the myth of getting vitamin D from tanning beds and what Dr. Oz suggests are the best ways to get it. • What alternatives can you think of to tanning in a tanning bed? What kinds of products are available today that offer safer ways to get a tan?

31. Prostate Cancer • Except for skin cancer, prostate cancer is the most common cancer in American men. • In 2010, a total of 217,230 new cases were diagnosed. • One in six men will be diagnosed in his lifetime, but only 1 in 36 will die from it. • The prostate is a muscular, walnut-sized gland surrounding part of the urethra. Its primary function is to produce seminal fluid.

32. Prostate Cancer • Symptoms include weak or interrupted urine flow; difficulty starting or stopping urination; need to urinate frequently; pain on urination; blood in the urine, or pain in low back, pelvis, or thighs. • Risk factors include age, race, nationality, family history, diet, and lifestyle. • Prevention involves following a healthy diet and maintaining a healthy weight.

33. Ovarian Cancer • Ovarian cancer is the fifth leading cause of cancer deaths among women; almost 22,000 new cases were diagnosed and more than 13,850 deaths were reported in 2010. • The most common symptom is enlargement of the abdomen. • Risk factors include personal or family history of breast cancer, never having been pregnant, and the use of fertility drugs. • Prevention involves maintaining a diet high in vegetables and low in fat, and healthy exercise, sleep, stress management, and having good weight-control habits.

34. Cervical and Endometrial (Uterine) Cancer • In 2010 in the United States, there were 12,200 new cases of cervical cancer and 43,470 of endometrial cancer. • In a pap test, cells are taken from the cervical region. • Risk factors: • For cervical cancer, risk factors include having had intercourse at an early age, having had multiple sex partners, smoking cigarettes, and having certain STIs. • For endometrial, age, endometrial hyperplasia, overweight, diabetes, and high blood pressure are all risk factors.

35. Testicular Cancer • Testicular cancer affected nearly 8,400 young men in 2010. • Men between the ages of 15 and 35 are at greatest risk. • It is important to practice regular testicular self-exams. • Testicular cancer has a 96 percent 5-year survival rate, making it one of the most curable cancers.

36. Testicular Self-Exam It is important to practice regular testicular self-exams. Please see page 544 for more information about how to examine your testicles.

37. Leukemia • 43,050 new cases of leukemia were diagnosed in 2010. • Leukemia can be acute or chronic and can strike at any age. • Treatment is with radiation and chemotherapy.

38. Lymphoma • Lymphomas are among the fastest-growing cancers, with an estimated 74,030 new cases in 2010. • The cause is unknown, but a weakened immune system is suspected. • Treatments vary by type and stage. Chemotherapy and radiation are frequently used.

39. Facing Cancer • The earlier the diagnosis, the better the prospect for survival. • Tests for detection • Magnetic resonance imaging (MRI) • Computerized axial tomography (CAT) scan • Prostatic ultrasound • Regular self-exams and checkups

42. Cancer Treatments • Surgery • Radiotherapy • Chemotherapy

43. New Cancer Treatments • Immunotherapy • Gene therapies • Angiogenesis inhibitors • “Smart” drugs • Enzyme inhibitors • Neoadjuvant chemotherapy • Stem cell research

44. Cancer Survivors • Fourteen percent of the estimated 10.8 million cancer survivors in the United States today were diagnosed more than 20 years ago. • Survivorship comprises the physical, psychological, emotional, and economic issues of cancer from diagnosis until the end of life.

45. Assess Yourself–A Personal Inventory • Did you take the Assess Yourself survey on pages 549–550 of your textbook titled, What’s Your Personal Risk for Cancer? • Do you routinely screen yourself for skin, breast, and testicular cancer, as appropriate? • Do you consider the influence that your family history or food choices might have on your risk of cancer? • Will you change your behavior because of what you have learned?