Learning Objectives

2. Learning Objectives • Define cancer • Discuss the incidence of cancer in the United States • List the most common types of cancer • Identify factors that influence your risk of developing cancer • Discuss several types of occupational carcinogens • Outline ways to reduce your risk of skin cancer due to exposure to ultraviolet light • Discuss the roles of diet and exercise in reducing cancer risk • Explain how free radicals increase your risk of cancer

3. What Is Cancer? • The second leading cause of death in the U.S. • A collection of over 100 related diseases characterized by rapid, uncontrolled cell growth that often forms tumors • Can occur in almost any tissue or organ in the body • Two kinds of tumors: • Benign (slower growing, less serious health threats) • Malignant (fast growing, very serious health threats) • Biopsy: procedure used to determine the type of cells • Metastasis: the spread of cancer cells through the body • Growing cancer cells invade other tissues and/or interfere with organ functions, which can lead to organ failure and death • The key to cancer treatment and survival is early detection

4. Cancer Growth and Metastasis Figure 13.1

5. How Normal Cells Become Cancerous • Cell growth and division are controlled by DNA • DNA becomes damaged by carcinogens (cancer-causing agents) and uncontrolled cell growth occurs • Carcinogens include: • Radiation • Chemicals • Drugs • Toxic substances

6. Transformation of a Normal Cell into a Cancerous Cell Figure 13.2

7. Types of Cancer Lung Cancer • Leading cause of all cancer deaths • Lack of methods of early detection • Easiest way to reduce risk is: Don’t Smoke Colon and Rectal Cancer (Colorectal) • Third leading cause of cancer deaths • Get regular screenings for polyps after age 50 – colonoscopy, fecal stool blood test • To reduce risk: regular exercise, variety of fruits and vegetables, whole grains • Check your family and personal history, Ashkenazi Jews of Easter European descent – highest rates.

8. Types of Cancer Breast Cancer • Most common cancer in women, and second cause of cancer deaths in women. 1 in 8 will have it in their lifetime. • Get mammograms (40) and perform breast self-examination • Risk: having no children or after 30, using hormones, alcohol (2-5 drinks/day), high fat diet, white women higher risk.

9. Types of Cancer, continued Prostate Cancer Prostate=small gland in a size of walnut, produces seminal fluid • Second leading cause of cancer deaths in men • Get regular exams, especially after age 50: DRE = digital rectal exam, PSA test = prostate-specific antigen blood test. • Risk factor: high fat diet, a lot of red meat, black men Testicular Cancer • Most common cancer in young men (15-34) • Perform routine self-examinations, check for lumps, hard spots • Risk factor: undescended testicle at birth, family history, white men

10. Types of Cancer, continued Skin Cancer • Most common type of cancers, very treatable and curable • Two types: Melanoma (on surface) and nonmelanoma (deeper in skin) • Avoid UV light and tanning beds, and wear sunscreen with SPF 15 or higher, perform routine self-exams, avoid sun between 10:00 AM – 4:00 PM

11. Types of Cancer, continued Uterine, Ovarian, and Cervical Cancer • Most common type of uterine cancer is endometrial cancer • Age, obesity, longer menstrual history, genetics, infertility and breast cancer are risk factors for ovarian cancer • Cervical cancer is linked to human papillomavirus (HPV) • Pap test, vaccination Other Cancers • Oral Cancer • Affects lips, mouth, throat and tongue • Associated with tobacco and alcohol use • Leukemia • Cancer of the blood • Pancreatic Cancer • Fourth leading cause of cancer deaths

12. Leading Sites of New Cancer Cases and Deaths – p.371 Figure 13.3

13. Seven Warning Signs of Cancer – see p.373 CAUTION • C – Change in bowl or bladder habits • A – Area or sore that does not heal • U – Unusual bleeding or discharge • T – Thickening or lump • I – Indigestion, difficulty swallowing, or loss of appetite • O – Obvious change in size or color of wart or mole • N – Nagging or persistent cough or hoarseness

14. Detecting Skin Cancer – see p.377 Examine moles monthly using the ABCD rule: • A: Assymetry (½ does not look like the other ½) • B: Border (irregular, notched or ragged) • C: Color (differing shades, patches) • D: Diameter (larger than 6mm, growing) Some skin cancers may not fit the ABCD rule, so check moles or skin lesions regularly for any changes: establish a baseline Other Warning Signs: • A sore that does not heal • New growth of any kind • Spread of pigment • Redness or swelling beyond the border • Change in sensation on the skin

15. Risk Factors for Cancer You Cannot Control Heredity • If a close relative has had cancer, your risk increases three-fold • Learn you family’s health history (blood relatives) • If you have a hereditary risk, start screenings sooner and get them more often Race • Blacks have higher overall cancer rates than whites, but death rates have been declining • Increased awareness and early detection is critical

16. Risk Factors for Cancer You Can Control Diet – read p. 381 • Most important behavioral factor in controlling cancer risk • Avoid high-fat, salt-cured, smoked and nitrite-cured foods • Eat foods high in fiber and rich in antioxidants (vitamins A, E, and C) Alcohol Use • Even moderate drinking increases your risk for some cancers • Eliminate or limit both the frequency and the amount of alcohol Tobacco Use • Single largest cause of cancer deaths • Risk stems from total lifetime exposure to smoke, including second-hand • Stopping at any time decreases your risk

17. Risk Factors for Cancer You Can Control, continued Physical Inactivity • Regular exercise protects against dying from cancer in multiple ways: Strengthens the immune system; helps maintain a healthy weight; has positive effects on hormone levels; increases bowel motility Exposure to Ultraviolet Light • Common UV sources are sunlight, tanning booths, sunlamps • Risk hinges on cumulative exposure, not just occasional overexposure • Limit sun exposure, avoid tanning salons and wear sunscreen daily Exposure to Viruses • Viruses can invade cells and damage DNA, causing blood, lymphatic, liver, cervical, nose, and pharynx cancer • To avoid HPV and cervical cancer, abstain from sex, use condoms, and limit your number of partners

18. Risk Factors for Cancer You Can Control, continued Radiation Exposure • Sources include medical X-rays, computer monitors, electric blankets, and cell phones • Take precautions and avoid or limit exposure Occupational Carcinogens • Sources include industrial chemicals, asbestos, coal tars, auto paints, herbicides and pesticides • Follow safety precautions and avoid exposure to industrial agents • Contact EPA with questions about chemical exposure or for information

19. Physical Fitness and Cancer Risk Figure 13.5

20. Determine your cancer risk • Finish self test on page 387 • List your behavior changes

21. Summary • Cancer is the #2 cause of death in the United States • Cancer is the uncontrolled growth and spread of abnormal cells. Groups of abnormal cells can form a tumor, which can be classified as benign or malignant • Carcinogens are cancer-causing agents. Normal cells become cancerous when DNA becomes damaged by carcinogens resulting in uncontrolled cell division • Common sites of cancer include the breasts, lungs, colon, prostate gland, cervix, testes, pancreas, and mouth

22. Summary, continued • Heredity and race are non-modifiable risk factors for cancer • Modifiable behavioral risk factors for cancer include exposure to carcinogens (such as radiation, viruses, tobacco, alcohol, occupational carcinogens, and ultraviolet light), eating a low-fiber diet, and being physically inactive • Diet is probably the most important factor in controlling your risk of cancer • Exercise has been shown to reduce the risk of cancer • Participation in cancer screenings is important for early detection of cancer