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Chapter 16

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  • Figure 16-1 Percentage of all cancer deaths linked to risk factors
  • Figure 16-2 Tumor development occurs in stages
  • Figure 16-3 Cancer cases and deaths by site and sex
  • Figure 16-4 The ABCD test for melanoma
  • Table 12-1 Food with Phytochemicals
  • Transcript

    • 1. Chapter 16© 2012 McGraw-Hill Companies. All Rights Reserved.
    • 2.  Causes about 570,000 deaths in the U.S. each year  1,500 per day Leading cause of disease-related death among people under age 75 Second most common cause of death Evidence supports that most cancers could be prevented by simple lifestyle changes Tobacco is responsible for about 30% of all cancer deaths Poor diet and exercise habits account for another 30% of cancer deaths © 2012 McGraw-Hill Companies. All Rights Reserved. 2
    • 3. © 2012 McGraw-Hill Companies. All Rights Reserved. 3
    • 4.  Definition: the abnormal and uncontrollable multiplication of cells that can lead to death  Tumor (neoplasm): a mass of tissue that serves no purpose Benign versus malignant tumors  Benign (noncancerous) tumor: made up of cells enclosed in a membrane that prevents their penetration of neighboring tissues  Malignant tumor: cancerous, can invade surrounding tissues  Every case of cancer begins as a change in a cell that allows it to grow and divide when it should not © 2012 McGraw-Hill Companies. All Rights Reserved. 4
    • 5. © 2012 McGraw-Hill Companies. All Rights Reserved. 5
    • 6.  Primary tumor = cancer’s original location  Definition: the spreading of cancer cells from the primary tumor to another part of the body; occurs because cancer cells do not stick to each other as strongly as normal cells do  Metastasizing – the traveling and seeding process of cancerous cells  Cells break away from primary tumor and invade surrounding tissues or travel through the blood and lymphatic system  New tumors are called  Secondary tumor or metastases © 2012 McGraw-Hill Companies. All Rights Reserved. 6
    • 7.  Staging = process of diagnosing cancer according to the amount of progress it has made in the victim’s body Five stages  0 = early cancer, present only in the layer of cells where it originated  I, II, III = More extensive cancer, with higher numbers indicating greater tumor size and/or the degree to which the cancer has spread to nearby lymph nodes or organs adjacent to the primary tumor  IV = Advanced cancer that has spread to another organ o Remission  Signs and symptoms of cancer disappear © 2012 McGraw-Hill Companies. All Rights Reserved. 7
    • 8.  Malignant Tumors  The behavior of tumors arising in different body organs is characteristic of the tissue of origin  Tumors classified according to types of cells  Initially retain some of the original properties of the host cell  As they continue to multiply, become groups of rogue cells with increasingly unpredictable behavior © 2012 McGraw-Hill Companies. All Rights Reserved. 8
    • 9.  Malignant Tumors  Carcinomas: most common; arise from epithelia, tissues that cover external body surfaces, line internal tubes, and form the secreting portion of glands  Sarcomas: arise from connective and fibrous tissues such as muscle, bone, cartilage, and membranes covering muscle and fat  Lymphomas: cancers of the lymph nodes  Leukemia: cancers of the blood-forming cells in bone marrow © 2012 McGraw-Hill Companies. All Rights Reserved. 9
    • 10. © 2012 McGraw-Hill Companies. All Rights Reserved. 10
    • 11.  1.5+million Americans are diagnosed yearly American Cancer Society  Estimates that the 5-year survival rate for all cancers diagnosed between 1995 and 2005 is 68% Nearly 1 in 2 men and more than 1 in 3 women will be develop cancer at some point in their lives Until 1991, number of cancer deaths increased steadily in the U.S., mostly due to lethal lung cancers among male smokers © 2012 McGraw-Hill Companies. All Rights Reserved. 11
    • 12.  Since 1991, the death rate has dropped 19% in men and 11% in women  Prevention  Early detection  Improved therapy American Cancer Society estimates  90% of skin cancer could be prevented  87% of lung cancer could be prevented Regular screening and self-examinations could save an additional 100,000 lives per year About 11.4 million living Americans have a history of cancer © 2012 McGraw-Hill Companies. All Rights Reserved. 12
    • 13.  Most common cause of cancer death in the U.S.  157,000 deaths per year  Risk Factors  Tobacco smoking contributes to 90% of lung cancer deaths  Combined with environmental carcinogens, risk is multiplied by a factor of 10  Detection and treatment (difficult to detect)  Symptoms are not detected until cancer has reached the invasive stage  Persistent cough, chest pain, or recurring bronchitis  Diagnosis by CT scan, chest X-ray, sputum examination, or fiber-optic bronchosectomy © 2012 McGraw-Hill Companies. All Rights Reserved. 13
    • 14.  Treatment:  Difficult to treat  If caught early, treated by surgery  Only 15% are detected prior to spreading  Radiation and chemotherapy are used in addition  If detected early, 53% of patients are alive 5 years after diagnosis  Overall, the survival rate is only 15%  Phototherapy, gene therapy, and immunotherapy (vaccines) are being studied © 2012 McGraw-Hill Companies. All Rights Reserved. 14
    • 15.  Third most common type of cancer  Risk Factors  Age: 91% occurs in ages 50 or older  Heredity  Lifestyle (alcohol use, smoking, exercise, nutrition)  Polyps  Detection and Treatment  Screening  Sigmoidoscopy or colonoscopy  Examine for polyps  Surgery is primary treatment  Radiation and chemotherapy used prior to surgery © 2012 McGraw-Hill Companies. All Rights Reserved. 15
    • 16.  Most common cancer in women Causes almost as many deaths in women as lung cancer 1 in 8 American women will develop it during her lifetime (207,000 each year) 1 in 30 will die from the disease (40,000 deaths)  Risk Factors  Strong genetic factor  Most common in women over 50  Common causes: genetic predisposition, high fat, high calorie diet and sedentary lifestyle, alcohol use, early onset of menstruation, first child after age 30, obesity  Current use of hormone replacement therapy (HRT)  Estrogen: cancer in estrogen-responsive sites © 2012 McGraw-Hill Companies. All Rights Reserved. 16
    • 17.  Detection and treatment  Early detection  Monthly breast self-exam for all women at age 20  Clinical breast exam by a physician every year if over 40  Mammography: every year for women over 40  Digital mammography (MRI)  Ultrasonography  Treatment  Lump biopsy, lumpectomy, or mastectomy  Survival rate  98% if the cells did not metastasized  90% for all stages at 5 years  New strategies for treatment and prevention © 2012 McGraw-Hill Companies. All Rights Reserved. 17
    • 18.  Most common cancer in men Second leading cancer death in men 218,000 new cases per year More than 32,000 deaths per year  Risk Factors  Age  Genetic predisposition  Lifestyle  Diet  Early detection is key  Prostate-specific antigen (PSA) blood test  Digital rectal exam  Treatment  Surgical removal of the prostate or radioactive seeding  Survival  All stages near 100% after 5 years © 2012 McGraw-Hill Companies. All Rights Reserved. 18
    • 19.  Cervical cancer - sexually transmitted  Most cases stem from infection by the human papillomavirus (HPV)- transmitted by unprotected sex  Group of about 100 related viruses  Women high in HPV 16 are at a high risk  Smoking  Infection by genital herpes  Cervical cancer most common in women in their 20s and 30s  Factors: unprotected sexual intercourse, multiple sex partners, cigarette smoking, immunosuppression, use of oral contraceptives  Screening:  PAP test  Cervical dysplasia  All sexually active women ages 18-65 should be tested  Treatment  Surgery  Chemotherapy with radiation © 2012 McGraw-Hill Companies. All Rights Reserved. 19
    • 20.  Uterine, or Endometrial:  Occurs after 55  Risk factors similar to breast cancer  Determined by pelvic exam  Treatment is surgery (hysterectomy)  96% survivability after 5 years Ovarian Cancer:  Difficult to detect and diagnose, may be no warning signs  Family history or genetic factors  Determined by  Pelvic exam  Ultrasound of ovaries  Treatment is surgical removal of the ovaries, the fallopian tubes, and the uterus  Radiation and chemotherapy are sometimes used  Survival rate after 5 years is 94% for tumor localized to ovary  Survival rate after 5 years for all stages is 46% © 2012 McGraw-Hill Companies. All Rights Reserved. 20
    • 21.  Most common form of cancer  1+ million cases per year  68,000 are melanoma, the most serious type  Easily detected and highly curable Risk Factors  Exposure to ultraviolet (UV) rays during childhood  Common cause – suntans, sunburns, tanning beds  Caucasians are 10 times more likely than African Americans to develop melanoma Types  Basal cell and squamous cell  Melanoma - more dangerous form, spreads rapidly Prevention  Avoid long-term overexposure to sunlight  Sunscreen, protective clothing, shade Detection and Treatment  ABCD screen test © 2012 McGraw-Hill Companies. All Rights Reserved. 21
    • 22. © 2012 McGraw-Hill Companies. All Rights Reserved. 22
    • 23.  Cancersof the oral cavity, pharynx, larynx, and nasal cavity  Smoking and tobacco use  Excessive use of alcohol  Risk twice as great in men as it is in women  50% of cancers of the tonsils and tongue are related to HPV infection  Treatment  Chemotherapy, radiation, surgery  Often develop another primary cancer of head and neck  The 5-year survival rate is about 61% © 2012 McGraw-Hill Companies. All Rights Reserved. 23
    • 24.  Rare (about 1% of cancer in men) Most common cancer in men ages 20-35 Much more common in white males Increased risk if undescended testicles Self-examination helps in early detection Tumors treated by surgical removal or chemo Radiation rarely used The 5-year survival rate is 96%© 2012 McGraw-Hill Companies. All Rights Reserved. 24
    • 25.  Pancreatic cancer  3 out of 10 are linked to smoking Stomach cancer  Twice as common in males  Infected by Helicobacter pylori Bladder cancer  Four times more likely in males  Smoking is the key risk factor Kidney cancer  Smoking and obesity are mild risk factors Brain cancer  Develops for no apparent reason © 2012 McGraw-Hill Companies. All Rights Reserved. 25
    • 26.  Cancers of the white blood cells  Starts in the bone marrow but can spread to the lymph nodes, spleen, liver, other organs, and CNS  Leukemia cells crowd out production of normal blood cells  Risk factors are unknown, but some possibilities include smoking, radiation, infections  Symptoms: fatigue, anemia, weight loss, infection  About 43,000 new cases and 22,000 deaths each year © 2012 McGraw-Hill Companies. All Rights Reserved. 26
    • 27.  Lymphoma  Arising from the lymph cells  Hodgkin’s disease  Non-Hodgkin’s disease (NHL)  More common  More deadly of the two types (6th most common cancer)  Risk factors are not well understood  Compromised immune system are at a greater risk Multiple Myeloma  Malignant plasma cells produce tumors in the bone marrow.  Leads to anemia, excessive bleeding, decreased resistance to infection  Age is most significant risk factor – median age is 66 © 2012 McGraw-Hill Companies. All Rights Reserved. 27
    • 28.  The role of DNA (deoxyribonucleic acid)  Each cells has 23 pairs of chromosomes  Each controls the way a cell will work  Each rung is made up of four different nucleotide bases:  Adenine, thymine, cytosine, guanine  A gene – smaller unit of DNA DNA mutations and cancer  Changes the way the cells function  Mutagens – radiation, certain viruses, chemical substances  Oncogenes – a gene involved in the transformation of a normal cell into cancer  Tumor suppressor genes – type of oncogene that restrains cellular growth Hereditary cancer risks © 2012 McGraw-Hill Companies. All Rights Reserved. 28
    • 29.  Cancer promoters • Do not directly produce mutations; accelerate the growth of cells without damaging or permanently altering the DNA Cancer initiators: • Carcinogenic agents  UV radiation Tobacco use• Cigarette smoking is a complete carcinogen because it is a cancer initiator and promoter © 2012 McGraw-Hill Companies. All Rights Reserved. 29
    • 30.  Your food choices affect your cancer risk by exposing you to potentially dangerous compounds and depriving you of protective ones Dietary Fat and Meat  American Cancer Society encourages everyone to limit their consumption of processed and red meats  Contributes to certain cancers:  Colon, stomach, prostate Alcohol Fried foods Dietary fiber Fruits and vegetables  Anticarcinogens  Carotenoids  Antioxidants versus free radicals  Phytochemicals  Sulforaphane © 2012 McGraw-Hill Companies. All Rights Reserved. 30
    • 31. © 2012 McGraw-Hill Companies. All Rights Reserved. 31
    • 32.  Linked to breast and colon cancer Benefits of physical activity  Speeding the movement of food through the digestive system  Strengthen the immune system  Decreasing blood fat levels  Prevention of obesity © 2012 McGraw-Hill Companies. All Rights Reserved. 32
    • 33.  Microbes About15-20% of the world’s cancers are caused by microbes  Viruses  Human papillomavirus – cervical cancer  Bacteria  Helicobacter pylori – stomach cancer  Epstein-Barr virus (mononucleosis) – Hodgkin’s disease, cancer of the pharynx and some stomach cancers  Human herpesvirus 8 – Kaposi’s sarcoma and certain types of lymphoma  Hepatitis B and C – cause as many as 80% of the world’s liver cancers © 2012 McGraw-Hill Companies. All Rights Reserved. 33
    • 34.  Ingested chemicals  Food industry uses preservatives and other additives to prevent food from spoiling  Nitrosamines – nitrates and nitrites combined with dietary substances are a highly potent carcinogen Environmental and industrial pollution Radiation - UV rays or man-made © 2012 McGraw-Hill Companies. All Rights Reserved. 34
    • 35.  Detecting:  Self-monitoring  Routine cancer checkups and specific screening tests Diagnosing:  Biopsy  Magnetic resonance imaging (MRI)  Computed tomography (CT)  Ultrasonography Traditional treatment:  Surgery  Chemotherapy  Radiation Therapy © 2012 McGraw-Hill Companies. All Rights Reserved. 35
    • 36.  Beyond traditional treatments:  Proteasome inhibitors  Monoclonal antibodies  Tyrosine kinase inhibitors  Anti-angiogenesis drugs  Biological therapies/immunotherapy  Bone marrow and stem cell transplants  Experimental techniques:  Gene therapy  Enzyme activators/blockers © 2012 McGraw-Hill Companies. All Rights Reserved. 36
    • 37.  About 11.4 million cancer survivors in the U.S. Psychological support is important  Family and friends  Doctors and nurses  Organized groups  Support groups for family and friends © 2012 McGraw-Hill Companies. All Rights Reserved. 37
    • 38. Chapter 16© 2012 McGraw-Hill Companies. All Rights Reserved.

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