Chapter Ten:  Living With Cancer and Other Chronic Conditions
Cancer <ul><li>Regulatory genes   </li></ul><ul><ul><li>Genes that control cell specialization, replication, DNA repair, t...
Oncogene Formation <ul><li>Three mechanisms:  </li></ul><ul><ul><li>Genetic mutations </li></ul></ul><ul><ul><ul><li>Misco...
The Cancerous Cell <ul><li>Characteristics: </li></ul><ul><ul><li>Infinite life expectancy due to  telomerase </li></ul></...
Staging Cancer <ul><li>TNS staging system </li></ul><ul><ul><li>T = extent of primary tumor </li></ul></ul><ul><ul><li>N =...
How Cancer Spreads
Types of Cancer <ul><li>Carcinomas: 85% of all cancers (organs, skin, nerves, membranes) </li></ul><ul><li>Sarcomas: Bone,...
Cancer Cases and Deaths
Skin Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Severe sunburn during childhood, chronic sun exposure during young ...
Self-Examination for Melanoma
Normal Mole versus Malignant Melanoma <ul><li>Melanoma characteristics: </li></ul><ul><li>A  is for asymmetry </li></ul><u...
Lung Cancer <ul><li>Risk factors  </li></ul><ul><ul><li>Smoking </li></ul></ul><ul><ul><li>Environmental pollutants (radon...
Colorectal Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Genetic susceptibility </li></ul></ul><ul><ul><li>Dietary hab...
Breast Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Early onset of menstruation, late menopause </li></ul></ul><ul><u...
Breast Cancer <ul><li>Prevention </li></ul><ul><ul><li>Dietary choices, limit on alcohol use </li></ul></ul><ul><ul><li>Ac...
Breast Self-Exam
Breast Cancer <ul><li>Treatment </li></ul><ul><ul><li>Lumpectomy </li></ul></ul><ul><ul><li>Mastectomy </li></ul></ul><ul>...
Prostate Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Age, African American ethnicity, family history, dietary fat in...
Testicular Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Family history, environmental factors, undescended testicles ...
Testicular Cancer: Self-Examination
Cervical Cancer <ul><li>Risk factors </li></ul><ul><ul><li>HPV infection </li></ul></ul><ul><ul><li>Smoking, socioeconomic...
Uterine Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Early menarche, late menopause, infertility, never having given ...
Ovarian Cancer <ul><li>Prevention </li></ul><ul><ul><li>Similar to what is recommended for breast cancer </li></ul></ul><u...
Pancreatic Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Male gender, smoking, high-fat diet, high alcohol consumption...
Lymphatic Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Reduction of immune system protection, exposure to pollutants,...
Treatment of Cancer <ul><li>Surgery </li></ul><ul><li>Radiation </li></ul><ul><li>Chemotherapy </li></ul><ul><li>New thera...
Preventive Measures <ul><li>Know your family history </li></ul><ul><li>Select and monitor your occupation carefully </li><...
Chronic Conditions Inflammatory bowel disease leading to abdominal pain and discomfort; treatable with medication Inflamma...
Diabetes Mellitus (Type 2) <ul><li>Body is insensitive to insulin </li></ul><ul><li>Symptoms (develop gradually)  </li></u...
Diabetes Mellitus (Type 1) <ul><li>Pancreas produces no insulin at all </li></ul><ul><li>Symptoms (develop rapidly): Weakn...
Sickle Cell Trait/Sickle Cell Disease <ul><li>8% of African Americans carry recessive gene for sickle-cell trait </li></ul...
Alzheimer’s Disease <ul><li>Organic brain syndrome associated with aging; symptoms such as memory loss, confusion, and dem...
Chapter Ten:  Living With Cancer and Other Chronic Conditions
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Living with Cancer and Chronic Conditions

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  • Image source: National Cancer Institute
  • Living with Cancer and Chronic Conditions

    1. 1. Chapter Ten: Living With Cancer and Other Chronic Conditions
    2. 2. Cancer <ul><li>Regulatory genes </li></ul><ul><ul><li>Genes that control cell specialization, replication, DNA repair, tumor suppression </li></ul></ul><ul><li>Oncogenes </li></ul><ul><ul><li>Faulty regulatory genes believed to activate the development of cancer </li></ul></ul><ul><li>Proto-oncogenes </li></ul><ul><ul><li>Normal regulatory genes that may become oncogenes </li></ul></ul>Cell regulation problem causing abnormal cell growth
    3. 3. Oncogene Formation <ul><li>Three mechanisms: </li></ul><ul><ul><li>Genetic mutations </li></ul></ul><ul><ul><ul><li>Miscopying of genes during cell division </li></ul></ul></ul><ul><ul><li>Viral infections </li></ul></ul><ul><ul><ul><li>HIV </li></ul></ul></ul><ul><ul><ul><li>HPV </li></ul></ul></ul><ul><ul><li>Carcinogens </li></ul></ul>
    4. 4. The Cancerous Cell <ul><li>Characteristics: </li></ul><ul><ul><li>Infinite life expectancy due to telomerase </li></ul></ul><ul><ul><li>Lacks contact inhibition </li></ul></ul><ul><ul><li>Spreads to distant sites via metastasis </li></ul></ul><ul><ul><li>Commands the circulatory system to provide additional blood supply ( angiogenesis ) </li></ul></ul><ul><li>Benign tumors do not spread but can be dangerous if they crowd out normal tissues </li></ul>
    5. 5. Staging Cancer <ul><li>TNS staging system </li></ul><ul><ul><li>T = extent of primary tumor </li></ul></ul><ul><ul><li>N = whether or not it has progressed to regional lymph nodes </li></ul></ul><ul><ul><li>S = presence or absence of metastasis </li></ul></ul><ul><li>A numerical system tracks extent of cancer spread </li></ul><ul><ul><li>I = In situ </li></ul></ul><ul><ul><li>II = Local </li></ul></ul><ul><ul><li>III = Regional </li></ul></ul><ul><ul><li>IV = Distant </li></ul></ul>
    6. 6. How Cancer Spreads
    7. 7. Types of Cancer <ul><li>Carcinomas: 85% of all cancers (organs, skin, nerves, membranes) </li></ul><ul><li>Sarcomas: Bone, blood, connective tissue </li></ul><ul><li>Lymphomas: Immune tissues/system </li></ul><ul><li>Leukemia: Blood and blood forming tissues </li></ul><ul><li>Melanoma: Sun exposure affecting the melanin of the skin </li></ul><ul><li>Neuroblastoma: Originates in the CNS </li></ul><ul><li>Adenocarcinoma: Cells of the endocrine glands </li></ul><ul><li>Hepatoma: Originates in the cells of the liver </li></ul>
    8. 8. Cancer Cases and Deaths
    9. 9. Skin Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Severe sunburn during childhood, chronic sun exposure during young adulthood </li></ul></ul><ul><li>Prevention </li></ul><ul><ul><li>Reduce exposure to sun’s rays, use sunscreens, avoid tanning booths </li></ul></ul><ul><li>Early detection </li></ul><ul><ul><li>Self-examination (see next slide) </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Surgery, chemotherapy, interleukin-2 </li></ul></ul>
    10. 10. Self-Examination for Melanoma
    11. 11. Normal Mole versus Malignant Melanoma <ul><li>Melanoma characteristics: </li></ul><ul><li>A is for asymmetry </li></ul><ul><li>B is for border irregularity </li></ul><ul><li>C is for color (change) </li></ul><ul><li>D is for diameter > 6 mm </li></ul>
    12. 12. Lung Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Smoking </li></ul></ul><ul><ul><li>Environmental pollutants (radon) </li></ul></ul><ul><ul><li>Genetic predisposition </li></ul></ul><ul><li>Prevention </li></ul><ul><ul><li>Don’t smoke and avoid environmental tobacco smoke </li></ul></ul><ul><li>Treatment (low success rate) </li></ul><ul><ul><li>Surgery </li></ul></ul><ul><ul><li>Radiation </li></ul></ul><ul><ul><li>Chemotherapy </li></ul></ul><ul><ul><li>Medications </li></ul></ul>
    13. 13. Colorectal Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Genetic susceptibility </li></ul></ul><ul><ul><li>Dietary habits </li></ul></ul><ul><ul><li>Smoking, alcohol consumption </li></ul></ul><ul><li>Prevention </li></ul><ul><ul><li>Removal of polyps, exercise, dietary changes </li></ul></ul><ul><li>Early detection </li></ul><ul><ul><li>Rectal exams, stool tests, sigmoidoscopy, colonoscopy </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Surgery, radiation, chemotherapy </li></ul></ul>
    14. 14. Breast Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Early onset of menstruation, late menopause </li></ul></ul><ul><ul><li>Having no children or first child later in life </li></ul></ul><ul><ul><li>Use of hormone replacement therapy </li></ul></ul><ul><ul><li>Specific genetic mutations </li></ul></ul><ul><ul><ul><li>BRCA1 </li></ul></ul></ul><ul><ul><ul><li>BRCA2 </li></ul></ul></ul><ul><ul><li>Family history </li></ul></ul><ul><ul><li>Obesity, sedentary lifestyle </li></ul></ul><ul><ul><li>High degree of breast density </li></ul></ul>
    15. 15. Breast Cancer <ul><li>Prevention </li></ul><ul><ul><li>Dietary choices, limit on alcohol use </li></ul></ul><ul><ul><li>Activity levels </li></ul></ul><ul><ul><li>Pregnancy and breastfeeding decisions </li></ul></ul><ul><ul><li>Avoidance of occupational toxins </li></ul></ul><ul><ul><li>New medications </li></ul></ul><ul><ul><li>Prophylactic mastectomy (for some women at very high risk) </li></ul></ul><ul><li>Early detection </li></ul><ul><ul><li>Breast self-examination </li></ul></ul><ul><ul><li>Mammography </li></ul></ul>
    16. 16. Breast Self-Exam
    17. 17. Breast Cancer <ul><li>Treatment </li></ul><ul><ul><li>Lumpectomy </li></ul></ul><ul><ul><li>Mastectomy </li></ul></ul><ul><ul><li>Chemotherapy </li></ul></ul><ul><ul><li>Radiation </li></ul></ul><ul><ul><li>Drug therapy </li></ul></ul><ul><ul><ul><li>Tamoxifen </li></ul></ul></ul><ul><ul><ul><li>Trastuzumab </li></ul></ul></ul><ul><ul><ul><li>Aromatase inhibitors </li></ul></ul></ul>
    18. 18. Prostate Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Age, African American ethnicity, family history, dietary fat intake </li></ul></ul><ul><li>Prevention </li></ul><ul><ul><li>Moderation of fat intake, increased intake of vitamin E and selenium, drug therapy </li></ul></ul><ul><li>Early detection </li></ul><ul><ul><li>Prostate-specific antigen (PSA) tests, rectal exam, ultrasound </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Surgery, radiation, brachytherapy (radioactive seeds) </li></ul></ul>
    19. 19. Testicular Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Family history, environmental factors, undescended testicles </li></ul></ul><ul><li>Prevention </li></ul><ul><ul><li>Self-exams, correction of undescended testicles in children </li></ul></ul><ul><li>Early detection </li></ul><ul><ul><li>Self-exams, awareness of symptoms </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Surgery, chemotherapy, radiation </li></ul></ul>
    20. 20. Testicular Cancer: Self-Examination
    21. 21. Cervical Cancer <ul><li>Risk factors </li></ul><ul><ul><li>HPV infection </li></ul></ul><ul><ul><li>Smoking, socioeconomic factors </li></ul></ul><ul><li>Prevention </li></ul><ul><ul><li>Sexual abstinence </li></ul></ul><ul><ul><li>Careful selection of sexual partners </li></ul></ul><ul><li>Early detection of precancerous cellular changes </li></ul><ul><ul><li>Pap tests </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Surgery (minor or major) </li></ul></ul><ul><ul><li>Radiation/chemotherapy </li></ul></ul>
    22. 22. Uterine Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Early menarche, late menopause, infertility, never having given birth, use of estrogen replacement therapy or tamoxifen, obesity, polycystic ovary syndrome, hereditary nonpolyposis colon cancer </li></ul></ul><ul><li>Prevention </li></ul><ul><ul><li>Minimize high levels of estrogen, regular gynecological care </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Surgery, radiation, chemotherapy, hormone treatment </li></ul></ul>
    23. 23. Ovarian Cancer <ul><li>Prevention </li></ul><ul><ul><li>Similar to what is recommended for breast cancer </li></ul></ul><ul><ul><li>Prophylactic oophorectomy in very high-risk women </li></ul></ul><ul><li>Early detection (“silent”) </li></ul><ul><ul><li>Annual pelvic exams </li></ul></ul><ul><ul><li>Awareness of potential symptoms </li></ul></ul><ul><ul><li>Genetic screenings </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Surgery </li></ul></ul><ul><ul><li>Chemotherapy </li></ul></ul><ul><ul><li>Drug therapy </li></ul></ul>
    24. 24. Pancreatic Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Male gender, smoking, high-fat diet, high alcohol consumption </li></ul></ul><ul><li>Prevention </li></ul><ul><ul><li>Abstaining from tobacco and alcohol, exercise, weight management </li></ul></ul><ul><li>Early detection (no early symptoms) </li></ul><ul><ul><li>CAT scan </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>No effective treatment at this time </li></ul></ul><ul><ul><li>Surgery, radiation, chemotherapy </li></ul></ul>
    25. 25. Lymphatic Cancer <ul><li>Risk factors </li></ul><ul><ul><li>Reduction of immune system protection, exposure to pollutants, viral infections </li></ul></ul><ul><li>Prevention </li></ul><ul><ul><li>Limit exposure to chemicals </li></ul></ul><ul><li>Early detection </li></ul><ul><ul><li>Enlarged lymph nodes, fever, weight loss </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Surgery, radiation, chemotherapy, stem cell transplant </li></ul></ul>
    26. 26. Treatment of Cancer <ul><li>Surgery </li></ul><ul><li>Radiation </li></ul><ul><li>Chemotherapy </li></ul><ul><li>New therapies </li></ul>
    27. 27. Preventive Measures <ul><li>Know your family history </li></ul><ul><li>Select and monitor your occupation carefully </li></ul><ul><li>Do not use tobacco products </li></ul><ul><li>Monitor environmental exposure to carcinogens </li></ul><ul><li>Follow a sound diet </li></ul><ul><li>Control your body weight </li></ul><ul><li>Exercise regularly </li></ul><ul><li>Limit your exposure to the sun </li></ul><ul><li>Consume alcohol in moderation, if at all </li></ul>
    28. 28. Chronic Conditions Inflammatory bowel disease leading to abdominal pain and discomfort; treatable with medication Inflammatory Bowel Disease Autoimmune disorder in which the body attacks itself for no reason; affects women more than men; treated with long-term non-steroidal anti-inflammatory drugs Systemic Lupus Erythematosus (SLE) Progressive disease that causes the myelin to be destroyed, leading to disrupted neurological function. Treatment includes immune targeted drugs, nerve blockers, and physical therapy Multiple Sclerosis (MS)
    29. 29. Diabetes Mellitus (Type 2) <ul><li>Body is insensitive to insulin </li></ul><ul><li>Symptoms (develop gradually) </li></ul><ul><ul><li>Thirst </li></ul></ul><ul><ul><li>Hyperglycemia </li></ul></ul><ul><ul><li>Numbness in the limbs </li></ul></ul><ul><li>Management </li></ul><ul><ul><li>Dietary modification </li></ul></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Drug therapy </li></ul></ul><ul><li>Diagnosis: Urine and blood tests </li></ul>
    30. 30. Diabetes Mellitus (Type 1) <ul><li>Pancreas produces no insulin at all </li></ul><ul><li>Symptoms (develop rapidly): Weakness, thirst, hunger, frequent urination </li></ul><ul><li>Management: Insulin must be obtained by injections or pump </li></ul><ul><li>Diagnosis: Urine and blood tests </li></ul>
    31. 31. Sickle Cell Trait/Sickle Cell Disease <ul><li>8% of African Americans carry recessive gene for sickle-cell trait </li></ul><ul><li>Red blood cells cannot pass through blood capillaries (sickle-shaped RBCs) </li></ul><ul><li>Symptoms: Impaired lung function, heart failure, infections, bone changes </li></ul><ul><li>Management: Drug therapy, stem cell transplant </li></ul><ul><li>Diagnosis: Blood test </li></ul><ul><li>Prevention: Screening for the recessive gene </li></ul>
    32. 32. Alzheimer’s Disease <ul><li>Organic brain syndrome associated with aging; symptoms such as memory loss, confusion, and dementia are common; treatments are still relatively experimental </li></ul>
    33. 33. Chapter Ten: Living With Cancer and Other Chronic Conditions
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