Cardiovascular Disease and Cancer Chapter 12
The Cardiovascular System <ul><li>Pulmonary circulation </li></ul><ul><ul><li>Blood to and from the lungs. </li></ul></ul>...
Cardiovascular System <ul><li>Systole  </li></ul><ul><ul><li>The hearts contraction </li></ul></ul><ul><li>Diastole. </li>...
 
Cardiovascular System <ul><li>Heart, blood vessels, hormones, enzymes and wastes. </li></ul><ul><li>Four chambers (size of...
 
 
Risk Factors For Cardiovascular Disease <ul><li>Major Risk factors </li></ul><ul><li>Contributing Risk Factors </li></ul><...
Tobacco Use <ul><li>1 in 5 deaths from CVD is a smoker </li></ul><ul><li>Smokers have 2-4 times higher risk of death from ...
High Blood Pressure <ul><li>Contributing factors </li></ul><ul><li>Hypertension </li></ul><ul><ul><li>Too much pressure ag...
High Blood Pressure <ul><li>Tachycardias. </li></ul><ul><ul><li>100 or more beats per minute. </li></ul></ul><ul><ul><li>C...
Low Blood Pressure <ul><li>Bradychardia </li></ul><ul><ul><li>60 or less beats per minute </li></ul></ul><ul><ul><li>Poor ...
Cholesterol <ul><li>LDL’s and HDL’s or good versus bad </li></ul><ul><li>Clogs the arteries </li></ul><ul><li>Increased ri...
 
Physical Inactivity <ul><li>Exercise reduces risk by: </li></ul><ul><ul><li>Controlling Blood pressure </li></ul></ul><ul>...
Obesity <ul><li>More than 30% above recommended weight. </li></ul><ul><li>BMI equal to or greater than 30 </li></ul><ul><l...
Diabetes <ul><li>Doubles the risk of CVD for men. </li></ul><ul><li>Triples the risk of CVD for women. </li></ul><ul><li>L...
Contributing Risk Factors That Can Be Changed <ul><li>High Triglyceride Levels </li></ul><ul><li>Psychological and Social ...
Major Risk Factors That Can’t Be Changed <ul><li>Heredity  - CVD has genetic component; high cholesterol levels, blood clo...
Possible Risk Factors Currently Being Studied <ul><li>Inflammation and C-reactive protein </li></ul><ul><li>Insulin resist...
Major Forms of Cardiovascular Disease <ul><li>Atherosclerosis -  narrowed by fatty deposits.  Starts during childhood fat....
 
Helping a Heart Attack Victim <ul><li>Most die within 2 hours from initial symptoms </li></ul><ul><li>Cardiopulmonary resu...
Detecting and Treating Heart Disease <ul><li>Electrocardiogram (ECG or EKG) </li></ul><ul><li>Electron-beam computed tomog...
Stroke or Cerebrovascular Accident (CVA) <ul><li>Ischemic stroke  –  blockage in blood vessels </li></ul><ul><ul><li>Throm...
 
The Effects of a Stroke <ul><li>700,000 Americans per year </li></ul><ul><li>One-third die within a year </li></ul><ul><li...
Detecting and Treating Stroke <ul><li>Prompt recognition of symptoms </li></ul><ul><ul><li>Sudden numbness or weakness of ...
Detecting and Treating Stroke <ul><li>Transient ischemic attack (TIA) </li></ul><ul><ul><li>Temporary stroke like symptoms...
Congested Heart Failure <ul><li>Number of conditions </li></ul><ul><li>Pulmonary edema  -  Fluid accumulates in the lungs....
Other Forms of Heart Disease <ul><li>Congenital heart disease  </li></ul><ul><ul><li>Malformation of the heart or major bl...
Protecting Yourself Against CVD <ul><li>Eat heart-healthy </li></ul><ul><li>Decreased Fat and Cholesterol </li></ul><ul><u...
Other Dietary Factors <ul><li>Omega-3 fatty acids </li></ul><ul><li>Plant stanols and sterols </li></ul><ul><li>Folic acid...
 
Protecting Yourself <ul><li>Exercise Regularly </li></ul><ul><li>Avoid Tobacco </li></ul><ul><li>Know and manage your bloo...
What is Cancer? <ul><li>Definition : an abnormal and uncontrollable growth of cells or tissue that can lead to death. </li...
How Cancer Spreads <ul><li>Metastasis :  Primary tumor </li></ul><ul><ul><li>Definition : the spreading of cancer cells, o...
Types of Cancer <ul><ul><li>Classified according to the types of cells. </li></ul></ul><ul><ul><ul><li>Initially retain so...
The Incidence of Cancer <ul><li>1.4 million Americans are diagnosed yearly </li></ul><ul><li>More than half will be cured....
Cancer cases and deaths by site and sex
Lung Cancer <ul><li>Most common cause of cancer death in the U.S. </li></ul><ul><ul><li>162,000 deaths per year </li></ul>...
Lung Cancer <ul><li>Treatment: </li></ul><ul><ul><li>Difficult to treat. </li></ul></ul><ul><ul><li>Caught early treated b...
Colon and Rectal <ul><li>Second leading cancer causing death. </li></ul><ul><ul><li>Risk Factors </li></ul></ul><ul><ul><u...
Breast Cancer <ul><li>Second most common cancer in women </li></ul><ul><li>Causes almost as many deaths in women as lung c...
Breast Cancer <ul><li>Detection and Treatment  </li></ul><ul><ul><li>Early detection. </li></ul></ul><ul><ul><ul><li>Month...
Prostate Cancer <ul><li>Most common cancer in men.  </li></ul><ul><li>235,000 new cases per year </li></ul><ul><li>More th...
Cancers of the Female Reproductive Tract <ul><li>Cervical cancer - sexually transmitted. </li></ul><ul><ul><ul><li>Most ca...
Cancers of the Female Reproductive Tract <ul><li>Uterine, or Endometrial : </li></ul><ul><ul><li>Occurs after 55 </li></ul...
Skin Cancer <ul><li>Most common form </li></ul><ul><ul><li>1 million cases per year </li></ul></ul><ul><ul><li>62,000 are ...
Other Cancers <ul><li>Oral Cancer </li></ul><ul><li>Testicular Cancer </li></ul><ul><li>… </li></ul>
Causes of Cancer <ul><li>The Role of DNA </li></ul><ul><ul><li>Each cells has 23 pairs of chromosomes </li></ul></ul><ul><...
Cancer promoters <ul><ul><li>Do not directly produce mutations, they accelerate the growth of cells without damaging of pe...
Dietary Factors <ul><li>Dietary Fat and Meat </li></ul><ul><ul><li>High in fat and meat has a direct impact of rates of ca...
Carcinogens in the Environment <ul><li>Ingested Chemicals </li></ul><ul><li>Environmental and Industrial pollution </li></...
Detecting, Diagnosing, and Treating Cancer <ul><li>Detecting:  </li></ul><ul><ul><li>Self-monitoring </li></ul></ul><ul><u...
Prevention <ul><li>Lifestyle choices </li></ul><ul><ul><li>Avoid tobacco </li></ul></ul><ul><ul><li>Controlling diet and w...
Cardiovascular Disease and Cancer Chapter 12
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  • Insel10ebrup Ppt Ch12

    1. 1. Cardiovascular Disease and Cancer Chapter 12
    2. 2. The Cardiovascular System <ul><li>Pulmonary circulation </li></ul><ul><ul><li>Blood to and from the lungs. </li></ul></ul><ul><li>Systemic circulation </li></ul><ul><ul><li>Left side of the heart pumps blood through the rest of the body. </li></ul></ul><ul><li>Total blood volume for a 150 pound person is about 5 quarts, which circulates once every minute </li></ul>
    3. 3. Cardiovascular System <ul><li>Systole </li></ul><ul><ul><li>The hearts contraction </li></ul></ul><ul><li>Diastole. </li></ul><ul><ul><li>The period of relaxation </li></ul></ul>
    4. 5. Cardiovascular System <ul><li>Heart, blood vessels, hormones, enzymes and wastes. </li></ul><ul><li>Four chambers (size of a fist). </li></ul><ul><ul><li>Upper chambers (Atriums). </li></ul></ul><ul><ul><ul><li>Right atrium contains the sinus node </li></ul></ul></ul><ul><ul><li>Lower chambers (Ventricles). </li></ul></ul><ul><ul><li>Vena cava. </li></ul></ul><ul><ul><li>Pulmonary Artery and vein. </li></ul></ul><ul><ul><li>Aorta. </li></ul></ul><ul><ul><li>Coronary Arteries and veins. </li></ul></ul><ul><ul><li>Veins </li></ul></ul><ul><ul><li>Capillaries </li></ul></ul>
    5. 8. Risk Factors For Cardiovascular Disease <ul><li>Major Risk factors </li></ul><ul><li>Contributing Risk Factors </li></ul><ul><li>Four Major Risk Factors that can be changed . </li></ul><ul><ul><li>Tobacco use. </li></ul></ul><ul><ul><li>High blood pressure. </li></ul></ul><ul><ul><li>High levels of cholesterol. </li></ul></ul><ul><ul><li>Physical inactivity. </li></ul></ul><ul><ul><li>Obesity. </li></ul></ul><ul><ul><li>Diabetes. </li></ul></ul>
    6. 9. Tobacco Use <ul><li>1 in 5 deaths from CVD is a smoker </li></ul><ul><li>Smokers have 2-4 times higher risk of death from a heart attack, than non-smokers </li></ul><ul><li>Reduces HDL’s </li></ul><ul><li>CO displaces O 2 </li></ul><ul><li>Causes platelets to become sticky and increases blood thickness </li></ul>
    7. 10. High Blood Pressure <ul><li>Contributing factors </li></ul><ul><li>Hypertension </li></ul><ul><ul><li>Too much pressure against arterial walls </li></ul></ul><ul><li>Atherosclerosis </li></ul><ul><ul><li>Heart has to work harder, weakens, enlarges, arteries narrow, scar and harden </li></ul></ul><ul><li>See Table 15-1 for blood pressure classification for healthy adults </li></ul>
    8. 11. High Blood Pressure <ul><li>Tachycardias. </li></ul><ul><ul><li>100 or more beats per minute. </li></ul></ul><ul><ul><li>Compromises the ability of the heart to pump effectively. </li></ul></ul><ul><ul><ul><li>Ventricles can not completely fill. </li></ul></ul></ul>
    9. 12. Low Blood Pressure <ul><li>Bradychardia </li></ul><ul><ul><li>60 or less beats per minute </li></ul></ul><ul><ul><li>Poor circulation of the blood </li></ul></ul><ul><ul><li>Lack of 0 2 throughout to body and brain </li></ul></ul>
    10. 13. Cholesterol <ul><li>LDL’s and HDL’s or good versus bad </li></ul><ul><li>Clogs the arteries </li></ul><ul><li>Increased risk of CVD </li></ul><ul><li>Recommended blood cholesterol levels see Table 15-2 </li></ul><ul><ul><li>LDL’s - less than 120 mg/dl </li></ul></ul><ul><ul><li>HDL’s - greater than 60 mg/dl </li></ul></ul><ul><ul><li>Total cholesterol should be below 200 mg/dl </li></ul></ul><ul><ul><li>Levels over 240 mg/dl indicates high risk of CVD </li></ul></ul><ul><ul><li>Triglycerides – less than 150 mg/dl </li></ul></ul><ul><li>Benefits of controlling cholesterol </li></ul>
    11. 15. Physical Inactivity <ul><li>Exercise reduces risk by: </li></ul><ul><ul><li>Controlling Blood pressure </li></ul></ul><ul><ul><li>Lowering LDL’s </li></ul></ul><ul><ul><li>Increasing HDL’s </li></ul></ul><ul><ul><li>Maintaining weight </li></ul></ul><ul><ul><li>Helps prevent or control Diabetes </li></ul></ul>
    12. 16. Obesity <ul><li>More than 30% above recommended weight. </li></ul><ul><li>BMI equal to or greater than 30 </li></ul><ul><li>Increase strain on the heart. </li></ul><ul><li>Strongly associated with </li></ul><ul><ul><li>Hypertension </li></ul></ul><ul><ul><li>High cholesterol </li></ul></ul><ul><ul><li>Insulin resistance </li></ul></ul><ul><ul><li>Diabetes physical inactivity </li></ul></ul><ul><ul><li>Increasing age </li></ul></ul><ul><ul><li>Endothelial cell dysfunction </li></ul></ul><ul><ul><ul><li>Coronary arteries constrict instead of dilating </li></ul></ul></ul><ul><ul><li>Inflammatory markers </li></ul></ul>
    13. 17. Diabetes <ul><li>Doubles the risk of CVD for men. </li></ul><ul><li>Triples the risk of CVD for women. </li></ul><ul><li>Loss of 5-10 years off your life </li></ul><ul><li>Higher risk </li></ul><ul><ul><li>Hypertension </li></ul></ul><ul><ul><li>Obesity </li></ul></ul><ul><ul><li>Unhealthy blood lipid levels </li></ul></ul><ul><ul><li>Elevated blood glucose and insulin can damage the endothelial cells lining the arteries </li></ul></ul><ul><ul><li>More vulnerable to atherosclerosis </li></ul></ul>
    14. 18. Contributing Risk Factors That Can Be Changed <ul><li>High Triglyceride Levels </li></ul><ul><li>Psychological and Social factors </li></ul><ul><ul><li>Chronic hostility and anger </li></ul></ul><ul><ul><li>Suppressing psychological distress </li></ul></ul><ul><ul><li>Depression </li></ul></ul><ul><ul><li>Anxiety </li></ul></ul><ul><ul><li>Social isolation </li></ul></ul><ul><ul><li>Low socioeconomic status </li></ul></ul>
    15. 19. Major Risk Factors That Can’t Be Changed <ul><li>Heredity - CVD has genetic component; high cholesterol levels, blood clotting and obesity </li></ul><ul><li>Age - Over the age of 65 </li></ul><ul><li>Sex - Men have higher risk earlier in life </li></ul><ul><li>Ethnicity - African Americans have higher risk of hypertension; Hispanics greater risk of HBP and Angina; Asians Lower rates of CVD </li></ul>
    16. 20. Possible Risk Factors Currently Being Studied <ul><li>Inflammation and C-reactive protein </li></ul><ul><li>Insulin resistance and metabolic syndrome </li></ul><ul><li>Homocysteine </li></ul><ul><li>Infectious agents </li></ul><ul><li>Lipoprotein(a) </li></ul><ul><li>LDL Particle size. </li></ul><ul><li>Fibrinogen </li></ul><ul><li>Blood Viscosity and Iron </li></ul><ul><li>Uric Acid </li></ul><ul><li>Time of day and time of year </li></ul>
    17. 21. Major Forms of Cardiovascular Disease <ul><li>Atherosclerosis - narrowed by fatty deposits. Starts during childhood fat. </li></ul><ul><li>Heart Attack - Coronary thrombosis, coronary occlusion or myocardial infarction. Vessels in the heart become blocked. </li></ul><ul><li>Angina – narrowed by disease, but under stress heart can not receive enough oxygen. </li></ul><ul><li>Arrhythmias and sudden cardiac death – Electrical conduction system is disrupted </li></ul>
    18. 23. Helping a Heart Attack Victim <ul><li>Most die within 2 hours from initial symptoms </li></ul><ul><li>Cardiopulmonary resuscitation (CPR) </li></ul><ul><li>Refer to Box “What to Do in Case of a Heart Attack, Cardiac Arrest, or Stroke”. </li></ul>
    19. 24. Detecting and Treating Heart Disease <ul><li>Electrocardiogram (ECG or EKG) </li></ul><ul><li>Electron-beam computed tomography (EBCT) </li></ul><ul><li>Echocardiograph – sound waves </li></ul><ul><li>Magnetic Resonance Imaging (MRI) </li></ul><ul><li>Angiogram </li></ul><ul><li>Balloon Angioplasty </li></ul><ul><li>Coronary Bypass Surgery </li></ul>
    20. 25. Stroke or Cerebrovascular Accident (CVA) <ul><li>Ischemic stroke – blockage in blood vessels </li></ul><ul><ul><li>Thrombotic stroke clot forms in a cerebral artery; hypertension </li></ul></ul><ul><ul><li>Embolic Stroke - wandering blood clot </li></ul></ul><ul><li>Hemorrhagic stroke - blood vessel ruptures in the brain </li></ul><ul><ul><li>Subarachnoid hemorrhage </li></ul></ul><ul><ul><li>Intracerebral hemorrhage </li></ul></ul><ul><ul><li>Aneurysm </li></ul></ul>
    21. 27. The Effects of a Stroke <ul><li>700,000 Americans per year </li></ul><ul><li>One-third die within a year </li></ul><ul><li>Those who survive have some lasting disability. </li></ul><ul><ul><li>Paralysis </li></ul></ul><ul><ul><li>Walking disability </li></ul></ul><ul><ul><li>Speech impairment </li></ul></ul><ul><ul><li>Memory loss </li></ul></ul><ul><ul><li>Changes in behavior </li></ul></ul>
    22. 28. Detecting and Treating Stroke <ul><li>Prompt recognition of symptoms </li></ul><ul><ul><li>Sudden numbness or weakness of face, arm, leg or one side of the body </li></ul></ul><ul><ul><li>Loss of Speech or difficulty speaking </li></ul></ul><ul><ul><li>Dimming or loss of vision in one eye </li></ul></ul><ul><ul><li>Unexplained dizziness in relation to other symptoms </li></ul></ul><ul><ul><li>Refer to “Stroke Warning Signs” </li></ul></ul>
    23. 29. Detecting and Treating Stroke <ul><li>Transient ischemic attack (TIA) </li></ul><ul><ul><li>Temporary stroke like symptoms. </li></ul></ul><ul><li>Computed tomography (CT) </li></ul><ul><li>Carotid endarterectomy surgery – plaque is removed from the artery </li></ul><ul><li>Rehabilitation </li></ul><ul><ul><li>Physical therapy </li></ul></ul><ul><ul><li>Speech and Language therapy </li></ul></ul><ul><ul><li>Occupational therapy </li></ul></ul>
    24. 30. Congested Heart Failure <ul><li>Number of conditions </li></ul><ul><li>Pulmonary edema - Fluid accumulates in the lungs. </li></ul><ul><ul><li>Heart can not maintain regular pumping rate; fluid backs up. </li></ul></ul><ul><li>Controlled by: </li></ul><ul><ul><li>Reducing cardiac load </li></ul></ul><ul><ul><li>Eliminating excess fluid </li></ul></ul><ul><ul><li>Restriction of salt </li></ul></ul><ul><ul><li>Drug therapy </li></ul></ul>
    25. 31. Other Forms of Heart Disease <ul><li>Congenital heart disease </li></ul><ul><ul><li>Malformation of the heart or major blood vessel </li></ul></ul><ul><li>Hypertrophic Cardiomyopathy (HCM) </li></ul><ul><ul><li>Most common cause of sudden death in athletes </li></ul></ul><ul><li>Rheumatic Heart Disease </li></ul><ul><ul><li>Streptococcal infections causes damage to the heart muscle and valves. </li></ul></ul><ul><ul><li>Strep throat needs to be treated, primary cause if not treated. </li></ul></ul><ul><li>Heart Valve Disorders </li></ul><ul><ul><li>Mitral valve prolapse </li></ul></ul>
    26. 32. Protecting Yourself Against CVD <ul><li>Eat heart-healthy </li></ul><ul><li>Decreased Fat and Cholesterol </li></ul><ul><ul><li>Total Fats less than 30% of total calories </li></ul></ul><ul><ul><li>Low Saturated Fats </li></ul></ul><ul><ul><li>Increased Dietary Fiber </li></ul></ul><ul><ul><li>Decreased sodium intake and increased potassium intake </li></ul></ul><ul><li>Moderation of Alcohol </li></ul>
    27. 33. Other Dietary Factors <ul><li>Omega-3 fatty acids </li></ul><ul><li>Plant stanols and sterols </li></ul><ul><li>Folic acid </li></ul><ul><li>Vitamins B-6 and B-12 </li></ul><ul><li>Calcium </li></ul><ul><li>Soy protein </li></ul><ul><li>Healthy carbohydrates </li></ul><ul><li>DASH </li></ul><ul><ul><li>Dietary Approaches to Stop Hypertension </li></ul></ul>
    28. 35. Protecting Yourself <ul><li>Exercise Regularly </li></ul><ul><li>Avoid Tobacco </li></ul><ul><li>Know and manage your blood pressure (monitored once every two years) </li></ul><ul><li>Know and manage your Cholesterol levels </li></ul><ul><li>Effective means of controlling stress and anger </li></ul>
    29. 36. What is Cancer? <ul><li>Definition : an abnormal and uncontrollable growth of cells or tissue that can lead to death. </li></ul><ul><ul><li>Tumor : a mass of tissue that serves no purpose. </li></ul></ul><ul><li>Benign versus malignant tumors </li></ul><ul><ul><li>Benign tumor : mass of cells enclosed in a membrane that prevents their penetration of other tissues. </li></ul></ul><ul><ul><li>Malignant tumor : (Neoplasm) cancerous, can invade surrounding tissues. </li></ul></ul><ul><ul><li>Every case of cancer begins as a change in a cell that allows it to grow and divide when it should not. </li></ul></ul>
    30. 37. How Cancer Spreads <ul><li>Metastasis : Primary tumor </li></ul><ul><ul><li>Definition : the spreading of cancer cells, occurs because cancer cells do not stick to each other as strongly as normal cells. </li></ul></ul><ul><ul><ul><li>Cells break away from primary tumor and invade surrounding tissues or travel through the blood and lymphatic system. </li></ul></ul></ul><ul><ul><ul><li>Secondary tumor or metastases </li></ul></ul></ul>
    31. 38. Types of Cancer <ul><ul><li>Classified according to the types of cells. </li></ul></ul><ul><ul><ul><li>Initially retain some of the original properties of the host cell. </li></ul></ul></ul><ul><ul><ul><li>Carcinomas - most common - arises from the epithelial tissue that cover body surfaces. Linings, tubes, cavities and secretion glands. </li></ul></ul></ul><ul><ul><ul><li>Sarcomas: arise in connective and fibrous tissues. Bone, muscle, cartilage and membranes covering muscle or fat. </li></ul></ul></ul><ul><ul><ul><li>Lymphomas: Cancers of the lymph nodes . </li></ul></ul></ul><ul><ul><ul><li>Leukemia : cancer of the blood-forming cells in bone marrow. </li></ul></ul></ul>
    32. 39. The Incidence of Cancer <ul><li>1.4 million Americans are diagnosed yearly </li></ul><ul><li>More than half will be cured. </li></ul><ul><li>About 40% will die as a result of cancer. </li></ul><ul><li>1 in 2 men and 1 in 3 women will be develop cancer during their lifetime. </li></ul><ul><li>American Cancer Society estimates </li></ul><ul><ul><li>90% of skin cancer could have be prevented </li></ul></ul><ul><ul><li>87% of lung cancer could have be prevented </li></ul></ul>
    33. 40. Cancer cases and deaths by site and sex
    34. 41. Lung Cancer <ul><li>Most common cause of cancer death in the U.S. </li></ul><ul><ul><li>162,000 deaths per year </li></ul></ul><ul><ul><li>Risk Factors </li></ul></ul><ul><ul><ul><li>Tobacco smoking contributes to 87%. </li></ul></ul></ul><ul><ul><ul><ul><li>Combined with environmental carcinogens multiply by a factor of 10. </li></ul></ul></ul></ul><ul><ul><li>Detection and Treatment (Difficult to detect) </li></ul></ul><ul><ul><ul><li>Symptoms are not detected until cancer has reached the invasive stage. </li></ul></ul></ul><ul><ul><ul><li>Persistent cough, chest pain, or recurring bronchitis. </li></ul></ul></ul><ul><ul><ul><li>Diagnosis - chest x-ray or sputum examination - fiber-optic bronchosectomy. </li></ul></ul></ul>
    35. 42. Lung Cancer <ul><li>Treatment: </li></ul><ul><ul><li>Difficult to treat. </li></ul></ul><ul><ul><li>Caught early treated by surgery </li></ul></ul><ul><ul><ul><li>Only 16% are detected prior to spreading </li></ul></ul></ul><ul><ul><ul><li>Radiation and chemotherapy are used in addition </li></ul></ul></ul><ul><ul><li>Detected early 50%of patients are alive 5 years post. </li></ul></ul><ul><ul><li>Overall the survival rate is only 15% </li></ul></ul><ul><ul><li>Phototherapy, gene therapy, and immunotherapy are being studied. </li></ul></ul>
    36. 43. Colon and Rectal <ul><li>Second leading cancer causing death. </li></ul><ul><ul><li>Risk Factors </li></ul></ul><ul><ul><ul><li>Directly linked to diet and genetic predisposition. </li></ul></ul></ul><ul><ul><ul><li>90% occurs after 50 yr. of age. </li></ul></ul></ul><ul><ul><ul><li>Heredity </li></ul></ul></ul><ul><ul><ul><li>Lifestyle </li></ul></ul></ul><ul><ul><ul><li>Up to 1/3 of the population is genetically prone . </li></ul></ul></ul><ul><ul><li>Detection and Treatment </li></ul></ul><ul><ul><ul><li>Diet low in fat and High in fiber </li></ul></ul></ul><ul><ul><ul><li>Screening </li></ul></ul></ul><ul><ul><ul><li>Sigmoidoscopy or colonoscopy </li></ul></ul></ul>
    37. 44. Breast Cancer <ul><li>Second most common cancer in women </li></ul><ul><li>Causes almost as many deaths in women as lung cancer </li></ul><ul><li>1:7 American women will develop it during her lifetime (213,000). </li></ul><ul><li>1:30 Will die from the disease (41,000 deaths). </li></ul><ul><ul><li>Risk Factors </li></ul></ul><ul><ul><ul><li>Most common in women over 50 </li></ul></ul></ul><ul><ul><ul><li>5 year survival rate is 79% </li></ul></ul></ul><ul><ul><ul><li>“ Disease of Civilization” </li></ul></ul></ul><ul><ul><ul><li>Common causes: Genetic predisposition, High fat, High calorie diet and Sedentary lifestyle, Alcohol use, early onset of menstruation, First child after 30 and obesity </li></ul></ul></ul><ul><ul><ul><li>Estrogen -cancer in estrogen-responsive sites </li></ul></ul></ul>
    38. 45. Breast Cancer <ul><li>Detection and Treatment </li></ul><ul><ul><li>Early detection. </li></ul></ul><ul><ul><ul><li>Monthly breast self-exam for all women over 20. </li></ul></ul></ul><ul><ul><ul><li>Clinical breast exam by a physician every 3 yr. </li></ul></ul></ul><ul><ul><ul><li>Mammography- Every 1-2 years 40-50 yr. old. </li></ul></ul></ul><ul><ul><ul><ul><li>Over 50 every year. </li></ul></ul></ul></ul><ul><ul><li>Treatment </li></ul></ul><ul><ul><ul><li>Ultrasonography </li></ul></ul></ul><ul><ul><ul><li>Biopsied </li></ul></ul></ul><ul><ul><li>Survival rate </li></ul></ul><ul><ul><ul><li>98% if the cells did not metastasized </li></ul></ul></ul><ul><ul><ul><li>88% for all stages at 5 years </li></ul></ul></ul><ul><ul><ul><li>80% at 10 years </li></ul></ul></ul><ul><ul><li>New strategies for treatment and prevention </li></ul></ul>
    39. 46. Prostate Cancer <ul><li>Most common cancer in men. </li></ul><ul><li>235,000 new cases per year </li></ul><ul><li>More than 27,000 deaths per year </li></ul><ul><ul><li>Risk Factors </li></ul></ul><ul><ul><ul><li>Age </li></ul></ul></ul><ul><ul><ul><li>Diet </li></ul></ul></ul><ul><ul><ul><li>Lifestyle </li></ul></ul></ul><ul><ul><ul><li>Genetic predisposition </li></ul></ul></ul><ul><ul><li>Early detection is key. PSA Blood test </li></ul></ul><ul><ul><li>Treatment - surgical removal of the prostate and radiation </li></ul></ul><ul><ul><li>Survival </li></ul></ul><ul><ul><ul><li>All stages near 100% after 5 years </li></ul></ul></ul>
    40. 47. Cancers of the Female Reproductive Tract <ul><li>Cervical cancer - sexually transmitted. </li></ul><ul><ul><ul><li>Most cases stem from infection by the papillomavirus - transmitted by unprotected sex. </li></ul></ul></ul><ul><ul><ul><li>Smoking </li></ul></ul></ul><ul><ul><ul><li>Infection by genital herpes </li></ul></ul></ul><ul><ul><li>Cervical cancer most common in women in their 20’s and 30’s. </li></ul></ul><ul><ul><ul><li>Factors: sexual intercourse before 18, multiple sex partners, cigarette smoking and low socioeconomic status. </li></ul></ul></ul><ul><ul><li>Screening: </li></ul></ul><ul><ul><ul><li>PAP Test </li></ul></ul></ul><ul><ul><ul><ul><li>Cervical dysplasia </li></ul></ul></ul></ul><ul><ul><ul><ul><li>All sexually active women ages 18-65 should be tested </li></ul></ul></ul></ul><ul><ul><li>Treatment </li></ul></ul><ul><ul><ul><li>Surgery </li></ul></ul></ul>
    41. 48. Cancers of the Female Reproductive Tract <ul><li>Uterine, or Endometrial : </li></ul><ul><ul><li>Occurs after 55 </li></ul></ul><ul><ul><li>Risk factors similar to breast cancer </li></ul></ul><ul><ul><li>Determined by Pelvic Exam </li></ul></ul><ul><ul><li>Treatment is surgery </li></ul></ul><ul><li>Ovarian Cancer : </li></ul><ul><ul><li>Difficult to detect and diagnosis, No warning signs </li></ul></ul><ul><ul><li>Family history or genetic factors </li></ul></ul><ul><ul><li>Determined </li></ul></ul><ul><ul><ul><li>Pelvic Exam </li></ul></ul></ul><ul><ul><ul><li>Blood test – tumor marker called CA-125 </li></ul></ul></ul><ul><ul><li>Treatment is surgery & radiation </li></ul></ul><ul><li>DES (diethylstilbestrol): </li></ul><ul><ul><li>Help prevent miscarriage </li></ul></ul><ul><ul><li>DES daughters have an increased risk of vaginal or cervical cancer. </li></ul></ul>
    42. 49. Skin Cancer <ul><li>Most common form </li></ul><ul><ul><li>1 million cases per year </li></ul></ul><ul><ul><li>62,000 are melanoma </li></ul></ul><ul><ul><li>Easily detected and highly curable </li></ul></ul><ul><ul><li>Exposure to ultraviolet rays during childhood </li></ul></ul><ul><ul><li>Common cause - sunburns and suntans </li></ul></ul><ul><ul><li>Types: </li></ul></ul><ul><ul><ul><li>Basal and Squamous </li></ul></ul></ul><ul><ul><ul><li>Melanoma - more dangerous form </li></ul></ul></ul><ul><ul><li>Prevention </li></ul></ul><ul><ul><ul><li>Avoid long term overexposure to sunlight </li></ul></ul></ul><ul><ul><ul><ul><li>Blistering and peeling sunburns </li></ul></ul></ul></ul><ul><ul><li>Detection and Treatment </li></ul></ul><ul><ul><ul><li>ABCD screen test </li></ul></ul></ul>
    43. 50. Other Cancers <ul><li>Oral Cancer </li></ul><ul><li>Testicular Cancer </li></ul><ul><li>… </li></ul>
    44. 51. Causes of Cancer <ul><li>The Role of DNA </li></ul><ul><ul><li>Each cells has 23 pairs of chromosomes </li></ul></ul><ul><ul><ul><li>Each controls the way a cell will work </li></ul></ul></ul><ul><ul><ul><li>A gene </li></ul></ul></ul><ul><li>DNA Mutations and Cancer </li></ul><ul><ul><li>Changes the way the cells function </li></ul></ul><ul><ul><li>Mutagens – radiation, certain viruses and chemical substances </li></ul></ul><ul><ul><li>Oncogenes – a gene involved in the transformation of a normal cell into cancer </li></ul></ul><ul><ul><li>Tumor suppressor genes – type of oncogene that restrains cellular growth </li></ul></ul>
    45. 52. Cancer promoters <ul><ul><li>Do not directly produce mutations, they accelerate the growth of cells without damaging of permanently altering the DNA. </li></ul></ul><ul><ul><li>Estrogen </li></ul></ul><ul><li>Cigarette smoking is a complete carcinogen because it is a cancer initiator and promoter. </li></ul>
    46. 53. Dietary Factors <ul><li>Dietary Fat and Meat </li></ul><ul><ul><li>High in fat and meat has a direct impact of rates of cancers. </li></ul></ul><ul><li>Alcohol </li></ul><ul><li>Fried Foods </li></ul><ul><li>Dietary Fiber </li></ul><ul><li>Fruits and Vegetables </li></ul><ul><ul><ul><li>Anticarcinogens </li></ul></ul></ul><ul><ul><ul><li>Carotenoids </li></ul></ul></ul><ul><ul><ul><li>Antioxidants versus Free radicals </li></ul></ul></ul><ul><ul><ul><li>Phytochemicals </li></ul></ul></ul>
    47. 54. Carcinogens in the Environment <ul><li>Ingested Chemicals </li></ul><ul><li>Environmental and Industrial pollution </li></ul><ul><li>Radiation - UV rays or man made </li></ul>
    48. 55. Detecting, Diagnosing, and Treating Cancer <ul><li>Detecting: </li></ul><ul><ul><li>Self-monitoring </li></ul></ul><ul><ul><li>CAUTION acronym </li></ul></ul><ul><li>Diagnosing: </li></ul><ul><ul><li>Biopsy </li></ul></ul><ul><ul><li>Magnetic resonance imaging (MRI) </li></ul></ul><ul><ul><li>Computed tomography (CT) </li></ul></ul><ul><ul><li>Ultrasonography </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>Radiation Therapy </li></ul></ul><ul><li>New and Experimental: </li></ul><ul><ul><li>Gene therapy </li></ul></ul><ul><ul><li>Bone marrow and Stem Cell transplants </li></ul></ul><ul><ul><li>Biological therapies </li></ul></ul><ul><ul><li>Proteasome inhibitors </li></ul></ul><ul><ul><li>Enzyme activators/blockers </li></ul></ul>
    49. 56. Prevention <ul><li>Lifestyle choices </li></ul><ul><ul><li>Avoid tobacco </li></ul></ul><ul><ul><li>Controlling diet and weight </li></ul></ul><ul><ul><li>Regular exercise </li></ul></ul><ul><ul><li>Protecting skin from the sun </li></ul></ul><ul><ul><li>Avoiding environmental and occupational carcinogens Recommended screening tests </li></ul></ul><ul><ul><li>Be aware of the early signs and symptoms </li></ul></ul>
    50. 57. Cardiovascular Disease and Cancer Chapter 12

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