Can We Prevent Cancer? - Dr. Goodwin

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Dr. Jerry Goodwin, chief medical officer of Sylvester Comprehensive Cancer Center/UMHC, presented "Can Cancer Be Prevented?" at the 2011 WellBeingWell Conference in Miami.

Published in: Health & Medicine
  • good post!!!!
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  • This is very useful information. Thank you for sharing your knowledge. I am very interested in 'Diet' to prevent cancer.
    So, I would like to share some information.
    Life style changes such as eating healthfully can be the most effective way to reduce a risk for cancer. Thus, eliminating one of the potential risk factors. Surprisingly, successful lifestyle changes frequently eliminate the need for medications
    The Good News is there are WAY more foods, plants, compounds, herbs, and supplements that are anti-cancer. cancer fighters, cancer minimizers and cancer-reversers than there are problem foods.
    Please visit Boca Wellness & Nutrition Services. Here, you will find more interesting information.
    https://bocawellness.wordpress.com/2011/06/05/protecting-yourself-from-cancer/
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Can We Prevent Cancer? - Dr. Goodwin

  1. 1. W. Jarrard Goodwin, M.D., F.A.C.S.Chief Medical Officer, Sylvester Comprehensive Cancer Center <br />Can We Prevent Cancer?<br />
  2. 2. Cancer in America<br />1.44 million Americans will be diagnosed in 2008<br />570,000 deaths annually (1 in 4)<br />1,500 deaths daily<br />Lifetime risk <br />1 in 2 men <br />1 in 3 women<br />These figures exclude non-melanoma skin cancer<br />Age-adjusted death rate is decreasing<br />Lots of good news<br />
  3. 3. Impact of Total Eradication<br />Impact of Total Eradication<br />Life expectancy of general population ↑ 2.5 years<br />For the approx 25% who would have died - ↑ 10 – 15 years<br />↓ Suffering for patients, friends and family<br />Economic costs 1990<br />Direct $27 billion<br />Indirect $69 billion<br />Total $96 billion <br />
  4. 4. Carcinogenesis<br />Multiple genetic mutations<br />Germline – 20%<br />Spontaneous<br />Abnormal proteins<br />Cell cycle<br />Cell surface<br />Malignant phenotype<br />Cell proliferation > apoptosis<br />Loss of contact inhibition, invasion<br />Escape immune surveillance<br />Angiogenesis<br />
  5. 5. Nature vs. Nurture<br />Environment more important<br />Inhibitors<br />Diet <br />Micronutrients<br />Exercise<br />Anti-inflammatory agents<br />Hormone inhibitors<br />Carcinogens<br />Tobacco/Alcohol<br />Obesity <br />Radiation<br />Stress<br />Chemicals<br />Viruses<br />Gene Pool<br />less<br />
  6. 6. 50% of Deaths are Preventable<br />Tobacco/Alcohol<br />Screening<br />Prevention<br />Early Detection<br />Lifestyle<br />Diet<br />Exercise<br />Stress/frustration<br />Depression<br />Social support<br />Viruses<br />Sun exposure +/-<br />Drugs/Micronutrients<br />Hormone agonists<br />Vitamins, antioxidants<br />Anti-inflammatory drugs –aspirin, NSAs<br />
  7. 7. Socialand Behavioral Issues<br />Socialand Behavioral Issues<br />Personal freedoms vs. good of society<br />Medical economics – focus on treatment, sick care vs. well care<br />Knowledge/education<br />Individual fears / cultural factors<br />Ignore symptoms and signs<br />Disregard screening guidelines<br />Disparities – minority and medically underserved bare an unequal burden<br />
  8. 8. Tobacco<br />Cancer of the lung<br />Mouth and throat cancer<br />Kidney cancer<br />Bladder cancer<br />Pancreatic cancer<br />Esophageal cancer<br />Breast cancer?<br />
  9. 9. Tobacco Prevalence<br />Problems- low income, low education, minorities, stable since 2004<br />
  10. 10. Second Hand Smoke<br />3,400 deaths from lung cancer<br />35,000 deaths from heart disease<br />Occupational exposure<br />Family exposure<br />Legislation and litigation helping<br />
  11. 11. Industry Marketing<br />1998 2005<br /> $6.7 B $13.1 B<br />Discounting strategies<br />
  12. 12. Quitting<br />Quitting<br />Behavioral interventions<br />Pharmaceutical treatment<br />Social initiatives<br />Legislative – taxes/pricing, clean air<br />Judicial<br />ACS quitline in Florida <br />Success rate 16%<br />200 calls/month to 400/day<br />
  13. 13. Excess Alcohol<br />Excess Alcohol<br />Mouth and throat<br />Esophagus<br />Liver<br />Breast<br />
  14. 14. Screening<br />Screening<br />Breast<br />Prostate<br />Colon<br />Lung - controversial<br />Uterine cervix <br />Skin<br />Mouth<br />Esophagus<br />Prevention<br />Early detection<br />
  15. 15. Diet<br />Diet<br />Calories<br />Fruits and Vegetables<br />Animal Fat<br />Fiber<br />Bioactive Micronutrients<br />Preservatives vs. Organic<br />
  16. 16. Exercise<br />Exercise<br />25-50% reduction in breast and colon cancer<br />Effects on fat distribution and metabolism<br />Reduced stress<br />Immune enhancement <br />Hormones <br />Reduced estrogen levels<br />Reduced insulin growth factors<br />Anti-angiogenesis <br />
  17. 17. Exercise and Breast Cancer<br />Exercise and Breast Cancer<br />Moderate levels of exercise – walking 2.9 mph for 1 hr.<br /><ul><li>Reduces incidence
  18. 18. Improves survival after diagnosis
  19. 19. Exercise prior to diagnosis or at any time after diagnosis</li></li></ul><li>Mind/Body Factors<br />Mind/Body Factors<br />Cancer Incidence<br />Progression<br /><ul><li>Chronic stress
  20. 20. Frustration
  21. 21. Depression 
  22. 22. Social isolation</li></li></ul><li>Neural Stress Pathways<br />M. Antoni, et al<br />Nature Medicine 2006<br />
  23. 23. Effect on the Tumor<br />
  24. 24. Infections<br />Viruses<br />HPV, Hepatitis B & C, EBV, HIV&HHV-8<br />Bacteria<br />Helicobacter pylori<br />Immunization, antivirals, antibiotics<br />Gardasil – HPV types 16, 18 - FDA approved in 9-26 year old females<br />
  25. 25. Environmental Carcinogens<br />Environmental Carcinogens<br />5-10% of deaths?<br />Ionizing Radiation<br />Radon: 15 – 20,000 lung cancer deaths annually<br />Sun<br />Occupational exposures – now regulated<br />Pesticides – skin contact<br />Pollutants <br />– second hand smoke<br />
  26. 26. Gastro-esophageal Reflux<br />Gastro-esophageal Reflux<br />Millions of Americans<br />Barrett’s esophagus – approximately 10%, annual screening<br />Esophageal cancer – 3-4/100,000 overall, 3-8% of Barrett’s patients, .5%/year<br />Treatment <br />Lifestyle changes<br />Medications<br />Surgery<br />
  27. 27. Inhibitors of Carcinogenesis<br />Inhibitors of Carcinogenesis<br />Antioxidants<br />BHT, BHA, selenium<br />Red wine, chocolate, garlic, herbals<br />Vitamins A, B12, C, D and E<br />Retinoids, beta carotene, lycopene<br />Anti-inflammatory drugs<br />Aspirin<br />Cox 2 inhibitors<br />Estrogen and androgen inhibitors<br />
  28. 28. American Cancer Society<br />American Cancer Society<br />Don’t smoke – or be around anyone who does!<br />Choose most foods from plant sources<br />Five servings of fruits and vegetables a day<br />Cereal and grains<br />Limit high fat foods – especially from animal sources<br />Be physically active – at least 30 minutes daily<br />Maintain a healthy body weight<br />Limit alcohol intake <br />Follow screening guidelines<br />Know the danger signals<br />
  29. 29. CDC/HHS/NCI<br />CDC/HHS/NCI<br />www.fruitsandveggiesmatter.gov<br />
  30. 30. ACS Screening Guidelines<br />ACS Screening Guidelines<br />Breast Cancer<br />Yearly mammogram starting at age 40<br />Annual MRI if lifetime risk > 20%<br />Colon Cancer – beginning at age 50<br />Annual stool test (occult blood, DNA)<br />Every 5 years – sigmoidoscopy/colonoscopy<br />
  31. 31. ACS Screening Guidelines<br />ACS Screening Guidelines<br />Cervical cancer<br />Annual Pap test beginning at 21 years<br />Less frequent if 3 normal tests in a row and may stop at age 70 years<br />Prostate cancer<br />Annual PSA and digital exam beginning at age 40 - 50 years depending on risk<br />
  32. 32. Individual Issues & Choices<br />Individual Issues & Choices<br />Know your own risk, but don’t obsess about it.<br />Manage stress and especially frustration<br />Invest time in family and friends<br />Should you take:<br />Aspirin?<br />Vitamin D?<br />Selenium?<br />Estrogen replacement therapy?<br />Red wine, chocolate, garlic, herbals?<br />Avoid gastroesophogeal acid reflux<br />Include laughter in every day <br />
  33. 33. Future<br />Future<br />Better public education <br />Personalized messaging<br />Behavioral research <br />Choices <br />Coping<br />Early detection <br />Imaging<br />Genetic and protein screening<br />Inhibitors<br />Vaccination<br />Public Policy / legislation<br />Research<br />Cures<br />Cancer<br />

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