1 Cardiovascular Disease and Cancer Chapter 12

2 Introduction Cardiovascular disease (CVD) is the leading cause of death in the U.S. (Just recently eclipsed by Cancer) One American dies from CVD every 33 seconds Nearly half of all Americans will die from CVD CVD is the leading cause of death for both men and women 45% of all heart attacks occur in people under the age of 65 Most of CVD risk is lifestyle-related

3 The Cardiovascular System Pulmonary circulation Right side of the heart pumps blood to and from the lungs. Systemic circulation Left side of the heart pumps blood through the rest of the body.

4 Muscular lft. side Less musclar rt.side All arteries carry oxygenated blood except this one All veins carry unoxygenated blood except these

5 Blue indicates un-oxygenated bloodRed indicates oxygenated blood

6 Cardiovascular System Concepts Systole and Diastole. action of the heart is controlled by an electrical signal which originates in the right atrium. Veins carry blood back to the heart. Arteries carry blood away from the heart. Capillaries are the microscopic exchange points *** “good for bad”

7 Risk Factors Major Risk factors ¤Six Major Risk Factors that can be changed. Tobacco use. Physical inactivity. High blood pressure. Obesity Diabetes High levels of cholesterol. LDL’s and HDL’s

8 #1Tobacco Use Smokers have 2-3 times higher risk of heart attack Reduces HDL’s CO displaces O2O2 Causes platelets to become sticky and increases blood thickness

9 High Blood Pressure Too much pressure against arterial walls Heart has to work harder which weakens and enlarges the heart Arteries scar and harden Hypertension

10 Cholesterol Clogs the arteries Increased risk of CVD LDL’s - less than 120 dl/mg HDL’s - greater than 60 dl/mg Total cholesterol should be below 200 dl/mg Levels over 240 indicates high risk of CVD

11 Physical Inactivity Exercise reduces risk by: Lowering LDL’s Controlling Blood pressure Increasing HDL’s Maintaining weight Helps prevent or controls Diabetes

12 Obesity More than 30% above recommended weight. Increase strain on the heart. High Blood Pressure Abdominal fat pattern highest risk Diabetes Doubles the risk of CVD.

13 Contributing Risk Factors That Can Be Changed High Triglyceride Levels Psychological factors Chronic hostility and anger Suppressing psychological disorders Depression and anxiety Social factors Social isolation Low socioeconomic status

14 Uncontrollable Factors Heredity Heredity - CVD has genetic component; high cholesterol levels, blood clotting and obesity Age Age - Over the age of 65 Sex Sex - Men have higher risk earlier in life Ethnicity Ethnicity - African Americans have higher risk of hypertension; Hispanics greater risk of HBP and Angina; Asians Lower rates of CVD

15 Major Forms of Cardiovascular Disease Hypertension Hypertension - may cause damage even before it is ever detected. Atherosclerosis - - narrowed by fatty deposits. Starts during childhood. Heart Attack Attack - Coronary thrombosis, coronary occlusion or myocardial infarction. Vessels in the heart become blocked. Stroke Stroke - Impeded blood supply to a part of the brain. Congestive Heart Failure Failure - Blood backs up in the veins leading to the heart, causing fluid retention in various body parts.

16 Major Forms of Cardiovascular Disease Angina Pectoris - Chest pain; heart doesn’t get enough O 2. Arrhythmia’s - Abnormal Heartbeat Heartbeat - Disruption of the electrical system - can lead to sudden death.

17 Visual depiction of Atherosclerosis development

18 Stroke or Cerebrovascular Accident (CVA) Ischemic stroke- stroke- restricted blood flow Thrombotic stationary stationary clot forms in a cerebral artery Embolic Stroke Stroke - wandering blood clot Hemorrhagic stroke- blood vessel ruptures in the brain Aneurysm- a weakening or “ballooning” in an artery

19 The Incidence of Cancer 1.3 million Americans are diagnosed yearly More than half will be cured. About 40% will die as a result of cancer. 1 in 2 men and 1 in 3 women will develop cancer during their lifetime.

20 Very high mortality rates Naked man & woman

21 Leading Causes of Cancer Risk Factor Tobacco Diet and obesity Sedentary lifestyle Family history of cancer Occupational factors Viruses Alcohol Environmental pollution

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23 What is Cancer? Definition Definition: an abnormal and uncontrollable growth of cells or tissue that can lead to death. (“Mitosis gone wrong”) Tumor Tumor: a mass of tissue that serves no purpose. Malignant tumor tumor : cancerous, can invade surrounding tissues. Benign tumor tumor : mass of cells enclosed in a membrane that prevents their penetration of other tissues.

24 Cancer Cell Characteristics Live Longer Enzyme that blocks internal time clock Lack contact Inhibition Don’t stop dividing Lack Cellular Cohesiveness Don’t stay in area of origin Angiogenesis Potential Set –up it’s own blood supply

25 How Cancer Spreads Metastasis: Metastasis: Movement from p primary tumor Definition Definition: the spreading of cancer cells, occurs because cancer cells do not stick to each other as strongly as normal cells. Cells break away from primary tumor and invade surrounding tissues or travel through the blood and lymphatic system. Results in the development of a secondary tumor or “metastases”

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27 Types of Cancer Malignant Tumors Classified according to the types of cells or the tissue they arise from. Initially retain some of the original properties of the host cell. Carcinomas Carcinomas - most common - start from the epithelial tissue that cover body surfaces. Linings, tubes, cavities and secretion glands.

28 Malignant Tumors Sarcomas: Sarcomas: arise in connective and fibrous tissues. Bone, muscle, cartilage and membranes covering muscle or fat. Lymphomas: Lymphomas: Cancers of the lymph nodes. Leukemia Leukemia: cancer of the blood-forming cells in bone marrow.

29 Common Cancers( The following are for brief discussion only! These are in your reading) Lung Cancer Cancer: Most common cancer. Risk Factors Tobacco smoking contributes to 87%. Combined with environmental carcinogens multiply by 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 - chest x-ray or sputum examination - fiber-optic bronchosectomy.

30 Common Cancers Lung Cancer Cancer treatment: Difficult to treat. Surgery- removal of involved cells. Typically- cancer cells have already spread. Very resistant to chemotherapy.

31 Common Cancers Colon and Rectal Rectal- second most prevalent cancer. Risk Factors Directly linked to diet and genetic predisposition. Mostly occurs after 50 yr. of age.Diet low in fat and High in fiber - best defense. Up to 1/3 of the population is genetically prone. Detection and Treatment

32 Common Cancers Breast Cancer Cancer - Second most common cancer in women; 1:9 American women will have it during her lifetime. Risk Factors Most common in women over 50 5 year survival rate is 79% “Disease of Civilization” Common causes: Genetic predisposition; High fat?, High calorie diet and Sedentary lifestyle, Alcohol use, early onset of menstruation, First child after 30 and obesity Estrogen -cancer in estrogen-responsive sites Detection and Treatment

33 Common Cancers Breast Cancer Cancer -. Three part program for early detection. Monthly breast self-exam for all women over 20. Clinical breast exam by a physician every 3 yr. Mammography- Every 1-2 years yr. old. Over 50 every year. New Strategies for Treatment and Prevention

34 Common Cancers Prostate Cancer Cancer - Most common cancer in men. Third leading cause of cancer deaths in men Risk Factors - Age, diet, lifestyle and genetic predisposition Early detection is key. PSA Blood test Treatment - surgical removal of the prostate and radiation, etc.

35 Common Cancers Female Reproductive Tract: Uterus, Cervix or Ovaries. Cervical cancer - sexually transmitted. 80% stems from infection by the papillomavirus - transmitted by unprotected sex. PAP Test Cervical cancer most common in women in their 20’s and 30’s. Factors: sexual intercourse before 18, multiple sex partners, cigarette smoking and low socioeconomic status.

36 Common Cancers Uterine, or Endometrial Endometrial: Occurs after 55 Determined by Pelvic Exam Treatment is surgery Ovarian Cancer Cancer: Difficult to detect and diagnosis, No warning signs Family history or genetic factors Determined by Pelvic Exam Treatment is surgery & radiation

37 Common Cancers Skin Cancer Cancer: Most common form Easily detected and highly curable Exposure to ultraviolet rays during childhood Common cause - sunburns and suntans Types: Basal and Squamous Melanoma - more dangerous form Prevention Detection and Treatment

38 The A,B,C,D of possible Melanoma

39 Common Cancers Leukemia Leukemia: Cancers of the blood forming tissues Abnormal production of immature white blood cells; rapidly growing cells displace red blood cell precursors Immature WBC’s cannot fight off infections Risk factors are unknown

40 Common Cancers Lymphoma Arising from the lymph cells Hodgkin’s disease Non-Hodgkin’s disease Multiple Myeloma Malignant plasma cells produce tumors in the bone marrow. Leads to anemia, excessive bleeding and decreased resistance to infection

41 The Cause of Cancer The Role of DNA Each cells has 23 pairs of chromosomes Each controls the way a cell will work A gene DNA Mutations and Cancer Changes the way the cells function Mutagens- altered genetic material Oncogenes- genes that can transform a cell into a cancerous cell Tumor suppressor genes- an undamaged oncogene that can control or restrict cancerous cell growth Hereditary Risks

42 Links to Cancer Foods Foods: Both carcinogens and compounds that provide protection Carcinogens Dietary Fat and Meat (Saturated Fats) Alcohol Protective compounds Dietary Fiber Fruits and Vegetables Anticarcinogens Carotenoids Antioxidants- which are Phytochemicals which help control free radicals

43 Foods That Contain Cancer- Preventing Substances Broccoli Brussels sprouts Cabbage Cauliflower Carrots Red peppers Tomato Sweet potato Collard greens Green Tea Kale Spinach Apricot Cantaloupe Grapefruit Orange Papaya Peach Plum Watermelon

44 7 warning signs of cancer

45 Detecting, Diagnosing and Treating Cancer Treatment Treatment: Surgery Chemotherapy Radiation Therapy New and Experimental Gene therapy Bone marrow and Stem Cell transplants Biological therapies- drugs which stop mestasis, anti-angiogenesis, allow cells to die at a normal rate

46 Prevention Lifestyle choices Avoid tobacco Control diet and weight Regular exercise Protecting skin from the sun Avoiding environmental and occupational carcinogens Regular self exams Medical screenings Be aware of the early signs and symptoms