1. Cancer: Understanding a Complex Condition
Chapter Seventeen
Cancer: Understanding a Complex Condition

2. What is Cancer? A condition of uncontrolled growth of cells
Develops from a single cell that goes awry, but a combination of events must occur before the cell turns into a tumor
clonal growth: when the replication of cells copy themselves in an uncontrolled manner

3. Healthy Cell Growth
Healthy cells have a complicated system of checks and balances that control cell growth and division
Healthy cells divide when needed to replace cells that have died or been sloughed off
A special protective mechanism exists for certain cells called stem cells
Stem cells can become different cells and are capable of dividing many times as well as self-destructing if exposed to a toxin

4. Cancer Cell Growth
Cancer arises from a single cell that is mutated or exposed to a carcinogen, a cancer causing substance
An initiating event occurs as a result of an error in duplication or in response to a carcinogen
An oncogene is a gene that drives a cell to grow and divide regardless of signals from surrounding cells
A tumor may form (mass of extra tissues) and become either benign (slow growth) or malignant (capable of spreading to surrounding tissues)

5. Classifying Cancers
Cancers are classified according to the tissue in which they originate called the primary site
Tumors are graded on the basis of the degree to which the tumor cells resemble healthy cells of the same tissue type, from a low grade (grade I) to a high grade (grade IV)
The stage of the disease is a description of how far the cancer has spread
Two systems of staging:
5 categories (0 to stage 4 based on the cancer layers of cells)
TNM (tumors, nodes, metastasis ratings from 0-4)

6. Types of Cancer Four broad types of cancer are distinguished:
Carcinomas (epithelial tissue, including the skin, surface of body organs, outer portion of glands)
Sarcomas (connective tissue such as bone, tendon, cartilage, muscle, fat tissues)
Leukemias (blood and bone marrow or the lymphatic system)
Lymphomas (lymph nodes and glands)

7. Risk Factors For Cancer
Family History
Lifestyle Factors
Tobacco Use
Dietary Patterns
Overweight and obesity
Physical inactivity
Alcohol consumption
Environmental Factors
Ultraviolet Radiation
Other forms of radiation
Chemical carcinogens
Infectious agents

8. Common Cancers Lung Cancer Colon and Rectal Cancer Breast Cancer
Leading cause of death for men and women in the US
Second most diagnosed cancer
Colon and Rectal Cancer
3rd leading cause of death and the 3rd most commonly diagnosed cancer
Breast Cancer
Second leading cause of cancer death in women
Prostate Cancer
Second most common cause of cancer death in men
Most commonly diagnosed cancer for men

9. Lung Cancer Risk Factors Symptoms Smoking Environmental pollutants
Coughing
Chest pain
Difficulty breathing

10. Lung Cancer Prevention Treatment Remove smoke element Surgery
Radiation
Chemotherapy
Medications

11. Colon and Rectal Cancer
Risk factors
Genetic and dietary habits
Warning signs
Change in bowel movements
Change in stool size or shape
Pain in the abdomen or blood in the stool

12. Colon and Rectal Cancer
Prevention
Removal of polyps, exercise, dietary supplementation
Early Detection
Rectal exams, stool test, sigmoidoscopy, colonoscopy
Treatment
Surgery, radiation, chemotherapy

13. Breast Cancer Risk factors Prevention Treatment
Early menstrual cycle for women
Women with no children or having children later in life
Hormone replacement therapy use
Prevention
Diet
Mammography
Activity levels
Pregnancy and breastfeeding decisions
Occupational hazards
New medications
Treatment
Lumpectomy
Drug therapy
Chemotherapy/radiation treatments

14. Prostate Cancer Risk factors Symptoms during the advanced stage
Age, dietary fat intake, genetic link
Symptoms during the advanced stage
Associated with difficulty urinating or pain in the pelvic region, or blood in the urine
Early Detection
PSA screenings, digital rectal exam
Treatment
Surgery, radiation, hormonal medications, chemotherapy

15. Cancers of the Female Reproductive System
Cancer can develop throughout the female reproductive system but occur more frequently in the following areas:
Cervix
Uterus
Ovaries

16. Cervical Cancer Risk factors Prevention Treatment
HPV infection (cervical dysplasia)
Smoking and socioeconomic factors
Prevention
Sexual abstinence
Pap tests
Careful selection of sexual partners
Treatment
Surgery (minor or major)
Radiation/chemotherapy

17. Uterine Cancer [Endometrial Cancer]
Risk Factors
Early menarche, late menopause, lack of ovulation, never having given birth, ERT, use of tamoxifen, and also in diabetics, obese, and hypertensive women
Prevention
Minimize high levels of estrogen and regular physician care
Treatment
Surgery, radiation, chemotherapy, hormone treatment

18. Ovarian Cancer
The leading gynecological cause of cancer death and the fourth overall cause of cancer in women
Prevention
Similar to what is recommended for breast cancer
Prophylactic oophorectomy
Early Detection
Referred as the “silent cancer”
Annual pelvic exams
Genetic screenings
Treatment
Surgery
Chemotherapy
Drug therapy

19. Skin Cancer There are 3 types of skin cancer that exist: Risk factors
Basal cell cancer (lesions and sores)
Squamous cell cancer (raised bumps and sores)
Melanoma (spreads quickly)
Risk factors
Severe sunburn during childhood, chronic sun exposure during young adulthood
Prevention
Reduce exposure to sun’s rays, use sunscreens
Early Detection
American Cancer Society guidelines (next slide)
Treatment
Surgery, chemotherapy, interleukin-2

20. American Cancer Society Guidelines (Figure 22.3)
Asymmetry
Border irregularity
Color change
Diameter greater than 6mm

21. Testicular Cancer The most common cancer for men aged 15-35 years
Risk factors
Family history, environmental factors
Prevention
Self exams
Early Detection
Observations and self exams
Treatment
Surgery, chemotherapy, radiation

22. Oral Cancer Risk factors include: Early signs include: Treatment
Cancers that develop in the mouth or the pharynx
Risk factors include:
Cigarettes, cigars, pipes or smokeless tobacco
High levels of alcohol consumption
Early signs include:
Persistent sore in the mouth
Lump or bump that won’t heal
Patch of white or red along the gums or cheeks
Treatment
Surgery
Chemotherapy
Radiation

23. Leukemia
Group of cancers that originate in the bone marrow or other parts of the body where white blood cells form
Results in the overproduction of one type of white blood cell which leads to increased risk of infection, anemia, and bleeding
Risk factors are:
Cigarette smoking and exposure to chemicals
Ionizing radiation exposure
Infection with a virus
Treatment
Chemotherapy
Possible bone marrow transplant

24. Cancer Treatments Surgery (removal of tissue)
Chemotherapy (drug treatment which interfere with rapid cell division)
Radiation (alters DNA which can destroy cancer cells with minimal damage to surrounding tissues)
Biological Therapies
Immunotherapy medications
Bone Marrow Transplantation
Gene Therapy and Genetic Testing

25. Cancer: Understanding a Complex Condition
Chapter Seventeen
Cancer: Understanding a Complex Condition