1. Copyright © 2010 Pearson Education, Inc. written by Bridget Melton, Georgia Southern University Lecture Outline Chapter 16 Cancer: Reducing Your Risk

2. Copyright © 2010 Pearson Education, Inc. Objectives Understand what cancer is, how it develops, and its causes. Discuss ways to prevent cancer and the implications of behavioral risks. Describe the different types of cancer and the risks they pose to people at different ages and stages of life.

3. Copyright © 2010 Pearson Education, Inc. Objectives (cont.) Explain the importance of early detection, self- exams, medical exams, and symptoms related to different types of cancer. Discuss cancer diagnosis and treatment, including radiation therapy, chemotherapy, immunotherapy, and other common methods of detection and treatment.

4. Copyright © 2010 Pearson Education, Inc. An Overview of Cancer In 2008, approximately 565,650 Americans died of cancer. Each year, 1.5 million new cases are diagnosed. One-third of cancers are related to poor nutrition, physical inactivity, and obesity—preventable causes.

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6. What Is Cancer? Cancer is a large group of diseases characterized by the uncontrolled growth and spread of abnormal cells. Neoplasm is new growth of tissue that serves no physiological function. A tumor is a clumping of neoplasmic cells. Malignant means “cancerous.” Benign means “noncancerous.” A biopsy is a microscopic examination of cell development.

7. Copyright © 2010 Pearson Education, Inc. What Is Cancer? (cont.) Metastasis is the process by which malignant tumors that are not enclosed in a protective capsule spread to other organs. Mutant cells form after a disruption of RNA and DNA within normal cells, which may produce cells that differ in form, quality, and function from the normal cell.

8. Copyright © 2010 Pearson Education, Inc. What Causes Cancer? External factors, such as chemicals, radiation, viruses, and lifestyle Internal factors, such as hormones, immune conditions, and inherited mutations Cellular change theory says cancer results from carcinogens. oncogenes.

9. Metastasis Copyright © 2010 Pearson Education, Inc.

10. Risks for Cancer Lifetime risk is the probability that an individual, over the course of a lifetime, will develop cancer or die from it. Relative risk is the measure of the strength of the relationship between risk factors and a particular cancer. Smoking is responsible for 30 percent of all cancer deaths and 87 percent of lung cancer deaths. Obesity increases risk to 50 percent for breast cancer in postmenopausal women, 40 percent for colon cancer in men.

11. Tobacco Use in the United States, 1900–2003 Copyright © 2010 Pearson Education, Inc.

13. Biological Factors Some cancers, such as breast, stomach, colon, prostate, uterus, ovary and lung, appear to run in families. Hodgkin’s disease and certain leukemias show similar patterns. Genes appear to account for approximately 5 to 10 percent of all cases of breast cancer.

14. Cancer Death Rates, by Race and Ethnicity, United States, 2000–2004 Copyright © 2010 Pearson Education, Inc.

15. Reproductive and Hormonal Risks for Cancer Pregnancy and oral contraceptives increase a woman’s chances of breast cancer. Late menarche, early menopause, early first childbirth, and having many children have been shown to reduce risk of breast cancer.

16. Leading Sites of New Cancer Cases and Deaths, 2008 Estimates Copyright © 2010 Pearson Education, Inc.

17. Occupational and Environmental Factors Asbestos Nickel Chromate Benzene Arsenic Radioactive substances Cool tars Herbicides and pesticides

18. Copyright © 2010 Pearson Education, Inc. Chemicals in Foods Sodium nitrate when ingested forms a potential carcinogen, nitrosamine. Sodium nitrate is still used because it is effective in preventing botulism. Pesticide and herbicide residues in high doses are known to cause cancer.

19. Copyright © 2010 Pearson Education, Inc. Social and Psychological Factors Stress has been implicated in increased susceptibility to several types of cancers. Sleep disturbances, diet, or a combination of factors may weaken the body’s immune system.

20. Copyright © 2010 Pearson Education, Inc. Infectious Disease and Cancers Herpes-related viruses may be involved in the development of leukemia, Hodgkin’s disease, cervical cancer, and Burkitt’s lymphoma. Epstein-Barr virus, associated with mononucleosis, may contribute to cancer. Human papillomavirus (HPV), a virus that causes genital warts, has been linked to cervical cancer. Helicobacter pylori causes ulcers, which are a major factor in the development of stomach cancer.

21. Copyright © 2010 Pearson Education, Inc. Medical Factors Some medical treatments actually increase a person’s risk for cancer. Diethylstilbestrol (DES) was used from 1940 to 1960 to control bleeding during pregnancy; the daughters of mothers who used DES were found to have an increased risk for cancers of the reproductive organs. Estrogen supplementation contributes to multiple cancer risks. Chemotherapy used to treat one form of cancer may increase risk for another type of cancer.

22. Copyright © 2010 Pearson Education, Inc. Types of Cancers Classification of cancers Carcinomas Sarcomas Lymphomas Leukemias

23. Copyright © 2010 Pearson Education, Inc. Lung Cancer In 2008, an estimated 161,840 people died from lung cancer. Since 1987, more women have died from lung cancer than breast cancer. Symptoms: persistent cough, blood-streaked sputum, and chest pain. Treatment: surgery, radiation therapy, and chemotherapy Prevention: avoid smoking and environmental tobacco smoke

24. Copyright © 2010 Pearson Education, Inc. Breast Cancer One in eight women will develop breast cancer in her lifetime. One in 210 between birth and age 39 One in 26 between ages 40 to 59 One in 15 between ages 60 to79 Detection: mammograms, regular breast self-exams Symptoms: lump in the breast, thickening, dimpling, skin irritation, distortion, tenderness

25. Copyright © 2010 Pearson Education, Inc. Breast Cancer (cont.) Risk factors: family history, hyperplasia, long menstrual history, obesity after menopause, oral contraceptives Treatment: lumpectomy, radical mastectomy, radiation, chemotherapy Prevention: exercise

26. Breast Self-Examination Figure 16.5 Copyright © 2010 Pearson Education, Inc.

27. Colon and Rectal Cancers Third most common cancers in men and women, with over 148,810 new cases diagnosed in 2008 Risk factors: over 50 years old, obese, family history of colon or rectal cancer or polyps, diets high in fats and low in fiber, smoking, high alcohol consumption, lack of exercise Ninety percent of colorectal cancers are preventable. Treatment: radiation, surgery, and possibly chemotherapy Prevention: regular exercise, a diet heavy in fruits and plant-origin foods, a healthy weight, and moderation in alcohol consumption

28. Copyright © 2010 Pearson Education, Inc. Skin Cancer Long-term sun exposure can result in skin cancer. Malignant melanoma is the deadliest form of skin cancer. The sun emits three types of harmful rays UVA UVB UVC

29. Types of Ultraviolet Rays Copyright © 2010 Pearson Education, Inc.

30. Skin Cancer (cont.) Use the ABCD rule to detect melanoma. Asymmetry: half of a mole does not look like the other half Border irregularity: the edges are uneven Color: pigmentation is not uniform Diameter: larger than a pea

31. Types of Skin Cancers Copyright © 2010 Pearson Education, Inc.

32. ABC News Video: Possible Melanoma Treatment Discussion Questions 1.Do scientific successes against cancer cause your worry about getting cancer to decrease? 2.What do you do to protect yourself from skin cancer? Could you do more? | Possible Melanoma Treatment

33. Copyright © 2010 Pearson Education, Inc. Prostate Cancer Most common cancer in American men, excluding skin cancer In 2008, 186,320 new cases were diagnosed. One in three men will be diagnosed in his lifetime. Prostate is a muscular, walnut-sized gland surrounding part of the urethra and whose primary function is to produce seminal fluid.

34. Copyright © 2010 Pearson Education, Inc. Prostate Cancer (cont.) Symptoms: weak or interrupted urine flow, difficulty starting or stopping urination Risk factors: age, race, nationality, family history, diet, and lifestyle Prevention: diet high in lycopenes, vitamin E

35. Copyright © 2010 Pearson Education, Inc. Ovarian Cancer Fifth-leading cause of cancer death for women; almost 22,000 new cases diagnosed and more than 15,000 deaths reported in 2008 Most common symptom is enlargement of the abdomen. Risk factors: family history, age, childbearing, cancer history, fertility drugs, talc use in genital area, genetic predisposition Prevention: diet high in vegetables and low in fat, exercise, sleep, stress management, and weight control

36. Copyright © 2010 Pearson Education, Inc. Cervical and Endometrial (Uterine) Cancer In 2008 in the United States, there were 11,070 new cases of cervical cancer; 40,100 of endometrial cancer. In a pap test, cells are taken from the cervical region. Risk factors: For cervical cancer, early age at first intercourse, multiple sex partners, cigarette smoking, and certain STIs For endometrial cancer: age, endometrial hyperplasia, overweight, diabetes, and high blood pressure

37. Copyright © 2010 Pearson Education, Inc. Testicular Cancer Affected nearly 7,920 young men in 2007 Men between the ages of 15 and 35 are at the greatest risk. Important to practice regular testicular self-exams Lance Armstrong Foundation’s LiveStrong campaign raises awareness.

38. Testicular Self-Examination Copyright © 2010 Pearson Education, Inc.

39. Other Cancers Pancreatic cancer has a 5-year survival rate of 5%. Leukemia is a cancer of blood-forming tissues. Lymphomas are cancers of the lymphatic system.

40. Copyright © 2010 Pearson Education, Inc. Detecting Cancer The earlier the diagnosis, the better the prospect for survival. Tests for detection Magnetic resonance imaging (MRI) Computerized axial tomography (CAT) scan Prostatic ultrasound Regular self-exams and checkups

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42. Cancer’s Seven Warning Signals Copyright © 2010 Pearson Education, Inc.

43. New Hope in Cancer Treatments Radiotherapy Chemotherapy Immunotherapy Cancer-fighting vaccines Gene therapy Angiogenesis inhibitors

44. Copyright © 2010 Pearson Education, Inc. ABC News Video: Treating Cancer with Bone Drugs Discussion Questions 1.Why do treatments such as this seem to focus on early-stage cancers? 2.Would you take a drug developed for a different health issue to help control the spread of cancer? How might taking a drug affect the rest of your body? 3.What questions should you ask your health care provider before taking medication? 4.Under what circumstances would you join a medical research study? | Treating Cancer with Bone Drugs

45. Radiation Therapy Copyright © 2010 Pearson Education, Inc.

46. Talking to Your Doctor about Cancer Kind of cancer? Type? Stage? Prognosis? Treatment choices? Short- and long-term effects of treatment?

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48. Cancer Survivors Cancer support groups Cancer information workshops Low-cost medical consultation Increased government funding to seek cures