1. © McGraw-Hill Companies. All rights reserved. Understanding Cancer and Diabetes Chapter 13

2. © McGraw-Hill Companies. All rights reserved. Cancer Cancer is a group of diseases characterized by uncontrolled, disorderly cell growth Cancer is a group of diseases characterized by uncontrolled, disorderly cell growth Cancer is the second-leading cause of death in the U.S. and the leading cause for young adults and children Cancer is the second-leading cause of death in the U.S. and the leading cause for young adults and children One in four Americans will eventually develop one or more of the more than 100 different forms of cancer One in four Americans will eventually develop one or more of the more than 100 different forms of cancer

3. © McGraw-Hill Companies. All rights reserved. Cancer Facts Sometimes the nucleus of a cell looses the ability to regulate cell growth, producing a mutant cell Sometimes the nucleus of a cell looses the ability to regulate cell growth, producing a mutant cell A mass of mutant cells is called a neoplasm (tumor) A mass of mutant cells is called a neoplasm (tumor) A neoplasm can be malignant (cancerous) or benign (noncancerous) A neoplasm can be malignant (cancerous) or benign (noncancerous) Malignant tumors can spread and crowd out normal tissue Malignant tumors can spread and crowd out normal tissue

4. © McGraw-Hill Companies. All rights reserved. Causes and Prevention Metastasis is the process by which cancer cells spread from their primary site to a secondary site Metastasis is the process by which cancer cells spread from their primary site to a secondary site Cancer is caused by both external and internal factors Cancer is caused by both external and internal factors Ten or more years often elapses from the time of cell mutation until actual detection of the cancer Ten or more years often elapses from the time of cell mutation until actual detection of the cancer

5. © McGraw-Hill Companies. All rights reserved. Causes and Prevention Carcinogens are any cancer-causing agents Carcinogens are any cancer-causing agents Proto-oncogenes regulatory genes found in all cells Proto-oncogenes regulatory genes found in all cells –Disruptions in proto-oncogenes caused by environmental factors or replication errors can result in a cancer-producing gene (oncogene) Suppressor genes control cell growth Suppressor genes control cell growth

6. © McGraw-Hill Companies. All rights reserved. Causes and Prevention Cancer requires the production of a cancer- producing gene as well as failure of the immune system to recognize and destroy mutant cells

7. © McGraw-Hill Companies. All rights reserved. Causes and Prevention Evidence suggests that about 1/3 of the 564,830 estimated cancer deaths in 2006 were related to nutrition, inactivity and obesity Evidence suggests that about 1/3 of the 564,830 estimated cancer deaths in 2006 were related to nutrition, inactivity and obesity It is also estimated that ~ 170,000 cancer deaths in 2006 were due to tobacco use It is also estimated that ~ 170,000 cancer deaths in 2006 were due to tobacco use ALL PREVENTABLE CAUSES

8. © McGraw-Hill Companies. All rights reserved. Cancer Sites Skin cancer is the most common cancer Skin cancer is the most common cancer The cancer that kills most often among both genders is lung cancer The cancer that kills most often among both genders is lung cancer

9. © McGraw-Hill Companies. All rights reserved. Cancers of Concern to Everyone Lung cancer Lung cancer –The leading cause of cancer death around the world –Early diagnosis is rare –Many cancer causing substances found in tobacco are also found in marijuana Colorectal cancer Colorectal cancer –Ranks third in cancer deaths for men and women In the U.S. –The cure rate for colorectal cancer is only 10% once is has spread –Diet is considered the primary cause of colorectal cancer development

10. © McGraw-Hill Companies. All rights reserved. Stomach, Liver, and Pancreatic Cancer Stomach cancer Stomach cancer –Steadily declining in the U.S., probably because of refrigeration and decreased use of salt as a preservative Liver cancer Liver cancer –Very deadly; in the U.S. it is most closely linked to hepatitis and cirrhosis Pancreatic cancer Pancreatic cancer –One of the five leading causes of cancer death, but relatively little is known about it –5 year survival rate is only 4%

11. © McGraw-Hill Companies. All rights reserved. Lukemia and Lymphoma Leukemia Leukemia –The causes are largely unidentified; in adults, progression of the disease is slow and produces few symptoms Lymphoma Lymphoma –Cancer of lymphoid tissue –Hodgkin’s disease rates have declined, especially among the elderly –Non-Hodgkin’s lymphoma rates have nearly doubled since the 1970s

12. © McGraw-Hill Companies. All rights reserved. Skin Cancer the most frequently occurring types of cancer are skin cancers Basal cell carcinoma Basal cell carcinoma –The most common skin cancer, but it grows slowly and rarely spreads Squamous cell carcinoma Squamous cell carcinoma –The second most common skin cancer; it also grows slowly, but it does metastasize Malignant melanoma Malignant melanoma –The least common skin cancer, but it causes of 75% of skin cancer deaths

13. © McGraw-Hill Companies. All rights reserved. Skin Cancer: Melanoma Incidence of melanoma seems to be related to intermittent sun exposure and blistering sunburns early in life Incidence of melanoma seems to be related to intermittent sun exposure and blistering sunburns early in life Melanoma often appears on parts of the body rarely exposed to the sun; use of sunscreen does not seem to decrease risk Melanoma often appears on parts of the body rarely exposed to the sun; use of sunscreen does not seem to decrease risk Melanoma incidence has increased dramatically in the last few decades Melanoma incidence has increased dramatically in the last few decades

14. © McGraw-Hill Companies. All rights reserved. Skin Cancer Knowing the ABCDs of skin cancer can help you detect melanoma in the early, treatable stages A = Asymmetry (halves are shaped differently) B = Border irregularity (may have scalloped or uneven edges) C = Color (color is not uniform) D = Diameter (larger than 6 mm)

15. © McGraw-Hill Companies. All rights reserved. Oral Cancer Occurs more than twice as often in males than females Occurs more than twice as often in males than females Cigar and pipe smoking as well as use of smokeless tobacco are primary causes Cigar and pipe smoking as well as use of smokeless tobacco are primary causes

16. © McGraw-Hill Companies. All rights reserved. Breast Cancer One in nine women who live to age 85 will develop breast cancer One in nine women who live to age 85 will develop breast cancer –The 5-year survival rate for localized breast cancer is 96% –Distant metastasis has only a 21% 5-year survival rate Monthly breast self-exams remain the primary way to detect breast cancer when small and localized Monthly breast self-exams remain the primary way to detect breast cancer when small and localized

17. © McGraw-Hill Companies. All rights reserved. Other Cancers Affecting Women Uterine cancer Uterine cancer –Occurs in either the cervix or the endometrium Cervical cancer Cervical cancer –One of the most treatable forms of cancer Ovarian cancer Ovarian cancer –Often deadly because it is rarely found in the early stages

18. © McGraw-Hill Companies. All rights reserved. Cancers Affecting Men Testicular Cancer Testicular Cancer –Five thousand 15- to 34-year-old men are diagnosed every year –Young men should perform a monthly testicular self-exam Prostate cancer Prostate cancer –rarely strikes young men –Although it is the second leading cause of cancer death in men, early diagnosis has a 100 percent cure rate

19. © McGraw-Hill Companies. All rights reserved. Treatment Surgery Surgery –Removal of malignant tissue Chemotherapy Chemotherapy –Combination of drugs and hormones –Destroy cancer cells’ ability to divide and replicate; also affects health cells Antiangiogenesis Therapy Antiangiogenesis Therapy –Stops cancerous growths from developing new blood vessels –Only mild side effects –Note very effective as the sole treatment

20. © McGraw-Hill Companies. All rights reserved. Other Treatments Radiotherapy Radiotherapy Bone marrow and peripheral blood stem cell transplants Bone marrow and peripheral blood stem cell transplants Immunotherapy Immunotherapy Complementary therapies Complementary therapies

21. © McGraw-Hill Companies. All rights reserved. Diabetes Mellitus A group of diseases characterized by the body’s inability to make insulin, insufficient insulin production, or the inability to properly use insulin Due to unavailability of insulin, the body’s glucose (blood sugar) is unavailable for use and hyperglycemia (high blood sugar) results Due to unavailability of insulin, the body’s glucose (blood sugar) is unavailable for use and hyperglycemia (high blood sugar) results

22. © McGraw-Hill Companies. All rights reserved. Diabetes Mellitus When sugar is not available for energy, fat must be used When sugar is not available for energy, fat must be used Fat as an energy source without glucose causes an excess of chemicals called ketone bodies to build up in the body Fat as an energy source without glucose causes an excess of chemicals called ketone bodies to build up in the body Ketone bodies increase the acid level of the blood, leading to many physical problems, including ketoacidosis and death Ketone bodies increase the acid level of the blood, leading to many physical problems, including ketoacidosis and death

23. © McGraw-Hill Companies. All rights reserved. How Diabetes Effects the Body

24. © McGraw-Hill Companies. All rights reserved. Type 1 Diabetes An autoimmune disease that occurs most frequently in children and young adults In type 1 diabetes, the pancreas fails to produce any insulin because of autoimmune damage In type 1 diabetes, the pancreas fails to produce any insulin because of autoimmune damage –Insulin injections of daily monitoring of blood sugar levels are necessary

25. © McGraw-Hill Companies. All rights reserved. Type II Diabetes The most common and is found primarily in people over 40 years old Type 2 diabetes is strongly linked to heredity and obesity Type 2 diabetes is strongly linked to heredity and obesity –Condition can often be controlled with diet, exercise, and weight management

26. © McGraw-Hill Companies. All rights reserved. Other Complications Pre-Diabetes Pre-Diabetes –At risk for developing type 2 diabetes –Blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes Gestational Diabetes (type 2) Gestational Diabetes (type 2) –Occurs in some women during pregnancy –Must be managed to avoid further complications

27. © McGraw-Hill Companies. All rights reserved. Treatment There is no cure for diabetes There is no cure for diabetes 50% to 85% of all complications are preventable or treatable 50% to 85% of all complications are preventable or treatable negligence can result in early death negligence can result in early death Type II can often be controlled with weight loss, exercise and adequate nutrition Type II can often be controlled with weight loss, exercise and adequate nutrition – emphasis on carbohydrate consumption – exercise linked to decreased incidence  for each 500 calorie increment in exercise-risk for type II decreases 6%

28. © McGraw-Hill Companies. All rights reserved. Treatment There have been many advancements in treating diabetes There have been many advancements in treating diabetes –new medications that increase insulin, slows absorption of blood sugar; makes the body more receptive to insulin –new types of insulin –new methods of delivering insulin to the body –better methods of monitoring glucose –Islet cell transplants –pancreas transplants

29. © McGraw-Hill Companies. All rights reserved. Understanding Cancer and Diabetes Chapter 13