1. Chapter Twelve Cardiovascular Disease and Cancer

2. The Cardiovascular System Cardiovascular disease is the leading cause of death in the United StatesCardiovascular disease is the leading cause of death in the United States Heart attacks and strokes are the most common life- threatening types of heart diseasesHeart attacks and strokes are the most common life- threatening types of heart diseases Much of these incidences are due to lifestyle concernsMuch of these incidences are due to lifestyle concerns

3. Characteristics of the Heart 4 chambered pump (atria, ventricles)4 chambered pump (atria, ventricles) Size of a fistSize of a fist Weighs about 1 poundWeighs about 1 pound Function - creates pressure to circulate blood throughout the bodyFunction - creates pressure to circulate blood throughout the body Blood enters via the Vena Cava into the right atrium (see Figure 15-2 on blood circulation)Blood enters via the Vena Cava into the right atrium (see Figure 15-2 on blood circulation)

4. Heart Beat Stimulation Signal sends impulses from the heartSignal sends impulses from the heart SA node (pacemaker of the heart) creates an electrical impulseSA node (pacemaker of the heart) creates an electrical impulse An electrical impulse spreads from the right side to the left (ECG)An electrical impulse spreads from the right side to the left (ECG) The pace of the heart is regulated by the brainThe pace of the heart is regulated by the brain

5. Risk Factors for Heart Disease That Can Be Changed (AHA) Tobacco SmokingTobacco Smoking Physical inactivityPhysical inactivity High cholesterol (Figure 15-2)High cholesterol (Figure 15-2) Hypertension Diabetes Mellitus Obesity and Overweight Reference: American Heart Association

6. Contributing Risk Factors for Heart Disease That Can Be Changed Contributing Risk Factors for Heart Disease That Can Be Changed High Triglyceride LevelsHigh Triglyceride Levels StressStress Chronic hostility and AngerChronic hostility and Anger Type D PersonalitiesType D Personalities Depression/AnxietyDepression/Anxiety Social IsolationSocial Isolation Low socioeconomic statusLow socioeconomic status

7. Major Risk Factors That Cannot Be Changed HeredityHeredity AgingAging Being MaleBeing Male EthnicityEthnicity

8. Possible Risk Factors Currently Being Studied Inflammation and C- Reactive ProteinInflammation and C- Reactive Protein Insulin Resistance and Metabolic SyndromeInsulin Resistance and Metabolic Syndrome HomocysteineHomocysteine Infectious agentsInfectious agents Lipoprotein (A)Lipoprotein (A) LDL Particle size Fibrinogen Blood viscosity and Iron Uric acid

9. Major Forms of Cardiovascular Disease CAD (coronary artery disease)CAD (coronary artery disease) Atherosclerosis: build up of plaque on the arteriesAtherosclerosis: build up of plaque on the arteries HypertensionHypertension StrokeStroke Congestive heart failureCongestive heart failure

10. Hypertension Blood pressure exceeds a systolic (pressure at contraction) over 140 mm/hg and/or a diastolic (pressure between contraction) over 90 mm/hgBlood pressure exceeds a systolic (pressure at contraction) over 140 mm/hg and/or a diastolic (pressure between contraction) over 90 mm/hg Symptoms – the “silent killer” (no symptoms)Symptoms – the “silent killer” (no symptoms) Diagnosis – regular checks of resting blood pressure (average blood pressure < 120/80)Diagnosis – regular checks of resting blood pressure (average blood pressure < 120/80) Treatment – medication, exercise, dietary changes)Treatment – medication, exercise, dietary changes) A cause of heart attacks, strokes, and kidney diseaseA cause of heart attacks, strokes, and kidney disease

11. Atherosclerosis Atheroschlerosis is a form of arteriosclerosis (hardening of the arteries)Atheroschlerosis is a form of arteriosclerosis (hardening of the arteries) Arteries become narrow due to plaque buildupArteries become narrow due to plaque buildup This process deprives blood and vital oxygen to specific organs, such as the heart, brain, etc.This process deprives blood and vital oxygen to specific organs, such as the heart, brain, etc. Results in the following:Results in the following: Coronary Heart DiseaseCoronary Heart Disease StrokeStroke Peripheral Arterial DiseasePeripheral Arterial Disease *Atherosclerosis often begins during childhood

12. Heart Attack Damage to vessels of the coronary arteryDamage to vessels of the coronary artery Principal cause – atherosclerosis (narrowing of artery)Principal cause – atherosclerosis (narrowing of artery) –Myocardial infarction: heart attack Caused by a coronary thrombosisCaused by a coronary thrombosis When the need for oxygen exceeds the supply, the result is chest pain called angina pectorisWhen the need for oxygen exceeds the supply, the result is chest pain called angina pectoris

13. Recognizing and Treating a Heart Attack Symptoms – shortness of breath, long-term chest pain (angina), numbness in the left side of face and armSymptoms – shortness of breath, long-term chest pain (angina), numbness in the left side of face and arm Diagnosis – ECG, angiogram, MRIDiagnosis – ECG, angiogram, MRI Surgical Treatment – bypass, angioplasty, heart transplantSurgical Treatment – bypass, angioplasty, heart transplant Non-surgical Treatment- platelet inhibitors, aspirin, alcoholNon-surgical Treatment- platelet inhibitors, aspirin, alcohol Cardiopulmonary resuscitation (CPR) is considered an emergency response for heart attack emergencies

14. Stroke (Cerebrovascular Accident) Blood supply to the brain is cut offBlood supply to the brain is cut off Types –ischemic strokes (blockage), hemorrhagic strokes (ruptures)Types –ischemic strokes (blockage), hemorrhagic strokes (ruptures) Diagnosis – CT scan, MRIDiagnosis – CT scan, MRI Treatment – clot dissolving drug therapy (TPAs)Treatment – clot dissolving drug therapy (TPAs)

15. Congestive Heart Failure Swollen heart due to the lack of strength known as Pulmonary edemaSwollen heart due to the lack of strength known as Pulmonary edema Causes – various causes from other illnesses to damaging heart to existing injury to the heartCauses – various causes from other illnesses to damaging heart to existing injury to the heart Treatment – drugs, modified lifestyleTreatment – drugs, modified lifestyle

16. Other Forms of Heart Disease Congenital Heart DiseaseCongenital Heart Disease Peripheral Artery DiseasePeripheral Artery Disease Rheumatic Heart DiseaseRheumatic Heart Disease Heart Valve DisordersHeart Valve Disorders

17. Protecting Yourself Against Cardiovascular Disease Eat Heart-HealthyEat Heart-Healthy Decrease Fat and Cholesterol IntakeDecrease Fat and Cholesterol Intake Increase Fiber IntakeIncrease Fiber Intake Moderate the amount of alcohol consumptionModerate the amount of alcohol consumption Decrease Sodium and increase Potassium IntakeDecrease Sodium and increase Potassium Intake Exercise RegularlyExercise Regularly DASH (Dietary Approaches to Stop Hypertension) Avoid Tobacco Know and manage your Blood Pressure Know and manage your Cholesterol levels Develop ways to handle stress and anger

18. Cancer Most cancers take the form of tumors: a mass of tissues that serve no physiological purposeMost cancers take the form of tumors: a mass of tissues that serve no physiological purpose Benign: cells similar to surrounding normal cells and are enclosed in a membrane that prevents them from penetrating neighboring tissuesBenign: cells similar to surrounding normal cells and are enclosed in a membrane that prevents them from penetrating neighboring tissues Malignant: capable of invading surrounding structures, producing invasive tumors or uncontrolled growthMalignant: capable of invading surrounding structures, producing invasive tumors or uncontrolled growth Cell regulation problem causing abnormal cell growth

19. How Cancer Spreads: Metastasis Metastasis is the spreading of cancer cells which occurs due to the lack of cellular cohesivenessMetastasis is the spreading of cancer cells which occurs due to the lack of cellular cohesiveness They break away and pass through the lining of lymph or blood vessels to invade nearby tissuesThey break away and pass through the lining of lymph or blood vessels to invade nearby tissues These new tumors are called secondary tumors or metastasesThese new tumors are called secondary tumors or metastases

20. Types of Cancer Carcinomas – Arise from epithelia, tissues that cover external body surfaces (organs, skin, nerves, membranes)Carcinomas – Arise from epithelia, tissues that cover external body surfaces (organs, skin, nerves, membranes) Sarcomas – bone, blood, connective tissueSarcomas – bone, blood, connective tissue Lymphomas – immune tissues/systemLymphomas – immune tissues/system Leukemia - blood and blood forming tissues (bone marrow)Leukemia - blood and blood forming tissues (bone marrow)

21. The Incidence of Cancer Each year, 1.4 million people in the United States are diagnosed with cancerEach year, 1.4 million people in the United States are diagnosed with cancer Cancer death rates have dropped more than 10% since 1990Cancer death rates have dropped more than 10% since 1990 The American Cancer Society believes that thousands of cases of colon, breast, and uterine cancer could be prevented by lifestyle changesThe American Cancer Society believes that thousands of cases of colon, breast, and uterine cancer could be prevented by lifestyle changes

22. Lung Cancer Risk FactorsRisk Factors –Smoking –Environmental pollutants PreventionPrevention –Remove smoke element TreatmentTreatment –Surgery –Radiation –Chemotherapy –Medications Full recovery remains unlikely in all but a small percentages of cases

23. Colon and Rectal Cancer Considered the second leading cause of cancer deaths (could arise from pre-existing polyps)Considered the second leading cause of cancer deaths (could arise from pre-existing polyps) Risk FactorsRisk Factors AgeAge HeredityHeredity Lifestyle factorsLifestyle factors Detection and TreatmentDetection and Treatment Removal of polypsRemoval of polyps Yearly stool blood testYearly stool blood test Sigmoidoscopy/colonoscopySigmoidoscopy/colonoscopy SurgerySurgery

24. Breast Cancer Most common cancer in WomenMost common cancer in Women Risk factorsRisk factors –Early menstrual cycle for women –Women with no children or having children later in life –Hormone replacement therapy use PreventionPrevention –Diet –Mammography –Activity levels –Pregnancy and breastfeeding decisions –Occupational hazards –New medications TreatmentTreatment –Lumpectomy –Drug therapy –Chemotherapy/radiation treatments

25. Preventive Measures, cont’d Self checks for breast cancer Breast cancer is still the #1 cancer for women

26. Prostate Cancer Most common cancer in MenMost common cancer in Men Risk factorsRisk factors –Age, dietary fat intake, genetic link PreventionPrevention –Dietary intake of Vitamin E and selenium, drug therapy Early DetectionEarly Detection –PSA screenings, ultrasound rectal exam TreatmentTreatment –Surgery, radiation, implantation of radioactive seeds

27. Cervical Cancer Risk factorsRisk factors –HPV infection –Smoking and socioeconomic factors PreventionPrevention –Sexual abstinence –Pap tests –Careful selection of sexual partners TreatmentTreatment –Surgery (minor or major) –Radiation/chemotherapy

28. Uterine Cancer Risk FactorsRisk Factors –Early menarche, late menopause, lack of ovulation, never having given birth, ERT, use of tamoxifen, and also in diabetics, obese, and hypertensive women PreventionPrevention –Minimize high levels of estrogen and regular physician care TreatmentTreatment –Surgery, radiation, chemotherapy, hormone treatment

29. Ovarian Cancer PreventionPrevention –Similar to what is recommended for breast cancer –Prophylactic oophorectomy Early DetectionEarly Detection –Referred as the “silent cancer” Annual pelvic examsAnnual pelvic exams Genetic screeningsGenetic screenings TreatmentTreatment –Surgery –Chemotherapy –Drug therapy

30. Skin Cancer Considered the most common cancer of allConsidered the most common cancer of all Risk factorsRisk factors –Severe sunburn during childhood, chronic sun exposure during young adulthood (UV) PreventionPrevention –Reduce exposure to sun’s rays, use sunscreens, Early DetectionEarly Detection –Recognition and early diagnosis TreatmentTreatment –Surgery, chemotherapy, interleukin-2

31. Skin Cancer Risk factorsRisk factors –Severe sunburn during childhood, chronic sun exposure during young adulthood PreventionPrevention –Reduce exposure to sun’s rays, use sunscreens, Early DetectionEarly Detection –American Cancer Society guidelines (next slide) TreatmentTreatment –Surgery, chemotherapy, interleukin-2

32. Testicular Cancer Risk factorsRisk factors –Family history, environmental factors PreventionPrevention –Self exams Early DetectionEarly Detection –Observations and self exams TreatmentTreatment –Surgery, chemotherapy, radiation

33. Self checks for testicular cancer Testicular cancer is the #1 cancer for men aged 18-35

34. The Causes of Cancer The Role of DNAThe Role of DNA Role of inheritance of certain genesRole of inheritance of certain genes DNA mutations such as oncogenesDNA mutations such as oncogenes Cancer promotersCancer promoters Dietary FactorsDietary Factors Dietary Fat and MeatDietary Fat and Meat AlcoholAlcohol Fiber intakeFiber intake Fruits and VegetablesFruits and Vegetables Inactivity and Obesity Microbes Carcinogens in the Environment Ingested chemicals Industrial pollution Radiation

35. Detecting Cancer (Figure 16-5) Identify the 7 warning signs of cancer C C hange in bowel/bladder habits A A sore that does not heal U U nusual bleeding or discharge T T hickening of tissues (schlerotic change) I I ndigestion or difficulty swallowing O O bvious change in a wart/mole N N agging cough

36. Diagnosing Cancer Detection begins with a physical examDetection begins with a physical exam Exploratory surgery or a biopsy may be performed to identify a cancer’s stage or the following:Exploratory surgery or a biopsy may be performed to identify a cancer’s stage or the following: MRIMRI CTCT Ultrasonography have been used to view tumors and is considered completely safeUltrasonography have been used to view tumors and is considered completely safe

37. Avoiding TobaccoAvoiding Tobacco Controlling Diet and WeightControlling Diet and Weight Regular ExerciseRegular Exercise Protecting Skin from the SunProtecting Skin from the Sun Avoiding Environmental and Occupational CarcinogensAvoiding Environmental and Occupational Carcinogens Having regular screening examsHaving regular screening exams Preventive Cancer

38. Chapter Twelve Cardiovascular Disease and Cancer