Chapter 12 Cancer

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Chapter 12Cancer

• Reducing Your Risks

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CANCER
NON-COMMUNICABLE DISEASES
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CANCER a large collection of Illnesses

• ONE COMMON TRAIT
• a loss of cell cycle control
• A SINGLE abnormal cell replicates to create
  others like itself

• Cluster into a Mass Cancerous / Malignant
• Can travel through the blood stream
• Cancer probably in everyone - single cell
• Immune system intervention

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Cells Out Of Control

• Cells from Henrietta Lacks, 1951- still dividing
  and used in many laboratories
• A few of her cells will take over other tissues
  in the lab
• Divide faster than their natural state
• .., dont stop

• Cell division is controlled rigorously
• Cell stops LISTENING to controls
• Gene 1- Oncogenes -promote cell division
• Gene 2 - Tumor Suppressor - inactivate or remove
  constraints on cell division

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Genes Out Of Control

• Proto-oncogenes - promote positive controlled
  cell division
• Add a Mutation and the Gene Changes to an ONCO
  (cancer) GENE
• Tumor Suppressor Genes - Chromosomal deletions
  and loss of gene function

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CHARACTERISTICS

• Tumors grow at fast rates
• Early detection imperative (size of a pea)
• If 99 of a Tumor is removed - millions of cancer
  cells remain
• Transplantable - movement within the body - other
  tissues!

• DEDIFFERENTIATED
• Skin - rounder, softer colour
• Density-Dependent Inhibition - dont stop when
  over crowed
• Invasiveness - squeeze into available space
• Anchor to Basement Membranes - secrete chemicals
  / cut through healthy tissue

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Inherited vs. Sporadic Cancer

• Cancer Susceptibility Gene is passed on to
  children
• Constitutional mutation present in every cell not
  active!
• Until a Second Mutation Occurs
• Smokers - some develop cancer
• many do not

• Sporadic Cancer is not passed to children
• TWO INDEPENDENT MUTATIONS required

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Cancer

• 2nd leading cause of death approximately
• (60,700) Canadians died
• in 1997 from cancer
• 1/3 related to tobacco
• 72 in people older than 60 years of age

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Three Groups a survival rating!

• Good Prognosis breast, prostrate, bladder,
  melanoma, body of the uterus, cervix, Hodgkins
  Disease, testes, and male bladder
• Fairly good prognosis colorectal, non-Hodgkins
  lymphoma, kidney, oral, larynx, female bladder.
• Poor prognosis lung, stomach, adult leukemia,
  pancreas, ovary, brain, and multiple myeloma

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Cancer Risk..

• Risk not equal / reflects age, sex, race,
  socioeconomic status
• responsible for majority of deaths - children
  3-14 years of age than any other disease

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Terminology

• neoplasm new growth of tissues / no
  physiological function related to original cells
  / tissues
• cells undergo abnormal change and grow into
  tumors (either benign or malignant)
• mutant cells differ from original cells in
  form, quality, or function
• malignant tumors are cancerous interfere with
  RNA/DNA in nucleus, causing cells to grow out of
  control or unregulated growth

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Terminology

• benign tumors are not cancerous however, benign
  tumors must be watched carefully - can change
• biopsy (remove a section) only way to determine
  if tumor is malignant
• oncogenes suspected cancer causing genes
  present in chromosomes

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Terminology..continued

• proto-oncogenes genes with the potential to
  become oncogenes
• oncologists physicians who specialize in the
  treatment of malignancies

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CANCER DEVELOPMENT

• Localized / pea size ( Best Time to Remove or
  Treat)
• progresses to surroundings regions
• .IF NOT DETECTED THEN.METASTASIS!!!
• detached cancer cells that are spread to other
  parts of body in lymph or blood systems
• if removed - millions of cancer cells remain!!!!!

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WHAT CAUSES CANCER ?

• Hereditary AND/OR Environmental
• Immune theory
• cancerous cells appear in body
• randomly and usually dealt with by immune system
• weakened immune system let these cells take
  hold
• factors such as vitamin status, extreme chronic
  fatigue, stress and carcinogens

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WHAT CAUSES CANCER?

• Virus theory
• associated with some animal cancers and several
  human cancers
• most humans carry viruses that have
  cancer-causing potential normally dormant
• Viral - Hepatitis B, AIDS.

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Cancer Causing Agents

• Carcinogens
• Mutating Genes
• environmental factors e.g. radiation, asbestos,
  industrial solvents, tar, coal dust, tobacco,
  etc.

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FACTORS ASSOCIATED WITH CANCER DEVELOPMENT

• Biological causes
• genetic link - familial patterns
• family history certain types of cancer run in
  families
• gender - breast, stomach, colon, and prostate
  cancers
• cell mutations (lung cancer was unheard of in
  women - but now present as a result of tobacco)

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Biological Reasons

• chemicals in processed food sodium nitrate
  (prevents botulism) gt nitrosamines formed during
  digestion gtcancer causing factors
• agricultural practices pesticide / herbicide gt
  residue on produce.

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Occupational Factors

• asbestos / radiation / coal tar / certain dyes,
  etc, etc.
• about 5 of all cancers from occupational factors
• construction, automotive, insulation / industrial
  waste

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Psychosocial Factors

• Psychosocial factors
• a negative emotional state may aggravate the
  disease process e.g. lonely/depressed
• also lifestyle e.g. stress, substances,
  exercise/lack of exercise

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Diet

• Diet
• low fiber high meat diets in particular
• may account for 60 of cancer in women and 40 in
  men.

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RECOMMENDATIONS FOR PREVENTION

• Nutrition
• reduce fat
• eat appropriate amounts of fiber
• sufficient vitamins A C
• sufficient vegetables (roughage)
• reduce consumption of salt and salt-cured foods
• maintain healthy weight
• moderate alcohol consumption

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COMMON CLASSIFICATIONS OF CANCER

• CARCINOMAS
• cancer of epithelial cells - tissues covering
  body surfaces and lining body cavities
• mouth
• skin
• lung
• breast

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SARCOMAS..

• Cancer of mesodermal layer (middle layers of
  tissues) such as bone, connective tissue and
  layers of tissues
• metastasize via blood during early stages
• rare form of cancer (solid tumor)

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LYMPHOMAS

• Cancer of the lymph
• system, e.g. Hodgkin's disease
• the infection fighting regions of the body
• solid tumors

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LEUKEMIA

• Cancer of blood forming parts of body such as
  bone marrow and spleen
• non-solid tumor formation
• dramatic increase in White Blood Cells

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COMMON CANCER SITES

• LUNG
• leading cause of death due to cancer for men and
  women smoking
• smoking 90 of male lung cancers, 79 of female
  lung cancers
• smokers have 12 to 25 times the death rates of
  non-smokers

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Lung Cancer

• incidence of lung cancer in females increasing
• symptoms are persistent cough, chest pain, and
  recurring pneumonia/bronchitis
• surgery the treatment of choice
• prognosis poor
• one third experience metastasis

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Fresh Air !!!

• difficult to treat
• only 13 alive and well after 5 years from
  diagnosis
• prevention quit smoking
• BEST PREVENTION
• Dont START!!!!!!

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COLON AND RECTUM

• high incidence
• ulcerative colitis (ulceration and inflammation
  of large intestine) and congenital polyposis
  (polyps, tumors, grow in rectum)
• diet - low fiber / high processed
• symptoms rectal bleeding, constipation or
  diarrhea, abdominal discomfort

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COLON AND RECTUM

• stoma surgically designed opening / abdominal
  wall to excrete body wastes collected in a bag
• Treatment Surgery (colostomy) - rectum and part
  of colon
• Radiation and Chemotherapy
• Prevention healthy diet, exercise testing

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BREAST CANCER

• leading site of cancer in women
• Risks family history
• smoking
• first child after age 30
• lump in breast or discharge from nipple
• age over 35

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Breast Cancer. Treatment

• lumpectomy
• Simple mastectomy
• (remove entire breast)
• Modified Radical
• Mastectomy (remove breast,
• and lymph nodes of armpits)
• Radical Mastectomy (remove
• breast, lymph nodes and muscles)

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UTERINE CANCER

• cancer of cervix (neck of uterus) and endometrium
  (body of uterus)
• most preventable is cancer of cervix
• greatest in low socio-economic groups
• multiple sex partners
• Pap test - diagnose - undetected in pre-cancerous
  state

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PROSTATE CANCER

• men over 50
• symptoms urinary obstruction / urinary
  infections
• surgery primary treatment
• drugs to shrink tumor

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TESTICULAR CANCER

• occurs in late adolescence and early adulthood
• genetic predisposition
• early detection / self examination

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SKIN CANCER - SEVERAL TYPES(Malignant Melanoma)

• basal and squamous highly curable
• melanomas are serious - dark brown
• or black pigmentation
• risks fair skin tanning salons, sun
• lamps and sunbathing are high-risk
• behaviors
• sun-block / stay out of the sun!
• treatment surgery / radiation /
• cryotherapy
• Perception that a Tan looks healthy

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ABCDs of Moles

• A - asymmetry
• (1/2 different other 1/2)
• B - border irregularity
• (ragged, uneven, dimpled)
• C - Colour
• (Pigmentation not uniform)
• D - Diameter (lt6mm)

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ORAL

• Cancer- lips, lining of cheeks, gums, tongue
  throat
• Chewing tobacco
• Smoking tobacco

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LEUKEMIA

• Cancer - blood forming tissues - immature white
  blood cells crowd other cells (WBCs, RBCs,
  Platelets etc)
• Affect men women / all ages
• symptoms
• enlarged lymph nodes /spleen / liver
• fatigue / weight loss / frequent infections /
  easy bruising and nosebleeds

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BIOPSY

• sample of tumor removed for analysis
• best results when cancer is localized
• early detection of cancer best
• removal of the tumor other treatments if
  spreading

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CANCER TREATMENT

• CHEMOTHERAPY
• use of drugs to treat
• works very well for some forms of cancer
• many side effects - not pleasant!

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RADIOTHERAPY

• x-ray treatment
• x-rays - destroy
• abnormal cells
• x-rays - minimal effect
• on normal cells

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IMMUNOTHERAPY

• enhances body's immune response to cancer cells
• Stress
• since cells are from the host body immune system
  may not recognize and attack cancer cells

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CANCER'S SEVEN WARNING SIGNALS

• a change in bowel or bladder habits
• a sore that does not heal
• unusual bleeding or discharge
• thickening or lump in breast or elsewhere
• indigestion or difficulty swallowing
• obvious change in wart or mole
• nagging cough or hoarseness
• If you have a warning signal see your doctor!

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PREVENTION IS THE KEY

• DON'T smoke.
• if you do then QUIT!!!!!!
• Eat a balanced diet
• Regular checkups
• Investigate any lumps or sores
• Protect against excess sunlight
• Avoid cancer-producing substances (if possible)
• Self examinations