Cardiovascular Disease and Cancer

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Cardiovascular Disease and Cancer

• Chapter 12

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Introduction

• Cardiovascular disease (CVD) is the leading cause
  of death in the U.S.
• One American dies from CVD every 33 seconds
• Nearly half of all Americans will die from CVD
• CVD is the leading cause of death for both men
  and women
• 45 of all heart attacks occur in people under
  the age of 65
• Most of CVD risk is lifestyle-related

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The Cardiovascular System

• Pulmonary circulation
• Blood to and from the lungs.
• Systemic circulation
• Left side of the heart pumps blood through the
  rest of the body.
• Coronary circulation
• Vessels that feed the heart
• Heart has four chambers (size of a fist).
• 2 Upper chambers (Atriums).
• 2 Lower chambers (Ventricles).
• Vena cava (in from the body)
• Pulmonary Artery and Vein. (to and from lungs)
• Aorta. (out to the body)

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Cardiovascular System

• Systole and Diastole.
• action of the heart is controlled by an
  electrical signal which originates in the right
  atrium.
• Veins carry blood back to the heart.
• Except pulmonary
• Arteries carry blood away from the heart.
• Except pulmonary
• Capillaries

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Risk Factors

• Six Major Risk Factors that can be changed.
• Tobacco use.
• Physical inactivity.
• Obesity
• High blood pressure.
• Diabetes
• High levels of cholesterol.
• LDLs and HDLs

• Tobacco use
• Smokers have 2-3 times higher risk of heart
  attack
• Reduces HDLs
• CO displaces O2
• Causes platelets to become sticky and increases
  blood thickness

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Blood Pressure

• High Blood Pressure
• Too much pressure against arterial walls
• Heart has to work harder, weakens, enlarges,
  arteries scar and harden
• Tachycardias.
• 100 or more beats per minute.
• Compromises the ability of the heart to pump
  effectively.
• Ventricles can not completely fill.

• Low Blood Pressure
• Bradychardia
• 60 or less beats per minute
• Poor circulation of the blood
• Lack of 02 throughout to body and brain

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Cholesterol and Activity

• Cholesterol
• Clogs the arteries
• Increased risk of CVD
• LDLs - less than 120 dl/mg
• HDLs - greater than 60 dl/mg
• Total cholesterol should be below 200 dl/mg
• Levels over 240 indicates high risk of CVD

• Exercise reduces risk by
• Lowering LDLs
• Controlling Blood pressure
• Increasing HDLs
• Maintaining weight
• Helps prevent or controls Diabetes

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Other Contributing Factors

• Obesity
• More than 30 above recommended weight.
• Increase strain on the heart.
• Diabetes
• Having doubles the risk of CVD.

• Body weight
• More than 30 above ideal weight
• High cholesterol levels
• High blood pressure
• Excessive strain on the heart
• Fat collected in the torso more dangerous

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Factors Not Controllable

• Heredity - CVD has genetic component high
  cholesterol levels, blood clotting and obesity
• Age - Over the age of 65
• Sex - Men have higher risk earlier in life
• Ethnicity - African Americans have higher risk of
  hypertension Hispanics greater risk of HBP and
  Angina Asians Lower rates of CVD

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Major Forms of CVD

• Hypertension - may cause damage even before it is
  ever detected.
• Atherosclerosis - narrowed by fatty deposits.
  Starts during childhood fat.
• Heart Attack - Coronary thrombosis, coronary
  occlusion or myocardial infarction. Vessels in
  the heart become blocked.
• Stroke - Impeded blood supply to a part of the
  brain.
• Congestive Heart Failure - Blood backs up in the
  veins leading to the heart, causing fluid
  retention in various body parts.

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Major Forms of CVD

• Angina Pectoris - Chest pain heart doesnt get
  enough O2. (Kehrs sign.).
• Arrhythmias - Abnormal Heartbeat - Disruption of
  the electrical system - can lead to sudden death.

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Detecting and Treating Heart Disease

• Electrocardiogram (ECG or EKG)
• Magnetic Resonance Imaging (MRI)
• Angiogram
• Balloon Angioplasty
• Coronary Bypass Surgery
• Helping a victim of heart attack
• Most die within 2 hours from time of first
  symptoms.
• Cardiopulmonary resuscitation (CPR)

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Cerebrovascular Accident (CVA)

• Ischemic stroke
• Thrombotic stroke clot forms in a cerebral artery
• Embolic Stroke - wandering blood clot
• Hemorrhagic stroke- blood vessel ruptures in the
  brain
• Aneurysm
• Effects of a stroke
• 600,000 Americans per year
• One-third die within a year
• Those who survive have some lasting disability.

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Stroke

• Stroke Warning Signs
• Sudden numbness or weakness of face, arm, leg or
  one side of the body
• Loss of Speech or difficulty speaking
• Dimming or loss of vision in one eye
• Unexplained dizziness in relation to other
  symptoms

• Detecting and treating a stroke
• Transient ischemic attack (TIA)
• Computed tomography (CT)
• Rehabilitation
• Physical therapy
• Speech and Language therapy
• Occupational therapy

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Congestive Heart Failure

• Number of conditions
• Pulmonary edema - Fluid accumulates in the lungs.
• Heart can not maintain regular pumping rate
  fluid backs up.
• Controlled by Reducing cardiac load, eliminating
  excess fluid, restriction of salt and drug
  therapy.

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Heart Disease in Children

• Congenital Heart Disease
• Most common are holes between the ventricles.
• Congenital narrowing of the aorta.
• Hypertrophic Cardiomyopathy
• Rheumatic Heart Disease - Streptococcal
  infections causes damage to the heart muscle and
  valves.
• Strep throat needs to be treated, primary cause
  if not treated.
• Heart Valve Disorders
• Mitral valve prolapse

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What is Cancer?

• Definition an abnormal and uncontrollable growth
  of cells or tissue that can lead to death.
• Tumor a mass of tissue that serves no purpose.
• Malignant tumor (Neoplasm) cancerous, can invade
  surrounding tissues.
• Benign tumor mass of cells enclosed in a
  membrane that prevents their penetration of other
  tissues.

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How Cancer Spreads

• Metastasis Primary tumor
• Definition the spreading of cancer cells, occurs
  because cancer cells do not stick to each other
  as strongly as normal cells.
• Cells break away from primary tumor and invade
  surrounding tissues or travel through the blood
  and lymphatic system.
• Secondary tumor or metastases

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Types of Cancer

• Malignant Tumors
• Classified according to the types of cells.
• Initially retain some of the original properties
  of the host cell.
• Carcinomas - most common - start from the
  epithelial tissue that cover body surfaces.
  Linings, tubes, cavities and secretion glands.
• Sarcomas arise in connective and fibrous
  tissues. Bone, muscle, cartilage and membranes
  covering muscle or fat.
• Lymphomas Cancers of the lymph nodes.
• Leukemia cancer of the blood-forming cells in
  bone marrow.

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The Incidence of Cancer

• 1.3 million Americans are diagnosed yearly
• More than half will be cued.
• About 40 will die as a result of cancer.
• 1 in 2 men and 1 in 3 women will be develop
  cancer during their lifetime.

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Lung Cancers

• Most common cancer.
• Risk Factors
• Tobacco smoking contributes to 87.
• Environmental carcinogens.
• Detection and Treatment (Difficult)
• Symptoms are not detected until cancer has
  reached the invasive stage.
• Persistent cough, chest pain, or recurring
  bronchitis.
• Diagnosis - chest x-ray or sputum examination -
  fiber-optic bronchosectomy.
• Treatment - Difficult to treat- removal of
  involved cells - Typically cancer cells have
  already spread - Very resistant to chemotherapy.

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Colon and Rectal Cancers

• Second most prevalent cancer.
• Risk Factors
• Directly linked to diet and genetic
  predisposition.
• Mostly occurs after 50 yr. of age.Diet low in fat
  and High in fiber - best defense.
• Up to 1/3 of the population is genetically prone.
• Detection and Treatment

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Breast Cancers

• Second most common cancer in women 19 American
  women will have it during her lifetime.
• Risk Factors
• Most common in women over 50
• 5 year survival rate is 79
• Disease of Civilization
• Common causes Genetic predisposition High fat,
  High calorie diet and Sedentary lifestyle,
  Alcohol use, early onset of menstruation, First
  child after 30 and obesity
• Estrogen -cancer in estrogen-responsive sites
• Detection and Treatment

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Breast Cancer continued

• Three part program for early detection.
• Monthly breast self-exam for all women over 20.
• Clinical breast exam by a physician every 3 yr.
• Mammography- Every 1-2 years 40-50 yr. old.
• Over 50 every year.
• New Strategies for Treatment and Prevention

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Prostate Cancers

• Most common cancer in men. Third leading cause of
  cancer deaths in men
• Risk Factors - Age, diet, lifestyle and genetic
  predisposition
• Early detection is key. PSA Blood test
• Treatment - surgical removal of the prostate and
  radiation

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Cancer of the Uterus, Cervix or Ovaries

• Cervical cancer - sexually transmitted.
• 80 stems from infection by the papillomavirus -
  transmitted by unprotected sex.
• PAP Test
• Cervical cancer most common in women in their
  20s and 30s.
• Factors sexual intercourse before 18, multiple
  sex partners, cigarette smoking and low
  socioeconomic status.

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Common Cancers

• Uterine, or Endometrial
• Occurs after 55
• Determined by Pelvic Exam
• Treatment is surgery
• Ovarian Cancer Difficult to detect and
  diagnosis, No warning signs
• Family history or genetic factors
• Determined by Pelvic Exam
• Treatment is surgery radiation

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Skin Cancers

• Most common form
• Easily detected and highly curable
• Exposure to ultraviolet rays during childhood
• Common cause - sunburns and suntans
• Types
• Basal and Squamous
• Melanoma - more dangerous form
• Prevention
• Detection and Treatment

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Common Cancers

• Oral Cancer
• Testicular Cancer
• Pancreatic Cancer
• Stomach Cancer
• Bladder Cancer
• Kidney Cancer
• Brain Cancer

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Common Cancers

• Leukemia
• Cancers of the blood forming tissues
• Abnormal production of immature white blood
  cells rapidly growing cells displace red blood
  cell precursors
• Immature WBCs cannot fight off infections
• Risk factors are unknown

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Common Cancers

• Lymphoma
• Arising from the lymph cells
• Hodgkins disease
• Non-Hodgkins disease
• Multiple Myeloma
• Malignant plasma cells produce tumors in the bone
  marrow.
• Leads to anemia, excessive bleeding and decreased
  resistance to infection

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Detecting, Diagnosing, and Treating

• Detecting
• Self-monitoring
• Diagnosing
• Biopsy
• Magnetic resonance imaging (MRI)
• Computed tomography (CT)
• Ultrasonography

• Treatment
• Surgery
• Chemotherapy
• Radiation Therapy
• New and Experimental
• Gene therapy
• Bone marrow and Stem Cell transplants
• Biological therapies

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Cancer Survivors

• Must live with fear of recurrence
• Face prejudice from health insurers
• Psychological support is important
• Financial impact

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Prevention

• Lifestyle choices
• Avoid tobacco
• Control diet and weight
• Regular exercise
• Protecting skin from the sun
• Avoiding environmental and occupational
  carcinogens
• Regular self exams
• Medical screenings
• Be aware of the early signs and symptoms

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