Transcript Chapter Eleven - McGraw Hill Higher Education

Chapter Ten:
Living With Cancer and
Chronic Conditions
© 2011 McGraw-Hill Higher Education. All rights reserved.
Cancer
Cell regulation problem causing
abnormal cell growth
• Regulatory genes
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Genes that control cell specialization,
replication, DNA repair, tumor suppression
• Oncogenes
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Faulty regulatory genes believed to
activate the development of cancer
• Proto-oncogenes
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Normal regulatory genes that may become
oncogenes
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Oncogene Formation
• Three mechanisms:
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Genetic mutations
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Miscopying of genes during cell division
Viral infections
HIV
 HPV
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Carcinogens
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The Cancerous Cell
•Characteristics:
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Infinite life expectancy due to telomerase
Lacks contact inhibition
Spreads to distant sites via metastasis
Commands the circulatory system to
provide additional blood supply
(angiogenesis)
Benign tumors do not spread but can be
dangerous if they crowd out normal tissues
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How Cancer
Spreads
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Types of Cancer
• Carcinomas: 85% of all cancers (organs,
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skin, nerves, membranes)
Sarcomas: Bone, blood, connective tissue
Lymphomas: Immune tissues/system
Leukemia: Blood and blood forming tissues
Melanoma: Sun exposure affecting the
melanin of the skin
Neuroblastoma: Originates in the CNS
Adenocarcinoma: Cells of the endocrine
glands
Hepatoma: Originates in the cells of the
liver
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Cancer Cases and Deaths
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Skin Cancer
• Risk factors
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Severe sunburn during childhood, chronic
sun exposure during young adulthood
• Prevention
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Reduce exposure to sun’s rays, use
sunscreens, avoid tanning booths
• Early detection
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Self-examination (see next slide)
• Treatment
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Surgery, chemotherapy, interleukin-2
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Self-Examination for Melanoma
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Normal Mole versus Malignant Melanoma
Melanoma characteristics:
• A is for asymmetry
• B is for border irregularity
• C is for color (change)
• D is for diameter > 6 mm
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Lung Cancer
• Risk factors
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Smoking
Environmental pollutants (radon)
Genetic predisposition
• Prevention
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Don’t smoke and avoid environmental tobacco
smoke
• Treatment (low success rate)
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Surgery
Radiation
Chemotherapy
Medications
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Colorectal Cancer
• Risk factors
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Genetic susceptibility
Dietary habits
Smoking, alcohol consumption
• Prevention
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Removal of polyps, exercise, dietary changes
• Early detection
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Rectal exams, stool tests, sigmoidoscopy,
colonoscopy
• Treatment

Surgery, radiation, chemotherapy
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Breast Cancer
• Risk factors
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Early onset of menstruation, late menopause
Having no children or first child later in life
Use of hormone replacement therapy
Specific genetic mutations
 BRCA1
 BRCA2
Family history
Obesity, sedentary lifestyle
High degree of breast density
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Breast Cancer
• Prevention
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Dietary choices, limit on alcohol use
Activity levels
Pregnancy and breastfeeding decisions
Avoidance of occupational toxins
New medications
Prophylactic mastectomy (for some women at
very high risk)
• Early detection
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Breast self-examination
Mammography
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Breast Self-Exam
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Breast Cancer
• Treatment
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Surgery
Chemotherapy
Radiation therapy
Hormone therapy
Targeted therapy
Herceptin
 Gleevac
 Avastin
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Prostate Cancer
Location of the Prostate Gland within the
Male Reproductive System
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Prostate Cancer
• Risk factors
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Age, African American ethnicity, family history,
dietary fat intake
• Prevention
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Moderation of fat intake, increased intake of
vitamin E and selenium, drug therapy
• Early detection
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Prostate-specific antigen (PSA) tests, ultrasound
rectal exam
• Treatment
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Surgery, radiation, brachytherapy (radioactive
seeds)
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Testicular Cancer
• Risk factors
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Family history, environmental factors,
undescended testicles
• Prevention
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Self-exams, correction of undescended
testicles in children
• Early detection
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Self-exams, awareness of symptoms
• Treatment
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Surgery, chemotherapy, radiation
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Testicular Cancer: Self-Examination
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Cervical Cancer
• Risk factors
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HPV infection
Smoking, socioeconomic factors
• Prevention
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Sexual abstinence
Careful selection of sexual partners
• Early detection of precancerous cellular
changes
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Pap tests
• Treatment
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Surgery (minor or major)
Radiation/chemotherapy
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Uterine Cancer
• Risk factors
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Early menarche, late menopause, infertility, never
having given birth, use of estrogen replacement
therapy or tamoxifen, obesity, polycystic ovary
syndrome, hereditary nonpolyposis colon cancer
• Prevention
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Minimize high levels of estrogen, regular
gynecological care
• Treatment
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Surgery, radiation, chemotherapy, hormone
treatment
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Ovarian Cancer
• Prevention
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Similar to what is recommended for breast cancer
Prophylactic oophorectomy
• Early detection (“silent”)
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Annual pelvic exams
Awareness of potential symptoms
Tests
 OvaSura, CA125, and HE4
Genetic screenings
• Treatment
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Surgery, chemotherapy, drug therapy
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Pancreatic Cancer
• Risk factors
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Male gender, smoking, high-fat diet, high alcohol
consumption
• Prevention
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Abstaining from tobacco and alcohol, exercise,
weight management
• Early detection (no early symptoms)
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CAT scan
• Treatment
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No effective treatment at this time
Surgery, radiation, chemotherapy
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Lymphatic Cancer
• Risk factors
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Reduction of immune system protection,
exposure to pollutants, viral infections
• Prevention
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Limit exposure to chemicals
• Early detection
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Enlarged lymph nodes, fever, weight loss
• Treatment
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Radiation, chemotherapy, stem cell
transplant
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Treatment of Cancer
• Surgery
• Radiation
• Chemotherapy
• New therapies
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Preventive Measures
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Know your family history
Select and monitor your occupation carefully
Do not use tobacco products
Monitor environmental exposure to
carcinogens
Follow a sound diet
Control your body weight
Exercise regularly
Limit your exposure to the sun
Consume alcohol in moderation, if at all
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Chronic Conditions
Systemic Lupus
Erythematosus (SLE)
Autoimmune disorder in which
the body attacks itself for no
reason; affects women more than
men; treated with long-term nonsteroidal anti-inflammatory drugs
Inflammatory Bowel
Disease
Inflammatory bowel disease
leading to abdominal pain and
discomfort; treatable with
medication
Multiple Sclerosis (MS)
Progressive disease that causes
the myelin to be destroyed,
leading to disrupted neurological
function. Treatment includes
immune targeted drugs, nerve
blockers, and physical therapy
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Diabetes Mellitus (Type 2)
• Body is insensitive to insulin
• Symptoms (develop gradually)
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Thirst
Hyperglycemia
Frequent urination
• Management
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Dietary modification
Exercise
Drug therapy
• Diagnosis: Urine and blood tests
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Diabetes Mellitus (Type 1)
• Pancreas produces no insulin at all
• Symptoms (develop rapidly):
Weakness, thirst, hunger, frequent
urination
• Management: Insulin must be
obtained by injections or pump
• Diagnosis: Urine and blood tests
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Sickle Cell Trait/Sickle Cell Disease
• 8% of African Americans carry recessive gene
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for sickle-cell trait
Red blood cells cannot pass through blood
capillaries (sickle-shaped RBCs)
Symptoms: Impaired lung function, heart
failure, infections, bone changes
Management: Drug therapy, stem cell
transplant
Diagnosis: Blood test
Prevention: Screening for the recessive gene
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Alzheimer’s Disease
Organic brain syndrome associated with aging;
symptoms such as memory loss, confusion,
and dementia are common; treatments are
still relatively experimental
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Chapter Ten:
Living With Cancer and Chronic Conditions
© 2011 McGraw-Hill Higher Education. All rights reserved.