Transcript Cancer and Chronic Disease

THE BIG “C”
Cancer is the second leading cause
of death among American women of all
ages. Cancers of the breast, colon, rectum,
ovaries, cervix and uterus are the most
common cause of premature morbidity for
women. Prognosis depends on the: Nature
of the tumor: Location: Stage at time of
discovery.
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Facts About Cancer and Women
• 1 in 3 women can expect to have cancer in her lifetime
• 50% of cancer cases involve the female reproductive tract
• 2 of the main ways cancer is detected is through Pap Smears and
Mammograms
• Denial is a common reaction
• The word cancer is so stigmatized that it evokes very strong emotions
• The key is PREVENTION AND EARLY INTERVENTION
• Most tumors are benign which means non-cancerous and harmless
• Cancer is uncontrolled growth of a cell and reproduction of itself and
abnormal development of cells that may be harmless or malignant
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CLASSIFICATION OF
CANCERS
• Cancers are classified according to the part of the body in
which they originate
• The World Health organization has Identified 46 body sites
and @ 100+ different cancers
• The 4 most common categories of cancer are:
• Carcinoma - Most common glandular or epithelial
• Sarcoma - Connective tissue either bone or soft tissue
• Lymphoma - Lymphatic system
• Leukemia - Blood forming tissues, may mimic other
diseases such as Mono., Tonsillitis, Mumps, and others
• Tumors are either IN SITU or Invasive, cancer has spread
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to other tissues
CANCER
7 WARNING SIGNS OF
CANCER
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C - Change in Bowel or bladder habits
A - Sore that does not heal
U - Unusual bleeding or discharge
T - Thickening or lump in breast or elsewhere
I - Indigestion or difficulty swallowing
O- Obvious change in wart or mole
N - Nagging cough or hoarseness
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CAUSES OF CANCER
• EXTERNAL Chemicals, radiation, viruses
• INTERNAL Hormones, immune conditions,
inherited
• Lifestyle and environmental factors: which
account for the most cancer risk
• Cigarette smoking which remains the most
significant factor in premature death of women:
• 87% of lung cancer deaths
• 29% of all cancer deaths
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CANCER DIETARY FACTS
• 1/3 of all cancer deaths in the U.S. relate to dietary factors
• Types of food consumed and amount of fat are risk factors
for some cancers in women, particularly breast cancer
• Fat calories should not exceed 30% of the total with no
more that 10% in saturated fat
• Fruits and Vegetables - of many deep colors
• Fibrous, cruciferous, soy products and legumes are
protective factors against cancers of the gastrointestinal
and respiratory tracts
• 5 A Day Plan or more servings of fruits and vegetables for
low fat and high fiber diet
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ENVIRONMENTAL FACTORS
• Radiation X rays are linked to radiation leukemia,
breast cancer, lung cancer
• Limiting exposure is prudent
• Exposure to sun and ultra-violet rays are linked to
skin cancer
• UV radiation causes most cases of basal and
squamous cell skin cancer and contributes
significantly to melanoma
• Hair dyes used for black hair for over 20 years
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CONTRIBUTING FACTORS
• The following factors have been implicated as carcinogens:
(substances that can cause growth of cancer)
• High fat diet
• Tobacco results in cancer of the mouth, esophagus, liver, larynx, and
stomach
• Age over 50% of all cancers occur in persons over age 65 and
probability for all sites increases with older age
• Viruses- e.g. HPB, HSV, HPV linked to cervical cancer plus many
others
• Alcohol consumption
• Pesticides, asbestos, formaldehyde
• Estrogen replacement
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PROTECTIVE FACTORS TO
FIGHT
AGAINST
CANCER
Do not smoke
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• Live with a nonsmoker
• Avoid smoke filled rooms
• Maintain your desirable
weight
• Eat a wide variety of
foods
• Eat in moderation
• High fiber diet-fruits and
vegetables
• Limit fat and alcohol
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• Consume little or no salt
cured, smoked or nitrite
cured foods
• Limit exposure to UV
• Limit exposure to
industrial agents
• Get cancer related checkups regularly
• Have Pap test and pelvic
exam
• Practice monthly BSE
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LUNG CANCER
• It has surpassed breast cancer as the leading cause
of cancer death in women
• All due to INCREASE IN CIGARETTE
SMOKING!
• Passive secondary smoke is also deadly
• Exposure to radon and other occupational
substances
• Chromium, coal products, oxide, nickel, mustard
gas, petroleum, uranium
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SIGNS AND SYMPTOMS
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Persistent cough
Blood in sputum
Chest pain
Recurring pneumonia or bronchitis
By the time the above symptoms occur, lung
cancer is in advanced stages
• This makes early detection almost impossible
• Prognosis for survival of lung cancer is poor
• A combination of surgery, radiation, and
chemotherapy is used to arrest cancer spread
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BREAST CANCER
• Second leading cancer killer of all women
• 85-95% of all women who develop BC have no family
history of the disease
• Afro-American women experience greater death rates from
breast cancer and overall cancer incidence
• All women are at risk for being a women and getting older
• Early detection of lumps or thickening in breast
• Regular screening mammograms
• Monthly breast self exams
• Immediate treatment if breast cancer is diagnosed
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RISK FACTORS
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Family history
Never having children
Having first child after age 30
Menarche before age 12
Menopause after age 55
History of some form of benign breast disease
High fat diet
Heavy alcohol consumption
Sedentary lifestyle
Obesity- over fat
Change in size or shape of breast, nipple discharge, change
in color or texture of
areola
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CANCER
5 LEVELS OF BREAST
CANCER
• Level 1 IN SITU stage is mammogram detectable
• Level 2 Stage 1 cancer remains localized to breast smaller
than 2 cm in size and has not spread to lymph nodes
• Level 3 Stage 11 cancer tumors are 2-5cm in size, and if
smaller than 2cm but spread to lymph nodes
• Level 4 Stage 111 tumors are over 5cm or have grown into
chest walls, skin or distant lymph nodes
• Level 5 Stage 1V tumors have spread to other parts of the
body
• 5 year survival rate drops with size and invasiveness of
tumor
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MAMMOGRAPHY
• Image of breast produced by low dose x-ray
• Concern is the potential carcinogenic cancer causing effect
of regular irradication of breast tissue from X-rays
• Possible to detect lump up to 2 years before a lump can be
felt
• Breast implants impede the effectiveness of a mammogram
• High frequency of false positive tests
• Advantages of mammography far out weigh disadvantages
of pain, unnecessary biopsies, time, and expense
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BIOPSIES
• False positive tests are common due to denseness of breast
tissue
• False negative tests are rare
• When a lump is detected, a second mammogram may be
required
• A lump can only be classified as benign or malignant
through a biopsy
• A biopsy is the use of a fine needle injected into the lump
and aspirated into a syringe
• The lump is either solid or fluid
• This is the only method to determine of cancer cells are
present
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CANCER
RADIATION
• Radiation uses high energy rays focused in
a beam used to stop reproduction
• It shrinks size and kills any remaining
cancer cells
• Radiation can cause fatigue
• Skin rashes
• Decrease WBC’s
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TREATMENT
• RADIATION
• CHEMOTHERAPY
• ADJUVANT
THERAPY
• SURGERY
INCLUDES:
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• LUMPECTOMY
• SIMPLE
MASECTOMY
• MODIFIED
RADICAL
MASECTOMY
• RADICAL
MASECTOMY
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SURGERY
• Surgery is still the primary treatment based on the stage of
cancer
• Preference is for conserving the breast with chemotherapy
and hormone therapy
• Women’s preference for lumpectomy or mastectomy
• Lumpectomy involves removal of part of the breast with
cancer and surrounding margin of breast tissue
• Modified radical mastectomy is removal of breast and
lymph nodes only
• Radical mastectomy is removal of entire breast, lymph
nodes, under arms, underlying chest wall muscles
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PAP SMEAR TEST
• A Pap Test is a screening test that can be effective
as an early detection method
• Abnormalities of the cervix are detected via the
cells sent to lab for analysis
• If abnormal cells are detected a biopsy is
performed to establish firm diagnosis
• Pre cancerous cell changes can be detected before
cancer actually develops in the cervix
• Paps can only detect portions or none of the
endometrial cancer cells
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CERVICAL DYSPLASIA
• Dysplasia is precancerous cell changes
• It can be classified as mild, moderate, or severe
• Cryosurgery, a freezing process is used to treat
mild or moderate dysplasia
• Severe dysplasia is likely to become cancerous
• Carcinoma -in-situ involving only outer layer of
skin
• Both dysplasia and carcinoma in-situ have nearly
100% cure rate
• Survival rate drops with invasive conditions
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CERVICAL CANCER
• Risk Factors include:
• Early and continued sexual activity with multiple
partners
• Age of first intercourse
• Genital herpes HSV2
• Genital warts HPV
• Frequent cervical infections
• Cigarette smoking
• Low socioeconomic status
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UTERINE CANCER
• CERVICAL AND ENDOMETRIAL cancers are
the most common types of Uterine Cancer
• Fibroids are benign tumors composed of muscular
and fibrous tissue in the uterus
• Hysterectomy is the surgical removal of the uterus
• Cervical Cancer is nearly 100% curable
• Endometrial Cancer is @ 94% curable and is most
common in women over 50
• Cervical carcinoma is one of the AIDS defined
illnesses
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ENDOMETRIAL CANCER
Risk Factors include:
Infertility problems
Ovulation failure
Family history
Never having children
Estrogen replacement therapy for 2 years without
progesterone
• Late menopause after age 55
• Combination of HBP, diabetes, and obesity
• Tamoxifen induced
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WARNING SIGNS of ENDOMETRIAL
CANCER
• Dysplasia or precancerous cell condition
• Changes in the cells
• May be detected in Pap smears years before onset
of cancer
• Abnormal vaginal bleeding
• Irregular bleeding
• Pelvic exam is imperative as Pap smears my not
always detect cancer
• Treated by surgery, radiation, hormones and or
chemotherapy
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OVARIAN CANCER
• Rare, yet causes more deaths than any other
gynecological cancer and prognosis is poor
• Risk Factors include:
• Women over age 50
• White women are more at risk
• Family History
• History of irregular menstrual periods
• Never having children
• Previous breast, colon, or endometrial cancer
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Use of fertility drugs
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OVARIAN CANCER 2
• Protective Factors include:
• Pregnancy, breast feeding, tubal sterilization and
Birth control pills
• Ovarian cancer is known as the silent killer
• It can only be detected in the later stages
• Early Warning signs include:
• Swollen abdomen, fluid retention, abnormal
vaginal bleeding and persistent digestive
disturbances, gas bloating and pelvic pressure
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SKIN CANCER
• It is the most prevalent and curable cancer found in women
• Can also be found on the epithelium of the lungs, anus,
cervix, larynx, nose and bladder
• There are two two types of cell cancer:
• Squamous, small round and raised areas, red and crusty or
sore that will not heal in the center and
• Basal, white or gray, small round or oval patches and firm
• 90% of squamous cell cancer is preventable with
protection from the sun
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RISK FACTORS
• Severe sun burning during childhood
• Excessive exposure to sunlight during
adolescence
• Fair of lightly pigmented skin
• Occupational exposure to some products
• Family history
• To protect oneself use sunscreen SPF 15 or
higher
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CANCER
TREATMENT FOR SKIN
CANCER
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Look for the following signs:
A is for asymmetry
B is for border irregularity
C is for color change
D is for diameter greater than 6mm
Treatment options include surgery, radiation therapy, drug
therapy, laser therapy and cryotherapy or cauterization
• Less common are malignant melanomas
• They begin in the melanocytes or cells that produce skin
coloring
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COLORECTAL CANCER
• Fear of colostomy is #1 fear with colorectal cancer
• A colostomy is the creation of an abdominal opening for
elimination of body wastes
• Risk Factors include:
• Personal or family history
• Polyps ( masses of tissue growing inward from wall of
bowel)
• Ulcerative colitis
• High fat/low fiber diet lacking in fruits and vegetables
• Over 93% of these cases occurred in individuals over 50
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SCREENING FOR COLORECTAL
CANCER
• Colon cancer is twice as common as rectal cancer
• A history of inflammatory bowel disease and carcinoma
• Warning signs include: rectal bleeding, blood in stool, or
change in bowel habits
• Screening includes:
• Digital rectal exam which is the least effective
• Sigmoidoscopy uses thin lighted tube up rectum and lower
colon extremely painful
• Fecal occult blood testing \
• Stool sample smear is placed on a chemical that changes
color
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OSTEOPOROSIS
• This is the condition of having porous bones
which affects predominately women
• A bone weakening disorder that increases skeletal
frailty and fracturing
• It has been labeled a “pediatric disease with a
geriatric outcome”
• Greatest loss in bone density occurs in women
during the first 5 years of menopause and
continues for 8-10 years before leveling off
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RISK FACTORS
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Age is #1 risk factor
50% women 45 and over
90% women 75 and over
Genetics
Diet
Exercise
All of these determine peak bone mass and indicate future
bone density
• Young women who suffer from anorexia or bulimia
• Highly trained female athletes with amenorrhea
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PROTECTIVE FACTORS
• Exercise in general
• Weight bearing exercises increase bone density, muscle strength, tone
and balance
• Running, brisk walking, hiking, wt lifting, aerobics
• Weight supported exercises have less benefit, swimming and biking
• Greatest density occurs at site of maximum stress and repetition
• Diet high in Calcium and Vitamin D
• Vitamin D is synthesized by the skin’s exposure to sunlight an
necessary for calcium absorption through small intestine
• Since calcium is also necessary for heart and nerve functions bones
become depleted
• Calcium supplements of up to 1300 mg per day or more
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HORMONE REPLACEMENT
THERAPY
• Estrogen lost during menopause needs to be replaced
• HRT prevents osteoporosis, improves calcium absorption
and reduces loss of calcium in urine
• Some forms of HRT may lead to breast or uterine cancer
(without progestin)
• Athletic amenorrhea, alcohol consumption of more than 3
drinks per day
• Both smoking and alcohol consumption interfere with the
processing of Vitamin D and the absorption of alcohol
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DIABETES MELLITUS
• Type 1 is insulin dependent and;
• Usually occurs in young children and
adolescents
• Pancreas produces little or no insulin
• Body cannot convert glucose to energy
• Blood sugar levels rise to dangerous levels
• Insulin must be injected under the skin
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TYPE 2 NON-INSULIN
DEPENDENT
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Risk Factors include:
Smoking
Women over age 40
Obesity
Family members with diabetes
Giving birth to a baby over 9 lbs
Having frequent miscarriages
Race- Afro-American, Hispanic, or Native
American
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ARTHRITIS
• Inflammation of the joints
• Characterized by swelling, pain, and lack of range of
movement that persists for more than 2 weeks
• Consequences range from mild to debilitating
• OSTEOARTHRITIS is due to overuse of weight bearing
joints, knees, hips and ankles
• RHEUMATOID ARTHRITIS is an autoimmune, chronic,
inflammatory disease
• It affects 3 times more women than men
• Prevalent in post menopausal women
• If left untreated cartilage between finger joints disappears
causing bone irritation
and pain
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TREATMENT OF ARTHRITIS
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Rest and relaxation
Exercise
Physical Therapy
Use of cold or heat
Medications and drugs
Surgery
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SYSTEMIC LUPUS
ERYTHEMATOSUS
• Commonly referred to as lupus
• It is a chronic, connective tissue, auto-immune
disease that causes inflammation and affects vital
organs such as:
• Skin, Kidneys, Heart, Lungs, Brain, CNS
• A butterfly rash appears across the bridge of the
nose
• Lupus is not infectious or rare
• Cause is unknown, however, genetic and
environmental factors
implicated
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CANCER
TREATMENT OF SLE
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Similar to arthritis
Prevention is key
Avoid excessive sun exposure
Use sunscreens
Regular exercise
Stress Management
Limited to no alcohol consumption
Proper use of prescribed medications
Maintain proper nutrition
80 to 90 % of women with SLE can expect to live a normal
lifespan
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URGENT REMINDER TO ALL
FACULTY
• FARSCCD WILL BE NEGOTIATING THE
NEW CONTRACT FOR THE 00-02 SCHOOL
YEARS
• SCC FACULTY REQUESTS FOR CHAIR
RELEASE TIME MUST BE SUBMITTED NO
LATER THAN 12-2-99 AT THE Academic
Senate Meeting or to Rosi Enriquez
• BE PROACTIVE AND TURN IN YOUR
RATIONALS WITH THE REQUEST
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SCC ACADEMIC SENATE
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