Transcript Chapter Eleven - McGraw

Chapter Eleven:
Living With Cancer
© 2011 McGraw-Hill Higher Education. All rights reserved.
Cancer
Cell regulation problem causing
abnormal cell growth
• Regulatory genes

Genes that control cell specialization,
replication, DNA repair, tumor suppression
• Oncogenes

Faulty regulatory genes believed to activate
the development of cancer
• Proto-oncogenes

Normal regulatory genes that may become
oncogenes
© 2011 McGraw-Hill Higher Education. All rights reserved.
Oncogene Formation
• Three mechanisms:

Genetic mutations


Miscopying of genes during cell division
Viral infections
HIV
 HPV


Carcinogens
© 2011 McGraw-Hill Higher Education. All rights reserved.
The Cancerous Cell
•Characteristics:




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
© 2011 McGraw-Hill Higher Education. All rights reserved.
Staging Cancer
• TNM staging system



T = extent of primary tumor
N = whether or not it has progressed to
regional lymph nodes
M = presence or absence of metastasis
• A numerical system tracks extent of
cancer spread




I = In situ
II = Local
III = Regional
IV = Distant
© 2011 McGraw-Hill Higher Education. All rights reserved.
How Cancer
Spreads
© 2011 McGraw-Hill Higher Education. All rights reserved.
Types of Cancer
• Carcinomas: 85% of all cancers (organs,
•
•
•
•
•
•
•
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
© 2011 McGraw-Hill Higher Education. All rights reserved.
Cancer Cases and Deaths
© 2011 McGraw-Hill Higher Education. All rights reserved.
Skin Cancer
• Risk factors

Severe sunburn during childhood, chronic
sun exposure during young adulthood
• Prevention

Reduce exposure to sun’s rays, use
sunscreens, avoid tanning booths
• Early detection

Self-examination (see next slide)
• Treatment

Surgery, chemotherapy, interleukin-2
© 2011 McGraw-Hill Higher Education. All rights reserved.
Self-Examination for Melanoma
© 2011 McGraw-Hill Higher Education. All rights reserved.
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
© 2011 McGraw-Hill Higher Education. All rights reserved.
Lung Cancer
• Risk factors



Smoking
Environmental pollutants (radon)
Genetic predisposition
• Prevention

Don’t smoke and avoid environmental tobacco
smoke
• Treatment (low success rate)




Surgery
Radiation
Chemotherapy
Medications
© 2011 McGraw-Hill Higher Education. All rights reserved.
Colorectal Cancer
• Risk factors



Genetic susceptibility
Dietary habits
Smoking, alcohol consumption
• Prevention

Removal of polyps, exercise, dietary changes
• Early detection

Rectal exams, stool tests, sigmoidoscopy,
colonoscopy
• Treatment

Surgery, radiation, chemotherapy
© 2011 McGraw-Hill Higher Education. All rights reserved.
Breast Cancer
• Risk factors







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
© 2011 McGraw-Hill Higher Education. All rights reserved.
Breast Cancer
• Prevention






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


Breast self-examination
Mammography
© 2011 McGraw-Hill Higher Education. All rights reserved.
Breast Self-Exam
© 2011 McGraw-Hill Higher Education. All rights reserved.
Breast Cancer
• Treatment





Surgery
Chemotherapy
Radiation therapy
Hormone therapy
Targeted therapy
Herceptin
 Gleevac
 Avastin

© 2011 McGraw-Hill Higher Education. All rights reserved.
Prostate Cancer
Location of the Prostate Gland within the
Male Reproductive System
© 2011 McGraw-Hill Higher Education. All rights reserved.
Prostate Cancer
• Risk factors

Age, African American ethnicity, family history,
dietary fat intake
• Prevention

Moderation of fat intake, increased intake of
vitamin E and selenium, drug therapy
• Early detection

Prostate-specific antigen (PSA) tests, ultrasound
rectal exam
• Treatment

Surgery, radiation, brachytherapy (radioactive
seeds)
© 2011 McGraw-Hill Higher Education. All rights reserved.
Testicular Cancer
• Risk factors

Family history, environmental factors,
undescended testicles
• Prevention

Self-exams, correction of undescended
testicles in children
• Early detection

Self-exams, awareness of symptoms
• Treatment

Surgery, chemotherapy, radiation
© 2011 McGraw-Hill Higher Education. All rights reserved.
Testicular Cancer: Self-Examination
© 2011 McGraw-Hill Higher Education. All rights reserved.
Cervical Cancer
• Risk factors


HPV infection
Smoking, socioeconomic factors
• Prevention


Sexual abstinence
Careful selection of sexual partners
• Early detection of precancerous cellular
changes

Pap tests
• Treatment


Surgery (minor or major)
Radiation/chemotherapy
© 2011 McGraw-Hill Higher Education. All rights reserved.
Uterine Cancer
• Risk factors

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

Minimize high levels of estrogen, regular
gynecological care
• Treatment

Surgery, radiation, chemotherapy, hormone
treatment
© 2011 McGraw-Hill Higher Education. All rights reserved.
Vaginal Cancer
• Risk factors

Prenatal exposure to DES
• Early detection

Pap test
• Treatment

Surgery
© 2011 McGraw-Hill Higher Education. All rights reserved.
Ovarian Cancer
• Prevention


Similar to what is recommended for breast cancer
Prophylactic oophorectomy
• Early detection (“silent”)




Annual pelvic exams
Awareness of potential symptoms
Tests
 OvaSura, CA125, and HE4
Genetic screenings
• Treatment

Surgery, chemotherapy, drug therapy
© 2011 McGraw-Hill Higher Education. All rights reserved.
Pancreatic Cancer
• Risk factors

Male gender, smoking, high-fat diet, high alcohol
consumption
• Prevention

Abstaining from tobacco and alcohol, exercise,
weight management
• Early detection (no early symptoms)

CAT scan
• Treatment


No effective treatment at this time
Surgery, radiation, chemotherapy
© 2011 McGraw-Hill Higher Education. All rights reserved.
Lymphatic Cancer
• Risk factors

Reduction of immune system protection,
exposure to pollutants, viral infections
• Prevention

Limit exposure to chemicals
• Early detection

Enlarged lymph nodes, fever, weight loss
• Treatment

Radiation, chemotherapy, stem cell
transplant
© 2011 McGraw-Hill Higher Education. All rights reserved.
Preventive Measures:
Cancer Warning Signals
Change in bowel/bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening of tissues (schlerotic change)
Indigestion or difficulty swallowing
Obvious change in a wart/mole
Nagging cough
© 2011 McGraw-Hill Higher Education. All rights reserved.
Preventive Measures
•
•
•
•
•
•
•
•
•
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
© 2011 McGraw-Hill Higher Education. All rights reserved.
Chapter Eleven:
Living With Cancer
© 2011 McGraw-Hill Higher Education. All rights reserved.