Transcript Cancer in the family - Arizona Myeloma Network

Christina Laukaitis, MD, PhD, FACP
6/21/12
What Is Cancer?
 The term “cancer” refers to more than 100
different diseases that begin in the cells, the
body’s basic unit of life.
What Is Cancer?
 Cancer develops when cells grow and form more
cells without order or control
 Under normal circumstances, new cell growth and
old cell death are kept in balance
 In cancer, this balance is disrupted
Normal Tissue
Beginning of Cancerous Growth
Cancerous Tumor
What Is Cancer?
 Cancer develops when cells grow and form more
cells without order or control
 Under normal circumstances, new cell growth and
old cell death are kept in balance
 In cancer, this balance is disrupted
Why is cell overgrowth a problem?
 Non-functional cells crowd out original ones
 Tissue no longer works right
 For example, can’t swallow food, can’t make urine
 Energy is going into making cancer cells
 Rest of body can’t maintain itself
 Person is tired, loses weight
 Cancer spreads to other organs
 Metastasis
 These get crowded with cancer and don’t work
Types of Cancer
 There are over 100 different types of cancer
 Start in different tissues, involve different cell types
 Treatment depends on the type of cancer
The body protects itself from cancer
 Cells are instructed to destroy themselves when they
malfunction or aren’t needed
 Mutations can mess up this instruction
 Some people are born with these mutations
 The immune cells destroy malfunctioning cells
 Diabetes and some medications make the immune
system less effective
 HIV affects the immune system
Cancers are named by where they start
1. Carcinomas begin in skin or tissues that line the
internal organs
2. Sarcomas start in bone, fat, muscle, joint, nerve,
blood vessel or deep skin tissues
3. Lymphomas start in lymph nodes or lymphoid tissues
(tissues of the body’s immune system)
4. Leukemia is cancer of the white blood cells
5. Myelomas start in plasma cells found in bone marrow
A tumor that has metastasized (spread) keeps its
original name
“Breast cancer metastatic to the bone”
In Summary
 Cancer comes from cells that grow out of control
 As cells become more out of control, they can spread to
other parts of the body
 Cancer is named based on the location where it started
What increases the risk of cancer?
 Age
 Exposures & infections
 Family history
New AZ cancer cases for AI by age
Exposures that increase cancer risk
 Radiation (Uranium, X-rays)
 Leukemia
 Sun
 Skin cancer
 Tobacco smoke
 Lung and bladder cancers
 Arsenic
 Liver, lung, kidney, bladder cancer
 Alcohol
 Liver and pancreas cancer
 Other chemicals & hormones
Infections that increase cancer risk
 Hepatitis B & C
 Liver cancer
 Human Papilloma Virus (HPV)
 Cervical and penis cancers
 There is now a vaccination for teenagers!
 Human Immunodeficiency Virus (HIV)
 Certain skin cancers (Kaposi’s Sarcoma)
 Lymphoma
 Cervical cancer
Cancer in the family?
If a parent, brother or sister had a certain kind of cancer,
a person’s risk of getting that cancer is doubled
 Average risk of colon cancer: 5%
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 Risk if a parent or sibling had colon cancer: 10%
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Screening for cancer in family
Start screening for specific cancers 10 years before
it happened in a relative
 If a mother had breast cancer at age 49, her
daughters should start mammograms by 39
Cancers that often run in families
 Breast
 Ovarian
 Colon
 Kidney
 Endocrine
 Pheochromocytoma
 Medullary thyroid cancer
 Skin
 Prostate
 Pancreatic
Summary
 Cancer becomes more likely as a person gets older
 Exposures and infections can increase cancer risk
 Some families are more affected by cancer than others
Cancer Screening and Prevention
 Checking for cancer in a person who does not have any
symptoms of the disease is called screening.
Cancer Screening and Prevention
 The goal of cancer screening is to discover and stop a
cancerous tumor before it grows and spreads (metastasizes)
 This is called early detection
Cancer Screening and Prevention
 Medical screening tests are effective tools for early
detection of cancer
 A few types of cancer can be detected early by specific
tests
Early detection = more survivors
Stage
Where is the cancer?
5-year survival
0
In the original tissue in the
organ
95%
1
Outside the original tissue,
just in the organ
90%
2
Large tumor or spread to 1-2
sites outside organ
80%
3
Spread to one area of the
body
60%
4
Spread throughout the body
5%
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Most common cancers (2011)
 Breast
 Kidney
 Prostate
 Colorectal
Top 4 cancers for AI
Screening tests for common types
of cancer
 Breast - screening mammogram
 Cervix - Pap test
 Colon - fecal occult blood test or fecal
immunotest, colonoscopy, sigmoidoscopy
 Prostate - digital rectal exam, PSA
 Skin – checking skin for unusual growths
Screening recommendations
Women
Men
 Colon cancer screening from age  Colon cancer screening from 50-85
50-85
 Discuss prostate cancer screening
 Mammogram every 1-2 years from with physician from 50
40 or 50
 Pap smear every 3 years from 2130; every 3-5 years from 30-65
Challenges to Cancer Screening
and Early Detection
 Difficulty getting to clinic
 Fear of cancer
 Lack of knowledge
 Modesty
 Communication
 Illness beliefs
Possible Symptoms of Cancer
 There are many different symptoms known to be
associated with certain types of cancers.
 A symptom is a sign that something is not right in the
body but does NOT always indicate cancer.
Pay attention to your body if there is. . .
 Change in bowel or bladder habits
 A sore that does not heal
 Unusual bleeding or discharge
 Thickening, lump, or swelling in the breast or any other
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part of the body
Indigestion or difficulty swallowing
Change in wart or mole
Nagging cough or hoarseness
Blood in urine
Pay attention to unexplained
symptoms such as…
 Continuing weight loss
 Fever
 Fatigue
 Pain
Symptoms of specific cancers
 Breast—lump in breast, skin change, nipple discharge
 Ovarian—bloating, change in bowel habits, abdominal size
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growth, abdominal or pelvic pain
Colon—constipation & diarrhea, low blood counts
Thyroid—neck lump
Kidney—back pain, blood in urine
Uterine—postmenopausal vaginal bleeding
Prostate—problems urinating, back pain
Skin—non-healing sores, moles that change colors
Lung—cough, multiple pneumonias
Family
History
Medical
Problems
Symptoms
Exam &
Test
Results
Cancer
Risk
Habits &
Exposures
How can you prevent cancer?
 Don’t get old?
 Choose good parents?
 Live a healthy life!
Maintain a healthy weight
 Be active
 30+ minutes of moderate exercise
 5 days per week
Eat a healthy diet
 5 or more servings of vegetables and fruits each day
 Choose whole grains over processed (refined) grains
 Limit processed and red meats
Choose other healthy habits
 Don’t drink alcohol, or do so only in moderation
 <1 drink per day for a woman
 <2 drinks per day for a man
 Don’t smoke!
Get recommended screening
 Pap smear every 3 years from age 20-65
 Mammograms every 1-2 years starting between 40-50
 Colonoscopy every 10 years from age 50-85
 Discuss PSA and rectal exam after age 50
Summary
 Pursue a healthy lifestyle
 Get recommended screening
 Know your family history
 Be aware of your body
 Get suspicious changes checked quickly
 If something doesn’t seem right, keep pushing until
you understand what is wrong
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