Transcript THE HUMAN COSTS OF TOBACCO USE

YOU HAVE A CHOICE!
Dr S Andaz MD, FACS, FRCS
Director
Center for Minimally Invasive Thoracic Surgery and
Thoracic Surgical Oncology
South Nassau Hospital
New York
Heart Disease Statistics
Every 20 seconds has a heart attack.
Every 34 seconds a person dies from heart
disease.
More than 2,500 deaths from heart disease
each day
“Symptoms - COSTLY mistakes”
• “I feel great.”
• “ I just had a check up and I am just fine”
• SILENT KILLERS
– Cadiovascular
– Cancer
Anatomy
Plaques
Major Risk Factors
• Smoking
• Cholesterol - LDL( < 70) HDL (>40)
• Hypertension
• Family history
• Obesity
• Diabetes
Warning Signs
Chest discomfort.
Discomfort in other areas of the upper body.
Shortness of breath.
Other signs: cold sweat, nausea or lightheadedness
Angina v/s “heart attack”
Investigations
•
•
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•
•
EKG
CXR
Blood work
Stress Test
Ultrafast CT and Total Body Scanners
Cardiac Cath
Management
• Medical
•
•
•
•
Aspirin
BP control
Statins - Liver and muscle damage
Diabetes control
• Lifestyle changes!!!!
– smoking
– exercise
– diet changes
Coronary Stents
S/P Agioplasty stenting
S/P angioplasty
Surgical - CABG
Surgical - CABG
Cardiac Surgery - New Frontiers
Cancer Statistics
2004 Estimated US Cancer Cases
Prostate
•32% Breast
33%
Lung & bronchus 13%
Men
699,560
Women •12% Lung & bronchus
668,470
•11% Colon & rectum
Colon & rectum
11%
Urinary bladder
6%
•6%
Melanoma of skin
4%
• 4% Ovary
Non-Hodgkin lymphoma 4%
Kidney
3%
Oral Cavity
3%
Leukemia
Pancreas
All Other Sites
Uterine corpus
• 4% Non-Hodgkin
lymphoma
•4%
Melanoma
of skin
3%
•3%
Thyroid
2%
•2%
Pancreas
18%
•2%
Urinary bladder
•20% All Other Sites
2004 Estimated US Cancer Deaths
Lung & bronchus 32%
•25% Lung & bronchus
Prostate
10%
•15% Breast
Colon & rectum
10%
Men
290,890
Women
272,810 •10% Colon & rectum
Pancreas
5%
• 6% Ovary
Leukemia
5%
• 6% Pancreas
Non-Hodgkin
lymphoma
4%
• 4% Leukemia
Esophagus
4%
• 3% Non-Hodgkin
lymphoma
Liver & intrahepatic 3%
bile duct
• 3% Uterine corpus
Urinary bladder
3%
• 2% Brain/ONS
Kidney
3%
•24% All other sites
All other sites
21%
• 2% Multiple myeloma
Lifetime Probability of Developing Cancer, by Site, Men, US,
1998-2000
Site
Risk
All sites
??????
Prostate
1 in 6
Lung & bronchus
1 in 13
Colon & rectum
1 in 17
Urinary bladder
1 in 29
Non-Hodgkin lymphoma
1 in 48
Melanoma
1 in 55
Leukemia
1 in 70
Oral cavity
1 in 72
Kidney
1 in 69
Stomach
1 in 81
Lifetime Probability of Developing Cancer, by Site, Men, US,
1998-2000
Site
Risk
All sites
1 in 2
Prostate
1 in 6
Lung & bronchus
1 in 13
Colon & rectum
1 in 17
Urinary bladder
1 in 29
Non-Hodgkin lymphoma
1 in 48
Melanoma
1 in 55
Leukemia
1 in 70
Oral cavity
1 in 72
Kidney
1 in 69
Stomach
1 in 81
Lifetime Probability of Developing Cancer, by
Site, Women, US, 1998-2000
Site
Risk
All sites
?????
Breast
1 in 7
Lung & bronchus
1 in 17
Colon & rectum
1 in 18
Uterine corpus
1 in 38
Non-Hodgkin lymphoma
1 in 57
Ovary
1 in 59
Pancreas
1 in 83
Melanoma
1 in 82
Urinary bladder
1 in 91
Uterine cervix
1 in 128
Lifetime Probability of Developing Cancer, by
Site, Women, US, 1998-2000
Site
Risk
All sites
1 in 3
Breast
1 in 7
Lung & bronchus
1 in 17
Colon & rectum
1 in 18
Uterine corpus
1 in 38
Non-Hodgkin lymphoma
1 in 57
Ovary
1 in 59
Pancreas
1 in 83
Melanoma
1 in 82
Urinary bladder
1 in 91
Uterine cervix
1 in 128
Smoking kills more people than
alcohol,
AIDS,
car accidents,
illegal drugs,
murders
suicides
combined.
There is a funeral
1150 times every day
48 times every hour
Because somebody was addicted to
cigarettes
SYSTEMS AFFECTED
CARDIOVASCULAR
LUNG
Cardiovascular Disease
•
•
•
•
•
Stroke
Sudden Death
Heart Attack
Peripheral Vascular Disease
Aortic Aneurysm
180,000 Deaths per Year
LUNG DISEASE
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•
•
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Pneumonia
Influenza
Bronchitis
Emphysema
90,000 Deaths per Year
Healthy Lung
Advanced Emphysema
ONLY LUNG
CANCER???????
Smoking causes other cancers!
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•
•
•
•
•
•
•
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Laryngeal cancer
Oral cancers
Esophageal cancer
Stomach cancer
Pancreatic cancer
Kidney cancer
Bladder cancer
Cervical cancer
Leukemia
When does it all START?
KIDS
Lighting the FIRST cigarette !!!!
Protecting our children and grandchildren
• More than 3 million kids age 12-17 are current smokers.
• More than 5 million children under age 18 alive today will
eventually die from smoking-related disease.
• More than 40% of high school boys report tobacco use.
HOW SEVERE IS
SECOND HAND SMOKING????
SECONDHAND SMOKE
Secondhand smoke contains over 4000
chemicals and 43 known carcinogens.
Among the chemicals are formaldehyde,
cyanide, arsenic, carbon monoxide, methane
and benzene.
Smoke filled rooms have up to 6 times the
air pollution of a busy highway.
“PRIDE IN TOBACCO”
Winston-Salem, NC – the home of R.J. Reynolds Tobacco Co.
This town depends on the tobacco dollar: 8200 factory workers produced
142 billion cigarettes last year.
Winston-Salem is a company town.
Smoking is allowed almost everywhere.
There is one place where
smoking is banned……..
smoking is banned at the R.J. Reynolds Tobacco Plant
-that’s for the benefit of the machines.
-One delicate machine makes 2000 filters a minute, while another
produces 400 packs a minute
LUNG CANCER
HOW MANY CAN BE SAVED?
• ONLY 1/3!!!!
ONLY 1/3 PRESENT AS
EARLY LUNG
CANCER!!!
Stage I
Stage II
2/3 PRESENT AS
ADVANCED LUNG
CANCER!!!
Stage III
Stage IV
Stage IV
Incurable.
Most die within 12 months
Trends in Consumption of Five or More Recommended Vegetable and Fruit Servings
for Cancer Prevention, Adults 18 and Older, US, 1994-2002
35
Prevalence (%)
30
25
24.2
24.4
24.1
24.4
24.5
1994
1996
1998
2000
2002
20
15
10
5
0
Year
Note: Data from participating states and the District of Columbia were aggregated to represent the United States.
Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape
(2000), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention, 1997, 1999, 2000, 2001.
Trends in Overweight* Prevalence, Children and Adolescents, by
Age Group (%), US, 1971-2000
20
15
Prevalence (%)
15
11
11
10
10
7
5
7
6
5
5
4
5
5
0
2 to 5 years
NHANES I (1971-74)
6 to 11 years
NHANES II (1976-80)
12 to 19 years
NHANES III (1988-94)
NHANES 1999-2000
*Overweight is defined as at or above the 95th percentile for body mass index by age and sex based
on reference data.
Source: National Health Examination Survey 1960-1962, National Health and Nutrition
Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2000, National Center for Health
Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20 to
74, US, 1960-2000
45
40
34
Prevalence (%)
35
31
30
28
26
23
25
21
20
15
17
16 17
15
13 15
11
12 13
10
5
0
Both sexes
Men
NHES I (1960-62)
NHANES I (1971-74)
NHANES III (1988-94)
NHANES 1999-2000
Women
NHANES II (1976-80)
*Obesity is defined as a body mass index of 30 kg/m2 or greater. Source: National Health Examination Survey
1960-1962, National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2000,
National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.
No one gets it
In a survey of 21,500
people, not a single
person consumed a
100% of RDA for the
10 most important
nutrients!
*as recommended by the National Cancer Institute
The Constant
Battle
Free Radicals are
unstable molecules that
cause cell and DNA damage;
They are a by-product of
metabolism.
Free Radicals
Sources:
Sunlight, Stress, Toxins, Pollution,
X-rays, Radioactivity, Airline travel,
Medications
Metabolism – Calories & Oxygen (75K)
Smoking = 10 Billion
free radicals per cigarette!
“The amount of antioxidants
that you maintain in your
body is directly proportional
to how long you will live.”
Dr. Richard Cutler, Director of the Anti-Aging Research
Department of the National Institute of Health(NIH), Wash D.C.
American Cancer Society
Recommendation
• Cancer-related Checkup
• every 3 years for people aged 20-40 and
• every year for people age 40 and older.
American Cancer Society
• Prostate
• The ACS recommends that both the prostate-specific
antigen (PSA) blood test and the digital rectal
examination be offered annually, beginning at age 50,
• Men in high-risk groups, such as those with a strong
familial predisposition (i.e., two or more affected firstdegree relatives)
Cancer Screening
• The 5-year relative survival rate for these
cancers is about 80%.
• If we participated in regular cancer
screenings, this rate could increase to 95%.
• Don’t have time - lame excuse!
• yourself
• and the family
• life style changes
• Don’t BLAME the GENES
• YOUR FAMILY DESERVES IT
• THEY GET HURT IF YOU FALL SICK
MARLBORO
COUNTRY
THE MARLBORO MAN
YOU HAVE A CHOICE