THE BIG “C”

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. 8/16/2008 REDUCING YOUR RISK OF CANCER 1 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 8/16/2008 REDUCING YOUR RISK OF CANCER 2 • 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 8/16/2008 REDUCING YOUR RISK OF 3 to other tissues CANCER CLASSIFICATION OF CANCERS 7 WARNING SIGNS OF CANCER • • • • • • • 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 REDUCING YOUR RISK OF CANCER 4 8/16/2008 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 8/16/2008 REDUCING YOUR RISK OF CANCER 5 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 8/16/2008 REDUCING YOUR RISK OF CANCER 6 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 8/16/2008 REDUCING YOUR RISK OF CANCER 7 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 8/16/2008 REDUCING YOUR RISK OF CANCER 8 • • 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 8/16/2008 PROTECTIVE FACTORS TO FIGHT AGAINST CANCER Do not smoke • 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 9 REDUCING YOUR RISK OF CANCER 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 8/16/2008 REDUCING YOUR RISK OF CANCER 10 SIGNS AND SYMPTOMS • • • • • 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 8/16/2008 REDUCING YOUR RISK OF CANCER 11 • 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 BREAST CANCER 8/16/2008 REDUCING YOUR RISK OF CANCER 12 RISK FACTORS • • • • • • • • • • • 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 areolaYOUR RISK OF 8/16/2008 REDUCING 13 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 8/16/2008 REDUCING YOUR RISK OF CANCER 14 5 LEVELS OF BREAST CANCER 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 8/16/2008 REDUCING YOUR RISK OF CANCER 15 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 8/16/2008 REDUCING YOUR RISK OF 16 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 8/16/2008 REDUCING YOUR RISK OF CANCER 17 TREATMENT • RADIATION • CHEMOTHERAPY • ADJUVANT THERAPY • SURGERY INCLUDES: 8/16/2008 • LUMPECTOMY • SIMPLE MASECTOMY • MODIFIED RADICAL MASECTOMY • RADICAL MASECTOMY REDUCING YOUR RISK OF CANCER 18 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 8/16/2008 REDUCING YOUR RISK OF CANCER 19 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 8/16/2008 REDUCING YOUR RISK OF CANCER 20 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 8/16/2008 REDUCING YOUR RISK OF CANCER 21 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 8/16/2008 REDUCING YOUR RISK OF CANCER 22 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 8/16/2008 REDUCING YOUR RISK OF CANCER 23 • • • • • • 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 8/16/2008 REDUCING YOUR RISK OF CANCER 24 • 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 8/16/2008 REDUCING YOUR RISK OF CANCER WARNING SIGNS of ENDOMETRIAL CANCER 25 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 •8/16/2008 of fertility drugs YOUR RISK OF Use REDUCING CANCER 26 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 8/16/2008 REDUCING YOUR RISK OF CANCER 27 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 8/16/2008 REDUCING YOUR RISK OF CANCER 28 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 8/16/2008 REDUCING YOUR RISK OF 29 CANCER TREATMENT FOR SKIN CANCER • • • • • • 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 8/16/2008 REDUCING YOUR RISK OF CANCER 30 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 8/16/2008 • Sedentary lifestyle REDUCING YOUR RISK OF CANCER 31 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 8/16/2008 REDUCING YOUR RISK OF CANCER 32 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 8/16/2008 REDUCING YOUR RISK OF CANCER 33 RISK FACTORS • • • • • • • 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 8/16/2008 REDUCING YOUR RISK OF CANCER 34 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 8/16/2008 REDUCING YOUR RISK OF CANCER 35 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 8/16/2008 REDUCING YOUR RISK OF CANCER 36 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 8/16/2008 REDUCING YOUR RISK OF CANCER 37 TYPE 2 NON-INSULIN DEPENDENT • • • • • • • • 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 8/16/2008 REDUCING YOUR RISK OF CANCER 38 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 RISK OF 8/16/2008 REDUCING YOUR 39 CANCER TREATMENT OF ARTHRITIS • • • • • • Rest and relaxation Exercise Physical Therapy Use of cold or heat Medications and drugs Surgery REDUCING YOUR RISK OF CANCER 40 8/16/2008 • 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 are implicated 8/16/2008 REDUCING YOUR RISK OF 41 CANCER SYSTEMIC LUPUS ERYTHEMATOSUS TREATMENT OF SLE • • • • • • • • • • 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 REDUCING YOUR RISK OF CANCER 42 8/16/2008 8/16/2008 REDUCING YOUR RISK OF CANCER 43 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 8/16/2008 FACULTY REMINDER FROM THE SCC ACADEMIC SENATE 44