CANCER PREVENTION
Shida Saam, D.O.
What is cancer?
It is the unregulated growth and spread of cells.
It is not a single disease,
It is a group of diseases in which a breakdown occurs in
the normal processes that control the multiplication of cells
Cancer is the 2nd most common
cause of death in the US
Annual U.S. Cancer Statistics
New cases Deaths
- Breast 182,000 46,000
- Colorectal 110,200 56,900
- Lung 76,000 60,000
- Ovary 24,000 13,600
- Cervix 15,000 4,600
Abnormal growth in the body:
- Cancer or neoplasm
- Benign tumor
- Wart
- Lipoma
Cancer vs. benign tumor
Cancer grows, spreads ,infiltrate ,
destroy bones and nerve
Cancer cells spread via blood vessels
and lymphatic channels
Increase in Cancer Rate
Cancer is more common during this century
Not because of pollution or radiation,
But because cancer is more common in older people.
As the number of older people increase, so frequency of
cancer.
Cancer & Age
Cancer is rare in < 20 years old
Double between 30-40
Double between 40-50 and
Double each decade thereafter.
What causes cancer?
Viruses
Chemicals
Radiation
Virus cause of cancer:
Several viruses in human can cause cancer
Hepatitis B virus causes a type of liver cancer
HPV can cause cervical cancer
Chemical causes:
The most significant chemical cause of cancer is tobacco
Smoking is the cause of most cancers such as: lung,
cervix, tongue, larynx, esophagus, and bladder
Other chemicals such as benzene, rubber and some plastics
are causing cancers of blood cells, liver and kidney and more
Radiation causes:
The main radiation hazard is sun light which causes skin
cancer
Radioactive isotopes, X-rays and Nuclear wastes can all
cause many cancers such as leukemia
Six steps to avoid cancer:
do not smoke or chew tobacco
eat a low fat, low salt, balanced diet of
naturally occurring foods
increase your fruits and vegetables and very
little smoked meat or fish
if you drink alcohol, drink in moderation: one to
two glass
do not expose your skin repeatedly to excessive
amounts of direct sun
eat white meat, eat well cooked red meat
practice "SAFE" sex to avoid sexually
transmitted diseases
Example of warning signs to rush/
run/ hurry!!!! To your doctor:
A scab, sore, or ulcer that does not heal within
3 weeks
A skin blemish or mole that enlarges, bleeds or
itches
A lump or swelling beneath the skin
Recurrent indigestion or difficulty swallowing
Hoarseness that lasts for more than a week
A persistence cough or coughing up blood
Any changes in bowel or bladder habits
Blood in the stool or urine
Any rapid weight loss without apparent cause
Skin cancer:
There are three very important skin cancers:
Basal cell carcinoma
Squamous cell carcinoma
Melanoma
Basal cell carcinoma:
most common malignant cutaneous tumor in human.
Risk factors: a) fair skin b) degree of sun
exposure
can happen in any age, but increase after age
40.
Waxy appearance, with vessels easily visible
mainly found in face and rarely in the back of
hands
rarely metastasizes, but can advances by direct
extension and destroys normal tissue.
If left untreated or inadequately treated can
destroy the whole side of the face or penetrate subcutaneous tissues into the
bone and brain.
Squamaous cell carcinoma:
Occurs in: fair skinned individuals who sunburn easily and
tan poorly
Smokers have 50% increase chance of this cancer
It appear as small red, conical, hard nodules that quickly
ulcerated
2-3% chance of metastasize
Melanoma:
Leading cause of death from skin disease.
incidence rates of melanoma have increase
Mortality rate from melanoma increase slightly
Risk factors:
1) Fair skin
2) Fair skin with tendency to sunburn or
freckle in expose to sun
3) People with many moles (atypical or
benign)
4) Family history
5) Intense exposure to sun or tanning lamps
Depth of invasion or tumor size is the single most
important prognostic factor.
Primary malignant melanoma may be classified into
6 clinicohistological types
Lentigo malignant melanoma
Superficial spreading malignant melanoma ( most common
occurs in 2/3 with melanoma
Nodular malignant melanoma
Acral-lentiginous melanoma
Malignant melanomas on mucous membrane
Miscellaneous forms such as those arising from blue nevi
and congenital and giant nevocytic nevi
Prevention of skin cancer:
Do not expose yourself under direct sun use protection
such as:
hat
scarf
sun screen with SPF of >15
PABA free sun screen to decrease the chance of allergies
Don’t smoke
Examine your skin monthly
Warning signs for checking with
your doctor
any lesion with change of size
any lesion with change of color
any new lesion which is suspicious
any irregular border lesion
any lesion with itching and bleeding
Breast Cancer
32% of all cancers in women
18% of cancer related deaths
One in nine lifetime risk
180,000 new cases per year
46,000 deaths
Risk factors are:
Age
Parity
Age at menarche
Age at menopause
Family history of breast cancer
Race
Previous history: endometrial cancer, cancer in other
breast, some forms of mammary dysphasia
Exogenous hormones/alcohol/diet
Preventive advice/screening
1) Self breast exam
2) Physical exam by a physician: yearly after age
50
3) Mammography:
Without risk factor
Age Repeat
Between 35-40 Once
Between 40-50 Once every 2 years
After age 50 Once every year
With risk factor: first mammogram at age 30
and every year
4) Avoid alcohol, increases chance of breast
cancer
5) High fiber diet, increase fruits and
vegetables and decrease animal fat
Colorectal Cancer:
It is leading cause of morbidity and mortality in this
country.
It is recognized that most colorectal cancer from
colonic adenomatous polyp to polyp to cancer transformation take 5-10 years.
It is important to recognize the cancer in early time.
Primary prevention
Diet
Screening
Dietary and lifestyle factors that have been risk
factors:
Increase risk:
Animal fat consumption
Alcohol consumption
Obesity
Physical inactivity
Decrease risk:
Higher fiber intake (fruits and vegetables)
Calcium intake
People at increase risk are:
People with close relatives who have had CRC or an
adenomatous polyp
People with a family history of Familial Adenomatous
Polyposis
People with a family history of Hereditary Nonpolyposis
CRC
People with inflammatory bowel disease
Also people at average risk:
Anybody asymptomatic age 50 and older with no other risk
factors.
Fecal occult blood test- yearly testing with 3 random
stools
Flexible sigmoidoscopy- recommended every 3-5 years
Secondary prevention
The identification and eradication of the premalignant
stage of the disease
Detection of the disease in its earliest stage
This is applied to:
People with symptoms
Strong Family History
Screening for any body after age 50, M/F
Colonoscopy for any positive screening
Gynecological Cancer
Only routine screening for cervical cancer; PAP
SMEAR
Who is high risk? Just about everyone
Two or more sexual partners in a lifetime
First intercourse less than 20 years old
Male with multiple partners
History of abnormal papsmear
History of endometrial, vaginal and vulvar cancer
Substance abuse individual
Smokers have higher chance
Low socioeconomic status
Human papilloma virus or HPV
DES exposure
Immunosuppression: such as HIV, Transplant,
Dialysis
Leukemia
Disorganized proliferation of white blood cells in bone
marrow
Two types
acute
chronic
classified as the origin:
lymphocytic leukemia
myeloblastic leukemia
Causes of acute lymphocytic
most common in children
virus similar to AIDS virus
chemical such as benzene
radioactive or radiation leaks from nuclear reactors
inherited factors
Chronic lymphocytic
most common in over 50 years old
Cause: *** UNKNOWN***
Myeloblatic leukemia
Mainly in older people
Cause: chromosomal abnormality, radiation
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