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UnderstandingUnderstanding
CancerCancer
DR S.M ONTITA
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Cancer is a largeCancer is a large
group of diseasesgroup of diseases(over 200)(over 200)
characterized bycharacterized by
uncontrolled growthuncontrolled growthand spread ofand spread of
abnormal cells.*abnormal cells.*
hat !s Cancer"hat !s Cancer"
**#merican Cancer $ociety% Cancer &acts and &igures#merican Cancer $ociety% Cancer &acts and &igures
200'200'
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ormal Cells s. Cancerormal Cells s. Cancer
CellsCells Cancer cellsCancer cells +ose control over growth+ose control over growth
and multiplicationand multiplication
,o not self-destruct,o not self-destruct
when they become wornwhen they become worn
out or damagedout or damaged
Crowd out healthy cellsCrowd out healthy cells
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$igns and $ymptoms of$igns and $ymptoms of
CancerCancer Change in bowel habits or bladder functionsChange in bowel habits or bladder functions
$ores that do not heal$ores that do not heal
Unusual bleeding or dischargeUnusual bleeding or discharge +umps or thicening of breast or other parts+umps or thicening of breast or other parts
of the bodyof the body
!ndigestion or di/culty swallowing!ndigestion or di/culty swallowing ecent change in wart or moleecent change in wart or mole
1ersistent coughing or hoarseness1ersistent coughing or hoarseness
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Carcinomas(cells that coverinternal and eternal
body surfaces)
3ypes of Cancers3ypes of Cancers
+ung
4reast
ColonColon
4ladder4ladder1rostate1rostate
(5en)(5en)
LeukemiaLeukemia
(4lood Cells)(4lood Cells)LymphomasLymphomas(+ymph nodes(+ymph nodes6tissues)6tissues)
SarcomasSarcomas
Cells in supportivetissues 7 bones 6
muscles
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hat Causes Cancer"hat Causes Cancer"
+ifestyle+ifestyle
8nvironment8nvironment
&amily&amily9istory9istory
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+ifestyle iss+ifestyle iss
$moing$moing
,iet high fat and low,iet high fat and low
in fruits andin fruits andvegetablesvegetables
+ac of eercise+ac of eercise
Unprotected eposureUnprotected eposureto the sun% (U) raysto the sun% (U) rays
:besity:besity
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8nvironmental iss8nvironmental iss
$econd hand smoe$econd hand smoe
#ir pollution#ir pollution
!ndustrial pollution!ndustrial pollution
Chemical eposuresChemical eposures
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!nherited iss!nherited iss
Less than 15% ofLess than 15% ofcancers are inheritedcancers are inherited
Gene mutations areGene mutations arelinked to somelinked to someinherited cancersinherited cancers
Cancers that may beCancers that may becaused by inheritedcaused by inheritedgene mutations are:gene mutations are: Colon cancerColon cancer Breast cancerBreast cancer OarianOarian !rostate cancer!rostate cancer Skin cancerSkin cancer
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$creening 3ests and$creening 3ests and
$elf-eams$elf-eams$creening tests$creening tests
ColonColon
4reast4reast CervicalCervical
1rostate1rostate
$elf-eams$elf-eams3esticular3esticular
$in$in
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hy $creeninghy $creening
3ests"3ests""he treatment of cancer
is most successful #henthe cancer is detected asearly as possible$ often
before symptoms occur
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Lung CancerLung Cancer
3obacco smoing is the leading cause of3obacco smoing is the leading cause ofvarious cancers.various cancers.
;0< of cancer deaths% including =>< of;0< of cancer deaths% including =>< of
lung cancer deaths% are attributed tolung cancer deaths% are attributed to
tobacco use.tobacco use. +ung cancer is the leading cause of cancer+ung cancer is the leading cause of cancer
deaths in the United $tates.deaths in the United $tates.
$moing cigarettes is most common cause.$moing cigarettes is most common cause.
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Lung CancerLung Cancer
&continued'&continued'
Signs and symptomsSigns and symptoms !n the early stages% signs and!n the early stages% signs and
symptoms may be di/cult to detect.symptoms may be di/cult to detect. Cigarette smoers may have chronic coughCigarette smoers may have chronic cough
or chronic bronchitisor chronic bronchitis (isk factors and preention(isk factors and preention
(isk increases #ith:(isk increases #ith:3he number of cigarettes smoed?day3he number of cigarettes smoed?day
3he number of years a person smoes3he number of years a person smoes 9ow deeply the smoer inhales9ow deeply the smoer inhales $moing high-tar or un@ltered cigarettes$moing high-tar or un@ltered cigarettes
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Lung CancerLung Cancer
&continued'&continued' Auitting tobacco use reduces lungAuitting tobacco use reduces lung
cancer ris% but it never returns tocancer ris% but it never returns tothat of a nonsmoer.that of a nonsmoer.
1assive smoing may increase1assive smoing may increasenonsmoersB ris of lung cancer.nonsmoersB ris of lung cancer. 8nvironmental tobacco smoe is8nvironmental tobacco smoe is
associated with 20< to ;00s (maority or cases occur in women D0 andover)over)
,rops signi@cantly after mid->0s,rops signi@cantly after mid->0s
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4reast Cancer4reast Cancer
$creening Euidelines$creening Euidelines
Yearly mammograms starting at age 40
and continuing for as long as a womanis in good ealt.
!linical "reast e#ams $!%&' sould "e
(art of a (eriodic ealt e#am) a"oute*ery tree years for women in teir
+0s and ,0s and e*ery year for women
40 and o*er.
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4reast Cancer4reast Cancer
$creening Euidelines$creening Euidelines -omen sould re(ort any "reast cange
(rom(tly to teir ealt care (ro*iders. %reastself e#am $%S&' is an o(tion for women for
women starting in teir +0s. -omen at increased ris $e.g.) family istory)
genetic tendency) (ast "reast cancer ' souldtal wit teir doctors a"out te "enefits and
limitations of starting mammogra(y screeningearlier) a*ing additional tests $e.g.) "reastultrasound or MRI') or a*ing more fre/uente#ams.
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Cerical CancerCerical Cancer
# causal association eists between# causal association eists betweeninfection with human papillomavirusinfection with human papillomavirus
(91) and cervical cancer.(91) and cervical cancer.
Causes genital wartsCauses genital warts
!s seually transmitted!s seually transmitted
is of infection increases with anis of infection increases with an
increased number of seual partnersincreased number of seual partners
and?or non-monogamous partnersand?or non-monogamous partners omen who became seually activeomen who became seually active
before age F> have higher risbefore age F> have higher ris
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Cerical CancerCerical Cancer
&continued'&continued' +ong-term use of oral contraceptives is+ong-term use of oral contraceptives isassociated with an increased ris of cervicalassociated with an increased ris of cervical
cancer.cancer.
!n 200G% the &ood and ,rug #dministration!n 200G% the &ood and ,rug #dministration
(&,#) approved a vaccine to prevent cervical(&,#) approved a vaccine to prevent cervical
cancer.cancer. 3he vaccine% Eardasil% prevents infection with four3he vaccine% Eardasil% prevents infection with four
types of 91.types of 91.
3he #merican Cancer $ociety (#C$)3he #merican Cancer $ociety (#C$)
recommends that all women should haverecommends that all women should have
annual 1ap tests three years after their @rstannual 1ap tests three years after their @rst
vaginal intercourse but not later than age 2F.vaginal intercourse but not later than age 2F.
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Cervical CancerCervical Cancer
$creening Euidelines$creening Euidelines #nnual pap testing should#nnual pap testing should
begin with the onset ofbegin with the onset ofseual activity or at age F=seual activity or at age F=
!nvestigate pros 6 cons of!nvestigate pros 6 cons ofnew 91 vaccinenew 91 vaccine
1ap testing should continue1ap testing should continueless freHuently at theless freHuently at the
discretion of the medicaldiscretion of the medicalprovider and patient afterprovider and patient afterthree or more annual teststhree or more annual testshave been normalhave been normal
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1rostate Cancer1rostate Cancer
$creening Euidelines$creening Euidelines
5en should spea to their doctor about the5en should spea to their doctor about the
pros and cons of prostate cancer screeningpros and cons of prostate cancer screening
4oth prostate speci@c antigen (1$#) and4oth prostate speci@c antigen (1$#) and
digital rectal eaminations (,8) aredigital rectal eaminations (,8) are
recommended for men over '0 and whorecommended for men over '0 and whochoose to undergo screening for prostatechoose to undergo screening for prostate
cancercancer
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3esticular Cancer3esticular Cancer
$creening Euidelines$creening Euidelines ,octors agree that eamination of a manBs,octors agree that eamination of a manBs
testicles is an important part of a generaltesticles is an important part of a generalphysical eam. !t is recommended that aphysical eam. !t is recommended that atesticular eam be conducted duringtesticular eam be conducted duringroutine cancer-related checups.routine cancer-related checups.
!t is believed that it is important to mae!t is believed that it is important to maemen aware of testicular cancer and thatmen aware of testicular cancer and thatany unusual mass should be evaluated byany unusual mass should be evaluated bya health care provider immediately.a health care provider immediately.
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9ow &ar 9ave e Come "9ow &ar 9ave e Come "
&ive year survival&ive year survival
raterate
FIF; - F0
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#void $moing or Chewing#void $moing or Chewing
3obacco3obacco
Cigarette smoing is theCigarette smoing is the
leading cause ofleading cause of
preventable death in the U$preventable death in the U$
$econd hand smoe aJects$econd hand smoe aJects
everyoneeveryone
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(educing Cancer (isk(educing Cancer (isk
8at a diet low in fat and red meats%8at a diet low in fat and red meats%
especially high-fat and processed meats.especially high-fat and processed meats.
8at a variety of fruits and vegetables daily.8at a variety of fruits and vegetables daily.
&ollow #C$Bs recommendations for cancer&ollow #C$Bs recommendations for cancerscreening tests.screening tests.
5en should conduct monthly testicular5en should conduct monthly testicular
self-eaminations.self-eaminations.
Know warning signs of cancer and seeKnow warning signs of cancer and see
your health care provider immediately ifyour health care provider immediately if
you detect any.you detect any.
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(educing Cancer (isk(educing Cancer (isk
&continued'&continued' $eually active people should use$eually active people should usecondoms to avoid contacting 91.condoms to avoid contacting 91.
5aintain a healthy weight.5aintain a healthy weight.
omen should consult with their healthomen should consult with their healthcare providers about riss of using oralcare providers about riss of using oralcontraceptives or hormone replacementcontraceptives or hormone replacementtherapy.therapy.
8ercise most days of the wee.8ercise most days of the wee. hen in the sun% taes steps to limit Uhen in the sun% taes steps to limit U
radiation eposure.radiation eposure.
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(educing Cancer (isk(educing Cancer (isk
&continued'&continued' ,onBt smoe or chew tobacco.,onBt smoe or chew tobacco. #void secondhand smoe.#void secondhand smoe. ,onBt drin ecessive amounts of alcohol.,onBt drin ecessive amounts of alcohol. #void unnecessary eposure to ionizing#void unnecessary eposure to ionizing
radiation% such as -rays and U light.radiation% such as -rays and U light. ,onBt lie in the sun or tanning beds.,onBt lie in the sun or tanning beds. #void direct sun eposure between F0 a.m.#void direct sun eposure between F0 a.m.
and D p.m.and D p.m.
#void eposure to toic chemicals and fumes.#void eposure to toic chemicals and fumes. #void asbestos dust and radon gas.#void asbestos dust and radon gas. #void eating cured or smoed meats.#void eating cured or smoed meats.