Cancer in the family

Cancer Prevention and Early DetectionChristina Laukaitis, MD, PhD, FACP6/21/12

What Is Cancer?The term cancer refers to more than 100 different diseases that begin in the cells, the bodys basic unit of life.

2What Is Cancer?Cancer develops when cells grow and form more cells without order or controlUnder normal circumstances, new cell growth and old cell death are kept in balanceIn cancer, this balance is disrupted

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Normal Tissue4

Beginning of Cancerous Growth5

Cancerous TumorWhat Is Cancer?Cancer develops when cells grow and form more cells without order or controlUnder normal circumstances, new cell growth and old cell death are kept in balanceIn cancer, this balance is disrupted

7Why is cell overgrowth a problem?Non-functional cells crowd out original onesTissue no longer works rightFor example, cant swallow food, cant make urineEnergy is going into making cancer cellsRest of body cant maintain itselfPerson is tired, loses weightCancer spreads to other organs MetastasisThese get crowded with cancer and dont work

Types of CancerThere are over 100 different types of cancerStart in different tissues, involve different cell typesTreatment depends on the type of cancer

The body protects itself from cancerCells are instructed to destroy themselves when they malfunction or arent neededMutations can mess up this instructionSome people are born with these mutationsThe immune cells destroy malfunctioning cellsDiabetes and some medications make the immune system less effectiveHIV affects the immune system

Cancers are named by where they start1. Carcinomas begin in skin or tissues that line the internal organs2. Sarcomas start in bone, fat, muscle, joint, nerve, blood vessel or deep skin tissues3. Lymphomas start in lymph nodes or lymphoid tissues (tissues of the bodys immune system)4. Leukemia is cancer of the white blood cells5. Myelomas start in plasma cells found in bone marrowA tumor that has metastasized (spread) keeps its original nameBreast cancer metastatic to the bone

In SummaryCancer comes from cells that grow out of controlAs cells become more out of control, they can spread to other parts of the bodyCancer is named based on the location where it started

What increases the risk of cancer?AgeExposures & infectionsFamily history

New AZ cancer cases for AI by ageOverview: Disparity Data for Community Cancer Prioritization6/22/201214Exposures that increase cancer riskRadiation (Uranium, X-rays)LeukemiaSunSkin cancerTobacco smokeLung and bladder cancersArsenicLiver, lung, kidney, bladder cancerAlcoholLiver and pancreas cancerOther chemicals & hormones

Infections that increase cancer riskHepatitis B & CLiver cancerHuman Papilloma Virus (HPV)Cervical and penis cancersThere is now a vaccination for teenagers!Human Immunodeficiency Virus (HIV)Certain skin cancers (Kaposis Sarcoma)LymphomaCervical cancer

Cancer in the family?If a parent, brother or sister had a certain kind of cancer, a persons risk of getting that cancer is doubled

Average risk of colon cancer: 5%

Risk if a parent or sibling had colon cancer: 10%Screening for cancer in familyStart screening for specific cancers 10 years before it happened in a relativeIf a mother had breast cancer at age 49, her daughters should start mammograms by 39

Cancers that often run in familiesBreastOvarianColonKidneyEndocrinePheochromocytomaMedullary thyroid cancerSkinProstatePancreatic

SummaryCancer becomes more likely as a person gets olderExposures and infections can increase cancer riskSome families are more affected by cancer than others

Cancer Screening and PreventionChecking for cancer in a person who does not have any symptoms of the disease is called screening.

Cancer Screening and PreventionThe 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 PreventionMedical screening tests are effective tools for early detection of cancerA few types of cancer can be detected early by specific tests

Early detection = more survivorsStageWhere is the cancer?5-year survival0In the original tissue in the organ95%1Outside the original tissue, just in the organ90%2Large tumor or spread to 1-2 sites outside organ80%3Spread to one area of the body60%4Spread throughout the body5%

BreastKidneyProstateColorectal Top 4 cancers for AI

Most common cancers (2011)25Now we will turn our attention to the number of new cancers anticipated in the US this year. It is estimated that almost 1.6 million new cases of cancer will be diagnosed in 2011. The most common cancers are prostate in men and breast in women; lung and colorectal cancers are the second and third most common cancers in both men and in women.

Screening tests for common types of cancerBreast - screening mammogramCervix - Pap testColon - fecal occult blood test or fecal immunotest, colonoscopy, sigmoidoscopyProstate - digital rectal exam, PSASkin checking skin for unusual growthsScreening recommendationsWomenMenColon cancer screening from age 50-85Mammogram every 1-2 years from 40 or 50Pap smear every 3 years from 21-30; every 3-5 years from 30-65Colon cancer screening from 50-85Discuss prostate cancer screening with physician from 50

Challenges to Cancer Screening and Early DetectionDifficulty getting to clinic Fear of cancerLack of knowledge ModestyCommunicationIllness beliefs

Possible Symptoms of CancerThere 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 habitsA sore that does not healUnusual bleeding or dischargeThickening, lump, or swelling in the breast or any other part of the bodyIndigestion or difficulty swallowingChange in wart or moleNagging cough or hoarsenessBlood in urinePay attention to unexplained symptoms such asContinuing weight loss Fever Fatigue Pain

Symptoms of specific cancersBreastlump in breast, skin change, nipple dischargeOvarianbloating, change in bowel habits, abdominal size growth, abdominal or pelvic painColonconstipation & diarrhea, low blood countsThyroidneck lumpKidneyback pain, blood in urineUterinepostmenopausal vaginal bleedingProstateproblems urinating, back painSkinnon-healing sores, moles that change colorsLungcough, multiple pneumoniasHow can you prevent cancer?Dont get old?Choose good parents?Live a healthy life!

Maintain a healthy weightBe active30+ minutes of moderate exercise5 days per week

Eat a healthy diet5 or more servings of vegetables and fruits each dayChoose whole grains over processed (refined) grainsLimit processed and red meats

Choose other healthy habitsDont drink alcohol, or do so only in moderation