Womens Health 16

© 2008 McGraw-Hill Higher Education. All rights reserved.

Chapter Sixteen

Reducing Your Risk of Cancer


Defining Cancer

• Cancer is a group of diseases characterized by uncontrolled growth of anaplastic cells that often invade surrounding tissue and metastasize to distant body sites

• A woman’s prognosis depends upon a variety of factors e.g. location, nature of the tumor, and its stage

• The key to survival is early detection• The higher incidence and mortality rates for cancer in women

are:• Breast• Lungs• Colon• Rectum

Tumors can be malignant or benign


Seven Warning Signs of Cancer

CChange in bowel/bladder habits

AA sore that does not heal

UUnusual bleeding or discharge

TThickening or a lump in the breast or elsewhere

IIndigestion or difficulty swallowing

OObvious change in a wart/mole

NNagging cough or hoarseness

In 2006 it was estimated that 679,510 women would be diagnosed with cancer and 273,560 would die


Leading Sites of New Cancer Cases and

Death in Women, 2006 Estimates Estimated New Cases Estimated Deaths

Breast – 212,920 (31%)Lung & Bronchus 72,130 (26%)

Lung & Bronchus (81,770 (12%) Breast 40,970 (15%)

Colon & Rectum 75,810 (11%) Colon & Rectum 27,300 (10%)

Uterine corpus 41,200 (6%) Pancreas 16,210 (6%)

Non-Hodgkin lymphoma 28,190 (4%) Ovary 15,310 (6%)

Melanoma of skin 27,930 (4%) Leukemia 9,810 (4%)

Thyroid 22,590 (3%) Non-Hodgkin lymphoma 8,840 (3%)

Ovary 20,180 (3%) Uterine corpus 7,340 (3%)

Urinary bladder 16,730 (2%) Multiple myeloma 5,630 (2%)

Pancreas 6,580 (2%) Brain & other nervous system 5,560 (2%)

All sites 679,510 (100%) All sites 273,560 (100%)


Four Most Common Categories of Cancer

• Carcinomas – 85% of all cancers tend to be classified here (organs, skin, nerves, membranes)

• Sarcomas – bone, blood, connective tissue (2% of malignant cancers)

• Lymphomas – immune tissues/system (i.e., Hodgkin’s Disease and non-Hodgkin’s)

• Leukemia - blood and blood-forming tissues (bone marrow)

See Table 16.2


Staging Cancer

• There has been an identification system known as the TNS staging system– T = recognizes the extent of malignancy– N = progressed or not to the lymph node– M = presence or absence of metastasis

A numerical system tracks the extent of the growth potential of cancer (I, II, III, or IV)


Causes of Cancer

• Cigarette Smoking• Diet• Growing older (age)• Viruses• Alcohol Consumption

• Close Relatives with certain types of Cancer

• Hormone Replacement Therapy (HRT)

• Diethylstillbestrol (DES)

Lifestyle Factors Implicated in Cancer


Causes of Cancer (cont.)

• Exposure to Sun• Ionizing Radiation• Chemical and other substances

Environmental Factors Implicated in Cancer


Current Research Regarding Causes and Treatment

• Molecular and Cellular Causes of Cancer

• Altered DNA may be responsible for abnormal growth

• Cell Cycle Research• Defects in the synthesis or

assembly of DNA during replication may cause genetic instability

• Gene Mutation Research• Some individuals may be

susceptible to mutation of suppressor genes

• Adjuvant Treatment• Substances to enhance

the action of drugs to treat cancer i.e. chemicals

• Immunotherapy Research• Boosting the immune

system to prevent tumor growth or attack cancer cells

• Stem Cell Transplantation Research

• Removal of cells in bone marrow before radiation or chemotherapy and later restored


Lung Cancer

• Two Types– Non-small cell (most common)– Small (oat) cell

• Risk Factors – Smoking– Environmental pollutants

• Early detection symptoms– Persistent cough, blood in the sputum, constant chest pain, recurring

pneumonia, or bronchitis

• Treatment– Surgery– Radiation– Chemotherapy– Laser therapy (PDT)

Leading cause of cancer death in women


Breast Cancer

• Identifiable protective factors– Breast feeding and having children– Exercise

• Early Detection– Lumps– Thickening in the breast or underarm area

• Additional warning signs:– Change in the size or shape of the breast– Discharge from the nipple– Change in the color or texture of the skin of the breast or

around the areola

Second leading cancer killer of all women


Risk Factors for Breast Cancer

– Being a woman– Age– Early menstrual cycle for

women– Women with no children or

having children later in life– Hormone replacement

therapy use– Dense breast tissue

• Family History• Previous breast biopsy• Previous breast exposure to

radiation• Alcohol• Obesity• High fat diet• Genetic alterations


Early Detection Through Regular Breast Self-Exams (BSE)

Breast self-examination

The American Cancer Society still recommends breast self-examination for women age 20 and over every month


Breast Cancer (cont.)

• Screening and Diagnosis– Mammography– Biopsies (excisional or incisional)

• Treatment (two categories)– Local therapy (surgery or radiation)

• Surgery is the most common treatment– Lumpectomy– Mastectomy– Modified radical mastectomy

– Systemic (chemotherapy, hormonal therapy, or biological therapy)


Uterine and Cervical Cancer

• Uterine cancer begins in the endometrium (lining of the uterus)

• Cervical cancer begins in the cervix and are considered squamous cell carcinomas

• Approximately 9,700 women develop cervical cancer each year

• Cervical cancer is 100% curable and endometrial cancer is 94% curable when detected early

• Deaths related to ovarian and uterine cancer, which comprise only 13 percent of the cancers of women, are exceeded only by lung, breast, and colon cancers


Cervical Cancer

• Risk factors– Early and continued sexual activity– HPV and/or Herpes infection– Smoking

• Prevention/Early Detection– Sexual abstinence– Pap tests– Careful selection of sexual partners

• Treatment– Surgery (minor or major)– Radiation– Chemotherapy


Uterine Cancer

• Risk Factors– Early menarche, late menopause, lack of ovulation,

never having given birth, ERT, use of tamoxifen, and also in diabetics, obese, and hypertensive women

• Prevention/Early Detection– Minimize high levels of estrogen and regular

physician care

• Treatment– Surgery, radiation, chemotherapy, hormone treatment


Ovarian Cancer• Ovarian cancer is a malignant tumor that begins in the ovaries

– Prevention• Similar to what is recommended for breast cancer• Prophylactic oophorectomy

– Early Detection• Referred as the “silent cancer”• Annual pelvic exams• Genetic screenings (CA-125 radioimmunoassay)

– Treatment• Surgery• Chemotherapy• Drug therapy• Radiation

• In 2006, ACS estimates that there will be 20,180 new cases of ovarian cancer and 15,310 women will die from this cancer

Ovarian cancer is the seventh most common cancer in women


Skin Cancer

• Skin cancer is the most prevalent and most curable type of cancer found in women

• Basal cell carcinomas are the most common type of malignancy in humans

• They are usually raised, hard, reddish lesions with a pearly surface and rarely metastasize

• These carcinomas are typically scaly and slightly elevated

• They are a relatively slow-growing malignancy


Skin Cancer (cont.)

• Malignant melanoma is the most dangerous but less common– Risk factors

• Severe sunburn during childhood, chronic sun exposure during young adulthood

– Prevention• Reduce exposure to sun’s rays, use sunscreens,

– Early Detection• American Cancer Society guidelines (next slide)

– Treatment• Radiation, Laser therapy, tissue destruction (heat or

freezing)

Skin Cancer is the most prevalent and curable type of cancer in women


American Cancer SocietyABCD Method

AAsymmetry

BBorder irregularity

CColor change

DDiameter greater than 6mm


Colon and Rectum Cancer

• In 2006, an estimated 75,810 new cases of colon and rectal cancer will be diagnosed in women and 27,300 women are estimated to die from the disease – Risk factors

• Personal and family history, polyps, or ulcerative colitis– Preventive Screening

• Digital rectal exam yearly after age 40 for women, FOBT, and sigmoidoscopy or colonoscopy exam every 3-5 years after age 50

– Early Detection• Rectal exams, stool test, sigmoidoscopy, colonoscopy

– Treatment• Surgery, radiation, chemotherapy


Steps to Take When Diagnosed with Cancer

• Once a woman knows the type of cancer, she can call the National Cancer Institute at 1-800-4-CANCER

• Get a second opinion before deciding on a particular treatment protocol

• Make sure you feel certain about your options• Social support is a critical factor in recovery

from cancer. There are many avenues of social support to pursue during all stages of treatment


Complementary Treatment in Cancer Management

• Magnetic and Electronic Devices• Radionic devices• Galvanic devices• Low-level output electrical devices• Magnetic devices• Color and light treatment devices

• Food remedies• Vegetarian diets• Herbal and vitamin therapy

• Spiritual and Meditation Practices• Relaxation• Acupuncture and Acupressure


Chapter Sixteen

Reducing Your Risk of Cancer

Womens Health 16

Health & Medicine

Transcript of Womens Health 16