Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Cancer
Chapter 12
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
What Is Cancer?
Cancer = abnormal, uncontrolled cellular growth
Benign versus malignant tumors Malignant tumor = cancerous and capable of
spreading; neoplasm Benign tumor = noncancerous and nonspreading
1.3 million cases of cancer per year; 550,000 deaths
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Percentage of All Cancer Deaths Linked to Risk Factors
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
How Cancer Spreads: Metastasis
Metastasis = spread of cancer cells from one part of the body to another Blood vessels Lymphatic system
Secondary tumors or metastases
Carcinogen = any substance that causes cancer
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
The Causes of Cancer: Role of DNA
DNA basics DNA = deoxyribonucleic acid, a chemical substance
that carries genetic information Chromosome = threadlike body in a cell nucleus that
contains molecules of DNA Gene = section of chromosome that contains the
instructions for making a particular protein
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
The Causes of Cancer: Role of DNA
DNA mutations and cancer A mutated gene no longer
contains the proper code for producing its protein
Within DNA are ONCOGENES and TUMOR SUPPRESSOR genes
Normally work together to repair and replace cells
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Action of the enzyme telomerase
•If cells maintain telomerase, they will reproduce indefinitely – increases chance for a cancer cell development
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Tumor Development
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Free Radicals and Cancer
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Guidelines for preventing Cancer:1. Dietary Changes:
Diet should be primarily vegetarian Cruciferous vegetables are important Antioxidants are important – absorb free radicalsA. Phytochemicals –
A. Prevent cancer by blocking formation of cancerous tumorsB. Also ‘detoxify’ cancer causing agents
B. Fiber – binds to bile acids – helps to extract bacteria in the intestinesC. Tea – Polyphenols block formation of nitrosaminesD. Dietary fat –
A. Some experts think fat intake should be 20% or less of daily intake
E. Processed Meat / Protein – Nitrate-cured foods associated w/ throat and stomach cancers
F. Soy – Plant estrogens may have protective effectG. Alcohol – excessive alcohol linked with certain cancersH. Excessive Body weight – Obesity is associated with colon, rectal, breast, prostate,
endometrium and kidney cancers
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
SOURCE: National CancerInstitute
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Phytochemicals and their effects and sources
Phytochemical Effect Sources
1. Sulfophrane Removes carcinogens from cells Broccoli
2. PEITC Keeps carcinogens from binding Broccoli
to DNA
3. Genistein Prevents small tumors from Soybeans
small capillaries to get oxygen
4. Flavonoids Helps keep cancer causing Fruits and
hormones from locking onto cells vegetables
5. p-coumaric Disrupts chemical combination of Strawberries.
cell molecules that can produce green peppers,
carcinogens tomatoes, pineapple
6. Capsaicin Keeps carcinogens from binding Hot chili peppers to DNA
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Guidelines for preventing Cancer:
2. Abstaining from Tobacco1. 87-90% of lung cancers from smoking
3. Avoid excessive sun exposure:1. Basal cell carcinoma2. Squamous cell carcinoma3. Malignant melanoma
4. Monitor estrogen, radiation, and occupational hazard exposure5. Physical activity – active lifestyles are protective
1. Colon2. Breast3. Liver4. Endometrial
6. Early Detection1. Once a month BSE for women2. Once a month TSE for men
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Cancer Cases and Deaths
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Cancer Rates by Country
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Male Cancer Death Rates, 1930–2000 (Source: American Cancer Society)
0
20
40
60
80
100
1930
1935
1940
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Lung
Colon & rectumProstate
Pancreas
Stomach
Liver
Rate Per 100,000
Leukemia
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Female Cancer Death Rates, 1930–2000 (Source: American Cancer Society)
Rate Per 100,000
0
20
40
60
80
100
1930
1935
1940
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Lung
Colon & rectum
Uterus
Stomach
Breast
Ovary
Pancreas
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Common Cancers: Lung Cancer
Leading cause of cancer death Chief risk factor = smoking ETS causes about 3000 lung cancer deaths
per year Symptoms = persistent cough, chest pain Treatment = combination of surgery,
radiation, chemotherapy Survival rate = 15% after five years
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Common Cancers: Colon and Rectal Cancer Second leading cause of cancer death Risk factors
Age Preexisting polyps Heredity Inactivity and obesity Diets high in red meat, smoked foods, simple
sugars Excessive alcohol consumption Smoking
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Common Cancers: Colon and Rectal Cancer Symptoms
Bleeding from the rectum Change in bowel habits
Testing Stool blood test Sigmoidoscopy or colonoscopy
Treatment Surgery is primary method of treatment
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Common Cancers: Breast Cancer
Most common cancer in women and second to lung cancer in the number of cancer deaths among women
Causes/risk factors Heredity Long-term exposure to high blood levels of estrogen
Early onset of menstruation Late onset of menopause No children or first child after age 30 Obesity Current use of HRT Alcohol use
Inactivity Diet low in vegetables and fiber
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Common Cancers: Breast Cancer
Early detection Mammography (low-dose X ray) after age 40 Clinical breast exams Breast awareness and self-examinations
Diagnosis Ultrasonography = imaging method using high-pitched
sound Biopsy = removal and examination of a small piece of
body tissue Treatment
Surgery (lumpectomy, mastectomy) Chemotherapy or radiation, social support
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Common Cancers: Prostate Cancer
Most common cancer in men and second to lung cancer in the number of cancer deaths among men
Risk factors Age African American ethnicity Heredity Lifestyle factors
Diets high in calories, dairy products, and animal fat and low in plant foods
Obesity and inactivity History of STDs
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Treatment Options example:Prostate Cancer
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Common Cancers: Prostate Cancer
Detection and diagnosis Rectal exam PSA (prostate-specific antigen) blood test Ultrasound Biopsy
Treatment Surgery Radioactive seeds
Survival rate = 98% at 5 years
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Cancers of the Female Reproductive Tract Cervical cancer
Linked to infection with HPV (genital warts) Detected with the Pap test = scraping of cells
from the cervix for examination Abnormal cells are monitored over time; if they
progress toward malignancy, they are removed
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Cancers of the Female Reproductive Tract Uterine or endometrial Cancer
Risk factors similar to those for breast cancer Usually detected by pelvic examination Treatment = surgery, possibly combined with radiation
and chemotherapy Survival rate = 96% at 5 years
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Cancers of the Female Reproductive Tract Ovarian cancer
Risk factors similar to breast and endometrial cancer Anything that lowers the lifetime number of ovulation cycles
reduces risk Usually has no symptoms and is difficult to detect Treatment = surgery Survival rate is low due to late detection
Other female reproductive tract cancers Clear cell cancer of vagina or cervix is more common
among daughters of women who took DES during pregnancy
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Skin Cancers
Most common type of cancer when cases of the highly curable forms are included
Primary risk factor is exposure to ultraviolet (UV) radiation UVA = longer wavelength; damages connective
tissue, leads to premature aging of the skin, causes skin cancer
UVB = shorter wavelength; causes sunburn, damages eyes and immune system, causes skin cancer
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Skin Cancers
Basal cell carcinoma = cancer of the deepest layers of the skin
Squamous cell carcinoma = cancer of the surface layers of the skin
Melanoma = a malignant tumor of the skin that arises from pigmented cells, usually a mole; the most dangerous form of skin cancer
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
ABCD Test for Melanoma
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Preventing Skin Cancer
Wear long-sleeved shirts, long pants, hats Use a broad-spectrum sunscreen with a high SPF (30+) Apply sunscreen 30 minutes before sun exposure, 15–
30 minutes after exposure begins, and frequently after that; apply extra if you are using DEET
Avoid sun exposure between 10 AM and 4 PM Check UV index Avoid tanning salons
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
UV Index
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Common Cancers
Oral cancer Key risk factors are tobacco use (including spit
tobacco) and consumption of alcohol Easy to detect but difficult to treat
Testicular cancer Rare overall, but most common cancer in men
age 20–35 years Can be detected with self-examination
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Other Cancers
Pancreatic cancer = very deadly form of cancer Bladder cancer Kidney cancer Brain cancer Leukemia = cancer of white blood cells Lymphoma = cancer that begins in the lymph
nodes
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Dietary Guidelines for Cancer Prevention
Eat a varied plant-based diet Eat 5–9 servings of fruits and vegetables each day
Cruciferous vegetables Citrus fruits and berries Dark-green leafy vegetables Dark-yellow, orange, or red fruits or vegetables
Eat high-fiber foods Limit consumption of meat and total fat; favor
monounsaturated and omega-3 polyunsaturated fats Limit consumption of charred, blackened, cured, and
smoked meat and fish Be moderate in consumption of alcohol
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
The Causes of Cancer
Inactivity and obesity Carcinogens in the environment
Ingested chemicals Environmental and industrial pollution Radiation Microorganisms
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Recommendations of Early Detection of Cancer in Asymptomatic People
Breast: Yearly mammograms at age 40 Clinical breast exam as part of periodic well-exam starting every 3 yr in 20s and 30s BSE monthly and reporting any irregularities
Colon / Rectal: Beginning at age 50, men/women should follow schedule:
Fecal occult blood test every year Flexible sigmoidscopy every 5 years Colonoscopy every 10 years
Prostate: PSA rectal test and digital rectal exam – annually starting at age 50 Men with history should begin at age 45
Uterus: Screening begins at 21 with regular Pap smear
Endometrium: ACS recommends at menopause – women should be informed about this cancer – report unusual
spotting /bleeding
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Seven Major Warning Signs of Cancer
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12© 2005 McGraw-Hill Higher Education
Preventing Cancer