1. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12 © 2005 McGraw-Hill Higher Education Cancer Chapter 12

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12 © 2005 McGraw-Hill Higher Education Tumor Development

9. 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

10. 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 radicals A. Phytochemicals – A. Prevent cancer by blocking formation of cancerous tumors B. Also ‘detoxify’ cancer causing agents B. Fiber – binds to bile acids – helps to extract bacteria in the intestines C. Tea – Polyphenols block formation of nitrosamines D. 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 effect G. Alcohol – excessive alcohol linked with certain cancers H. Excessive Body weight – Obesity is associated with colon, rectal, breast, prostate, endometrium and kidney cancers

11. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12 © 2005 McGraw-Hill Higher Education SOURCE: National Cancer Institute

12. 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 PhytochemicalEffectSources 1. SulfophraneRemoves carcinogens from cellsBroccoli 2. PEITCKeeps carcinogens from binding Broccoli to DNA 3. GenisteinPrevents small tumors from Soybeans small capillaries to get oxygen 4. FlavonoidsHelps keep cancer causingFruits and hormones from locking onto cellsvegetables 5. p-coumaricDisrupts chemical combination ofStrawberries. cell molecules that can producegreen peppers, carcinogenstomatoes, pineapple 6. CapsaicinKeeps carcinogens from bindingHot chili peppers to DNA

13. 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 Tobacco 1. 87-90% of lung cancers from smoking 3. Avoid excessive sun exposure: 1. Basal cell carcinoma 2. Squamous cell carcinoma 3. Malignant melanoma 4. Monitor estrogen, radiation, and occupational hazard exposure 5. Physical activity – active lifestyles are protective 1. Colon 2. Breast 3. Liver 4. Endometrial 6. Early Detection 1. Once a month BSE for women 2. Once a month TSE for men

14. 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

15. 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

16. 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) Lung Colon & rectum Prostate Pancreas Stomach Liver Rate Per 100,000 Leukemia

17. 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 Lung Colon & rectum Uterus Stomach Breast Ovary Pancreas

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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

31. 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

32. 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

33. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12 © 2005 McGraw-Hill Higher Education UV Index

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12 © 2005 McGraw-Hill Higher Education Preventing Cancer