1. Understanding Cancer

3. Different Kinds of Cancer Lung Breast (women) Colon Bladder Prostate (men) Some common sarcomas: Fat Bone Muscle Lymphomas: Lymph nodes Leukemias: Bloodstream Some common carcinomas:

4. Loss of Normal Growth Control Cancer cell division Fourth or later mutation Third mutation Second mutation First mutation Uncontrolled growth Cell Suicide or Apoptosis Cell damage— no repair Normal cell division

5. Example of Normal Growth Cell migration Dermis Dividing cells in basal layer Dead cells shed from outer surface Epidermis

6. The Beginning of Cancerous Growth Underlying tissue

7. Tumors (Neoplasms) Underlying tissue

8. Invasion and Metastasis 3 Cancer cells reinvade and grow at new location 1 Cancer cells invade surrounding tissues and blood vessels 2 Cancer cells are transported by the circulatory system to distant sites

9. Malignant versus Benign Tumors Malignant (cancer) cells invade neighboring tissues, enter blood vessels, and metastasize to different sites Time Benign (not cancer) tumor cells grow only locally and cannot spread by invasion or metastasis

10. Why Cancer Is Potentially Dangerous Melanoma cells travel through bloodstream Melanoma (initial tumor) Brain Liver

11. Cancer Detection and Diagnosis

12. Early Symptoms Fatigue Weight loss Fevers Night sweats Cough Hemoptysis (coughing up blood) Hematemesis (vomiting blood) Pain Change in bowel habits

13. Early Cancer May Not Have Any Symptoms

14. Cervical Cancer Screening Abnormal Pap smear Normal Pap smear

15. Breast Cancer Screening

16. Prostate and Ovarian Cancer Screening

17. Colon Cancer Screening

18. Biopsy Patient’s tissue sample or blood sample Genomic profile Proteomic profile Pathology

19. Microscopic Appearance of Cancer Cells

20. What Causes Cancer? Some viruses or bacteria Heredity Diet Hormones RadiationSome chemicals

21. Population-Based Studies CANADA: Leukemia Regions of Highest Incidence BRAZIL: Cervical cancer U.S.: Colon cancer AUSTRALIA: Skin cancer CHINA: Liver cancer U.K.: Lung cancer JAPAN: Stomach cancer

22. Heredity? Behaviors? Other Factors? 100 50 5 0 Stomach Cancer (Number of new cases per 100,000 people) U.S.JapanJapanese families in U.S. 100 70 7 0 Colon Cancer (Number of new cases per 100,000 people) U.S.JapanJapanese families in U.S.

23. Tobacco Use and Cancer Some Cancer-Causing Chemicals in Tobacco Smoke

24. Low-Strength Radiation Annual Sunshine (UV radiation) Skin Cancer Incidence Most Dallas Pittsburgh High Detroit Low Least

25. High-Strength Radiation Most High Low Least Leukemia Incidence X-ray Dose (atomic radiation)

26. Lag Time 4000 3000 2000 1000 20-Year Lag Time Between Smoking and Lung Cancer Cigarettes Smoked per Person per Year Lung Cancer Deaths (per 100,000 people) Year Lung cancer (men) Cigarette consumption (men) 1900 1920 1940 1960 1980 150 100 50

27. Viruses Virus inserts and changes genes for cell growth Cancer-linked virus

28. Examples of Human Cancer Viruses Some Viruses Associated with Human Cancers

29. AIDS and Kaposi’s Sarcoma Kaposi’s sarcoma Without disease Depressed immune system HIV infection KSHV infection

30. Bacteria and Stomach Cancer H. pylori Patient’s tissue sample

31. Heredity and Cancer Inherited factor(s) All Breast Cancer Patients Other factor(s)

32. Heredity Can Affect Many Types of Cancer Inherited Conditions That Increase Risk for Cancer

33. Cancer Risk and Aging 400 300 200 100 Cancer Risk and Aging Number of Cancer Cases (per 100,000 people) Age of Person (in years) Colon Breast 0 20 40 60 80

34. Genes and Cancer Chromosomes are DNA molecules Heredity Radiation Chemicals Viruses

35. What Causes Cancer? Regarding the most common diseases, Dr. Lamont Murdoch of Loma Linda University School of Medicine has put it aptly: “faulty genetics loads the gun,... lifestyle pulls the trigger.”

36. 2009 Estimated US Cancer Deaths* ONS=Other nervous system. Source: American Cancer Society, 2009. Men 292,540 Women 269,800 26%Lung & bronchus 15%Breast 9%Colon & rectum 6%Pancreas 5%Ovary 4%Non-Hodgkin lymphoma 3%Leukemia 3%Uterine corpus 2% Liver & intrahepatic bile duct 2%Brain/ONS 25% All other sites Lung & bronchus30% Prostate9% Colon & rectum 9% Pancreas6% Leukemia4% Liver & intrahepatic4% bile duct Esophagus4% Urinary bladder3% Non-Hodgkin 3% lymphoma Kidney & renal pelvis3% All other sites 25%

37. Trends in the Number of Cancer Deaths Among Men and Women, US, 1930-2006 Women Men Number of Cancer Deaths Men Women Source: US Mortality Data, 1930-2006, National Center for Health Statistics, Centers for Disease Control and Prevention, 2009.

38. Cancer Prevention Cancer viruses or bacteria Carcinogenic radiation Carcinogenic chemicals

39. Avoid Tobacco 15x 10x 5x Non-smoker Cigarettes Smoked per Day Lung Cancer Risk Increases with Cigarette Consumption Lung Cancer Risk 0 15 30

40. Protect Yourself From Excessive Sunlight

41. Limit Alcohol and Tobacco 40x 30x 20x 10x Alcoholic Drinks Consumed per Day Packs of Cigarettes Consumed per Day Combination of Alcohol and Cigarettes Increases Risk for Cancer of the Esophagus Risk Increase AND

42. Diet: Limit Fats and Calories 0 Number of Cases (per 100,000 people) Grams (per person per day) Correlation Between Meat Consumption and Colon Cancer Rates in Different Countries 40 30 20 10 30020010080

43. Diet: Consume Fruits and Vegetables

44. Cancer Death Rates According to Fitness Status Men 男性 Women 女性 20 15 10 5 0 20.3 16.3 7.3 9.7 4.7 1 Poor Fitness Good Fitness Age-adjusted Per 10,000 Person - Years 10,000 人之中每年的歲數調整 25 Average Fitness Cancer death rates were substantially higher in low-fit subjects compared to those with moderate or good fitness.

45. Avoid Cancer Viruses Noninfected women HPV Infection Increases Risk for Cervical Cancer Cervical Cancer Risk Low High Women infected with HPV

46. Avoid Carcinogens at Work Some Carcinogens in the Workplace

47. Industrial Pollution 1930 Incidence of Most Cancers Year 199019701950

48. Is There a Cancer "Epidemic"?