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10 CARDIOVASCULAR DISEASE & CANCER 10 “You only live once… but if you work it right, once is enough.” - Joe E. Lewis - 10 CARDIOVASCULAR DISEASE DEATH RATES FOR HEART DISEASE OF WOMEN, AGES 45+ 10 THE HEART CROSS-SECTION 10 PATHOPHYSIOLOGY OF THE HEART Categories of Cardiovascular Diseases: Coronary Heart Disease (CHD) Cerebrovascular Disease (Stroke) Hypertension Congestive Heart Failure (CHF) Congenital Heart Disease Rheumatic Heart Disease Angina Pectoris Peripheral Artery Disease (PAD) 10 Coronary Heart Disease: Arteriosclerosis - generic term describing any disease of the arteries that leads to thickening and hardening of artery walls Atherosclerosis Myocardial Infarction Thrombus Congestive Heart Failure: weak heart muscles that cannot perform the pump function with proper vigor 10 Cerebrovascular Disease (Stroke): 3 Types of Stroke Thrombus Embolism Aneurysm 10 Congenital Heart Disease: Babies born with a hole in septum, imperfectly formed blood vessels, valvular damage, or left ventricular imperfections Rheumatic Heart Disease: Results from bacterial infection ‘streptococcus’, which causes damage to heart valves Angina Pectoris: Chest pain resulting from insufficient supply of blood (oxygen) to heart muscle Peripheral Artery Disease: Disease of the extremities in which blood supply is diminished resulting in lack of nutrients/oxygen to arms/legs 10 RISK FACTORS FOR CVD Age Hypertension Genetics Elevated Cholesterol Race Sedentary Lifestyle Obesity Diabetes Smoking Menopause Drugs Oral Contraceptives 10 GENDER DIFFERENCES OF CVD Prevalence of CHD higher in men Approximately equal number of deaths Incidence is much higher in men at earlier ages Incidence in women increases after menopause Symptoms and signs vary among genders Women more likely to have a recurrent attack Women more likely to die from heart attack RACIAL DIFFERENCES OF CVD CVD death rate higher in African American women than in white women 10 CANCER MAIN GROUPS OF CANCER Carcinoma Sarcoma Leukemia Lymphoma Hepatoma Melanoma Neuroblastoma 10 BREAST CONDITIONS Benign Breast Diseases: Fibrocystic Breast Disease Hyperplasia Fibroadenoma Breast Cancer: 5 Levels Stage I: <2cm in size, localized Stage II: 2-5cm in size, localized Stage III: >5cm in size, grown into chest wall, skin, or lymph nodes Stage IV: Growth spread to other parts of body 10 Risk Factors for Breast Cancer: Gender Age Family history Never had children Had firs child after 30 yrs. Early menarche (before 12) Late menopause (after 55) Oral contraceptive use Hormone Replacement Therapy Higher breast density 10 Breast Cancer Screening: The Mammogram 10 GYNECOLOGICAL CONDITIONS Benign Cervical Changes: Polyps Cervical Dysplasia Cervical Cancer: Stages 0-IV Screening = Pap Smear Risk Factors: Human papillomavirus (HPV), smoking, immunosuppressant drugs, early sexual intercourse, multiple sex partners, >4 pregnancies Treatment: Cyrosurgery, Cone biopsy, laser cone biopsy 10 Benign Uterine Conditions: Fibroids Adenomyosis Endometrial Hyperplasia Endometriosis Malignant Uterine Tumors: 4 Stages Screening: Pelvic exam, transvaginal ultrasound, endometrial biopsy Risk Factors Age, high levels of estrogen, obesity, diabetes, failure to ovulate, history of infertility, family history, using Tamoxifen Treatment Hysterectomy, surgery, radiotherapy, progesterone 10 Benign Ovarian Growths: Cysts Polycystic Ovarian Syndrome Ovarian Cancer: 4 Stages Screening: Pap smear, transvaginal ultrasound, blood test Risk Factors Reproductive tract history, no children, early menstruation, late menopause, pregnancy after age 30, oral contraceptives, previous cancer, long-term use of fertility drug Clomiphene Citrate Treatment Hysterectomy, surgery, radiotherapy, chemotherapy 10 OTHER CANCERS Lung Cancer Colorectal Cancer Skin Cancer Comparison of Estimated New Cancer Cases and deaths, U.S. Women, 1999 10 INFORMED DECISION MAKING SCREENING TESTS FOR WOMEN OF DIFFERENT AGES Age Recommendations Benefit Under 40 Breast exam by doctor No data 40-49 Breast exam by doctor; mammogram ever 1-2 years Chances of dying from breast cancer by 17% 50-74 Breast exam by doctor; mammogram every 1-2 years Chances of dying from breast cancer by 30% 75+ Breast exam by doctor; mammogram every 1-2 years No data