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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:
Dietary Changes:
1.



A.
Diet should be primarily vegetarian
Cruciferous vegetables are important
Antioxidants are important – absorb free radicals
Phytochemicals –
A.
B.
B.
C.
D.
Fiber – binds to bile acids – helps to extract bacteria in the intestines
Tea – Polyphenols block formation of nitrosamines
Dietary fat –
A.
E.
F.
G.
H.
Prevent cancer by blocking formation of cancerous tumors
Also ‘detoxify’ cancer causing agents
Some experts think fat intake should be 20% or less of daily intake
Processed Meat / Protein – Nitrate-cured foods associated w/ throat and
stomach cancers
Soy – Plant estrogens may have protective effect
Alcohol – excessive alcohol linked with certain cancers
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 Cancer
Institute
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
1.
Sulfophrane
2.
PEITC
3.
Genistein
4.
Flavonoids
5.
p-coumaric
6.
Capsaicin
Effect
Removes carcinogens from cells
Keeps carcinogens from binding
to DNA
Prevents small tumors from
small capillaries to get oxygen
Helps keep cancer causing
hormones from locking onto cells
Disrupts chemical combination of
cell molecules that can produce
carcinogens
Keeps carcinogens from binding
to DNA
Sources
Broccoli
Broccoli
Soybeans
Fruits and
vegetables
Strawberries.
green peppers,
tomatoes, pineapple
Hot chili peppers
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:
Abstaining from Tobacco
2.
1.
87-90% of lung cancers from smoking
Avoid excessive sun exposure:
3.
1.
2.
3.
Basal cell carcinoma
Squamous cell carcinoma
Malignant melanoma
Monitor estrogen, radiation, and occupational hazard exposure
Physical activity – active lifestyles are protective
4.
5.
1.
2.
3.
4.
Colon
Breast
Liver
Endometrial
Early Detection
6.
1.
2.
Once a month BSE for women
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)
100
Lung
Rate Per 100,000
80
60
Stomach
Prostate
Colon & rectum
40
20
Pancreas
2000
1995
1990
1985
1980
1970
1965
1960
1955
1950
1945
1940
1935
1930
0
1975
Liver
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)
100
80
Rate Per 100,000
60
Lung
40
Uterus
Breast
20
Colon & rectum
Stomach
Ovary
2000
1995
1990
1985
1980
1975
1970
1960
1955
1950
1945
1940
1935
1930
1965
Pancreas
0
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




Diagnosis



Mammography (low-dose X ray) after age 40
Clinical breast exams
Breast awareness and self-examinations
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
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 12
© 2005 McGraw-Hill Higher Education