Download Cardiovascular Disease and Cancer

Chapter 10
Cardiovascular Disease
and Cancer
Cardiovascular Disease and Cancer
The greatest causes of death in the
United States and the world
• Cardiovascular disease
– Heart disease
– Cerebrovascular disease (stroke)
• Cancer
– Can affect any area
– In women, most likely to affect breasts,
lung, reproductive system and skin
Epidemiology of
Cardiovascular Disease
• 450,000 U.S. women die annually of CVD
• If all major forms of CVD were eliminated,
life expectancy would increase by 7 years
• Of the various forms of CVD
– Coronary heart disease is the leading killer,
killing nearly 480,000 people
– Stroke kills over 150,000 people per year
(about 1 of 5 CVD deaths)
– 60% of stroke deaths are women
Economic Dimensions
• Estimated cost annual cost for
cardiovascular disease:
– Direct costs: health expenditures, hospital
and nursing home services, medications,
home health care
– Indirect costs: lost productivity (both to
people with CVD and their caretakers)
Cardiovascular System
Coronary heart disease
• Occurs when the
coronary arteries
become blocked or
narrowed with
plaque
• Clots forming in an
artery can also lead
to blockages
• Can lead to a heart
attack (death of part
of the heart)
If Plaque Causes CHD, what
Causes Plaque?
CHD begins with plaque buildup
inside the lining of the coronary
arteries.
Plaque begins with LCL cholesterol
moving inside the arteries; white
blood cells can also get stuck inside
the lining and die.
Plaque can grow until it takes up 95%
of the space in an artery.
Other Forms of Heart Disease
Congestive heart failure
• Weak heart muscles that cannot perform the
pumping function with proper vigor
• Often a disease of older women who have
suffered heart damage from other causes
Arrhythmias
• Problems with the heartbeat (can be fast, slow, or
irregular
Other Forms of Heart Disease, Cont.
Rheumatic heart disease
• Results from bacterial infection with Streptococcus,
which can cause damage to heart valves. Can usually
be cured with antibiotics.
Angina pectoris
• Chest pain resulting from insufficient supply of blood
(oxygen) to heart muscle
• Disease of the extremities (arms/legs) in which blood
supply is diminished, resulting in lack of nutrients and
oxygen
Metabolic syndrome
• Group of disease that occur together and cause
CVD. Risk factors include:
– Elevated waist circumference
– High blood lipid levels
– Low HDL levels
– High blood cholesterol
– Elevated fasting blood glucose level
Metabolic syndrome is a greater risk for women
than it is for men.
Cerebrovascular Disease,
aka Stroke
• Blood vessels either within or leading to
the brain becomes damaged, blocked,
or burst.
• This leads to portions of the brain being
unable to receive oxygen, and thus
dying.
• Often survivors have a long, difficult
recovery process—many things may
have to be relearned.
Stroke, Cont.
Types of stroke
• Ischemic stroke—the most
common type, caused by a
cerebral thrombus or
embolism
• Hemorrhagic stroke—caused
by ruptured blood vessels
such as an aneurysm
• Possible warning sign: transient
ischemic attacks (TIAs)—brief
memory loss, garbled speech,
or other symptoms
Recovery From a Stroke
Recovery statistics
• 50% to 70% of survivors regain functional
independence
• 15% to 30% are permanently disabled
• 20% require institutional care within three months after
onset
• 25% of women with a stroke die within a year (risk of
death and future strokes increases with age)
Rehabilitation
• Depends on area affected—may require physicians,
nurses, physical therapy, speech therapy, mental
health professionals, or others
Risk Factors for CVD
• High LDL (“bad”) cholesterol, low HDL (“good”)
cholesterol
• Diabetes
• Hypertension
• Overweight and obesity
• Cigarette smoking
• Age (for women, after menopause)
• Physical activity
• Race/ethnicity
• Physical inactivity
Risk Factors for CVD, Cont.
• Age
• Hypertension
• Genetics
• Elevated cholesterol
• Race
• Sedentary lifestyle
• Obesity
• Diabetes
• Smoking
• Menopause
Gender Differences of CVD
• Before menopause, women’s hormones protect them
from CVD. But afterward, their risk increases more
sharply with age
• Symptoms and signs of a heart attack vary among
genders; women tend to have fewer, “quieter”
symptoms
– Fewer sharp, intense pains
– Shortness of breath
– Cold sweat, nausea, dizziness
• Women more likely to die from heart attack
Cigarette Smoking and CVD
• Smoking is a major risk factor for CVD (as well as
lung and other cancers)
• Carbon monoxide, nicotine, and other substances
in cigarette smoke constrict and injure arteries
• Health risks for smoking decline the earlier a
woman quits
• Secondhand smoke is a CVD (& cancer) risk factor
Cancer and Related Terms
• Cancer: disease caused by uncontrolled cellular
growth or reproduction
• Tumor: any abnormal cell growth; can be
benign (contained) or malignant
(growing/spreading)
• Metastasis: the process of cancer spreading
throughout the body
• Carcinogen: a substance that can cause cancer
Cancer and Women:
Epidemiological Overview
• Cancer is the second-leading cause of death in
the United States.
• 75% of cancers are diagnosed in people aged 55
and older
• Breast cancer is the most common cancer for
women
• Lung cancer is the second most common, but
causes the most deaths (lower survival rate)
• Third most common cancer = colorectal
• Fourth most common cancer = endometrial
Breast Conditions
Most women will find a lump in their breast at some
point in their lives. In 9 of 10 cases, this is not
cancer.
Benign breast diseases include:
• Fibrocystic breast disease (cystic mastitis)
• Hyperplasia
• Fibroadenoma
Breast Conditions
Breast cancer is a frightening, misunderstood issue in
women’s health. It can usually be successfully
treated if detected early.
• Five levels
– In situ: Too small to be felt; nearly 100%
5-year survival rate
– Stage I: < 2 cm in size, localized
– Stage II: 2–5 cm in size, localized
– Stage III: > 5 cm in size, grown into chest wall,
skin, or lymph nodes
– Stage IV: Growth spread to other parts of body
Risk Factors for Breast Cancer
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Gender
Age
Family history
Never had children or first child after 30
Early menarche (before 12) or late menopause
(after 55)
Consumption of high-fat diet or alcohol
Environmental factors
Obesity
Oral contraceptive use?
Breast Cancer Screening
• Breast self-exam
• Clinical breast exam
• Mammography
Treatment
• Lumpectomy
• Partial or segmental mastectomy
• Simple mastectomy
• Radical mastectomy
• Modified radical mastectomy
• Chemotherapy, radiation therapy, and
hormone therapy may be used alongside
surgery to improve chances of recovery.
Lung Cancer
Cigarette smoking is responsible for almost every
case of lung cancer, the deadliest form of cancer
for men and women.
• Lung cancer often spreads to other parts of the
body before it can be detected.
• Common symptoms are persistent cough, weight
loss, bloody sputum, recurring bronchitis,
pneumonia, and chest pain.
• Treatment is very difficult but can include surgery,
radiotherapy, and chemotherapy.
Cervical Cancer
• Caused by “high risk” strains of HPV
• Modern medicine has the potential to prevent
almost all cases of cervical cancer
• Screening: Pap smear, HPV test (for women 30
and over)
• Vaccination can prevent most, but not all, cases
of cervical cancer (screening still needed)
• Treatment: cyrosurgery, cone biopsy, laser cone
biopsy
Gynecological Conditions
Benign uterine conditions
• Fibroids
• Endometriosis—when it
grows into wall of uterus,
called adenomyosis
• Endometrial hyperplasia
• Treatments include hormone
therapy or surgery
(myomectomy, laparoscopy,
hysterectomy)
Malignant Uterine Tumors
Risk factors
• Age (over 50), obesity, diabetes, high blood
pressure, early menarche or late menopause,
history of infertility, family or personal history of
other cancers, long-term high-dose ERT, cigarette
smoking, use of Tamoxifen for breast cancer
Difficult to detect—too high up to be found on a pelvic
examination
Treatment may involve surgery and/or radiotherapy.
Benign Ovarian Growths
• Cysts—follicular, hemorrhagic, epithelial, dermoid
• Polycystic ovarian syndrome
Ovarian Cancer
• A deadly, stealthy, and largely misunderstood form of
cancer.
• Risk factors: no children, early menstruation, late
menopause, pregnancy after age 30, previous cancer,
long-term use of some fertility drugs
• Early symptoms: pelvic pressure, abdominal swelling,
gas pains, indigestion, vague abdominal discomfort
• Treatment: surgery, radiotherapy, chemotherapy
Cervical Cancer
• Caused by HPV, a very common sexually
transmitted virus
• Only high-risk strains of HPV can cause
cervical cancer
• Most women with high-risk HPV will NOT
develop cervical cancer
• Easily treated if found early (Pap smears,
HPV test)
• A new vaccine can now protect against some
high-risk strains of HPV
Colorectal Cancer
• Increasing age and familial adenomatous
polyposis (FAP) are major risk factors; high fat,
low-fiber diet is also a risk factor
• Warning signs: blood in stool, cramping in lower
abdomen
• Screening: digital rectal exam, sigmoidoscopy,
fecal occult blood testing, colonoscopy
• Treatment: surgery, radiotherapy, chemotherapy
Skin Cancer
Skin cancer
• Melanomas vs. nonmelanomas (basal cell and
squamous cell carcinomas)
• Risk factors: UV from sunlight, moles, family history,
race
• Screening and diagnosis: skin exam looking for ABCD
– Asymmetry
– Border irregularities
– Color irregularities
– Diameter
• Treatment: surgery, radiation
therapy, electrodessication,
cryosurgery, laser therapy
Reducing Your Risk of CVD and Cancer
• Importance of preventive lifestyle habits
• Knowledge of family history, genetic
risks
• Importance of screening for early
detection
What are you doing to reduce your risk
of CVD and cancer?