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Nutrition and
Cancer
What is Cancer ?
!
!
Aranshi Gebregiorgis
Netanya Bledsoe
Liliya Daniyelyants
!
How cancer develops
!
!
Normally, cells divide to produce new cells only when the
body needs them.
" Replacing dead cells and repairing damaged ones.
Mutations in the genes that regulate cell division.
" Silence the genes that usually keep an eye on
reproducing DNA for chemical errors.
" Affected cells have no built-in brakes to stop cell
division.
A group of over 100
different diseases of the
body.
Named after the body
tissue from which it
originates.
The uncontrolled growth
and spread of abnormal
cells that can invade and
damage healthy body
tissues and organs.
How cancer develops
!
If cells keep dividing when new cells are not needed, a
mass of extra tissue, called a tumor, forms.
" Benign: Tumor stops growing without intervention or
can be removed surgically and poses no threat to
health.
" Malignant: Tumor multiplies out of control, threatens
health, and requires treatment.
! Tumor cells enter the bloodstream or lymphatic
system and may metastasize.
Benign
Tumor Formation
Carcinogen
Initiation
Promotion
Normal cells
Tumor
formation
Non-cancerous (benign) tumor
Malignant
Normal cells
Multiple Myeloma
Normal cells
Initiators begin the
Promoters enhance
process of changing the development of
the DNA in some of
abnormal cells.
the cells.
Cancerous (malignant) tumor
releases cells into the
bloodstream (metastasis)
Multiple Myeloma
How Myeloma Functions in the
Body
Cancer of the Plasma Cell
" Produces antibodies to
fight infections and
disease
" Derived from B-cells
!
!
Excessive amounts of
abnormal plasma cells in the
bone marrow
!
!
“Abnormal” refers to an
overproduction of plasma
cells
!
!
!
Lymphocytes (lymph
cells); main type of cell in
the immune system
Lymph cells are divided
to T cells and B cells
B cells respond to
antigens by transforming
into plasma cells, which
reside in the in the bone
marrow. (The inner soft
part of the bone)
Plasma cells release
antibodies to fight
bacteria.
www.users.rcn.com/jkimball.ma.ultranet/BiologyPages/B/B
an Tcells.html
Functions Cont.
!
!
!
!
!
When too many plasma cells are grown simultaneously,
it causes an abnormality and tumors are created in the
bone marrow
When the plasma cell tumors spread throughout the
bone, they are called “Myeloma”.
Hypercalcemia and anemia are some major causes of
overabundance of plasma cells
Carries same effects as osteoporosis, dissolves bones
through bone marrow
Myeloma cells are mostly found in pelvis, ribs, spine, and
skull
One Year Survival Rate
Who it effects
Age: Over 71; due to weakened immune
systems. Less than 1% are under 40 years of
age.
! Sex: Men are more prone
! Race: African Americans are highest at risk,
Asian Americans are least at risk; reasons
unknown.
! Family history/Genetics
! Weight (Obesity causes weaker immune
system)
! Other Plasma Cell diseases
!
Ten Year Survival Rate
Nutrition
How to Prevent Cancer
!
Beta-Carotene:
"
"
"
!
!
"
Molecule that gives oranges and carrots orange color.
Found in many fruits and vegetables, as well as egg
yolks.
Antioxidant; helps ward off cancerous cells, and
bacteria.
"
"
Selenium:
"
"
"
Vitamin C:
Essential trace mineral that is only needed in small
amounts.
Selenoproteins are antioxidant enzymes that prevent
cellular damage from free radicals. (antigens)
Walnuts, Tuna, Oatmeal, Eggs, Cottage Cheese, and
Brown Rice
Nutrition with Myeloma
Nutrition
!
Eicosapentaenoic Acid (EPA):
"
"
"
"
One of the several omega-3 fatty acids used by the
body.
Helps strengthen immune system and prevent
autoimmune diseases.
Mainly found in fish oils, including cold water fish such
as wild salmon.
Flaxseed oil, canola oil, walnuts, fish oil
Water soluble vitamin
needed for development
and growth.
Essential for healing
wounds, and repair of
cartilage, bones and teeth.
Green Peppers, citrus fruits
and juices, strawberries,
broccoli, tomatoes, leafy
greens, and cantaloupe.
!
Stay active
"
!
Drink Plenty of Fluids
"
!
Exercise on a regular basis at least twice a week for
stronger bones.
Preferably water
Maintain a Balanced Diet
"
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Calorie intake is important due to quick weight loss
Omit vitamins, herbs, and other medication unless
otherwise told by your doctor.
Increasing the Risk of Cancer
Avoiding natural sunlight
! Lack of physical Activity
Back pains
! Fatigue
! Extreme Thirst
! Frequent infections and Fevers
! Rapid Weight Loss
! Nausea and/or Constipation
! Frequent Urination
Treatment
Bibliography
!
Sodium Nitrate:
Symptoms
"
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Added in most packaged meats; hot dogs, pepperoni,
ham, bacon, sausage.
Hydrogenated Oils:
"
White bread, artificial sweeteners, cookies and
crackers; Smoking
!
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Melphalan (Alderan)
"
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"
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George, D Enitza Ph.D. “Recognition and Matter” American Family
Physician. 1999. American Academy of Family Physicians.
http://www.aafp.org/afp/990401ap/1885.html
!
3D Science. “Images” 3D science.com. 2006.
http://images.google.com/imgres?imgurl=http://www.3dscience.com/
img/Products/Images/clip_art/cells_cancer_web.jpg&imgrefurl=http:/
/www.3dscience.com/3D_Images/Biology/Cells/Cancer_Cell.php&h
=212&w=300&sz=64&hl=en&start=14&tbnid=vrCcfKeysl00IM:&tbnh
=82&tbnw=116&prev=/images%3Fq%3Dcancer%2Bcells%26svnum
%3D10%26hl%3Den%26rls%3DGGLG,GGLG:2005-43,GGLG:en
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Lional, Sagar Ph.D. “Intro to Myeloma” Multiple Myeloma Research
Foundation. 2005.
http://www.multiplemyeloma.org/about_myeloma/index.html#anchor_pa
ge_top
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National Cancer Institute. “What Is Myeloma” National Cancer Institute.
2005. US National Institutes of Health.
http://www.cancer.gov/cancertopics/wyntk/myeloma/page3
Taken by injection over 15 min.
Stops cancer cells from breaking down bones
Radiation
"
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Treats Lesions in bones caused by Myeloma
Zoledronate
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High energy X-rays or electric beams to destroy
cancer cells
Chemotherapy
"
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Stops cancer cells from dividing and reproducing.
Given in cycles, usually the same day, weekly.
BREAST CANCER
Bibliography Cont.
!
American Cancer Society. “How Is Myeloma Treated” American
Cancer Society. 2006. Cancer Reference Information.
http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_How_is_m
ultiple_myeloma_treated_30.asp?rnav=cri
!
MedicineNet. “Multiple Myeloma” MedicineNet.com. 2006.
http://www.medicinenet.com/multiple_myeloma/page9.htm
!
Cancer Institute. “Multiple Myeloma Survival Statistics” News and
Resources. 2004. Cancer Research UK.
http://images.google.com/imgres?imgurl=http://info.cancerresearchu
k.org/images/gpimages/cs_mmy_f04_12_04&imgrefurl=http://info.ca
ncerresearchuk.org/cancerstats/types/multiplemyeloma/survival/&h=
275&w=430&sz=11&hl=en&start=3&tbnid=TQBPWgTs
!
Whitney, Ellie. “Cancer” Diet and Health. China. Peter
Marshell.2005
What is breast cancer?
!
!
!
Cancer that forms in tissues of the breast, usually the
ducts (tubes that carry milk to the nipple) and lobules
(glands that make milk). It occurs in both men and
women, although male breast cancer is rare.
Most common cancer among women, other than skin
cancers.
Second leading cause of cancer deaths in women today
(after lung cancer).
Men and breast cancer
!
Men
" Less than 1% of all breast carcinomas occur in men.
" Mean age at diagnosis is between 60 and 70 years,
though men of all ages can be affected with the
disease.
" The American Cancer Society estimates male breast
cancer in the United States in 2006:
!
!
New cases: 1,450
Deaths: 470
Symptoms
!
A change in how the
breast or nipple feels:
" A lump or thickening in
or near the breast or in
the underarm area.
" Nipple tenderness.
!
Nipple discharge:
" fluid other than milk.
!
A change in how the
breast or nipple looks:
" A change in the size or
shape of the breast.
" A nipple turned inward
into the breast.
" The skin of the breast,
areola, or nipple may
be scaly, red, or
swollen. It may have
ridges or pitting so that
it looks like the skin of
an orange.
Diagnosis
!
Diagnosis
!
Breast Ultrasound Test:
"
"
The breast ultrasound
examination is a test using
ultrasonic (high-frequency
sound) waves.
These waves are sent to
the breast and echo waves
are then visualized on a
monitor.
!
Biopsy Test/ Needle
Test:
"
If tests 1-3 find an
abnormality that may be
cancerous, it is necessary
to extract tissue for
observation under a
microscope. A fine needle
aspiration biopsy (FNBA) is
done first.
Clinical Breast Examination
(Visual/Touch Exam):
" Examined visually and by
touch for any abnormalities
in the skin or nipples.
" Comparing the left and
right breasts and checking
for any swelling or lumps.
!
Mammography (Breast X-ray
Examinations):
" Breasts are compressed
between special plastic
plates for the X-ray.
" The X-ray shows abnormal
shadows such as masses,
calcifications, and
architectural distortions in
the breasts.
" Radiologist then compares
the new images of a
woman's breast to each
other and to previous
mammograms a woman
has had.
Diagnosis
!
Core biopsy:
" Thick needle used to
remove breast tissue.
" A pathologist checks
for cancer cells. This
procedure is also
called a needle biopsy.
!
Surgical biopsy:
" Removal of a sample
of tissue. A pathologist
checks the tissue for
cancer cells.
" An incisional biopsy
takes a sample of a
lump or abnormal area.
" An excisional biopsy
takes the entire lump
or area.
Most common types of breast
cancer
!
Invasive/infiltrating ductal carcinoma
"
"
"
Accounting for 80% of all breast cancers, the most
common type of breast cancer.
Cancer cells that form in the lining of your milk duct,
breaking free of the ductal wall and invading
surrounding breast tissue.
The cancer cells stay near the site of origin or they
can spread (metastasize) even farther throughout
your body, carried by your bloodstream or lymphatic
system.
Most common types of breast
cancer
!
Invasive (or infiltrating) lobular carcinoma.
"
"
"
Accounts for about 10%–15% of all breast cancers.
Starts in the milk-producing lobule and invades the surrounding
breast tissue.
It can also spread to more distant parts of your body.
Enlargement:
A normal cells
B lobular cancer cells breaking
through the basement
membrane
C basement membrane
Invasive/infiltrating ductal
carcinoma
Breast profile:
! A ducts
! B lobules
! C dilated section of duct to
hold milk
! D nipple
! E fat
! F pectoralis major muscle
! G chest wall/rib cage
Enlargement:
! A normal duct cells
! B ductal cancer cells breaking
through the basement
membrane
! C basement membrane
Risk factors for both sexes
Increased Relative Risk
Mechanism
Increasing age
Pre-menopausal: Increases
estrogen exposure
Postmenopausal: Impairs immune
function
Female sex
Increased estrogen exposure
BRCA genes
Inherited mutations in cancer
defense genes
Alcohol
Increases estrogen level by
decreasing liver function
Birth control pills
Increases estrogen exposure
Risk factors
Hormone replacement therapy
(HRT)
Increases estrogen exposure
Early menarche
Increases estrogen exposure
Late menopause
Increases estrogen exposure
Postmenopausal obesity
Increases estrogen exposure
Risk factors
Nulliparity (never bearing children) Maturity of breast lobules does not
occur
Late childbirth (over 30 years old)
Increases exposure of immature
type 1 & 2 lobules to estrogen
before first birth
Risk factors only for men
!
Klinefelter syndrome: This is a congenital (present at
birth) condition that affects about 1 of 1000 men.
" Normally men have a single X chromosome along
with their Y chromosome, but with Klinefelter
syndrome they have more than one X chromosome
(sometimes as many as 4).
" Causes testicles to be smaller than usual and not
produce functioning sperm cells, causing infertility
(making them infertile).
" Have lower levels of androgens (male hormones)
and more estrogens (female hormones). For this
reason, they often develop gynecomastia.
Risk factors only for men
!
Gynecomastia: A benign male breast growth, is the
most common male breast disorder. It is not a tumor but
rather an increase in the amount of a man's breast tissue.
"
Usually, men have too little breast tissue to be felt or
noticed.
"
Has a button-like or disk-like growth under nipple and
areola, which can be felt and sometimes seen.
"
Common among teenage boys and older men, this is
due to changes in hormone balance.
Protective factors
Decreased Relative Risk
Mechanism
Late menarche
Decreases estrogen exposure
Early menopause
Decreases estrogen exposure
Protective factors in food
Source
Vitamin/Antioxidant
Water fish, walnuts,
Omega-3 fatty acids,
eggs, flax oil, darkLignan
green leafy vegetables,
cod liver oil
Soy
Flavonoids
Oophorectomy (removal of ovaries Decreases estrogen production
before menopause)
Exercise
Decreases estrogen levels
Having children (especially starting Decreases number of immature
at an early age)
breast lobules
Breast feeding
Decreases estrogen by decreasing
number of menstrual cycles and/or
ovulation
Dairy products and
sunlight
Protective factors in food
Fruits & Vegetables
Carotenoid
Leafy green
vegetables, legumes,
seeds, liver, fortified
grains
Folate
Fruits, vegetables, &
whole grains
Fiber
Lutein: Indole-3carbinol decreases
estrogen exposure by
causing estrogen to
be changed to an
inactive metabolite of!
estrogen. Lycopene:
!attacks roaming
oxygen molecules,
known as free radicals.
Helps your cells repair
possible DNA damage
that occurs with heavy
alcohol use
Reduce hormone
levels
Vitamin D
Mechanism
May suppress the
growth of metastatic
cancer cells
Phytoestrogens: weak,
non-steroidal
estrogens that could
suppress cancerous
changes. inhibiting the
growth of epithelial
cells and new blood
vessels that tumors
require
to flourish
May regulate
the
growth and promote
the differentiation of
many types of normal
and malignant cells
Common treatments
!
Surgery
"
Breast conserving surgery (lumpectomy) - only the
tumor is removed and the healthy breast tissue is
radiated afterwards.
"
Mastectomy - in which the whole breast is removed.
Radiation is common to prevent reoccurrence of the
cancer.
"
Axillary's lymph node dissection- when required,
surgery also includes removal of sick arm pit lymph
nodes.
Common treatments
Common treatments
!
Chemotherapy
" Chemotherapy treats the whole body.
!
!
!
!
!
!
!
!
Hormonal therapy/anti-estrogen therapy
" One should be tested to see if the cancer is indeed fitting for this
kind of treatment as only hormone receptor positive cancer can
be treated this way.
"
Before surgery it is used to shrink the tumor size and
after surgery it is used to reduce reoccurrence.
"
Causes a hormonal shield against the reoccurrence of cancer by
blocking the ability of estrogen hormone to stimulate the creation
and growth of cancer cells.
"
Chemotherapy is effective against cancer cells
because the drugs given interfere with the dividing of
cells, so this stops the growth of the cancer tumor and
thus kills it.
"
Tamoxifen is the medicine of choice for pre menstrual women
with hormone-receptor-positive cancer.
"
Aromatase inhibitors are popular today for post menstrual
women who react to hormonal treatment of breast cancer.
Resources
!
!
http://www.healthcastle.com
http://www.aicr.org/site/PageServer
http://www.breast-cancer-treatment.org/
http://www.cancure.org/cancer_fighting_foods.htm
http://www.cancer.gov/cancertopics/wyntk/breast/page7
http://info.cancerresearchuk.org/cancerstats/types/breast/riskfactors/
#reproductive
http://www.breastcancer.org/type_breast_cancer_picture.html
http://www.imaginis.com/breasthealth/index.asp
http://cancer.ucsf.edu/crc/nutrition_breast.pdf
Ovarian Cancer
What is Ovarian Cancer?
!
Ovarian cancer is cancer
that begins in the ovaries.
In women, the ovaries
produce eggs (ova) for
reproduction. The eggs
travel through the
fallopian tubes into the
uterus where the fertilized
egg implants and
develops into a fetus.
Cancer can also begin in
the fallopian tubes. The
ovaries are also the main
source of the female
hormones estrogen and
progesterone. One ovary
is located on each side of
the uterus in the pelvis.
Who’s at Risk?
!
1st degree relatives of those with ovarian cancer
have the highest risk.
!
A family history of breast or colon cancer also
increases the risk of developing ovarian cancer.
!
Women who have had breast or colon cancer
are at higher risk.
!
The age you are affects the development of
cancer. Age 50 plus at high risk.
Symptoms
Loss of appetite
! Feeling full after a small meal
! Weight gain or loss ( with no reason)
! Nausea
! Diarrhea
! Constipation
! Frequent urination
! Abnormal bleeding
! Abdominal discomfort or pain
!
"
(Swelling, bloating, or cramps, gas, pressure)
Stages
!
Stage I. Ovarian
cancer is confined to
one or both ovaries.
!
Stage II. Ovarian
cancer has spread to
other locations in the
pelvis such as the
uterus or fallopian
tubes.
!
Stage III. Ovarian
cancer has spread to
the lining of the
abdomen (peritoneum)
or to the lymph nodes
within the abdomen.
This is the most
common stage of
disease identified at
the time of diagnosis.
!
Stage IV. Ovarian
cancer has spread to
organs beyond the
abdomen.
Stages
What Increases The Development
of Ovarian Cancer
!
Obesity leads to high increase of cancer
"
30-40% of all cancer can be prevented by appropriate
diet, physical activity and maintenance of body weight
(BMI 20-25)
What Increases The Development
of Ovarian Cancer
!
Fertility drugs
!
Women who use (HTM) Hormonal replacement
therapy after menopause may have a slight
increase of ovarian cancer.
!
High intake of dairy products has been linked to
increase risk of developing ovarian cancer
What Decreases The Development
of Ovarian Cancer
!
Taking birth control pills
!
Cox-2 (aspirin and non – steroidal anit –
inflammatory drugs) inhibitors help decrease
ovarian cancer (may as well promote ovarian
cancer)
!
Having children protects you for being on high
risk of developing ovarian cancer.
What Decreases The Development
of Ovarian Cancer
!
!
Breast feeding may reduce chances of ovarian
cancer
Vitamin D
"
"
"
"
1000 international units (IU) of vitamin D daily can cut
colon cancer, breast, and ovarian cancer.
Age 1-50 consume 200 IU of vitamin D
Age 51-70 400 IU
Age 70+ 600 IU
Potential Cancer Fighters in Foods
Phytochemical
Food Source
Isothiocyanates
Cruciferous vegetables, mustard, horseradish
Phenolic compounds
Garlic, green tea, soybeans, cereal grains,
cruciferous, umbelliferous, solanaceous,
cucurbitaceous vegetables, licorice root, flax
seed
Flavanoids
Most fruits and vegetables (cruciferous,
umbelliferous, solanaceous, cucurbitaceous),
citrus fruits, wine, green tea, onions, cereal
grains, soybeans, flax seed
Mono-terpenes
Garlic, citrus fruits, caraway seeds,
umbelliferous, solanaceous, Cucurbitaceous
vegetables, sage, camphor, dill, basil, mint
Organo-sulfides
Garlic, onion, leeks, shallots, cruciferous
vegetables
Isoflavones
Soybeans, legumes, flax seed
Indoles
Cruciferous vegetables
Carotenoids
Dark yellow/orange/green vegetables and
fruits
Antioxidants in Foods (in mg)
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Important Plant Sources for Good Health
Q3+,R
lant Family
Examples
Grains
Wheat, rye, oats, rice, corn, bulgur, barley
Green leafy vegetables
Lettuce, spinach, swiss chard, endives, beet
greens, romaine
Cruciferous vegetables
Broccoli, cabbage, turnip, brussels sprouts,
cauliflower, kohlorabi, bok choy, watercress,
collards, kale, mustard greens, rutabaga
Umbelliferous vegetables
Celery, parsley, fennel, carrots, parsnip
Allium vegetables
Garlic, onion, shallots, chives, leek
Legumes
Soybeans, peas, chickpeas, lima beans,
peanut, carob, dried beans (kidney, mung,
pinto, black-eyed), entils
Solanaceous vegetables
Nightshade family: eggplant, tomatoes
Cucurbitaceous vegetables
Gourd family: pumpkin, squash, cucumber,
muskmelon, watermelon
Diagnosing
!
Pelvic exam - Feeling the uterus, vagina, ovaries,
fallopian tubes, bladder, and rectum to find any
abnormality in the shape
!
Ultrasound – helps distinguish fluid-filled cysts
from a solid tumor. The use of high frequency
sound waves
!
CA-125 – A blood test used to measure the level
of CA-125 (cancer antigen)
Diagnosing
! Lower
GI series, or barium enema – series
of x-rays of the colon and rectum are done.
! CT
scan –produces x-ray images of crosssections of body tissues
! Biopsy – Is the removal of tissue for
examination done under a microscope
Sources
Treatment
! Surgery
– is a usual initial treatment for
women with ovarian cancer
!
!
! Chemotherapy
– its given to destroy
cancerous cells that are in the body after
surgery or to control tumor growth
!
!
!
! Radiation
therapy- the use of high energy
rays to kill cancer cells
!
www.webmd.com/ovaariancancer/news/20041203/study-link-milk-to -ovariancancer.
www.webmd.com/cancer/news/20051228/vitamin-dmay-lower-some-cancer-risk
www.cancerproject.org/protective_food/facts/foods_pre
vention.php
http://Ovariancancer.
JHM;edu/coping.cfm?categoryID=7
www.pcrm.org/health/cancer_project/foodchoices.html.
www.cancer.gov/publications