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Women's cancers navs 2011
- 1. A Presentation at North American Vegetarian Summerfest 7/2011 Stephan Esser MD www.esserhealth.com
- 2. Women’s Cancers a Primer and Review Stephan Esser USPTA, MD www.esserhealth.com
- 3. Goals • Review definitions and tenets • Overview of the Statistics • Visit the classroom: anatomy, physiology • Brief review of each common cancer • Propose some models for cause • Discuss opportunities for prevention
- 4. NOT Goals • Personal recommendations for screening or treatment • Updates on surgical techniques • Intro to alternative treatments
- 5. What this is! • The beginning…….not the end • Incomplete….. • More questions than answers
- 6. Definition – Etymology: Middle English, from Latin, literally, crab; akin to Greek karkinos crab – a northern zodiacal constellation between Gemini and Leo b (1) : the fourth sign of the zodiac in astrology – A malignant tumor of potentially unlimited growth that expands locally by invasion and systematically by metastasis – Something evil or malignant that spreads destructively
- 7. “Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues.”
- 8. Levels of the Organism • Atomic: Oxygen • Molecular: DNA • Organelle: Nucleus of the cell • Cellular: Cell • Tissue: Cells function together • Organ: multiple Tissues work together • Organ System: respiratory, circulatory etc. • Organism: Human Being
- 10. Cell Cycle G1: Growth and function S: DNA Replication G2: Preparation M: Mitosis
- 11. Cancer Growth
- 12. Cell Cycle G1: Growth and function S: DNA Replication G2: Preparation M: Mitosis
- 13. Cancer Operatives • 1: Failure to slow/block abnormal growth • 2: Acceleration of growth (ie: to an abnormal level)
- 15. Cancer Subtypes • Carcinoma: skin or tissues that line/cover internal organs • Sarcoma: begin in bone, cartilage, fat, muscle blood vessels or other connective tissues • Leukemia: blood forming tissue. Eg: bone marrow • Lymphoma/Myeloma: cells of the immune system • Central Nervous System: in the brain and spinal cord
- 16. Valuable Terminology • Staging: evaluates the extent of a persons cancer • Grading: how abnormal a tumor looks under a microscope
- 17. What we know! • Cancer is an abnormal state of the cell • It is often caused by dysfunction in the cell cycle • Overgrowth/inappropriate growth at the cellular level = dysfunction at the tissue/organ = dysfunction at the organism level
- 19. Women’s Cancers • Breast Cancer • Gynecologic Cancers – Uterine (Endometrial) Cancer – Cervical Cancer – Ovarian Cancer
- 21. Cancer deaths per year
- 23. Cancer Risk Total 1:3 Breast 1:8 Uterus 1:37 Cervix 1:117
- 24. In Review • Cancer is the 2nd leading cause of death • Breast Cancer is the leading female cancer • Cancer mortality: – Breast Cancer ≈ unchanged – Uterine Cancer < 1930 – Ovarian Cancer ≈ unchanged – Cervical Cancer < 1930 • Cancer risk is quite significant
- 25. Reactions • Fear • Anxiety • Educate • Empower • Motivate
- 26. Perspective
- 27. 90 77.3 80 70.8 65.4 64.6 Percent of Population 70 60 53.2 54.1 50 38.8 38.4 40 30 24.4 16.2 20 12.2 6.6 10 0 20-34 35-44 45-54 55-64 65-74 75+ Men Women Prevalence of high blood pressure in Adults age 20 and older, by age and sex (NHANES: 2003-2006). Source: NCHS and NHLBI.
- 28. Per 100,000 Population 200 150 130.0 101.5 100 57.0 41.1 41.1 39.0 50 31.6 22.9 0 Coronary Heart Stroke Lung Cancer Breast Cancer Disease White Females Black Females Age-adjusted death rates for CHD, stroke, lung and breast for white and black females (United States: 2006). Source: NCHS.
- 29. Mini- Med School
- 30. Breast
- 31. Breast
- 32. Breast Anatomy
- 35. Lum Skin Dimpling Change in color p or texture Change in how the Clear or bloody fluid nipple looks: like that leaks out of the nipple pulling in nipple
- 36. Uterus
- 37. Basic Anatomy
- 38. Uterine Physiology • Complex • Multi System • Punctuated – Puberty – Menses – Pregnancy – Menopause • Hormone Sensitive
- 40. Basic Anatomy
- 42. The Power of Hormones • Glands and hormonal response Organ or gland: adrenals, thyroid, pituitary etc. Gland: Breast Ducts, ovarian tissue, endometrium etc.
- 43. In Review • Cancer is more common in hormonally responsive tissues • The relationship is a complex, multi-factorial one • Breast Cancer and Uterine/Cervical Cancer are easier to diagnose • Ovarian Cancer may be a silent killer
- 44. Transition
- 45. Risk Factors • Non-Modifiable Modifiable • Modifiable
- 46. Breast Cancer
- 49. Uterine Cancer
- 50. Cervical Cancer • Non-Modifiable Risk: – Family History – Personal History – Age>30
- 51. Cervical Cancer
- 53. The Big Picture
- 54. Toxins Dietary Habits Cancer Genetics Chronic Stress Sedentary Aging Lifestyles Population
- 55. Toxins Dietary Habits Chronic Cancer Genetics Stress Aging Sedentary Population Lifestyles
- 56. Dietary Toxins Habits Cancer Genetics Chronic Stress Sedentary Lifestyles Aging Population
- 57. What can we do? Clean Toxins Food Health Sleep Emotional Poise Exercise Clean Water
- 60. “Inflammation is a critical component of tumor progression. It is now becoming clear that the tumor microenvironment, which is largely orchestrated by inflammatory cells, is an indispensable part of the neoplastic process.”
- 61. Breast Cancer
- 64. Uterine Cancer
- 65. Cervical Cancer • Modifiable Risks: – Sexual Habits – Human Papilloma Virus – Tobacco – Impaired Immunity: HIV – Diet – OCPs – Toxins: DES, etc.
- 66. Cardiovascular Disease Atherosclerosis, Heart Failure,. CVD, Cardiomyopathy, Stroke Neurologic Auto- Disorders Immune etc. Alzheimers, RA, Psoriasis, Parkinsons, ALS, IBD, Chronic Dementia, Panx., CIDP Chronic Inflammation Bone and Metabolic Muscle Disorders Osteoporosis, Fatty Liver Osteoarthritis, Type 2 Diabetes DDD, MD Heart Disease CKD, HLD Cancer Lung, Breast, Uterine, Colon, Gastric, Pancreatic etc.
- 67. Conclusions • Cancer is a significant cause of death and disability in America today • Cancer is directly related to inappropriate cell division and development
- 68. Conclusions • An environment of inflammation appears to foster cancer growth and proliferation • Reducing systemic and local inflammation can – Reduce the risk of cancer – Slow progression – Reduce recurrence rates
- 69. 7 CLASSIC TENETS • Clean Air • Clean Water • Emotional Poise • Exercise • Healthy Food • Sleep • Sunlight
- 70. T his is such a great thing, it should spread like wildfire. It offers great hope for people, and a wide variety of conditions respond well ……………….But it requires discipline. It is not something to be bought or to be sold as a quick fix. Those who are not disciplined are accustomed to their addictions, and it is very difficult for them to get away from that.………..I tell people to value health and the pleasure of being well. Cherish the wonderful knowledge and enjoyment that you gain from living in a healthy way. That is the reward of it all! William Esser ND. D.C
- 71. Thank
- 72. Enjoy more powerpoints and educational resources at www.esserhealth.com
Notas del editor
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994795/
- http://www.merriam-webster.com/dictionary/cancer I put the word cancer into google as a search and received 229,000,000 results.
- http://www.cancer.gov/cancertopics/what-is-cancer
- Tissue --> a bunch of cells working together on one job Organ --> lots of tissues working together Organ system --> a group of organs working together for a particular function Organism --> many organ systems working together
- So here is our prototipical cell……..this illustration shows well the basic structural components of a cell. And it is at this level that I want to briefly discuss cancer. Trillions of cells = the body
- G1: cell is synthesizing its structural proteins and enzymes to perform its functions. Notice the checkpoints on the cell and it’s function. These are moments when the cell is evaluated by RNA/DNA Check points: are proteins in the cytoplasm which making the key decision of whether the cell should divide, delay division, or enter a resting stage
- Road Rage example…one hit…late for work…..two hits someone cuts us off….someone stressing us from home…etc….then we snap
- G1: cell is synthesizing its structural proteins and enzymes to perform its functions. Notice the checkpoints on the cell and it’s function. These are moments when the cell is evaluated by RNA/DNA Check points: are proteins in the cytoplasm which making the key decision of whether the cell should divide, delay division, or enter a resting stage
- The real cell cycle……likely even more complex than this….this is where the influence of a multitude of outside and internal factors can influence the health of the cell cycle. Alter any of these cell processes…those that limit the rate of cell multiplication or alter the self-checking potential or potential for apoptosis and the result will be abnormal growth
- What is staging? Staging describes the extent or severity of an individual’s cancer based on the extent of the original (primary) tumor and the extent of spread in the body. Staging is important:Staging helps the doctor plan a person’s treatment.The stage can be used to estimate the person’s prognosis (likely outcome or course of the disease). Cancer cells divide and grow without control or order to form a mass of tissue, called a growth or tumor. As the tumor grows, it can invade nearby organs and tissues. Cancer cells can also break away from the tumor and enter the bloodstream or lymphatic system. By moving through the bloodstream or lymphatic system, cancer can spread from the primary site to form new tumors in other organs. The spread of cancer is called metastasis Tumor (T) TX Primary tumor cannot be evaluated T0 No evidence of primary tumor Tis Carcinoma in situ (early cancer that has not spread to neighboring tissue) T1, T2, T3, T4 Size and/or extent of the primary tumor Regional Lymph Nodes (N) NX Regional lymph nodes cannot be evaluated N0 No regional lymph node involvement (no cancer found in the lymph nodes) N1, N2, N3 Involvement of regional lymph nodes (number and/or extent of spread) Distant Metastasis (M) MX Distant metastasis cannot be evaluated M0 No distant metastasis (cancer has not spread to other parts of the body) M1 Distant metastasis (cancer has spread to distant parts of the body)
- Dysfunction may be excess stimulus of growth, failure to slow growth or the like.
- Approx. 1,300,000 new cases per year www.cdc.gov/.../mmwrhtml/ figures/m846qsf.gif www.ncbi.nlm.nih.gov/ bookshelf/picrender.fcgi.. http://www.ctahr.hawaii.edu/CS/blogs/sustainable_agriculture/cdc_logo(2).jpg
- Unfortunately 1 million plus American’s die from cancer every year as well. And of these you can see the break down on the side. Notice the distribution. Although breast cancer was far more common than Lung cancer, lung cancer tends to be much more aggressive cancer and causes greater mortality as a result.
- Blue =breast Green = Uterus Purple= Ovary Age Adjusted Cancer death rates for females per cancer type. You can appreciate that since 1930 we have noticed a decline in several cancers including Uterine and Stomach cancer for a variety of reasons but regrettably most cancer death has remained stable or in the case of Lung cancer has significantly increased
- Probability of Developing Invasive Cancers Within Selected Age Intervals by Gender, United States, 1996-1998 a
- www.mayoclinic.com/health/ breast-cancer-early-stage/BC00001 health.allrefer.com commons.wikimedia.org http://www.healthbase.com/resources/images/newsletters/newsletter_0808/healthbase_breast_cancer_symptoms_medical_tourism.jpg
- https://my.advocatehealth.com/files/images/content/universal_image_directory/ei_0192.gif
- holistic-herbalist.com http://rakdojke.kbsplit.hr/images/fig12.jpg http://biomedme.com/wp-content/uploads/2009/12/Breast-Cancer.jpg
- http://www.mashedreport.com/2010/06/17/uterus.jpg http://www.yalemedicalgroup.org/stw/images/161349.jpg
- http://embryology.med.unsw.edu.au/wwwhuman/MCycle/images/Mcycle.gif
- http://www.mashedreport.com/2010/06/17/uterus.jpg http://www.yalemedicalgroup.org/stw/images/161349.jpg http://i.ehow.com/images/a05/du/mm/effects-female-hormones-males-200X200.jpg
- soc.ucsb.edu
- A gland is an organ in an animal's body that synthesizes a substance for release such as hormones or breast milk, often into the bloodstream (endocrine gland) or into cavities inside the body or its outer surface (exocrine gland).
- http://4.bp.blogspot.com/_onQvIg4FVII/Sx55mTGSteI/AAAAAAAACNw/fbHqhkmXOvI/s400/vegetables-body-20091130-145044.jpg
- Caucasian women more likely to ……. http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-risk-factors
- The Health Consequences of Involuntary Exposure to Tobacco Smoke, concluded that there is &quot;suggestive but not sufficient&quot; evidence of a link at this point. In any case, this possible link to breast cancer is yet another reason to avoid secondhand smoke. Higher red meat intake in adolescence may increase the risk of premenopausal breast cancer. (Cancer Epidemiol Biomarkers Prev 2008;17(8):2146–51) The approximate 50% reduction in risk( of recurrence) associated with these healthy lifestyle behaviors was observed in both obese and nonobese women, although fewer obese women were physically active with a healthy dietary pattern (16% v 30%). Among those who adhered to this healthy lifestyle, there was no apparent effect of obesity on survival. The effect was stronger in women who had hormone receptor–positive cancers. http://www.mayoclinic.com/health/breast-cancer/DS00328/DSECTION=risk-factors
- http://www.mayoclinic.com/health/endometrial-cancer/DS00306/DSECTION=risk-factors Caucasian women are 70% more likely to get Endometrial CA than Blacks http://www.mskcc.org/mskcc/html/13172.cfm
- OCPs reduce uterine cancer risk increase breast, cervical cancer risk http://www.cdc.gov/cancer/uterine/basic_info/risk_factors.htm
- Up to 80% of sexually active Americans may be infected Sexual Habits= early exposure, # of partners, Plasma beta-carotene reduced risk from top to bottom quartile by 80%, vitamin C by 60%, and fruit juices by 50%., Consumption of a diet rich in anti-oxidents reduces progression, Those patients in the highest quartiles of dietary vitamin A, β -carotene, and vitamin C intakes had statistically significantly lower cervical cancer risks than those in the lowest quartiles for vitamin A, β -carotene, and vitamin C Vitamin A and vegetable intake were unrelated to risk. Dark yellow-orange vegetable consumption and duration of multivitamin use were each strongly related to reduced risk of in situ disease (P for trend = 0.02 and 0.002, respectively) and need to be evaluated in other studies. http://www.cdc.gov/cancer/cervical/basic_info/risk_factors.htm http://www.healthyhints.co.uk/wp-content/uploads/cache/2921_NpAdvHover.jpg http://www.ehealthmd.com/library/cervicalcancer/cc_causes.html http://www.webmd.com/sex/birth-control/news/20071108/pill-raises-cervical-cancer-risk ( 5 years of use =‘s double the risk) http://aje.oxfordjournals.org/cgi/content/short/132/3/432 http://jnci.oxfordjournals.org/cgi/content/abstract/80/8/580 http://www.springerlink.com/content/mqu69081w6084672/ http://www.smw.ch/docs/pdf200x/2001/37/smw-09779.pdf http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WG6-50BBSS4-1&_user=10&_coverDate=06%2F18%2F2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1411187379&_rerunOrigin=scholar.google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=d742dd9fa8f7c7f0e6aab798fc344cf1 http://www.informaworld.com/smpp/content~db=all~content=a918786268 http://www.nature.com/bjc/journal/v101/n1/full/6605098a.html
- The real cell cycle……likely even more complex than this….this is where the influence of a multitude of outside and internal factors can influence the health of the cell cycle. Alter any of these cell processes…those that limit the rate of cell multiplication or alter the self-checking potential or potential for apoptosis and the result will be abnormal growth
- http://www.jci.org/articles/view/31537/files/JCI0731537.f3/medium http://mycanceradvisor.com/wp-content/uploads/2009/12/inflammatory-breast-cancer.jpg http://gregcarver.com/blog/wp-content/uploads/2009/06/inflammation.jpg
- Chronic Inflammation creates a micro-environment that encourages, cancer development, proliferation and growth The body is in a constant state striving for balance……you see there are pro-inflammatory cells and anti-inflammatory cells which work in concert together to balance the body. For example….the immune cells which help protect us from bacterial and viral infections also have the potential when they become overactive or mis-infirmed to cause Rheumatoid arthritis etc……so when inflammation becomes a primary force….then dysfunction increases
- Caucasian women more likely to ……. http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-risk-factors
- The Health Consequences of Involuntary Exposure to Tobacco Smoke, concluded that there is &quot;suggestive but not sufficient&quot; evidence of a link at this point. In any case, this possible link to breast cancer is yet another reason to avoid secondhand smoke. Higher red meat intake in adolescence may increase the risk of premenopausal breast cancer. (Cancer Epidemiol Biomarkers Prev 2008;17(8):2146–51) The approximate 50% reduction in risk( of recurrence) associated with these healthy lifestyle behaviors was observed in both obese and nonobese women, although fewer obese women were physically active with a healthy dietary pattern (16% v 30%). Among those who adhered to this healthy lifestyle, there was no apparent effect of obesity on survival. The effect was stronger in women who had hormone receptor–positive cancers. http://www.mayoclinic.com/health/breast-cancer/DS00328/DSECTION=risk-factors
- http://www.mayoclinic.com/health/endometrial-cancer/DS00306/DSECTION=risk-factors Caucasian women are 70% more likely to get Endometrial CA than Blacks http://www.mskcc.org/mskcc/html/13172.cfm
- OCPs reduce uterine cancer risk increase breast, cervical cancer risk http://www.cdc.gov/cancer/uterine/basic_info/risk_factors.htm
- Up to 80% of sexually active Americans may be infected Sexual Habits= early exposure, # of partners, Plasma beta-carotene reduced risk from top to bottom quartile by 80%, vitamin C by 60%, and fruit juices by 50%., Consumption of a diet rich in anti-oxidents reduces progression, Those patients in the highest quartiles of dietary vitamin A, β -carotene, and vitamin C intakes had statistically significantly lower cervical cancer risks than those in the lowest quartiles for vitamin A, β -carotene, and vitamin C Vitamin A and vegetable intake were unrelated to risk. Dark yellow-orange vegetable consumption and duration of multivitamin use were cach strongly related to reduced risk of in situ disease (P for trend = 0.02 and 0.002, respectively) and need to be evaluated in other studies. http://www.cdc.gov/cancer/cervical/basic_info/risk_factors.htm http://www.healthyhints.co.uk/wp-content/uploads/cache/2921_NpAdvHover.jpg http://www.ehealthmd.com/library/cervicalcancer/cc_causes.html http://www.webmd.com/sex/birth-control/news/20071108/pill-raises-cervical-cancer-risk ( 5 years of use =‘s double the risk) http://aje.oxfordjournals.org/cgi/content/short/132/3/432 http://jnci.oxfordjournals.org/cgi/content/abstract/80/8/580 http://www.springerlink.com/content/mqu69081w6084672/ http://www.smw.ch/docs/pdf200x/2001/37/smw-09779.pdf http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WG6-50BBSS4-1&_user=10&_coverDate=06%2F18%2F2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=1411187379&_rerunOrigin=scholar.google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=d742dd9fa8f7c7f0e6aab798fc344cf1 http://www.informaworld.com/smpp/content~db=all~content=a918786268 http://www.nature.com/bjc/journal/v101/n1/full/6605098a.html