estimation of gangliosides in Cancer screening.ppt

estimation of gangliosides in Cancer screening.ppt

1. Screening for Breast, Screening for Breast,
Cervical, Prostate and Cervical, Prostate and
Lung CancerLung Cancer
Jo-Anna L. Rorie, PhD (c)Jo-Anna L. Rorie, PhD (c)
Assistant ProfessorAssistant Professor
RHA Training Program RHA Training Program
Module 11Module 11

2. Definition of CancerDefinition of Cancer

What is cancer?What is cancer?

The body is made up of trillions of living cells. Normal body
cells grow, divide, and die in an orderly way. During the early
years of a person's life, normal cells divide faster to allow the
person to grow. After the person becomes an adult, most cells
divide only to replace worn-out, damaged, or dying cells.

Cancer begins when cells in a part of the body start to grow
out of control. There are many kinds of cancer, but they all
start because of this out-of-control growth of abnormal cells.

http://www.cancer.org/Cancer/LungCancer-SmallCell/OverviewGuide/lung-cancer-small-cell-overview-
what-is-cancer

3. Breast Cancer ScreeningBreast Cancer Screening

4. The DataThe Data

Not counting some kinds of skin cancer, breast cancer Not counting some kinds of skin cancer, breast cancer
in the United States is:in the United States is:

The most common cancer in women, no matter your The most common cancer in women, no matter your
race or ethnicity. race or ethnicity.

The most common cause of death from cancer among The most common cause of death from cancer among
Hispanic women. Hispanic women.

The second most common cause of death from cancer The second most common cause of death from cancer
among white, black, Asian/Pacific Islander, and among white, black, Asian/Pacific Islander, and
American Indian/Alaska Native women.American Indian/Alaska Native women.

http://www.breastcancer.org/symptoms/understand_bc/statistics.jsphttp://www.breastcancer.org/symptoms/understand_bc/statistics.jsp

5. The DataThe Data
2011 estimates for US Women2011 estimates for US Women

230,480 new cases of invasive breast cancer were expected 230,480 new cases of invasive breast cancer were expected
to be diagnosed to be diagnosed
in 2011in 2011

57,650 new cases of carcinoma in situ (CIS) were expected to 57,650 new cases of carcinoma in situ (CIS) were expected to
be found (CIS is non-invasive and is the earliest form of breast be found (CIS is non-invasive and is the earliest form of breast
cancer).cancer).

About 39,520 deaths from breast cancer were expected inAbout 39,520 deaths from breast cancer were expected in

http://www.breastcancer.org/symptoms/understand_bc/statistics.jsphttp://www.breastcancer.org/symptoms/understand_bc/statistics.jsp

6. Who is at risk?Who is at risk?

Research has found several risk factors that may increase your Research has found several risk factors that may increase your
chances of getting breast cancer, including:chances of getting breast cancer, including:

Getting older. Getting older.

Being younger when you first had your menstrual period. Being younger when you first had your menstrual period.

Starting menopause at a later age. Starting menopause at a later age.

Being older at the birth of your first child. Being older at the birth of your first child.

Never giving birth. Never giving birth.

Not breastfeedingNot breastfeeding

http://www.cdc.gov/cancer/breast/basic_info/risk_factors.htmhttp://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm

7. Who is at risk?Who is at risk?

Personal history of breast cancer or some non-cancerous breast Personal history of breast cancer or some non-cancerous breast
diseases. diseases.
Family history of breast cancer (mother, sister, daughter). of breast cancer (mother, sister, daughter).

Treatment with radiation therapy to the breast/chest. Treatment with radiation therapy to the breast/chest.

Being overweight (increases risk for breast cancer after Being overweight (increases risk for breast cancer after
menopause). menopause).

Long-term use of hormone replacement therapy (estrogen and Long-term use of hormone replacement therapy (estrogen and
progesterone combined). progesterone combined).

Drinking alcohol (more than one drink a day). Drinking alcohol (more than one drink a day).

Not getting regular exercise Not getting regular exercise

http://www.cdc.gov/cancer/breast/basic_info/risk_factors.htmhttp://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm

8. SymptomsSymptoms

Breast cancer symptoms vary widely — from Breast cancer symptoms vary widely — from
lumps to swelling to skin changes — and many lumps to swelling to skin changes — and many
breast cancers have no obvious symptoms at breast cancers have no obvious symptoms at
all. Symptoms that are similar to those of all. Symptoms that are similar to those of
breast cancer may be the result of non-breast cancer may be the result of non-
cancerous conditions like infection or a cyst.cancerous conditions like infection or a cyst.

http://www.breastcancer.org/symptoms/http://www.breastcancer.org/symptoms/

9. ScreeningScreening

Diagnosis is a process than can take several Diagnosis is a process than can take several
weeks .weeks .Breast self-exam (BSE) should be part (BSE) should be part
of your monthly health care routine, and you of your monthly health care routine, and you
should visit your doctor if you experience should visit your doctor if you experience
breast changes. BSE is recommended for breast changes. BSE is recommended for
women beginning in their twenties.women beginning in their twenties.

10. ScreeningScreening

Between ages 20-30 years you should have a Between ages 20-30 years you should have a
clinical breast exam done by a health provider clinical breast exam done by a health provider
every 3 years.every 3 years.

11. ScreeningScreening

If you're over 40 or at a high risk for the If you're over 40 or at a high risk for the
disease, you should also have an annual disease, you should also have an annual
mammogram and physical exam by a doctor. mammogram and physical exam by a doctor.
The earlier breast cancer is found and The earlier breast cancer is found and
diagnosed, the better your chances of beating diagnosed, the better your chances of beating
it.it.

http://www.breastcancer.org/symptoms/http://www.breastcancer.org/symptoms/

12. ScreeningScreening

Mammogram.Mammogram. A A mammogrammammogram is an X-ray of the breast. is an X-ray of the breast.
Mammograms are the best method to detect breast cancer Mammograms are the best method to detect breast cancer
early when it is easier to treat and before it is big enough to early when it is easier to treat and before it is big enough to
feel or cause symptoms. Having regular mammograms can feel or cause symptoms. Having regular mammograms can
lower the risk of dying from breast cancer. If you are age 50 to lower the risk of dying from breast cancer. If you are age 50 to
74 years, be sure to have a screening mammogram every two 74 years, be sure to have a screening mammogram every two
years. If you are age 40–49 years, talk to your doctor about years. If you are age 40–49 years, talk to your doctor about
when and how often you should have a screening when and how often you should have a screening
mammogram. mammogram.

http://www.cdc.gov/cancer/breast/basic_info/screening.htmhttp://www.cdc.gov/cancer/breast/basic_info/screening.htm

13. Prostate CancerProstate Cancer
American Cancer SocietyAmerican Cancer Society
http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-what-is-prostate-cancerhttp://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-what-is-prostate-cancer

14. About the ProstateAbout the Prostate

The prostate is a gland found only in males. It is The prostate is a gland found only in males. It is
located in front of the rectum and below the urinary located in front of the rectum and below the urinary
bladder. In younger men, it is about the size of a bladder. In younger men, it is about the size of a
walnut, but it can be much larger in older men. walnut, but it can be much larger in older men.

The prostate's job is to make some of the fluid that The prostate's job is to make some of the fluid that
protects and nourishes sperm cells in semen, making protects and nourishes sperm cells in semen, making
the semen more liquid. Just behind the prostate are the semen more liquid. Just behind the prostate are
glands called glands called seminal vesiclesseminal vesicles that make most of the that make most of the
fluid for semen. The fluid for semen. The urethra,urethra, which is the tube that which is the tube that
carries urine and semen out of the body through the carries urine and semen out of the body through the
penis, goes through the center of the prostatepenis, goes through the center of the prostate
American Cancer SocietyAmerican Cancer Society
http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-what-is-prostate-cancerhttp://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-what-is-prostate-cancer

15. Who is at risk?Who is at risk?

AgeAge
The chances of having prostate cancer rises rapidly after 50The chances of having prostate cancer rises rapidly after 50
2 out 0f 3 men over the age of 65 are found to have prostate2 out 0f 3 men over the age of 65 are found to have prostate
cancer.cancer.

Race/ethnicityRace/ethnicity
Prostate cancer occurs more often among African American men
More likely to be diagnosed at an advanced stage
African American men are 2-3 times more likely to die from prostate cancer
than white men
American Cancer SocietyAmerican Cancer Society
http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-what-is-prostate-cancerhttp://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-what-is-prostate-cancer

16. Who is at risk?Who is at risk?

Family HistoryFamily History
Having a father or brother with prostate cancer more than doubles a man’s risk
of developing the disease

Genes
Recently studies have found some common genes variations have been linked
to a higher risk of prostate cancer, however, gene testing for most genes
changes is not yet avaialble

Diet
The exact role of diet in prostate cancer is not clear.
American Cancer SocietyAmerican Cancer Society
http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-what-is-prostate-cancerhttp://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-what-is-prostate-cancer

17. Who is at risk?Who is at risk?

Obesity
Relationship unknown-no firm conclusions

Smoking
Relationship unknown-no firm conclusions

Sexually Transmitted Infections
Relationship unknown-no firm conclusions
Vasectomy
Men who have had a vasectomy before the age of 35 may have a
slightly higher risk of developing prostate cancer

18. SymptomsSymptoms

In the early stages there are usually In the early stages there are usually no
symptoms.

In the more advanced stages-urinary frequency
especially at night

In the very advanced cases-blood in urine or
impotence

The symptoms can also be consistent with
other conditions other than prostate cancer

19. Screening for Prostate CancerScreening for Prostate Cancer

Screening should take place at age 50 for men Screening should take place at age 50 for men
with an average risk for prostate cancer and with an average risk for prostate cancer and
age 45 for men at high risk this includes age 45 for men at high risk this includes
African American men and men who have a African American men and men who have a
first degree relative who had the disease at an first degree relative who had the disease at an
earlier age.earlier age.

http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-detectionhttp://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-detection

20. Screening for Prostate CancerScreening for Prostate Cancer

Screening includes a digital rectal examination Screening includes a digital rectal examination
and prostate-specific antigen (PSA) blood test.and prostate-specific antigen (PSA) blood test.

Men with a PSA less than 2.5 may only need Men with a PSA less than 2.5 may only need
to be retested every 2 yearsto be retested every 2 years

Men with a PSA greater than 2.5 should be Men with a PSA greater than 2.5 should be
tested yearly.tested yearly.

21. Cervical CancerCervical Cancer

Described by Papanicolaou in 1940’sDescribed by Papanicolaou in 1940’s

Malignant transformation of cervical epithelial cellsMalignant transformation of cervical epithelial cells

Begins in “Transformation Zone” “TZ”Begins in “Transformation Zone” “TZ”
between original cervical canal glands & squamous between original cervical canal glands & squamous
cells lining the outer cervix cells lining the outer cervix
“ “Squamocolumnar junction” or SCJSquamocolumnar junction” or SCJ

Invasive cervical cancer final stage in a series of Invasive cervical cancer final stage in a series of
abnormal changes in cervical cellsabnormal changes in cervical cells

22. The DataThe Data

Once # 1 now 10Once # 1 now 10
thth
in cancer-related deaths in cancer-related deaths

15,000 new cases per year15,000 new cases per year

4,800 will die of cervical cancer4,800 will die of cervical cancer

Death rate decreased > 70% since 1950’sDeath rate decreased > 70% since 1950’s

African-American women STILL have 2Xs African-American women STILL have 2Xs
greater incidence rates compared to whitesgreater incidence rates compared to whites

ACOG DataACOG Data

23. Early
detection
by
Pap smear
testing
decreases
cervical
cancer-
related
deaths

24. ScreeningScreening

Initial pap test and pelvic exam:Initial pap test and pelvic exam:
-when sexual activity begins or by age 18 -when sexual activity begins or by age 18
-then repeat yearly-then repeat yearly

Pap test may be performed less frequently in a Pap test may be performed less frequently in a
low-risk womanlow-risk woman at health care providers at health care providers
discretion discretion after 3 or more consecutive, satisfactory after 3 or more consecutive, satisfactory
annual exams with normal findingsannual exams with normal findings

ACOG RecommendationsACOG Recommendations

25. Consider more frequent pap testing WhenConsider more frequent pap testing When

Multiple sexual partners or partner’s hx multiple partnersMultiple sexual partners or partner’s hx multiple partners

Sexual activity initiated at early age (<age 17) Sexual activity initiated at early age (<age 17)

Male partners whose partners have had cervical cancerMale partners whose partners have had cervical cancer

Current or prior hx of sexually transmitted infections:Current or prior hx of sexually transmitted infections:
GonorrheaGonorrhea Chlamydia ChlamydiaHPVHPVHSVHSVHIVHIV

Smokers, substance abuse, including alcoholSmokers, substance abuse, including alcohol

History cervical dysplasiaHistory cervical dysplasia

History cervical, vaginal, vulvar or uterine cancerHistory cervical, vaginal, vulvar or uterine cancer

**low socio-economic status (marker for higher risk of **low socio-economic status (marker for higher risk of
developing cervical cancer)developing cervical cancer)

26. Human Papilloma VirusHuman Papilloma Virus

90% of Squamous lesions associated with 90% of Squamous lesions associated with
HPVHPV

Type 16: most commonType 16: most common
50% of moderate to severe SIL & cervical 50% of moderate to severe SIL & cervical
cancer cancer
AND in normal paps, therefore AND in normal paps, therefore not specificnot specific

27. Lung CancerLung Cancer

28. Lung Cancer DataLung Cancer Data

Lung cancer is the leading cause of cancer death in the U.S. It is the most Lung cancer is the leading cause of cancer death in the U.S. It is the most
common cancer in men and women combined, after skin cancer. Lung common cancer in men and women combined, after skin cancer. Lung
cancer (both small cell and non-small cell) is by far the leading cause of cancer (both small cell and non-small cell) is by far the leading cause of
cancer death for both men and women. More people die of lung cancer cancer death for both men and women. More people die of lung cancer
than of colon, breast, and prostate cancers combined. Lung cancer is fairly than of colon, breast, and prostate cancers combined. Lung cancer is fairly
rare in people under the age of 45. rare in people under the age of 45.

The average lifetime chance that a man will develop lung cancer is about 1 The average lifetime chance that a man will develop lung cancer is about 1
in 13. For a woman it is 1 in 16. These numbers include both smokers and in 13. For a woman it is 1 in 16. These numbers include both smokers and
non-smokers. For smokers the risk is much higher, while for non-smokers non-smokers. For smokers the risk is much higher, while for non-smokers
the risk is lower.the risk is lower.

http://www.cancer.org/Cancer/LungCancer-SmallCell/OverviewGuide/lung-cancer-small-cell-overview-what-causeshttp://www.cancer.org/Cancer/LungCancer-SmallCell/OverviewGuide/lung-cancer-small-cell-overview-what-causes

29. Lung Cancer DataLung Cancer Data

The American Cancer Society's most recent The American Cancer Society's most recent
estimates for lung cancer (both small cell and estimates for lung cancer (both small cell and
non-small cell) in the United States are for non-small cell) in the United States are for
2012:2012:

About 226,160 new cases of lung cancer (both About 226,160 new cases of lung cancer (both
small cell and non-small cell) small cell and non-small cell)

About 160,340 deaths from lung cancerAbout 160,340 deaths from lung cancer

30. Who is at Risk?Who is at Risk?

Smoking is by far the leading risk Smoking is by far the leading risk
factor causing 8 out 10 cases of lung factor causing 8 out 10 cases of lung
cancer.cancer.

31. SymptomsSymptoms

The most common symptoms of lung cancer are:The most common symptoms of lung cancer are:

A cough that does not go away or gets worse A cough that does not go away or gets worse

Chest pain, often made worse by deep breathing, coughing, or laughing Chest pain, often made worse by deep breathing, coughing, or laughing

Hoarseness Hoarseness

Weight loss and loss of appetite Weight loss and loss of appetite

Coughing up bloody or rust-colored sputum (spit or phlegm) Coughing up bloody or rust-colored sputum (spit or phlegm)

Shortness of breath Shortness of breath

Feeling weak or tired Feeling weak or tired

Infections such as bronchitis and pneumonia that don’t go away or keep coming Infections such as bronchitis and pneumonia that don’t go away or keep coming
back back

New onset of wheezingNew onset of wheezing

http://www.cancer.org/Cancer/LungCancer-SmallCell/OverviewGuide/lung-cancer-small-cell-overview-http://www.cancer.org/Cancer/LungCancer-SmallCell/OverviewGuide/lung-cancer-small-cell-overview-
diagnoseddiagnosed

32. ScreeningScreening

Until recently, no lung cancer screening test had been shown Until recently, no lung cancer screening test had been shown
to lower the risk of dying from this disease. Studies of 2 to lower the risk of dying from this disease. Studies of 2
possible screening tests, chest x-ray and sputum cytology, did possible screening tests, chest x-ray and sputum cytology, did
find that these tests detected lung cancers at an early stage, but find that these tests detected lung cancers at an early stage, but
neither test helped patients live longer. For this reason, major neither test helped patients live longer. For this reason, major
medical organizations have not recommended routine medical organizations have not recommended routine
screening with these tests for the general public or even for screening with these tests for the general public or even for
people at increased risk, such as smokers. Recently, though, a people at increased risk, such as smokers. Recently, though, a
different lung cancer screening test has been shown to help different lung cancer screening test has been shown to help
lower the risk of dying from this disease.lower the risk of dying from this disease.

http://www.cancer.org/Cancer/LungCancer-SmallCell/DetailedGuide/small-cell-lung-cancer-http://www.cancer.org/Cancer/LungCancer-SmallCell/DetailedGuide/small-cell-lung-cancer-
detectiondetection