Causes Of Cancer

Causes of Cancer 80% are considered sporadic- meaning the cause is unknown. There are several risk factors that increase the chance of cancer: Age- risk increases >50. z Diet- high fat, high cholesterol diets increase risk. z

Causes of Cancer Obesity- no clear link but research indicates it is a factor z Cigarettes- increases lung cancer, other tobacco products such as shesha, pipes and chewing tobacco increase cancers of the mouth. z Long term exposure to chemicalsasbestos, radon and benzene. z

Causes of Cancer Exposure to high levels of radiation z Harmful ultraviolet rays from the sun. z Some viruses- Hepatitis B, C, HPV, Epsteinn-Barr. z Immune system diseases z

Causes of Cancer z

Heredity – Screenings are recommended for high risk families. – You are considered high risk if : • Several relatives have had cancer or • if someone had cancer at a very early age.

Carcinogenesis Agents Causing Neoplasm z

Nutritional Oncogenesis – Scant evidence linking cancer to diet except for known chemical carcinogens – Some associations • Low-fiber diet and colonic cancer • Fatty diet with breast cancer • Smoking with oral cancer

– Protective agents – antioxidant effect, awaiting confirmation • Beta-carotene • Vitamins C, E • Selenium

Carcinogen The term carcinogen refers to any form of substance, radionuclide or radiation which is an agent in the promotion or direct involvement in the facilitation of cancer or genomic instability due to the disruption or damage of cellular metabolic changes. Recent reports have implicated acrylamide in fried or overheated carbohydrate foods (such as french fries and potato chips) as a possible carcinogen

Symptoms of Cancer Remember one word: CAUTION Changes in bowel or bladder habits. z A sore that will not heal. z Unusual bleeding or discharge z Thickening or lump in breast or any part of the body. z

Symptoms of Cancer Remember one word: CAUTION Indigestion or difficulty swallowing. z Obvious change in any wart or mole z Nagging cough or hoarseness. z

Diagnosis of Cancer Biopsy- small tissue sample under a microscope to look for cancerous cells. z Endoscopy- a flexible plastic tube with a tiny camera z Diagnostic Imaging- x rays z

Diagnosis of Cancer CT scan- more precise than standard xray. z MRI- uses a powerful magnetic field, very accurate but expensive. z Blood Tests- some tumors release substances called tumor markers which can be found in the blood. z

CONSEQUENCES OF CANCER In a significant number of patients, malignant processes have a systemic influence that is associated with: z Anorexia z Hypermetabolism z Progressive wasting of tissue z Cancer Cachexia Syndrome z Nutrient losses

CONSEQUENCES OF CANCER z

Anorexia – Chronic nausea and early satiety – Fatigue – Pain – Psychological stress – Obstructions – Cancer therapy: chemotherapy, radiation, surgery, and bone marrow transplant.

Treatment of Cancer Types of treatment: z Surgery- 60% of all cancer pts. have some kind of surgery. z Radiation Therapy z Chemotherapy z Immunotherapy z Complementary therapies

Diet and Cancer Cancer prevention: z Choose most of the foods you eat from plant sources. 5 or more servings z Limit intake of high fat foods, particularly from animal sources. z Be physically active. z Stop cigarette smoking and alcohol intake.

Dietary Components Associated with Cancer Excesses of certain substances such as: z Fat- the end products of metabolism have been found to be carcinogenic. z Alcohol- has been connected with liver, colorectal, and breast cancers. z Pickled and Smoked Foods- related to cancers of the esophagus and stomach.

Nutritional Effect of Cancer Treatment z

Surgery: – Radical surgery for head and neck area frequently produces swallowing defects that range from milk intake impairment to total disability. – Nutritional problems also occur with restriction of stomach and small intestine.

Nutritional Effect of Cancer Treatment Radiation:

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Radiotherapy to the head and neck area may produce severe inflammation with ulceration and oedema of the oral and pharyngeal mucosa. Radiation may permanently disable the salivary glands with resulting xerostomia (dryness of the mouth) which contributes to difficulties in mastication and dental carries. Anorexia may also develop during radiation and senses of smell and taste may be inhibited.

Nutritional Effect of Cancer Treatment Chemotherapy:

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The action of chemotherapeutic agents is not limited to malignant tissues but affects normal cells as well. As result major toxicities seen and dietary intake affected food intake inhibited by mucositis, cheilosis, glossitis, stomatitis caused by many drugs. • • • • •

Nausea and vomiting occur almost in all cancer agents Taste abnormalities, adromyine anovaria and oligophagy (eating for foods). Diarrhoea may be induced e.g. Actinomycin D Constipation or dynamic ileus (inhibition of motility) Organ damage e.g. liver methotrexate

NUTRITIONAL MANAGEMENT OF CANCER PATIENTS z

Goals of Cure – Prevent or correct nutritional deficiencies – Minimise weight loss

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Nutritional cure plan – – – – – –

Initial assessment to determine the risk of nutrition depletion. medical, social and nutritional history Anthropometric data Nutrient – drug interactions Biochemical measurements Oral intake or dietary analysis.

Dietary Components Associated with Cancer z

Timing of food presentation: – The timing of food presentation deserves consideration. – Patients complain of decrease ability to eat as day progress the morning is best for eating. – Frequent small feedings with particular emphasis in the morning would be beneficial.

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Accommodating Taste Changes: – The patients should be the guide for which food will be eaten and how they are seasoned. – Aromas from hot food sometimes aggravate nausea. – So, cold, non spicy food is recommended

Protective Dietary Components Certain foods and nutrients have been shown to protect against certain types of cancers. z Vitamin C - has been shown to protect against cancer of stomach, esophagus, and oral cavity. z antioxidants- these are certain nutrients found in fruits and vegetables. z

Protective Dietary Components z z z z

Fruits and Veggies- contain vitamins, fiber and phytochemicals. Vitamin E and selenium- both antioxidants that protect cells against breakdown. Calcium- reduces cell turnover rates. Water- drinking more than 5 glasses a day has been associated with a lower risk of cancer.

Diet and Cancer z

Fiber- Insoluble fiber is connected to decreased risk of colon cancer. Beans, vegetables, whole grains and fruit are good sources.

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Salt- some evidence links diets containing large amounts of foods preserved by pickling and salting to increased cancers of the stomach, nose and throat.

Diet and the Cancer Patient Nutrition is an important part of treatment. z Eating the right kinds of food before, during and after treatment can help the patient feel better and stay stronger. z Treatment can have an adverse effect on appetite. z

Diet and the Cancer Patient People with cancer have unique nutrition needs. z Eating enough food is usually not a problem. z Nutrition suggestions often emphasize eating high calorie, high protein foods. z

Diet and the Cancer Patient z z z z z z z z z z

Treatments kill cancer cells but they also kill healthy cells. This can cause side effects such as: Loss of appetite Sore mouth or throat Dry mouth Dental and gum problems Changes in taste or smell Nausea Diarrhea Constipation Fatigue Depression.

Diet and the Cancer Patient It is very important to have good nutrition to minimize the side effects of cancer, prevent or reverse nutritional deficiencies, and to maximize the quality of life. z The best method of calorie intake is by mouth. Sometimes this is not possible. z

Diet and the Cancer Patient Other options of intake are: z Tube feeding: – If oral intake becomes inadequate to maintain nutritional status and the intestinal tract is functional, tube feeding can provide relief for anorexia patients. – This often administerial at home to reduce need for hospitalising. – Blendarized formulas may be used in large fields.

Diet and the Cancer Patient z z z z z z

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TPN If the G.I.T. is not functioning Via infusion into large vein usually the subclavian veins. Parental support may be partial or complete TPN. Energy and protein are usually given as glucose and a mixture of amino acids. Intravenous fat may be given to prevent essential fatty acid deficiency and a source of concentrated energy. Electrolytes are added as well as trace elements and vitamins

Suggestions for increasing food intakes of cancer patients z z z z z z z z z z

Provide a patient with a good breakfast at least two hours before radiation or chemotherapy. Minimise nausea by antinausea drugs and result after treatment. Individual likes and dislikes should always be kept in mind. Use cold protein items, salad plates of fruit and cheese. Use cold snacks high in protein e.g. ice cream, salted-nuts. Adjust seasoning to improve flavour of foods for patient e.g. addition of lemon. Provide extended food service for exposure in evenings. Make available family kitchen in which familiar food may be prepared. Cachetic patients may particularly benefit from high protein (20%) formulas such as Sustacal. Insure, pediasure also good. Mltivitamin supplementation is warranted for these patients.

‫إﺣﺼﺎﺋﻴﺎت اﻟﺴﺮﻃﺎن ﻓﻲ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬ ‫أآﺜﺮ ﻋﺸﺮ أﻧﻮاع ﺳﺮﻃﺎن اﻧﺘﺸﺎرًا ﺑﻴﻦ اﻟﺴﻌﻮدﻳﻴﻦ‪:‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﺜﺪي ﻟﺪى اﻟﻨﺴﺎء )‪.(%8.8‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻜﺒﺪ )‪.(%7.5‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﺑﻴﻀﺎض اﻟﺪم )‪.(%7.5‬‬ ‫‪ z‬اﻟﻠﻤﻔﻮﻣﺎ اﻟﻐﻴﺮ هﺪﺟﻜﻨﻴﺔ )‪.(%7.3‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻘﻮﻟﻮن واﻟﻤﺴﺘﻘﻴﻢ )‪.(%5.5‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻐﺪة اﻟﺪرﻗﻴﺔ )‪.(%5.2‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﺮﺋﺔ )‪.(%4.7‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﺠﻬﺎز اﻟﻌﺼﺒﻲ )‪.(%3.9‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻤﻌﺪة )‪.(%3.8‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻤﺜﺎﻧﺔ )‪.(%3.5‬‬

‫إﺣﺼﺎﺋﻴﺎت اﻟﺴﺮﻃﺎن ﻓﻲ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬ ‫أآﺜﺮ ﻋﺸﺮ أﻧﻮاع ﺳﺮﻃﺎن اﻧﺘﺸﺎرًا ﺑﻴﻦ اﻟﺴﻌﻮدﻳﻴﻦ )ذآﻮر(‪:‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻜﺒﺪ )‪.(%10.3‬‬ ‫‪ z‬اﻟﻠﻤﻔﻮﻣﺎ ﻏﻴﺮ اﻟﻬﺪﺟﻜﻨﻴﺔ )‪.(%8.5‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﺑﻴﻀﺎض اﻟﺪم )‪.(%8.1‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﺮﺋﺔ )‪.(%7‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻘﻮﻟﻮن واﻟﻤﺴﺘﻘﻴﻢ )‪.(%5.8‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻤﻌﺪة )‪.(%5.5‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻤﺜﺎﻧﺔ )‪.(%5.4‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﺒﺮوﺳﺘﺎﺗﺎ )‪.(%5.3‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﺠﻬﺎز اﻟﻌﺼﺒﻲ )‪.(%4.6‬‬ ‫‪ z‬اﻟﻠﻤﻔﻮﻣﺎ اﻟﻬﺪﺟﻜﻨﻴﺔ )‪.(%3.9‬‬

‫إﺣﺼﺎﺋﻴﺎت اﻟﺴﺮﻃﺎن ﻓﻲ اﻟﻤﻤﻠﻜﺔ اﻟﻌﺮﺑﻴﺔ اﻟﺴﻌﻮدﻳﺔ‬ ‫أآﺜﺮ ﻋﺸﺮ أﻧﻮاع ﺳﺮﻃﺎن اﻧﺘﺸﺎرًا ﺑﻴﻦ اﻟﺴﻌﻮدﻳﻴﻦ ) إﻧﺎث(‪:‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﺜﺪي )‪.(%10.3‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻐﺪة اﻟﺪرﻗﻴﺔ )‪.(%8.8‬‬ ‫‪ z‬اﺑﻴﻀﺎض اﻟﺪم )‪.(%6.7‬‬ ‫‪ z‬اﻟﻠﻤﻔﻮﻣﺎ ﻏﻴﺮ اﻟﻬﺪﺟﻜﻨﻴﺔ )‪.(%5.9‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻘﻮﻟﻮن واﻟﻤﺴﺘﻘﻴﻢ )‪.(%5.4‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻤﺒﻴﺾ )‪.(%4.3‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻜﺒﺪ )‪.(%4.1‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﺮﺣﻢ )‪.(%3.8‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﺠﻬﺎز اﻟﻌﺼﺒﻲ )‪.(%3.5‬‬ ‫‪ z‬ﺳﺮﻃﺎن اﻟﻤﻌﺪة )‪.(%3.5‬‬

Stop , Look, and Listen z

Be aware of your body, this is the best prevention against cancer.

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Early detection can be the difference between life and death!

Stop , Look, and Listen z

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Breast Cancer- look for a lump, any puckering, dimpling or scaling of the breast skin. Colorectal Cancer- blood in the stool, prolonged diarrhea, or constipation. Endometrial Cancer- (lining of the uterus) bleeding between periods or after menopause. Prostate- Frequent or painful urination, blood in the urine, difficulty starting and stopping.

Stop, Look, and Listen Oral Cancer- white or velvety red patches z Skin Cancer- Check body from head to toe, looking for new moles, or those that have suddenly increased in size, changed color, or bleed easily. z Lung cancer- chest pain, recurring bronchitis, or pneumonia z

5 for the Road Five things you should remember about preventing cancer. Eats lots of fruits, vegetables, and whole grains. z Discover the pleasure of physical activity. z

5 for the Road

Stay tobacco free z Enjoy a low-fat diet z Protect yourself from the sun between 10:00 am and 4:00 pm. z

Conclusion Cancer is a preventable disease in most cases. z Lead a healthy lifestyle. z Be aware of your body. z Great resource: www.cancer.org z

WWW.KFSHRC.edu.sa