Cancers

1
Cancers

• Colon Cancer
• Lung Cancer
• Prostate Cancer
• Liver Cancer
• Kidney Cancer
• Pancreatic Cancer
• Oral Cancer

2
Unit Expectations

• Understanding the meaning of various cancers and
  medical terms.
• Identify and explain type of exam used to
  diagnosis certain cancers
• Identify the four stages of cancer
• Identify risk factors associated with various
  cancers
• Identify symptoms of skin cancer

3
Overview

• Test
• Online Skin Cancer Quiz
• Guest Speaker American Cancer Society??
• Videos Cancer, Colon Cancer, Breast Cancer,
  Ovarian Cancer, Cervical Cancer, Skin Cancer

4
Cancer Video

• http//www.sparkpeople.com/resource/health_videos_
  detail.asp?Video23
• http//www.msnbc.msn.com/id/21134540/vp/259378852
  5937885

5
Colon Cancer

• Colon cancer is third most common cancer in the
  United States.
• Colon cancer is cancer that starts in the large
  intestine or the rectum. Such cancer is sometimes
  referred to as "colorectal cancer."
• There is no single cause for colon cancer. Nearly
  all colon cancers begin as non-cancerous (benign)
  polyps, which slowly develop into cancer.
• Stage I and II colon cancer have very high cure
  rates (60 to 90) lower cure rates are seen
  with stage III and IV colon cancer.
• To detect colon cancer early, when it is most
  curable, everyone over the age of 55 should have
  bi-annual endoscopic examinations of the colon.

6
Colon Cancer Risk Factors

• You have a higher risk for colon cancer if you
  have
• Cancer elsewhere in the body
• Colorectal polyps (growth sticks out of lining of
  colon)
• Crohns Disease (chronic inflammation of
  gastrointestinal tract)
• Family history of colon cancer
• Personal history of breast cancer
• Diet low in fiber and high in fat

7
Colon Cancer Symptoms

• Many cases of colon cancer have no symptoms. The
  following symptoms, however, may indicate colon
  cancer
• Abdominal pain and tenderness in the lower
  abdomen
• Blood in the stool
• Diarrhea, constipation, or other change in bowel
  habits
• Intestinal obstruction
• Narrow stools
• Unexplained anemia
• Weight loss with no known reason

8
Types of Colon Cancer Examines

• There are 4 basic tests for colon cancer..
• 1 Stool test (to check for blood)
• 2 Sigmoidoscopy (inspection of the lower colon)
• 3 Colonoscopy (inspection of the entire colon)
• 4 Double contrast barium enema
• All 4 are effective in catching cancers in the
  early stages, when treatment is most beneficial.

9
Colonoscopy/Sigmoidoscopy
10
Barium Enema

• The barium enema is a valuable diagnostic tool
  that helps detect abnormalities in the large
  intestine (colon).
• The barium enema, along with colonoscopy, remain
  standards in the diagnosis of colon cancer and
  other diseases of the colon.

11
Barium Enema
12
Stages of Cancer

• The staging of a carcinoma has to do with the
  size of the tumor, and the degree to which it has
  penetrated.
• When the tumor is small and has not penetrated
  the mucosal layer, it is said to be stage I
  cancer.
• Stage II tumors are into the muscle wall, and
  stage III involves nearby lymph nodes.
• The rare stage IV cancer has spread
  (metastasized) to remote organs.

13
Stages of Cancer
14
Colon Culture

• When polyps are discovered in a sigmoidoscopy (an
  inspection of the lower third of the large
  intestine), they are retrieved to be tested for
  cancer.
• If a large amount of polyps are found, a more
  thorough examination of the entire length of the
  large intestine (a colonoscopy) may be
  recommended.

15
Polyp Removal
16
Colon Cancer Series (Normal Anatomy)
17
Colon Cancer Series (Indication)
18
Colon Cancer Series (Incision)
19
Colon Cancer Series (Procedure)
20
Colon Cancer Series (Aftercare)
21
Colon Cancer Treatment

• Surgery is main treatment for colon cancer and
  removal of the involved colon is required.
• If cancer is located near rectum, a colostomy may
  be necessary.
• Stage I and II colon cancer, surgery is usually
  the only treatment.
• Stage III or IV colon cancer, chemotherapy is
  necessary after surgery.
• Chemotherapy may also be helpful in some selected
  stage II patients.
• Chemotherapy involves a course of drugs which are
  toxic to cancer cells.

22
Colostomy

• A colostomy is done when the lower large
  intestine, rectum, or anus is unable to function
  normally. Intestinal obstruction with associated
  inflammation, is a common indication for
  colostomy.
• A colostomy creates an opening on the abdomen
  for the drainage of stool from the large
  intestine.
• The end of the healthy colon brought out to the
  skin of the abdominal wall, where it is sutured
  in place. An adhesive drainage bag is placed
  around the opening. The abdominal incision is
  then closed.
• In more than 90 of the cases, the surgery is
  successful.

23
Colostomy Series (Normal Anatomy Indication)
24
Colostomy Series (Procedure Part I II)
25
Colostomy Series (Aftercare)
26
Colon Cancer Video

• http//www.nwcn.com/video/cancerfree-index.html?nv
  id251401

27
Lung Cancer

• Lung cancer is cancer that begins in the lungs,
  the two organs found in the chest that help you
  breathe.
• The lungs are made up of areas called lobes. The
  right lung has three lobes the left lung has
  two, so there's room for the heart. When you
  breathe, air goes through your nose, down your
  windpipe (trachea), and into the lungs where it
  spreads through tubes called bronchi. Most lung
  cancer begins in the cells that line these tubes.
• Lung cancer is the deadliest type of cancer for
  both men and women. Each year, more people die of
  lung cancer than breast, colon, and prostate
  cancers combined.
• Lung cancer is more common in older adults. It is
  rare in people under age 45.

28
Lung Cancer Causes

• Cigarette smoking is the leading cause of lung
  cancer.
• The more cigarettes you smoke per day and the
  earlier you started smoking, the greater your
  risk of lung cancer. There is no evidence that
  smoking low-tar cigarettes lowers the risk.
• However, lung cancer has occurred in people who
  have never smoked.
• Secondhand smoke (breathing the smoke of others)
  increases your risk of lung cancer. According to
  the American Cancer Society, an estimated 3,000
  non-smoking adults will die each year from lung
  cancer related to breathing secondhand smoke.

29
Lung Cancer Risk Factors

• The following may also increase one's risk of
  lung cancer
• High levels of air pollution
• High levels of arsenic in drinking water
• Radon gas
• Asbestos
• Family history of lung cancer
• Radiation therapy to the lungs
• Exposure to cancer-causing chemicals such as
  uranium, vinyl chloride, nickel chromates, coal
  products, mustard gas, gasoline, and diesel
  exhaust

30
Lung Cancer Symptoms

• Early lung cancer may not cause any symptoms.
  Many times, lung cancer is found when an x-ray is
  done for another reason.
• Symptoms depend on the specific type of cancer
  you have, but may include
• Cough that doesn't go away
• Coughing up blood
• Shortness of breath
• Wheezing
• Chest Pain
• Loss of appetite
• Losing weight without trying
• Fatigue

31
Lung Cancer Exams/Tests

• The health care provider will perform a physical
  exam and ask questions about your medical
  history. You will be asked if you smoke, and if
  so, how long you have smoked.
• When listening to the chest with a stethoscope,
  the health care provider can sometimes hear fluid
  around the lungs, which could (but doesn't
  always) suggest cancer.
• Tests that may be performed include
• Chest x-ray
• Sputum cytology test
• Blood work
• CT scan of the chest
• MRI of the chest

32
Sputum Cytology Test

• A sputum sample is obtained by coughing deeply
  and expelling the material that comes from the
  lungs into a sterile cup. The sample is taken to
  a laboratory and placed in a medium under
  conditions that allow the organisms to grow. A
  positive culture may identify disease-producing
  organisms that may help diagnose bronchitis,
  tuberculosis, a lung abscess, or pneumonia.

33
Sputum Cytology Test
34
Removal of Lung Tissue

• In some cases, the health care provider may need
  to remove a piece of tissue from your lungs for
  examination under a microscope. This is called a
  biopsy. There are several ways to do this
• Bronchoospy combined with biopsy
• Pleural biopsy
• Mediastinoscopy with biopsy

35
Bronchoscopy

• A bronchoscope is a tube with a tiny camera on
  the end which is inserted through the nose (or
  mouth) into the lungs. During a bronchoscopy
  procedure, a scope will be inserted through the
  nostril until it passes through the throat into
  the trachea and bronchi. A bronchoscope is used
  to provide a view of the airways of the lung. The
  scope also allows the doctor to collect lung
  secretions and lung tissue for biopsy for tissue
  specimens.

36
Bronchoscopy
37
Pleural Biopsy

• In a pleural biopsy, a small piece of pleural
  tissue in the chest is removed with a needle. The
  biopsy may distinguish between a cancerous and
  noncancerous disease. It also can help to detect
  whether a viral, fungal or parasitic disease is
  present.

38
Pleural Biopsy
39
Mediastinoscopy

• Mediastinoscopy is a procedure in which a lighted
  instrument (mediastinoscope) is inserted through
  a neck incision to visually examine the
  structures in the top of the chest cavity and
  take tissue samples. This procedure can be used
  to biopsy lymph nodes surrounding the airway to
  help diagnose or see how far a particular
  disease has spread.

40
Mediastinoscopy
41
Lung Cancer Treatment

• Treatment depends on the specific type of lung
  cancer. Each type is treated differently.
  Chemotherapy, radiation, and surgery may be
  needed.
• Small cell lung cancer spreads quickly throughout
  the body, treatment must include cancer-killing
  drugs (chemotherapy) taken by mouth or injected
  into the body. Chemotherapy may be combined with
  high-powered x-rays (radiation therapy).
• Chemotherapy or radiation will be needed if
  surgery occurs. However, because the disease has
  usually spread by the time it is diagnosed, very
  few patients with small cell lung cancer are
  candidates for surgery.
• Combination chemotherapy and radiation treatment
  is given to persons with extensive small cell
  lung cancer. However, the treatment only helps
  relieve symptoms it does not cure the disease.

42
Lung Cancer Treatment

• There are different types of treatment for
  non-small cell lung cancer
• Surgery - part or all of the lung is removed
• Radiation therapy - uses powerful x-rays or other
  radiation to kill cancer cells
• Chemotherapy - uses drugs to kill cancer cells
  and stop new ones from growing
• Laser therapy - a small beam of light burns and
  kills cancer cells

43
Lung Cancer Prevention

• If you smoke, quit. It is never too late to stop
  smoking. You should also avoid breathing in the
  smoke from other people's cigarettes, cigars, or
  pipes.
• Eating a diet rich in fruits and vegetables may
  help prevent some cases of lung cancer.

44
Lung Cancer Video

• http//www.sciencedaily.com/videos/2005/1002-survi
  ving_lung_cancer.htm

45
Prostate Cancer

• Prostate cancer is cancer that grows in prostate
  gland. The prostate is a small, walnut-sized
  structure that makes up part of a man's
  reproductive system. It wraps around the urethra,
  the tube that carries urine out of the body.
• Prostate cancer is the third most common cause of
  death from cancer in men of all ages and is the
  most common cause of death from cancer in men
  over 75 years old. Prostate cancer is rarely
  found in men younger than 40.
• Men at higher risk include African-America men
  older than 60, farmers, tire plant workers,
  painters, and men exposed to cadmium. The lowest
  number of cases occurs in Japanese men and those
  who do not eat meat (vegetarians).

46
Prostate Cancer Causes

• The cause of prostate cancer is unknown, some
  studies have shown a relationship between high
  dietary fat intake and increased testosterone
  levels. When testosterone levels are lowered
  either by surgical removal of the testicles or by
  medication, prostate cancer can slowly get
  better.
• There is no known association with benign
  prostatic hyperplasia (BPH).

47
Benign Prostatic Hyperplasia
48
Prostate Cancer Stages

• Prostate cancers are grouped according to how
  quickly they spread and how different they are
  from the surrounding prostate tissue. This is
  called staging. There are several different ways
  to stage tumors, a common one being the A-B-C-D
  staging system, also known as the Whitmore-Jewett
  system
• Stage A Tumor is not felt on physical
  examination, and is usually detected by accident
  after prostate surgery is done for other reasons.
  
• Stage B Tumor is only in the prostate and
  usually detected during a physical exam or with a
  blood test.
• Stage C Tumor has spread beyond the prostate but
  is not in the lymph nodes.
• Stage D Tumor has spread (metastasized) to lymph
  nodes or other parts of the body, such as the
  bone and lungs.

49
Prostate Cancer Symptoms

• With the advent of PSA (Prostate-specific
  antigen) testing, most prostate cancers are now
  found before they cause symptoms. Additionally,
  while most of the symptoms listed below can be
  associated with prostate cancer, they are more
  likely to be associated with non-cancerous
  conditions.
• Urinary hesitancy (delayed or slowed start of
  urinary stream)
• Urinary dribbling, especially immediately after
  urinating
• Urinary retention
• Pain with urination
• Pain with ejaculation
• Lower back pain
• Pain with bowel movement

50
Prostate Cancer Exams/Tests

• A rectal exam often reveals an enlarged prostate
  with a hard, irregular surface. A number of tests
  may be done to confirm the diagnosis of prostate
  cancer.
• PSA test may be high, although non-cancerous
  enlargement of the prostate can also increase PSA
  levels.
• Urinalysis may show blood in the urine.
• Urine or prostatic fluid cytology may reveal
  unusual cells.
• Prostate biopsy confirms the diagnosis.
• A newer test called AMACR is more sensitive for
  determining the presence of prostate cancer than
  the PSA test.

51
Prostate Cancer Rectal Exam
52
Prostate Cancer Treatment

• The appropriate treatment of prostate cancer is
  often controversial. Treatment options vary based
  on the stage of the tumor. In the early stages,
  surgery and radiation therapy may be used to
  remove or kill the tumor.
• Prostate cancer that has spread may be treated
  with drugs to reduce testosterone levels, surgery
  to remove the testes, or chemotherapy.
• Surgery, radiation therapy, and hormonal therapy
  can interfere with sexual desire or performance
  on either a temporary or permanent basis. Discuss
  your concerns with your health care provider.

53
Prostate Cancer Surgery

• Surgery is usually only recommended after
  thorough evaluation and discussion of all
  treatment options. A man considering surgery
  should be aware of the benefits and risks of the
  procedure.
• Removal of prostate gland (Radical Prostatectomy)
  is often recommended for treatment of stage A and
  B prostate cancers. This is a lengthy procedure,
  usually done using general or spinal anesthesia.
  An surgical cut is made through the abdomen or
  perineal area. You may remain in the hospital for
  5 to 7 days. Possible complications include
  impotence and urinary incontinence, although
  nerve-sparing procedures may reduce the risk of
  these complications. This surgery should be done
  by a urologist with extensive experience doing
  this specific procedure.

54
Radical Prostatectomy
55
Prostate Cancer Radiation

• Radiation therapy used primarily to treat
  prostate cancers classified as stages A, B, or C.
  Patients whose health makes risk of surgery high,
  radiation therapy is often the preferred
  alternative. Radiation therapy to the prostate
  gland is either external or internal
• External beam radiation therapy is done in a
  radiation oncology center by specially trained
  radiation oncologists, usually on an outpatient
  basis. Prior to treatment, a therapist will mark
  the part of the body that is to be treated with a
  special pen. The radiation is delivered to the
  prostate gland using a device that resembles a
  normal x-ray machine. The treatment itself is
  generally painless. Side effects may include loss
  of appetite, fatigue, skin reactions such as
  redness and irritation, rectal burning or injury,
  diarrhea, and blood in urine. External beam
  radiation therapy is usually done 5 days a week
  for 6 - 8 weeks.

56
Prostate Cancer Radiation

• Internal radiation therapy places radioactive
  seeds inside you, directly in or near the tumor.
  A surgeon makes a small cut in the area to inject
  the seeds. They are so small, you don't feel
  them. The seeds can be temporary or permanent.
  Because internal radiation therapy is directed to
  the prostate, it reduces damage to the tissues
  surrounding the prostate. Side effects may
  include pain, swelling or bruising in your penis
  or scrotum, red-brown urine or semen, impotence,
  incontinence, and diarrhea.

57
Prostate Cancer Prevention

• There is no known prevention. Following a
  vegetarian, low-fat diet or one similar to the
  traditional Japanese diet may lower risk. Early
  identification (as opposed to prevention) is now
  possible by yearly screening of men over 40 or 50
  years old through digital rectal examination
  (DRE) and PSA blood test.
• There is a debate, however, as to whether PSA
  testing should be done in all men. There are
  several potential downsides to PSA testing. The
  first is that a high PSA does not always mean a
  patient has prostate cancer. The second is that
  health care providers are detecting and treating
  some very early-stage prostate cancers that may
  never have caused the patient any harm. The
  decision about whether to pursue a PSA should be
  based on a discussion between patient and health
  care provider.

58
Colposcopy
59
Liver Cancer

• Hepatocellular carcinoma is cancer of the liver.
• This type of cancer occurs more often in men than
  women, usually in people 50 to 60 years old. The
  disease is more common in parts of Africa and
  Asia than in North or South America and Europe.

60
Liver Cancer Causes

• The cause of liver cancer is usually cirrhosis
  (scarring of the liver).
• Cirrhosis may be caused by viral hepatitis,
  primarily hepatitis B and C, alcohol abuse,
  autoimmune diseases of the liver, and other
  diseases that result in chronic inflammation of
  the liver.
• The most common cause for cirrhosis in the United
  States is alcohol abuse.

61
Liver Cancer Symptoms

• Abdominal pain or tenderness, particularly in the
  right-upper quadrant
• Enlarged abdomen
• Easy bruising or bleeding
• Jaundice (a yellow discoloration of the skin and
  eyes)

62
Liver Cancer Exams/Tests

• Physical examination shows an enlarged, tender
  liver.
• A liver biopsy shows hepatocellular carcinoma.
• There may be a mass shown on abdominal CT scan.
• A liver scan may indicate an abnormality.
• Liver enzymes (liver function tests) are
  elevated.

63
Liver Biopsy
64
Liver CT Scan
65
Liver Cancer Treatment

• Aggressive surgery or liver transplantation may
  be successful in treating small or slow-growing
  tumors if they are diagnosed early.
• Chemotherapy and radiation treatments are not
  usually effective but may be used to shrink large
  tumors so that surgery has a greater chance of
  success.

66
Liver Cancer Outlook

• The usual outcome is poor, because only 10 - 20
  of hepatocellular carcinomas can be removed
  completely using surgery.
• If the cancer cannot be completely removed, the
  disease is usually deadly within 3 to 6 months,
  although this varies greatly. Survival much
  longer than this occasionally occurs.

67
Liver Cancer Prevention

• Preventing and treating viral hepatitis may help
  reduce risk.
• Avoid excessive alcohol consumption.
• Certain patients may benefit from hemochromatosis
  screening.

68
Kidney Cancer

• Renal cell carcinoma is a type of kidney cancer
  in which the cancerous cells are found in the
  lining of very small tubes (tubules) in the
  kidney.
• Renal cell carcinoma is the most common type of
  kidney cancer in adults. It occurs most often in
  people 50 - 70 years old, and typically affects
  men.
• The exact cause is unknown.
• Kidneys are responsible for removing wastes from
  the body, regulating electrolyte balance and
  blood pressure, and stimulating red blood cell
  production.

69
Kidney Cancer Causes

• Dialysis treatment
• Family history of the disease
• Genetics
• Smoking
• Von Hippel-Lindau disease (a hereditary disease
  that affects the capillaries of the brain)

70
Dialysis

• Dialysis is a method of removing toxic substances
  (impurities or wastes) from the blood when the
  kidneys are unable to do so.
• Dialysis uses special ways of accessing the blood
  in the blood vessels.
• Blood is diverted from the access point in the
  body to a dialysis machine. Here, the blood flows
  counter-current to a special solution called the
  dialysate. The chemical imbalances and impurities
  of the blood are corrected and the blood is then
  returned to the body. Typically, most patients
  undergo hemodialysis for three sessions every
  week. Each session lasts 3 - 4 hours.

71
Kidney Cancer Symptoms

• Abdominal pain
• Abnormal urine color (dark, rusty, or brown)
• Back pain
• Blood in urine
• Emaciated, thin, malnourished appearance
• Enlargement of one testicle
• Flank pain (pain in one side of the body between
  the upper abdomen and the back
• Swelling or enlargement of the abdomen
• Unintentional weight loss of more than 5 of body
  weight

72
Kidney Cancer Exams/Tests

• Palpation of the abdomen may show a mass or organ
  enlargement, particularly of the kidney or liver.
  Men may have a varicocele in the testicles.
• Intravenous pyelogram (IVP) - iodine-based
  contrast dye is injected into a vein, a series of
  images are taken at timed intervals.
• Kidney x-ray
• Renal arteriography x-ray of the blood vessels
  in the kidney.
• Ultrasound of the abdomen and kidney
• Urine test

73
Palpation
74
Varicocele
75
Kidney Cancer Treatment

• Nephrectomy - surgical removal of all or part of
  the kidney is recommended. This may include
  removing the bladder or surrounding tissues or
  lymph nodes.
• Radiation therapy does not usually work for renal
  cell carcinoma and, therefore, is not often used.
  
• Many chemotherapy drugs and other medications
  have been successful in reducing the growth of
  some renal cell carcinomas, including cancers
  that have spread. Current therapies such as
  interferon and interleukin-2 work by blocking the
  blood supply of the tumor. Some chemotherapy
  drugs have been used to treat this and other
  cancers for many years.
• A cure is unlikely unless all of the cancer is
  removed with surgery.

76
Nephrectomy Series (Normal and Indication)
77
Nephrectomy Series (Incision and Procedure)
78
Nephrectomy Series (Aftercare)
79
Kidney Cancer Outlook

• The outcome depends on the degree of cancer
  spread.
• The survival rate is highest if the tumor is in
  the early stages and has not spread outside the
  kidney.
• If it has spread to the lymph nodes or to other
  organs, the survival rate is much lower.

80
Kidney Cancer Prevention

• Stop smoking.
• Follow your health care provider's
  recommendations in the treatment of kidney
  disorders, especially those that may require
  dialysis.

81
Pancreatic Cancer

• Pancreatic carcinoma is cancer of the pancreas.
• Pancreatic cancer is the fourth leading cause of
  death from cancer in the United States.
• The disease is slightly more common in men than
  in women, and risk increases with age.

82
Pancreatic Cancer Causes

• The cause is unknown, but it is more common in
  smokers and in obese individuals.
• Almost a third of cases of pancreatic cancer are
  due to cigarette smoking.
• There is controversy as to whether type 2
  diabetes is a risk factor for pancreatic cancer.
• A small number of cases are known to be related
  to syndromes that are passed down through
  families.

83
Pancreatic Cancer Symptoms

• Weight loss
• Abdominal pain
• Loss of appetite
• Jaundice
• Nausea and vomiting
• Weakness
• Fatigue
• Diarrhea
• Indigestion
• Back pain
• Clay-colored stools
• Paleness
• Depression

84
Pancreatic Cancer Exams/Tests

• ERCP - procedure used to identify stones, tumors,
  or narrowing in the bile ducts. The procedure is
  done through an endoscope.
• Abdominal CT scan
• Pancreatic biopsy
• Abdominal ultrasound
• Abdominal MRI

85
ERCP
86
Pancreatic Cancer Treatment

• At the time of diagnosis, only about 20 of
  pancreatic tumors can be removed by surgery. The
  standard procedure is called a pancreaticoduodenec
  tomy (Whipple procedure).
• When the tumor is confined to the pancreas but
  cannot be removed, a combination of radiation
  therapy and chemotherapy may be recommended. When
  the tumor has spread (metastasized) to other
  organs such as the liver, chemotherapy alone is
  usually used.
• For patients who have biliary obstruction
  (blockage of the vessels that transport bile) and
  the tumor cannot be totally removed, the
  obstruction must be relieved. There are generally
  two approaches to this -- surgery and placement
  of a biliary stent (similar to stents placed in
  the arteries of the heart to relieve blockages)
  during ERCP.

87
Pancreatic Cancer Outlook

• Some patients with pancreatic cancer that is
  resectable (can be surgically removed) are cured.
  However, cure rates are significantly less than
  50.
• Chemotherapy and radiation are often given after
  surgery to attempt to increase the cure rate. For
  pancreatic cancer that cannot be removed
  completely with surgery, or cancer that has
  spread beyond the pancreas, cure is not currently
  possible and the average survival is usually less
  than 1 year. Such patients might consider
  enrollment in a clinical trial (a medical
  research study to determine the best treatment).

88
Pancreatic Cancer Prevention

• If you smoke, stop smoking.
• Eat a diet high in fruits, vegetables, and whole
  grains.
• Exercise regularly.

89
Oral Cancer

• Oral cancer is cancer of the mouth.
• Oral or mouth cancer most commonly involves the
  tissue of the lips or the tongue.
• It may also occur on the floor of the mouth,
  cheek lining, gingiva (gums), or palate (roof of
  the mouth).
• Most oral cancers look very similar under the
  microscope and are called squamous cell
  carcinomas. These are malignant and tend to
  spread rapidly.
• Oral cancer accounts for about 8 of all
  malignant growths.
• Men get oral cancer twice as often as women,
  particularly men older than 40.

90
Oral Cancer Causes and Risks

• Smoking and other tobacco use are associated with
  70-80 of oral cancer cases.
• Smoke and heat from cigarettes, cigars, and pipes
  irritate the mucous membranes of the mouth.
• Use of chewing tobacco or snuff causes irritation
  from direct contact with the mucous membranes.
• Heavy alcohol use is another high-risk activity
  associated with oral cancer.
• Other risks include poor dental and oral hygiene
  and chronic irritation (such as that from rough
  teeth, dentures, or fillings).
• Some oral cancers begin as leukoplakia or mouth
  ulcers.

91
Oral Cancer Symptoms

• Skin lesion, lump, or ulcer
• May be a deep, hard edged crack in the tissue
• Most often pale colored, may be dark or
  discolored
• On the tongue, lip, or other mouth area
• Usually painless at first (may develop a burning
  sensation or pain when the tumor is advanced)
• Usually small
• Additional symptoms
• Abnormal taste in the mouth
• Mouth sores
• Swallowing difficulty
• Tongue problems

92
Mouth Sores
93
Black Hairy Tongue
94
Oral Cancer Exams/Tests

• An examination of the mouth by the health care
  provider or dentist shows a visible or palpable
  (can be felt) lesion of the lip, tongue, or other
  mouth area. As the tumor enlarges, it may become
  an ulcer and bleed. Speech difficulties, chewing
  problems, or swallowing difficulties may develop,
  particularly if the cancer is on the tongue.
• A tongue biopsy, gum biopsy, and microscopic
  examination of the lesion confirm the diagnosis
  of oral cancer.

95
Oral Cancer Treatment

• Surgical excision (removal) of the tumor is
  usually recommended if the tumor is small enough.
  
• Radiation therapy and chemotherapy would likely
  be used when the tumor is larger or has spread to
  lymph nodes in the neck.
• Surgery may be necessary for large tumors.
• Rehabilitation may include speech therapy or
  other therapy to improve movement, chewing,
  swallowing, and speech.

96
Oral Cancer Outlook

• Approximately 50 of people with oral cancer will
  live more than 5 years after diagnosis and
  treatment.
• If the cancer is detected early, before it has
  spread to other tissues, the cure rate is nearly
  75.
• Unfortunately, more than 50 of oral cancers are
  advanced at the time the cancer is detected. Most
  have spread to the throat or neck.
• Approximately 25 of people with oral cancer die
  because of delayed diagnosis and treatment.

97
Oral Cancer Prevention

• You should have the soft tissue of the mouth
  examined once a year. Many oral cancers are
  discovered by routine dental examination.
• Other tips
• Have dental problems corrected
• Minimize or avoid alcohol use
• Minimize or avoid smoking or other tobacco use
• Practice good oral hygiene

98
Cancer Video

• Cancer (Video).mp4

99
Diseases

• Lyme Disease
• Staph Infection
• MRSA
• Stroke
• Diabetes
• Cardiovascular Disease (Heart Disease)

100
Overview

• Test
• Videos Herpes, HPV, Lyme Disease, MRSA, Stroke,
  Diabetes, CVD

101
Lyme Disease

• Lyme disease is an inflammatory disease spread
  through a tick bite.
• Lyme disease was first reported in the United
  States in the town of Old Lyme, Connecticut, in
  1975. Cases have now been reported in most parts
  of the US. Most occur in the Northeast, upper
  Midwest, and along the Pacific coast. Lyme
  disease is usually seen during the late spring,
  summer, and early fall.
• There are three stages of Lyme disease.
• Stage 1 is called primary Lyme disease.
• Stage 2 is called secondary Lyme disease.
• Stage 3 is called tertiary Lyme disease.

102
Deer Tick
103
Lyme Diseases Causes and Risks

• Lyme disease is caused by the bacteria Borrelia
  burgdorferi (B. burgdorferi). Certain ticks carry
  the bacteria. The ticks pick up the bacteria when
  they bite mice or deer that are infected with
  Lyme disease. You can get the disease if you are
  bitten by an infected tick.
• Risk factors for Lyme disease include the
  following
• Walking in high grasses
• Doing activities that increase tick exposure
• Having a pet that may carry ticks home

104
Lyme Disease Symptoms Initial Stage

• Not everyone infected with the bacteria gets ill.
  If a person does become ill, the first symptoms
  resemble the flu and include
• Chills
• Fever
• Headache
• Lethargy
• Muscle pain
• There may be a "bulls-eye" rash, a flat or
  slightly raised red spot at the site of the tick
  bite often with a clear area in the center. It
  can be larger than 1 - 3 inches wide.

105
Bulls-Eye Rash
106
Lyme Disease Symptom Later Stages

• Symptoms in people with the later stages of the
  disease include
• Body-wide itching
• Joint inflammation
• Stiff neck
• Unusual or strange behavior
• Note Deer ticks can be so small that they are
  almost impossible to see. Therefore, many people
  with Lyme disease never even saw a tick.

107
Lyme Disease Exams/Tests

• A blood test can be done to check for antibodies
  to the bacteria that causes Lyme disease. The
  most common one used is the ELISA for Lyme
  disease test (presence of Lyme disease antibodies
  in your blood ). A western blot test is done to
  confirm ELISA results.
• A physical exam may show joint, heart, or brain
  problems in people with advanced Lyme disease.

108
Lyme Disease Treatment

• Most people who are bitten by a tick do NOT get
  Lyme disease. Antibiotics may be offered to
  someone who isn't sick if
• They have a tick that can carry Lyme disease
  attached to their body
• The tick is estimated to have been attached to
  them for at least 36 hours
• They are over 8 years old and are not pregnant or
  breastfeeding
• Antibiotics are used to treat Lyme disease. The
  specific antibiotic used depends on the stage of
  the disease and the symptoms.
• Anti-inflammatory medications, such as ibuprofen,
  are sometimes prescribed to relieve joint
  stiffness.

109
Lyme Disease Outlook

• If diagnosed in the early stages, Lyme disease
  can be cured with antibiotics. Without treatment,
  complications involving joints, the heart, and
  the nervous system can occur.
• Rarely, a person will continue having symptoms
  that can interfere with daily life. Some people
  call this post-Lyme disease syndrome.
  Unfortunately, there is no effective treatment
  yet for this syndrome.

110
Lyme Disease Complications

• Advanced stages of Lyme disease can cause
  long-term joint inflammation (Lyme arthritis) and
  heart rhythm problems. Neurological problems are
  also possible, and may include
• Decreased concentration
• Memory disorders
• Nerve damage
• Numbness
• Pain
• Paralysis of the facial muscles
• Sleep disorders
• Visual disturbances

111
Lyme Disease Prevention

• When walking or hiking in wooded or grassy areas
• Spray all exposed skin and your clothing with
  insect repellant (spray outdoors only, do not use
  on face, use just enough to cover all other
  exposed skin, don't spray under clothing, don't
  apply over wounds or irritated skin, wash skin
  after going inside)
• Wear light-colored clothing to make it easier to
  spot ticks
• Wear long-sleeved shirts and long pants with the
  cuffs tucked into shoes or socks
• Wear high boots, preferably rubber
• Check yourself and your pets frequently during
  and after your walk or hike.
• Ticks that carry Lyme disease are so small that
  they are very hard to see. After returning home,
  remove your clothes and thoroughly inspect all
  skin surface areas, including your scalp.

112
Lyme Disease Video

• http//video.search.yahoo.com/video/play?plymedi
  seaseeiUTF-8fryfp-t-501tnr21vid00017080605
  7

113
Staph Infections

• Staph infections are caused by the bacteria
  Staphylococcus aureus, which many healthy people
  carry on their skin and in their noses without
  getting sick. But when skin is punctured or
  broken, staph bacteria can enter the wound and
  cause infections, which can lead to other health
  problems.

114
Staph Infection Causes

• Staph bacteria can spread through the the
  following
• Air
• Contaminated surfaces
• Person to person
• Kids can carry staph bacteria from one area of
  their body to another  or pass it to other
  people via dirty hands or fingernails

115
Staph Infection Symptoms

• Swollen lump or mass under the skin. (size of a
  pea or as large as a golf ball)
• Skin red and irritated and might hurt when you
  touch it.
• Grows very fast
• White or yellow center
• Weep, ooze, or crust
• Spread to other skin areas

116
Staph Infection Prevention

• You can help prevent staph infections by
  encouraging the following
• Regular hand washing
• Daily bathing
• Keeping areas that have been cut clean or covered

117
Staph Infection Exams/Tests

• Your doctor will look at your skin.
• The diagnosis is primarily based on what the skin
  looks like.
• A skin biopsy may be done to help make the
  diagnosis or determine the exact type of bacteria
  involved.

118
Staph Infection Treatment

• Most localized staph skin infections can be
  treated by washing the skin with an antibacterial
  cleanser, warm soaks, applying an antibiotic
  ointment prescribed by a doctor, and covering the
  skin with a clean dressing.
• To keep the infection from spreading, use a towel
  only once when you soak or clean an area of
  infected skin, then wash it.
• Your doctor may prescribe an oral antibiotic for
  your staph skin infection. If so, take antibiotic
  on schedule for as many days as the doctor
  directs.
• More serious staph infections may require
  hospitalization.

119
Staph Infection Outlook

• Staph infections may heal on their own. Others
  usually respond well to treatment. However, a
  staph infection can return again and again for
  months or years following the first infection.

120
MRSA

• Methicillin-resistant Staphylococcus aureus
  (MRSA), a type of staph bacteria with a
  resistance to the antibiotics usually used to
  treat staph infections. Although MRSA infections
  can be harder to treat, in most cases they heal
  with proper care.
• MRSA can be fatal.
• Most MRSA infections occur in hospitals or other
  health care settings, such as nursing homes and
  dialysis centers.

121
MRSA Symptoms

• MRSA, generally start as small red bumps that
  resemble pimples, boils or spider bites.
• These can quickly turn into deep, painful
  abscesses that require surgical draining.
  Sometimes the bacteria remain confined to the
  skin.
• But they can also penetrate into the body,
  causing potentially life-threatening infections
  in bones, joints, surgical wounds, the
  bloodstream, heart valves and lungs.

122
MRSA
123
MRSA
124
MRSA
125
MRSA Causes

• Staph infections Staph bacteria are normally
  found on the skin or in the nose of about
  one-third of the population. If you have staph on
  your skin or in your nose but aren't sick, you
  are said to be "colonized" but not infected.
  Healthy people can be colonized and have no ill
  effects. However, they can pass the germ to
  others.
• Staph bacteria are generally harmless unless they
  enter the body through a cut or other wound, and
  even then they often cause only minor skin
  problems in healthy people.
• Past several years, serious infections have been
  occurring in otherwise healthy people in the
  community, for example athletes who share
  equipment or personal items.

126
MRSA Causes

• Antibiotic resistanceSurvival tactics of
  bacteria contribute to antibiotic resistance,
  humans bear most of the responsibility for the
  problem. Leading causes of antibiotic resistance
  include
• Unnecessary antibiotic use. Like other superbugs,
  MRSA is the result of decades of excessive and
  unnecessary antibiotic use. For years,
  antibiotics have been prescribed for colds, flu
  and other viral infections that don't respond to
  these drugs, as well as for simple bacterial
  infections that normally clear on their own.
• Antibiotics in food and water. Prescription drugs
  aren't the only source of antibiotics. In the
  United States, antibiotics can be found in
  livestock. These antibiotics find their way into
  municipal water systems when the runoff from
  feedlots contaminates streams and groundwater.
• Germ mutation. Even when antibiotics are used
  appropriately, they contribute to the rise of
  drug-resistant bacteria because they don't
  destroy every germ they target. Bacteria live on
  an evolutionary fast track, so germs that survive
  treatment with one antibiotic soon learn to
  resist others.

127
MRSA Risk Factors

• Young age. Children susceptible because their
  immune systems aren't fully developed or they
  don't yet have antibodies to common germs.
• Participating in contact sports. MRSA has
  affected sports teams. The bacteria spread easily
  through cuts and abrasions and skin-to-skin
  contact.
• Sharing towels or athletic equipment. MRSA has
  spread among athletes sharing razors, towels,
  uniforms or equipment.
• Having a weakened immune system. People with
  weakened immune systems, such as those living
  with HIV/AIDS, are more likely to have severe
  CA-MRSA infections.
• Living in crowded or unsanitary conditions.
  Outbreaks of MRSA have occurred in military
  training camps and in American and European
  prisons.
• Association with health care workers. People who
  are in close contact with health care workers are
  at increased risk of serious staph infections.

128
MRSA Treatment

• MRSA still responds to certain medications. In
  hospitals and care facilities, doctors often rely
  on the antibiotic vancomycin to treat resistant
  germs.
• MRSA may be treated with vancomycin or other
  antibiotics that have proved effective against
  particular strains.
• Although vancomycin saves lives, it may become
  less effective as well. Some hospitals are
  already seeing strains of MRSA that are less
  easily killed by vancomycin.
• In some cases, antibiotics may not be necessary.
  For example, doctors may drain a superficial
  abscess caused by MRSA rather than treat the
  infection with drugs.

129
MRSA Prevention

• Wash your hands
• Keep personal items personal
• Keep wounds covered
• Shower after athletic games or practices
• Sit out athletic games or practices if you have a
  concerning infection
• Sanitize linens
• Get tested
• Use antibiotics appropriately

130
MRSA Videos

• http//video.search.yahoo.com/video/play?pmrsaei
  UTF-8fryfp-t-501tnr21vid000168573957
• http//video.search.yahoo.com/video/play?pmrsaei
  UTF-8fryfp-t-501tnr21vid000168573966
• http//video.search.yahoo.com/video/play?pmrsaei
  UTF-8fryfp-t-501tnr21vid000168573948

131
Stroke

• A stroke is an interruption of the blood supply
  to any part of the brain.
• A stroke is sometimes called a "brain attack."
• Every 45 seconds, someone in the United States
  has a stroke.
• If blood flow is stopped for longer than a few
  seconds, the brain cannot get blood and oxygen.
  Brain cells can die, causing permanent damage.

132
Stroke Causes

• A blood vessel carrying blood to the brain is
  blocked by a blood clot. This is called an
  ischemic stroke.
• A blood vessel breaks open, causing blood to leak
  into the brain. This is a hemorrhagic stroke.
• ISCHEMIC STROKE Most common type of stroke.
  Results from clogged arteries, a condition called
  atherosclerosis. Fatty deposits collect on the
  wall of the arteries, forming a sticky substance
  called plaque. Over time, the plaque builds up.
  Often, the plaque causes the blood to flow
  abnormally, which can cause the blood to clot.
• HEMORRHAGIC STROKE Second major cause of stroke
  is bleeding in the brain. This can occur when
  small blood vessels in the brain become weak and
  burst. Some people have defects in the blood
  vessels of the brain that make this more likely.
  The flow of blood after the blood vessel ruptures
  damages brain cells.

133
Stroke
134
Stroke Risks

• High blood pressure is the number one reason that
  you might have a stroke.
• The risk of stroke is also increased by age,
  family history of stroke, smoking, diabetes, high
  cholesterol, and heart disease.
• Certain medications increase the chances of clot
  formation, and therefore your chances for a
  stroke. Birth control pills can cause blood
  clots, especially in woman who smoke and who are
  older than 35.
• Men have more strokes than women. But, women have
  a risk of stroke during pregnancy and the weeks
  immediately after pregnancy.
• Cocaine use, alcohol abuse, head injury, and
  bleeding disorders increase the risk of bleeding
  into the brain.

135
Stroke Symptoms

• The symptoms of stroke depend on what part of the
  brain is damaged. In some cases, a person may not
  even be aware that he or she has had a stroke.
• Usually, a SUDDEN development of one or more of
  the following indicates a stroke
• Weakness or paralysis of an arm, leg, side of the
  face, or any part of the body
• Numbness, tingling, decreased sensation
• Vision changes
• Slurred speech, inability to speak or understand
  speech, difficulty reading or writing
• Swallowing difficulties or drooling
• Loss of memory
• Vertigo (spinning sensation)
• Loss of balance or coordination

136
Stroke Exams/Tests

• During the exam, your doctor will look for
  specific neurologic, motor, and sensory deficits.
  
• Tests are performed to determine the type,
  location, and cause of the stroke and to rule out
  other disorders that may be responsible for the
  symptoms. These tests include
• Head CT or Head MRI -- used to determine if the
  stroke was caused by bleeding (hemorrhage) or
  other lesions and to define the location and
  extent of the stroke.
• ECG (electrocardiogram) -- used to diagnose
  underlying heart disorders.
• Echocardiogram -- used if the cause may be a
  blood clot from the heart, uses sound waves makes
  more detailed picture than an x-ray.

137
Stroke Treatment

• Treatment varies, depending on the severity and
  cause of the stroke. Virtually all strokes,
  hospitalization is required, including intensive
  care and life support.
• IMMEDIATE TREATMENT
• Thrombolytic medicine, breaks up blood clots and
  can restore blood flow to the damaged area.
  Strict criteria for who can receive
  thrombolytics. The most important is that the
  person be examined and treated by a specialized
  stroke team within 3 hours of when the symptoms
  start. If the stroke is caused by bleeding rather
  than clotting, this treatment can make the damage
  worse -- so care is needed to diagnose the cause
  before giving treatment.
• In other circumstances, blood thinners such as
  heparin and Coumadin are used to treat strokes.
  Aspirin may also be used.

138
Stroke Treatment

• For hemorrhagic stroke, surgery is often required
  to remove pooled blood from the brain and to
  repair damaged blood vessels.
• LONG-TERM TREATMENT
• The goal of long-term treatment is to recover as
  much function as possible and prevent future
  strokes. Depending on the symptoms,
  rehabilitation includes speech therapy,
  occupational therapy, and physical therapy. The
  recovery time differs from person to person.
• Certain therapies, such as repositioning and
  range-of-motion exercises, are intended to
  prevent complications related to stroke, like
  infections and bed sores. People should stay
  active within their physical limitations.
  Sometimes, urinary catheterization or
  bladder/bowel control programs may be needed to
  control incontinence.

139
Stroke Outlook

• The long-term outcome from a stroke depends on
  the extent of damage to the brain, the presence
  of any associated medical problems, and the
  likelihood of recurring strokes.
• Of those who survive a stroke, many have
  long-term disabilities, but about 10 of those
  who have had a stroke recover most or all
  function.
• Fifty percent are able to be at home with medical
  assistance while 40 become residents of a
  long-term care facility like a nursing home.

140
Stroke Prevention

• Get screened for high blood pressure at least
  every 2 years, especially if you have a family
  history of high blood pressure.
• Have your cholesterol checked. If you are high
  risk, your LDL "bad" cholesterol should be lower
  than 70 mg/dL.
• Follow a low-fat diet.
• Quit smoking.
• Exercise regularly -- 30 minutes a day if you are
  not overweight 60 - 90 minutes a day if you are
  overweight.
• Do not drink more than 1 to 2 alcoholic drinks a
  day.

141
Stroke Video

• http//www.msnbc.msn.com/id/21134540/vp/259378852
  3844176

142
Diabetes

• Diabetes is a life-long disease marked by high
  levels of sugar in the blood.
• Diabetes affects more than 20 million Americans.
  About 54 million Americans have pre-diabetes.
• To understand diabetes, it is important to first
  understand the normal process of food metabolism.
  Several things happen when food is digested
• A sugar called glucose enters the bloodstream.
  Glucose is a source of fuel for the body.
• An organ called the pancreas makes insulin. The
  role of insulin is to move glucose from the
  bloodstream into muscle, fat, and liver cells,
  where it can be used as fuel.
• People with diabetes have high blood sugar. This
  is because their pancreas does not make enough
  insulin or their muscle, fat, and liver cells do
  not respond to insulin normally, or both.

143
Diabetes Causes/Risks

• Diabetes can be caused by too little insulin (a
  hormone produced by the pancreas to control blood
  sugar), resistance to insulin, or both.
• A parent, brother, or sister with diabetes
• Obesity
• Age greater than 45 years
• Some ethnic groups (particularly African
  Americans, Native Americans, Asians, Pacific
  Islanders, and Hispanic Americans)
• Gestational diabetes or delivering a baby
  weighing more than 9 pounds
• High blood pressure
• High blood levels of triglycerides (a type of fat
  molecule)
• High blood cholesterol level
• Not getting enough exercise

144
Diabetes Types

• Type 1 diabetes is usually diagnosed in
  childhood. The body makes little or no insulin,
  and daily injections of insulin are needed to
  sustain life.
• Type 2 diabetes is far more common than type 1
  and makes up most of all cases of diabetes. It
  usually occurs in adulthood. The pancreas does
  not make enough insulin to keep blood glucose
  levels normal, often because the body does not
  respond well to the insulin. Many people with
  type 2 diabetes do not know they have it,
  although it is a serious condition. Type 2
  diabetes is becoming more common due to the
  growing number of older Americans, increasing
  obesity, and failure to exercise.
• Gestational diabetes is high blood glucose that
  develops at any time during pregnancy in a woman
  who does not have diabetes.

145
Diabetes Symptoms Type 1

• Increased thirst
• Increased urination
• Weight loss in spite of increased appetite
• Fatigue
• Nausea
• Vomiting
• Patients with type 1 diabetes usually develop
  symptoms over a short period of time, and the
  condition is often diagnosed in an emergency
  setting

146
Diabetes Symptoms Type 2

• Increased thirst
• Increased urination
• Increased appetite
• Fatigue
• Blurred vision
• Slow-healing infections
• Impotence in men

147
Diabetes Exams/Tests

• Fasting blood glucose level
• Random (non-fasting) blood glucose level (This
  test must be confirmed with a fasting blood
  glucose test.)
• Oral glucose tolerance test (This test is used
  more for type 2 diabetes.)

148
Diabetes Treatment

• There is no cure for diabetes. Treatment involves
  medicines, diet, and exercise to control blood
  sugar and prevent symptoms and complications.
• Basic diabetes management skills will help
  prevent the need for emergency care. These skills
  include
• How to recognize and treat low blood sugar
  (hypoglycemia) and high blood sugar
  (hyperglycemia)
• What to eat and when
• How to take insulin or oral medication
• How to test and record blood glucose
• How to adjust insulin or food intake when
  changing exercise and eating habits
• How to handle sick days
• Where to buy diabetes supplies and how to store
  them

149
Diabetes Outlook

• With good blood glucose and blood pressure
  control, many of the complications of diabetes
  can be prevented.
• Studies have shown that strict control of blood
  sugar and blood pressure levels in persons with
  diabetes helps reduce the risk of kidney disease,
  eye disease, nervous system disease, heart
  attack, and stroke.

150
Diabetes Prevention

• Maintaining an ideal body weight and an active
  lifestyle may prevent the onset of type 2
  diabetes.
• Currently there is no way to prevent type 1
  diabetes.

151
Diabetes Videos

• http//healthline.healthology.com/hybrid/hybrid-au
  todetect.aspx?content_id1922focus_handlediabete
  sbrand_namehealthline
• http//www.foxnews.com/video2/video08.html?maven_r
  eferralObject3009571maven_referralPlaylistIdsR
  evUrlhttp//www.foxnews.com/health/diabetes/index
  .html

152
CVD

• Cardiovascular disease is a broad term used to
  describe a range of diseases that affect your
  heart or blood vessels.
• Various diseases fall under cardiovascular
  disease
• Coronary artery disease
• Heart attack
• Heart failure
• High blood pressure
• The term "cardiovascular disease" is often used
  interchangeably with heart disease because both
  terms refer to diseases of the heart or arteries.
  
• Cardiovascular disease is the No. 1 worldwide
  killer of men and women, including in the United
  States. For example, cardiovascular disease is
  responsible for 40 percent of all the deaths in
  the United States, more than all forms of cancer
  combined.

153
CVD Causes

• Atherosclerosis is a disease that affects your
  arteries. Arteries are blood vessels that carry
  oxygen and nutrients from your heart to the rest
  of your body. Healthy arteries are flexible,
  strong and elastic.
• Over time, too much pressure in your arteries can
  make the walls thick and stiff sometimes
  restricting blood flow to your organs and
  tissues. This process is called arteriosclerosis,
  or hardening of the arteries, and atherosclerosis
  is the most common form of this disorder. So if
  atherosclerosis is the most common cause of
  cardiovascular disease, you may wonder what
  ultimately causes atherosclerosis.
• Some forms of cardiovascular disease aren't
  caused by atherosclerosis. Those forms include
  diseases such as congenital heart disease, heart
  valve diseases, heart infections or disease of
  the heart muscle called cardiomyopathy.

154
CVD Causes

• The culprits are the same risk factors you've
  heard mentioned in connection with heart disease
  and cardiovascular disease
• An unhealthy diet (lots of saturated fats)
• Lack of exercise
• Overweight
• Smoking
• All of these are major risk factors for
  developing atherosclerosis and, in turn,
  cardiovascular disease.

155
Atherosclerosis
156
CVD Types

• Coronary artery disease are diseases of the
  arteries that supply the heart muscle with blood.
  Means blood flow through coronary arteries has
  become obstructed, reducing blood flow to the
  heart muscle. Coronary artery disease and the
  resulting reduced blood flow to the heart muscle
  can lead to other heart problems, such as chest
  pain and heart attack.
• Heart attack is an injury to the heart muscle
  caused by a loss of blood supply. Heart attack
  usually occurs when a blood clot blocks the flow
  of blood through a coronary artery a blood
  vessel that feeds blood to a part of the heart
  muscle. Interrupted blood flow to your heart can
  damage or destroy a part of the heart muscle.

157
CVD Types

• Cardiomyopathy means diseases of the heart
  muscle. Some is genetic, some unknown.
  Cardiomyopathy means one of three things loss of
  heart muscle, heart chambers are enlarged and
  hypertrophic, which means the heart muscle is
  thickened.
• Aneurysm is a bulge or weakness in a blood vessel
  (artery or vein) wall. Aneurysms usually get
  bigger over time. Because of that, they have the
  potential to rupture and cause life-threatening
  bleeding. Aneurysms can occur in arteries in any
  location in your body. The most common sites
  include the abdominal aorta and the arteries at
  the base of the brain.

158
CVD Types

• High blood pressure (hypertension) is the
  excessive force of blood pumping through yo