CVD/Cancer

Question 1

Coronary arteries

Answer 1

Carry blood to heart
Heart beat > twisting > scar tissue/plaques
Atheromatous plaques – cholesterol and tissues
Atherosclerosis
Coronary artery disease (CAD)

Question 2

Diseases of the heart

Answer 2

Cardiovascular disease (CVD)
CAD
Coronary heart disease (CHD)
Myocardial infarction (heart attack)
Hypertension (high blood pressure)
Brain – cerebrovascular disease 
Cerebral infarction (stroke)

Question 3

CVD prevalence

Answer 3

About 1 in every 4 people has hypertension 
Per 1,000
Heart disease – all types – 100+
Heart disease – coronary – 50+
Stroke – between 0-50

Question 4

Risk factors for CVD

Answer 4

Inherent risk factors
Advancing age, family history, gender, ethnic background
Physiological conditions
Hypertension, high cholesterol, problems in glucose metabolism, overweight/obesity, inflammation
Behavioral factors
Smoking, diet, physical activity
Psychosocial factors
Education level and income, social support and marriage, stress/anxiety/depression, hostility and ager

Question 5

Framingham Heart Study

Answer 5

Recruited 5209 males and female – age 30-62
Extensive medical exams ever 2-4 years since 1948
Established link between cholesterol, high blood pressure and effects of heart disease
Still using these participants and expanded samples to understand CVD

Question 6

Gender differences

Answer 6

Incidence of CAD increases with age among men and women, but rate of increase is greatest among women after menopause
CVD accounts for twice as many death among women as do all cancers combines
Diagnoses of disease occurs on average 10 years later in women than in men
Across all ages, CAD kills more women then men

Question 7

Why women?

Answer 7

Differences in symptoms, disease
Unique risk factors
Metabolic syndrome, mental stress and depression, smoking, low levels of estrogen after menopause
Women may not seek help based on vague symptoms
Women are more likely to get misdiagnosed
Awareness of gender differences among physicians
Gender gap for referral for testing and treatment options

Question 8

Benign vs. malignant

Answer 8

Benign – localized, less threatening
Malinant – secondary qualities, spreading, more threatening evades surrounding tissues, can move through blood and other symptoms

Question 9

Four types of cancer

Answer 9

Carcinomas
Cancers of the epithelial tissue, lines outer surface of the body
Sarcomas
Arise from cells in connective tissue (bone, muscles, and cartilage)
Lymphomas
Cancers of the lymphatic system (very rare – 5%)
Leukemias
Originate in the blood or blood forming cells (stem cells in the bone marrow)

Question 10

Family history and cancer

Answer 10

Genes that are implicated in the risk for the development of cancer
BRCA1 and 2 genes – increased risk if have mutated version for breast caner
In unmutated form create a protein for the development against breast cancer

Question 11

Age

Answer 11

Advancing age, true for both men and women

Second leading cause of death among children between 1-4 years

Question 12

Ethnic background

Answer 12

African American fare far worse in terms of instance and mortality across all forms of cancer
Also psychosocial and behavioral factors that can explain the discrepancy

Question 13

Smoking

Answer 13

Lung cancer, and pretty much every cancer that is within the body

Question 14

Diet

Answer 14

Harmful foods, lack of preservation in foods increases risks of being exposed to certain bacteria and fungi
Too much exposure to preservation can also increase risk
Dietary fat increases risk to colon cancer, and CVD

Question 15

Alcohol consumption

Answer 15

Known to increase risk of mouth, esophagus, breast and liver cancers

Question 16

Physical activity/sedentary lifestyle

Answer 16

Increase risk for colon, endometrium, lung and pancreas cancers

Question 17

UV exposure

Answer 17

exposure
Vitamin D comes from the sun or from dietary supplements
People most at risk are fair skinned, blue eyed, light colored hair
Enough vitamin D = 5-10 min 2 to 3 times a week

Question 18

Sexual behavior

Answer 18

AIDS and developing caposes sarcoma and hotchkins lymphoma
General sexual practices of every day indiviudals (number of sexual partners, risky sexual behaviors, and unprotected sex)
Women who have more sexual partners develop a higher risk for cervical cancer
Men who have had multiple sex partners with women who have also had multiple partners are at higher risk for HPV
HPV oral related cancer is twice as likely to impact men than women

Question 19

Environmental risk

Answer 19

Asbestos – in our homes
Radiation – increases risk of cancer, radon gas that is carcinogenic
Infection – go to book

Question 20

Personality/Stress and Cancer

Answer 20

Type C personality
Difficulty expressing emotions, suppress emotions (anger), seem quiet, and introspective but actually are frustrated, may have increased risk of cancer
Tendency to deny are address coping with stress
Current thinking – moderate evidence and possible mechanisms?
Association between development of breast cancer and tendency to use denial or repression in coping with life stressors
Limited evidence that people with conflict-avoidant personality style are more likely to develop cancer
No evidence that depression, anxiety, extroversion, introversion, and anger expression are associated with acquiring cancer

Question 21

Coping with cancer

Answer 21

Cancer survival (head and neck cancer) not linked to positive attitude
9 year longitudinal study
No relationship between emotional well-being and cancer progression and death
“Fighting cancer” cultural attitude
Psychotherapy appears to ease depression symptoms and reduce systemic inflammation among newly diagnosed breast cancer patients
Health disparities – GO TO SLIDES

Question 22

Define cancer health disparities and discuss the factors that may contribute to
these disparities.

Answer 22

Lack of health care coverage
Low socioeconomic status (SES)
SES!access to education, occupations, health insurance, living conditions, behavioral risk factors
Physical and cultural barriers!lack of health care !diagnosis at late stage

Question 23

What factors might contribute to the higher breast cancer death rate observed in African American/Black women?

Answer 23

Lack of medical coverage
Barriers to early detection and screening
Unequal access to improvements in cancer treatment
Aggressive breast tumors are more common in younger AA/B and H/L women living in low SES areas (! poorer survival)