HSC4579 Women's Health Exam 3

cancer

-second leading cause of death in women in the U.S.

-second leading cause of death black, white, hispanic, american indian, native alaskan women

-leading cause of death asian american women

internal and external factors

internal: hormones, estrogen, immune condition, gene mutation

external: lifestyle, environment (smoking, diet, sun exposure, chemicals, radiation), carcinogens

cigarette smoking

most significant factor in premature death among women

-lung, larynx, pharynx, oral cavity, esophagus, pancreas, bladder, kidney, uterus, cervix

-90% of all lung cancer deaths, 30% of all cancer deaths

-lung cancer mortality is 13x higher for women who smoke

-no known risk factors for most women, secondhand smoke can affect health too

diet and physical exercise

-1/3 of cancer deaths in U.S. are due to diet/lack of physical exercise

-breast cancer, colon cancer, rectal cancer

-healthy diet can help reduce the risk of most cancers

-women need to maintain diet of: fruits and veggies, whole grains, limit processed foods, red meats

*****most important changeable behavior other than smoking that can reduce cancer is DIET AND PHYSICAL ACTIVITY*****

other lifestyle factors

getting older: ACA most important risk factor (older than age of 65) most cancer death is age-related, but no age immune

viruses: # of viruses have been linked to an increased risk for cancer (HPV, HEPB, mono, etc.)

alcohol consumption: heavy consumption increases risk

-mouth, esophagus, liver, larynx, pharynx, breast (increase in estrogen), stomach (all other burn lining and damage organs)

environmental factors

sun exposure: more than 1 million cases of basal/squamous cell cancers occur annually

-melanoma-most serious skin cancer

ionizing radiation: high doses linked to increased risk of leukemia, breast cancer, thyroid cancer, lung cancer, stomach cancer

-second cancer-diagnosed after completing treatment for another cancer, usually different place in body

chemicals and other substances: asbestos, nickel, cadmium, uranium, radon, vinyl chloride, benzene, etc.

women and cancer

-1 out of every 3 women can expect to have cancer at some point in their life (50% directly related to reproductive system)

-all cancers combined: incidence highest among white, then black, hispanic, asian/pacific islander, and american indian/alaska native

most common cancer in women

1. breast cancer (all races)

2. lung cancer (white, back, am. indian) 3rd for asian, hispanic

3. colorectal cancer (2nd for asian, hispanic)

most common cancer DEATH in women

1. lung cancer (white, black, asian, am. indian) 2nd for hispanic

2. breast cancer (1st for hispanic)

2. colorectal (all races)

-early detection key

-prognosis based on: nature, location, state

**annual screenings

lung cancer

-surpassed breast cancer in 1987 as most deadly form of cancer

-primary cause is smoking

-women more vulnerable to effects of secondhand smoke

-women less likely to quit smoking

-hormones affect cancer growth

-rates of lung cancer declining in men, increasing in women

risk factors & prevention:

-don't smoke

-avoid smoke-filled areas/ secondhand smoke (non-smoker married to smoker has 30% greater risk than non-smoker)

-avoid asbestos

-avoid radon exposure

signs/symptoms: persistent cough, blood in spit, chest pain, pneumonia/bronchitis, swelling in neck or face, extreme weight loss for no reason

breast cancer

-most common cancer among women

-change of woman having invasive breast cancer in lifetime=little less than 1/8

-chance of dying 1/31

-risk increases as women age**most important risk factor

-1 out of 7 women are living with breast cancer in the U.S.

risk factors: being a woman, genetic, personal/family history, age, race, dense tissue, radiation, early periods, not having children, alcohol, lack of exercise, obesity

detection: mammongram, self-exam, ultrasound, MRI

signs/symptoms: breast swelling, lump/mass, nipple pain/discharge, skin irritation, redness

cervical cancer

malignant tumor of the cervix (lower part of uterus), cells grow out of control, related to HPV

risk factors: HPV, smoking, oral contraceptives, HIV, weak immune system, chlamydia, several sexual partners, family history, etc.

prevention: prescreening, pap smears, condom use

treatment: surgery, radiation, chemo, angiogenesis

uterine cancer

endometrial cancer, starts in inner lining of uterus, sarcoma or carcinoma, common in postmenopausal women over age 55

risk factors: age, increased # of menstrual cycles, overweight, no prior pregnancies, HRT, genetics

prevention: BC pills, healthy weight, stay active, know family history

treatment: surgery-hysterectomy, oophorectomy, lymphadenectomy, hormone therapy

ovarian cancer

originates in the ovaries, causes most deaths of cancer in reproductive system

risk factors: age, family history, HRT, haven't had children, endometriosis, obesity, fertility drugs, white

prevention: BC, healthy lifestyle, women with kids, hysterectomy, know family history

treatment: surgery, chemo, radiation, harvest eggs, hormone therapy, diet

arthritis

-among most chronic (life-long) conditions in the U.S.

-46 million individuals doctor diagnosed, which means # is higher

-among leading causes of disability in U.S. (pain, stiffness, inability to function)

-negative impact on quality of life

-typically diagnosed over age of 55 but can be younger

-african american/black women more severe symptoms

osteoarthritis

-up to age 55-more common in men, after age 55-ridiculous spike for women (**menopause, no longer have estrogen protective factor)

-inflammation around where joint and cartilage meets

-cartilage starts to wear, biggest risk factor is overuse (runners)

-most common=knees, hips, spine, neck, hands, feet

rheumatoid arthritis

-more painful bc its an autoimmune inflammation, not natural wear and tear, own immune system is attack joints (2-3x more common in women)

-common in appendages, phalanges, functional disability

-difficult to grip

-treatment like you would autoimmune disorder

arthritis stats

-women higher rates than men in every age group

-most frequent and disabling chronic condition among women

-almost 3/5 people with arthritis are under age 65***

-negative affect to quality of life

-about 26% women in U.S. have been doctor diagnosed

-women aged 65-74 highest rates

-highest in non-hispanic other, lowest in non-hispanic asian

risk factors and symptoms

risk factors:heredity, obesity, overuse, age, joint injury, nerve injury

symptoms: swelling, pain, tenderness, obvious redness, fever, stiffness, inability to move joint, weight loss, weakness

treatment

exercise, lose weight, medication, heat therapy, cold therapy, relaxation therapy, glucosamine

high heels

-proper footwear imperative to good bone/joint health

-wearing high heels over long periods of time can lead to foot damage and back pain

protection: get the best fit, thicker heel/wedge, cushion, open-toe

women and tobacco

-CDC-14/100 women 18 and over smoke cigarettes

-more likely to begin as teenagers, susceptible to marketing, peer pressure, mimicking parents

-if companies can get to teenagers, they'll have them for life

-compared to non-smokers, women who smoke more than double their annual risk of dying

-cuts off 15 years for female

-50% of individuals who smoke will die from smoking-related illness

-increase risk for several cancers

-chemicals (85% of chemicals are maintained in smoke)

why women smoke

-used to be considered a male activity

-media influence in 1920-1930s marketing as sign of independence/rebellion

-1964 first surgeon general warning

-1971 started regulating cigarette commercials

-2009 FDA took over and removed ads from magazines

-desired image and lifestyle

-weight maintenance

-parental smoking

what is in tobacco smoke/cigarettes?

-4000+ chemical compounds

**60 of which are carcinogenic

-nicotine-increases endorphins

-carbon monoxide-women more susceptible to effects, more found in blood of women who smoke than what EPA allows for externally in the air

-tar-articulate matter, mixes compounds together to produce tar that adheres to alveoli in lungs

-90% of articulate matter stays in the lungs of smokers

environmental tobacco smoke (ETS)

-passive, involuntary, secondhand smoke (side-stream smoke)

-women married to smokers 30% more likely to develop lung cancer than those married to non smokers

-pets, children, etc. issues due to ETS

third hand smoke: can stay on clothes, upholstery, blankets etc. for months

hookah

-pipe, smoke chamber, bowl, hose

-tobacco is heated and passed through water

-research still emerging

-could be inhaling more tobacco smoke than cigarettes

-not safer, social aspect?

-WHO calls it "emerging threat to public health", increasing among american youth

-high levels of toxic compounds, linked to lung and oral cancers, nicotine dependence, low birth weight babies, unclean pipes=infection/disease

-UF study in 2010 of 557 college students ages 18-22-81.5% had never smoked cig but 39% had been to hookah bar 10 times or more

-african american females less likely to engage in hookah

-1 hour of smoking hookah=nicotine of 100 cigarettes

caffeine

-over 150 million coffee consumers in the U.S.

-women who drink 3-6 cups a day-help with dementia etc. anything more is negative

-caffeine can affect: osteoporosis, breast health, pregnancy

-can have inverse effects when it wears off, so people just drink more

-individuals in the U.S. consume 50 gallons of soda a day (added caffeine)

melanoma

most common, most preventable

$8.1 billion in annual costs

skin layers and cells

skin is the largest organ in the body

-epidermis: TOP, squamous and basal cells, melanocytes

-dermis: MIDDLE, hair follicles, blood vessels, sweat glands

-subcutis: DEEP, collagen and fat cells, shock affect

basic terminology

cancer: abnormal cells grow out of control. most cancer cells form a tumor

tumor: swelling of a part of the body caused by an abnormal growth of tissue

-benign: stable, treatable, typically not life-threatening, encapsulated, doesn't spread, doesn't invade surrounding tissue

-malignant: cancerous, threatening to life, can spread and destroy normal cells

metastasize: ability of cells to break away from tumor, not encapsulated, travel to other parts of the body, forms new tumors

common malignancies

carcinoma: (epithelial) malignant cancer that arises from epithelial cells, invade surrounding tissue or spread to lymph nodes, may also arise from glandular tissue

sarcoma: (connective) malignant cancer that arises from connective tissue, uncommon, about 1% of adult cancer, 15-20% children cancer, fat, muscle, blood vessels, nerves, bone, cartilage

types of skin cancer

-1/5 americans will develop skin cancer in their lifetime

basal cell carcinoma: most common, outer most layer

-open sore, red patches, shiny bumps

-head, face, ear, neck, upper back, arms

-almost never spreads

-90% of cancer cases

squamous cell carcinoma: skin upper layers

-crust of bleed, UV exposure

-scalp, face, ears, lips, hands, lower legs, feet

-8% of skin cancer cases

melanoma: most dangerous

-1% of all skin cancer cases

-can spread into organs

-males: chest, abdomen, back

-females: lower legs

-majority of skin cancer deaths

incidence rates by race and ethnicity

-men=white males highest rate, african american lowest

-women=white women highest

-before age 50=melanoma rates higher in women than in men

-by age 50=rates twice as high in men than in women

*****white highest rates for males and females*****

stats

-one person dies of melanoma every hour (57 minutes)

-people who first use tanning bed before age 35 increase risk for melanoma by 75%!!

-melanoma can be diagnosed as early as 1 year old and in individuals 84 & older, median age of diagnosis= 63 years old

-skin cancer most common cancer among american women

-melanoma is the #1 most common skin cancer among women

treatment options

depends on stage and overall health

surgery, clinical trial, radiation therapy, chemotherapy, exercise, nutrition, social support, immunotherapy

ABCDEs of melanoma

Asymmetrical/uneven?

Border-irregular? jagged?

Color-multiple or just one?

Diameter-larger than pencil eraser? (1/4 inch)

Evolving-gotten bigger/thicker?

risk factors

fair skin, red or blonde hair, light eyes, more than 50 moles, history of sunburn or UV exposure, family history, indoor tanning, freckles, males with weakened immune system

sun protective factor (SPF)

UV radiation (UVA, UVB, UVC rays)

-3 different wavelengths, proven human carcinogen

-UVA and UVB play key roles in skin cancer

-UVA can penetrate clouds and glass, dominant tanning ray

-UVB causes burning/redness of skin 10am-4pm

-UVC shortest rays, don't pose threat

-SPF 15 blocks 93%

-SPF 30 blocks 97%

-SPF 50 blocks 98%

-recommended SPF 30-50

**above 30 is essentially the same

how to reduce risk of melanoma

-use broad spectrum sunscreen with 30 SPF

-avoid peak rays 10am-4pm

-wear protective clothing

-don't use tanning beds

-examine skin head to toe each month

-skin check by dermatologist each year

-protect children

AA#4 according to the article, what are the three main facets of the tobacco health treat for women?

tobacco use by women, exposure to secondhand smoke (SHS) from male smokers, and diversion of family resources from food, shelter, healthcare and education to purchase tobacco products

global trends indicate that smoking among women is what:

increasing

according to the article, what two events have long been associated with smoking increase among women?

women's emancipation and increases in status

studies indicate that tobacco companies, when marketing to females, attempt to link smoking with that desirable attributes?

independence, modernity, glamour, stress relief, weight control

what has had a major impact on reducing smoking prevalence in high income countries?

tobacco control policies

the authors suggest what type of understanding/approach would best serve to plan strategies aimed at stopping and reversing smoking trends among women?

a multifaceted understanding of women's smoking patterns

what do the authors pose as a challenge for the 21st century regarding tobacco use among women?

to prevent further rise and reduce currently high levels of tobacco use by women, while ensuring that women's status continue's to improve

AA#5 what do the authors report as

behavioral risk factor reduction

what three variables were used as risk factors for impaired functional status and premature mortality?

body mass index (BMI), cigarette smoking, physical inactivity

of the three variables listed above, which was associated with a 2-fold increased risk for moderate disability?

smoking

the study indicated that even though age of death was similar, mortality rates were ____% higher for high- compared with low-risk participants?

50%

definition of a longitudinal study?

observational research method in which data is gathered for the same subjects repeatedly over a period of time

the study showed three variables researched are persistently associated with what?

slower development of disability and reduction in mortality

main conclusion?

This study provides support for health policy approaches that postpone morbidity through lifestyle risk reduction. etc.

urinary incontinence

involuntary leakage of urine

-stress: associated with effort or physical exertion including sports, coughing/sneezing

-urgency: associated with urgency

-mixed

risk factors: age, vaginal delivery, parity (more children you have), weight, other diseases and conditions, high impact exercise/sports

prevention: kegels, healthy weight, nutrition, don't smoke, squat toilet habits, PT of pelvic floor

PCOS

hormonal disorder, ovaries may develop numerous small collections of fluid and fail to regularly release eggs, one of the most common hormonal disorders affecting women of childbearing age (15-44)

-affects 1 in 10 women

-50% of women w/ PCOS not diagnosed

causes: excess insulin, low grade inflammation, heredity, excess androgens

signs and symptoms:

***must have 2/3

infrequent, irregular or prolonged menstrual cycles, excess male hormones, polycystic ovaries

complications: infertility, miscarriage, premature birth, diabetes, black women have increased prevalence

treatment: improved diet, exercise, medication (BC pills)

domestic violence

-20 ppl per min abused in the U.S.

-driving forces are power and control

-1 in 3 women victims (30%), 20,000 phone calls to DV hotlines, gun present increases violence by 500%

-can happen to anyone

-african american women 3x to experience death as a result compared to white

-rates for age of first experience:

1) 8-24 36% of cases

2) 11-17 10% HS dating

3) 35-44

-more women, 1 in 4 men

-transgender: 30-40%

-only 27% of women report crimes, 105,669 in FL 2016 so really a lot more

types:

-economic (money)

-coercion/threats

-intimidation (fear)

-isolation

-minimize/deny/blame

-use children

-male privilege

UTIs

-infection of any part of the urinary system (kidneys, ureters, bladder, urethra), most in lower tract

-8-10 million each year in U.S.

-20% of women will develop UTI in their lifetime, of that 20, 20% will have recurrence

symptoms: changes in urination pattern, changes in urine, pain and discomfort

causes: most commonly from GI tract, e-coli., sex, bathroom

risk factors: woman, previous UTI, sex, new partner, pregnancy, BC, age, menopause, reduced mobility, kidney stones, catheter use

prevention: wiping front to back, empty bladder after sex, shower not bath, hydration, BC, cotton underwear

osteoporosis

"porous bone", decreases bone density and integrity

-osteoclast: cells that breakdown and reabsorb bone to remodel bone and mediate bone loss

-osteoblast: cells that are responsible for the formation of bone

-silent disease

-10 million americans have osteoporosis, 8 million are women

-white and asian women more prone

-menopause causes osteoclasts to break down bone at much higher rate

diagnosis: DNA machine (dual X-ray absorptiometry)

-normal: T score -1.0 or above

-osteopenia/low: T score between -1.0 and -2.5

-osteoporosis: T score -2.5 or below

how to decrease risk: well balanced diet, weight bearing exercises, minimize smoking and drinking

postpartum depression

modd disorder that commonly affects women after they have given birth to a child

-days to weeks after birth

-not same for everyone, can affect any women

-1 out of every 7 women

-1/2 develop symptoms during pregnancy

-with with low SES are 11x more likely to develop PPD

-history with depression 30-35% more likely to develop PPD

risk factors: history, hormone changes, stressors, social relationships and support, complications, alcohol and drugs, multiple children

symptoms: mood swings, withdrawal, worry, guilt, doubt, difficulty with everyday tasks, thoughts of hurting self or child

treatment: lifestyle changes, seek help, medication, support groups

importance of water consumption

-women's bodies are 55% water, men 60%

-human body can only survive 3 days without water

-recommended daily intake 91 oz for women, 125 oz men

-women of childbearing age should aim to consume 60 oz

-african american women 40% higher odds of inadequate hydration

-decrease coffee to 2 cups a day

symptoms of dehydration: headaches, fatigue, difficulty concentrating, adverse changes in mood, can affect short-term memory, arithmetic ability, perceptual discrimination