YOU HAVE A CHOICE! Dr S Andaz MD, FACS, FRCS Director
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Transcript of YOU HAVE A CHOICE! Dr S Andaz MD, FACS, FRCS Director
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YOU HAVE A CHOICE!
Dr S Andaz MD, FACS, FRCS
Director
Center for Minimally Invasive Thoracic Surgery and Thoracic Surgical Oncology
South Nassau Hospital
New York
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Heart Disease Statistics
Every 20 seconds has a heart attack.
Every 34 seconds a person dies from heart disease.
More than 2,500 deaths from heart disease each day
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“Symptoms - COSTLY mistakes”
• “I feel great.”
• “ I just had a check up and I am just fine”
• SILENT KILLERS – Cadiovascular– Cancer
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Anatomy
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Plaques
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Major Risk Factors• Smoking
• Cholesterol - LDL( < 70) HDL (>40)
• Hypertension
• Family history
• Obesity
• Diabetes
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Warning Signs
Chest discomfort.
Discomfort in other areas of the upper body.
Shortness of breath.
Other signs: cold sweat, nausea or lightheadedness
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Angina v/s “heart attack”
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Investigations
• EKG
• CXR
• Blood work
• Stress Test
• Ultrafast CT and Total Body Scanners
• Cardiac Cath
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Management• Medical
• Aspirin
• BP control
• Statins - Liver and muscle damage
• Diabetes control
• Lifestyle changes!!!!– smoking
– exercise
– diet changes
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Coronary Stents
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S/P Agioplasty stenting
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S/P angioplasty
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Surgical - CABG
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Surgical - CABG
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Cardiac Surgery - New Frontiers
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Cancer Statistics
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2004 Estimated US Cancer Cases
Men699,560
Women668,470
•32% Breast
•12% Lung & bronchus
•11% Colon & rectum
•6% Uterine corpus
• 4% Ovary
• 4% Non-Hodgkin lymphoma
•4% Melanomaof skin
•3% Thyroid
•2% Pancreas
•2% Urinary bladder
•20% All Other Sites
Prostate 33%
Lung & bronchus 13%
Colon & rectum 11%
Urinary bladder 6%
Melanoma of skin 4%
Non-Hodgkin lymphoma 4%
Kidney 3%
Oral Cavity 3%
Leukemia 3%
Pancreas 2%
All Other Sites 18%
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2004 Estimated US Cancer Deaths
Men290,890
Women272,810
•25% Lung & bronchus
•15% Breast
•10% Colon & rectum
• 6% Ovary
• 6% Pancreas
• 4% Leukemia
• 3% Non-Hodgkin lymphoma
• 3% Uterine corpus
• 2% Multiple myeloma
• 2% Brain/ONS
•24% All other sites
Lung & bronchus 32%
Prostate 10%
Colon & rectum 10%
Pancreas 5%
Leukemia 5%
Non-Hodgkin 4%lymphoma
Esophagus 4%
Liver & intrahepatic 3%bile duct
Urinary bladder 3%
Kidney 3%
All other sites 21%
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Lifetime Probability of Developing Cancer, by Site, Men, US, 1998-2000
Site Risk
All sites ??????
Prostate 1 in 6
Lung & bronchus 1 in 13
Colon & rectum 1 in 17
Urinary bladder 1 in 29
Non-Hodgkin lymphoma 1 in 48
Melanoma 1 in 55
Leukemia 1 in 70
Oral cavity 1 in 72
Kidney 1 in 69
Stomach 1 in 81
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Lifetime Probability of Developing Cancer, by Site, Men, US, 1998-2000
Site Risk
All sites 1 in 2Prostate 1 in 6
Lung & bronchus 1 in 13
Colon & rectum 1 in 17
Urinary bladder 1 in 29
Non-Hodgkin lymphoma 1 in 48
Melanoma 1 in 55
Leukemia 1 in 70
Oral cavity 1 in 72
Kidney 1 in 69
Stomach 1 in 81
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Lifetime Probability of Developing Cancer, by Site, Women, US, 1998-2000
Site Risk
All sites ?????
Breast 1 in 7
Lung & bronchus 1 in 17
Colon & rectum 1 in 18
Uterine corpus 1 in 38
Non-Hodgkin lymphoma 1 in 57
Ovary 1 in 59
Pancreas 1 in 83
Melanoma 1 in 82
Urinary bladder 1 in 91
Uterine cervix 1 in 128
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Lifetime Probability of Developing Cancer, by Site, Women, US, 1998-2000
Site Risk
All sites 1 in 3
Breast 1 in 7
Lung & bronchus 1 in 17
Colon & rectum 1 in 18
Uterine corpus 1 in 38
Non-Hodgkin lymphoma 1 in 57
Ovary 1 in 59
Pancreas 1 in 83
Melanoma 1 in 82
Urinary bladder 1 in 91
Uterine cervix 1 in 128
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Smoking kills more people than
alcohol, AIDS, car accidents, illegal drugs, murders suicides
combined.
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There is a funeral
1150 times every day
48 times every hour
Because somebody was addicted to cigarettes
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SYSTEMS AFFECTED
CARDIOVASCULAR
LUNG
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Cardiovascular Disease• Stroke
• Sudden Death
• Heart Attack
• Peripheral Vascular Disease
• Aortic Aneurysm
180,000 Deaths per Year
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LUNG DISEASE• Pneumonia
• Influenza
• Bronchitis
• Emphysema
90,000 Deaths per Year
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Healthy Lung Advanced Emphysema
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ONLY LUNG CANCER???????
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Smoking causes other cancers!
• Laryngeal cancer• Oral cancers• Esophageal cancer• Stomach cancer• Pancreatic cancer• Kidney cancer• Bladder cancer• Cervical cancer• Leukemia
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When does it all START?
KIDS
Lighting the FIRST cigarette !!!!
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Protecting our children and grandchildren
• More than 3 million kids age 12-17 are current smokers.
• More than 5 million children under age 18 alive today will eventually die from smoking-related disease.
• More than 40% of high school boys report tobacco use.
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HOW SEVERE IS
SECOND HAND SMOKING????
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SECONDHAND SMOKE
Secondhand smoke contains over 4000 chemicals and 43 known carcinogens.
Among the chemicals are formaldehyde, cyanide, arsenic, carbon monoxide, methane and benzene.
Smoke filled rooms have up to 6 times the air pollution of a busy highway.
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“PRIDE IN TOBACCO”Winston-Salem, NC – the home of R.J. Reynolds Tobacco Co.
This town depends on the tobacco dollar: 8200 factory workers produced 142 billion cigarettes last year.
Winston-Salem is a company town.
Smoking is allowed almost everywhere.
There is one place where smoking is banned……..
smoking is banned at the R.J. Reynolds Tobacco Plant
-that’s for the benefit of the machines.
-One delicate machine makes 2000 filters a minute, while another produces 400 packs a minute
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•ONLY 1/3!!!!
LUNG CANCER
HOW MANY CAN BE SAVED?
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ONLY 1/3 PRESENT AS EARLY LUNG
CANCER!!!
Stage I
Stage II
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2/3 PRESENT AS ADVANCED LUNG
CANCER!!!
Stage III
Stage IV
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Stage IV
Incurable.
Most die within 12 months
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Note: Data from participating states and the District of Columbia were aggregated to represent the United States.Source: Behavioral Risk Factor Surveillance System CD-ROM (1984-1995, 1996, 1998) and Public Use Data Tape (2000), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 1999, 2000, 2001.
24.2 24.4 24.1 24.4 24.5
0
5
10
15
20
25
30
35
1994 1996 1998 2000 2002
Year
Pre
vale
nce
(%)
Trends in Consumption of Five or More Recommended Vegetable and Fruit Servings for Cancer Prevention, Adults 18 and Older, US, 1994-2002
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Trends in Overweight* Prevalence, Children and Adolescents, by Age Group (%), US, 1971-2000
*Overweight is defined as at or above the 95th percentile for body mass index by age and sex based on reference data. Source: National Health Examination Survey 1960-1962, National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.
54
55
7 67
11
5
10
15
11
0
5
10
15
20
2 to 5 years 6 to 11 years 12 to 19 years
Pre
va
len
ce
(%
)
NHANES I (1971-74) NHANES II (1976-80) NHANES III (1988-94) NHANES 1999-2000
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Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20 to 74, US, 1960-2000
*Obesity is defined as a body mass index of 30 kg/m2 or greater. Source: National Health Examination Survey 1960-1962, National Health and Nutrition Examination Survey, 1971-1974, 1976-1980, 1988-1994, 1999-2000, National Center for Health Statistics, Centers for Disease Control and Prevention, 2002.
1311
1615
12
1715
13
17
2321
26
31
28
34
0
5
10
15
20
25
30
35
40
45
Both sexes Men Women
Pre
vale
nce
(%)
NHES I (1960-62) NHANES I (1971-74) NHANES II (1976-80)
NHANES III (1988-94) NHANES 1999-2000
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No one gets itIn a survey of 21,500 people, not a single person consumed a 100% of RDA for the 10 most important nutrients!
*as recommended by the National Cancer Institute
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The Constant BattleFree Radicals are unstable molecules that
cause cell and DNA damage;
They are a by-product of metabolism.
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Free RadicalsSources:
Sunlight, Stress, Toxins, Pollution,
X-rays, Radioactivity, Airline travel,
Medications
Metabolism – Calories & Oxygen (75K)
Smoking = 10 Billion
free radicals per cigarette!
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“The amount of antioxidants that you maintain in your
body is directly proportional to how long you will live.”
Dr. Richard Cutler, Director of the Anti-Aging Research Department of the National Institute of Health(NIH), Wash D.C.
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American Cancer Society
Recommendation
• Cancer-related Checkup
• every 3 years for people aged 20-40 and
• every year for people age 40 and older.
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American Cancer Society• Prostate
• The ACS recommends that both the prostate-specific antigen (PSA) blood test and the digital rectal examination be offered annually, beginning at age 50,
• Men in high-risk groups, such as those with a strong familial predisposition (i.e., two or more affected first-degree relatives)
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Cancer Screening
• The 5-year relative survival rate for these cancers is about 80%.
• If we participated in regular cancer screenings, this rate could increase to 95%.
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• Don’t have time - lame excuse!
• yourself
• and the family
• life style changes
• Don’t BLAME the GENES
• YOUR FAMILY DESERVES IT
• THEY GET HURT IF YOU FALL SICK
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MARLBORO COUNTRY
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THE MARLBORO MAN
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YOU HAVE A CHOICE