Transcript THE HUMAN COSTS OF TOBACCO USE
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
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
Anatomy
Plaques
• Smoking
Major Risk Factors
• Cholesterol - LDL( < 70) HDL (>40) • Hypertension • Family history • Obesity • Diabetes
Warning Signs
Chest discomfort.
Discomfort in other areas of the upper body.
Shortness of breath.
Other signs:
cold sweat, nausea or lightheadedness
Angina v/s “heart attack”
Investigations
• EKG • CXR • Blood work • Stress Test • Ultrafast CT and Total Body Scanners • Cardiac Cath
Management
• Medical • Aspirin • BP control • Statins - Liver and muscle damage • Diabetes control •
Lifestyle changes!!!!
– smoking – exercise – diet changes
Coronary Stents
S/P Agioplasty stenting
S/P angioplasty
Surgical - CABG
Surgical - CABG
Cardiac Surgery - New Frontiers
Cancer Statistics
2004 Estimated US Cancer Cases Prostate 33% Lung & bronchus 13% Colon & rectum 11% Urinary bladder Melanoma of skin 6% 4% Non-Hodgkin lymphoma Kidney Oral Cavity 3% 3% Leukemia Pancreas All Other Sites 3% 2% 18% 4%
Men 699,560
• 32% Breast
Women 668,470
•12% Lung & bronchus •11% Colon & rectum •6% Uterine corpus • 4% Ovary • 4% Non-Hodgkin lymphoma •4% Melanoma of skin •3% Thyroid •2% Pancreas •2% Urinary bladder •20% All Other Sites
2004 Estimated US Cancer Deaths Lung & bronchus 32% Prostate Colon & rectum 10% 10% Pancreas Leukemia Non-Hodgkin lymphoma Esophagus 5% 5% 4% 4% Liver & intrahepatic 3% bile duct Urinary bladder 3% Kidney All other sites 3% 21%
Men 290,890 Women 272,810
•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
Lifetime Probability of Developing Cancer, by Site, Men, US, 1998-2000
Risk Site All sites
Prostate Lung & bronchus Colon & rectum Urinary bladder Non-Hodgkin lymphoma Melanoma Leukemia Oral cavity Kidney Stomach
??????
1 in 6 1 in 13 1 in 17 1 in 29 1 in 48 1 in 55 1 in 70 1 in 72 1 in 69 1 in 81
Lifetime Probability of Developing Cancer, by Site, Men, US, 1998-2000
Risk Site All sites
Prostate Lung & bronchus Colon & rectum Urinary bladder Non-Hodgkin lymphoma Melanoma Leukemia Oral cavity Kidney Stomach
1 in 2
1 in 6 1 in 13 1 in 17 1 in 29 1 in 48 1 in 55 1 in 70 1 in 72 1 in 69 1 in 81
Lifetime Probability of Developing Cancer, by Site, Women, US, 1998-2000
Site All sites
Breast Lung & bronchus Colon & rectum Uterine corpus Non-Hodgkin lymphoma Ovary Pancreas Melanoma Urinary bladder Uterine cervix
Risk ?????
1 in 7 1 in 17 1 in 18 1 in 38 1 in 57 1 in 59 1 in 83 1 in 82 1 in 91 1 in 128
Lifetime Probability of Developing Cancer, by Site, Women, US, 1998-2000
Site All sites
Breast Lung & bronchus Colon & rectum Uterine corpus Non-Hodgkin lymphoma Ovary Pancreas Melanoma Urinary bladder Uterine cervix
Risk 1 in 3
1 in 7 1 in 17 1 in 18 1 in 38 1 in 57 1 in 59 1 in 83 1 in 82 1 in 91 1 in 128
Smoking kills more people than alcohol, AIDS, car accidents, illegal drugs, murders suicides
combined.
There is a funeral
1150 times every day
48 times every hour
Because somebody was addicted to cigarettes
SYSTEMS AFFECTED
CARDIOVASCULAR
LUNG
Cardiovascular Disease
• Stroke • Sudden Death • Heart Attack • Peripheral Vascular Disease • Aortic Aneurysm
180,000 Deaths per Year
LUNG DISEASE
• Pneumonia • Influenza • Bronchitis • Emphysema
90,000 Deaths per Year
Healthy Lung Advanced Emphysema
ONLY LUNG CANCER???????
Smoking causes other cancers!
• Laryngeal cancer • Oral cancers • Esophageal cancer • Stomach cancer • Pancreatic cancer • Kidney cancer • Bladder cancer • Cervical cancer • Leukemia
When does it all START?
KIDS Lighting the FIRST cigarette !!!!
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.
HOW SEVERE IS SECOND HAND SMOKING????
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.
“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
LUNG CANCER
HOW MANY CAN BE SAVED?
•
ONLY 1/3!!!!
ONLY 1/3 PRESENT AS EARLY LUNG CANCER!!!
Stage I Stage II
2/3 PRESENT AS ADVANCED LUNG CANCER!!!
Stage III Stage IV
Stage IV
Incurable.
Most die within 12 months
Trends in Consumption of Five or More Recommended Vegetable and Fruit Servings for Cancer Prevention, Adults 18 and Older, US, 1994-2002
35 30 25 24.2
24.4
24.1
24.4
24.5
20 15 10 5 0 1994 1996 1998 Year 2000 2002 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.
Trends in Overweight* Prevalence, Children and Adolescents, by Age Group (%), US, 1971-2000 20
15
15
11 10 11
10
7 7 5 6 5
5
5 5 4
0
2 to 5 years 6 to 11 years 12 to 19 years NHANES I (1971-74) NHANES II (1976-80) NHANES III (1988-94) NHANES 1999-2000 *Overweight is defined as at or above the 95 th 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.
Trends in Obesity* Prevalence (%), By Gender, Adults Aged 20 to 74, US, 1960-2000
45 40 35 30 31 28 34 26 25 20 15 10 13 15 15 23 11 12 13 21 16 17 17 5 0 Both sexes Men Women NHES I (1960-62) NHANES III (1988-94) NHANES I (1971-74) NHANES 1999-2000 NHANES II (1976-80) *Obesity is defined as a body mass index of 30 kg/m 2 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.
No one gets it
In 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
The Constant Battle
Free Radicals are unstable molecules that cause cell and DNA damage; They are a by-product of metabolism.
Free Radicals
Sources:
Sunlight, Stress, Toxins, Pollution, X-rays, Radioactivity, Airline travel, Medications Metabolism – Calories & Oxygen (75K) Smoking = 10 Billion free radicals per cigarette!
“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.
American Cancer Society
Recommendation
•
Cancer-related Checkup
• every 3 years for people aged 20-40 and • every year for people age 40 and older.
•
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)
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%.
• 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
MARLBORO COUNTRY
THE MARLBORO MAN
YOU HAVE A CHOICE